Jaslyn Dugmore

Context: Weight-neutral approaches for health are emerging therapeutic alternatives to traditional weight-loss approaches. The existing literature base comparing these approaches has not yet been systematically evaluated by a meta-analysis. Objective: This review aims to determine if weight-neutral approaches are valid alternatives to weight-loss approaches for improving physical, psychological, and behavioral health outcomes. Data Sources: Embase, Scopus, PsycINFO, PubMed, CINAHL, and the University of Queensland Library databases were searched. Study Selection: Peer-reviewed, experimental, or quasi-experimental studies that included weight-neutral and weight-loss arms and reported physical, psychological, or behavioral outcomes were eligible. A total of 525 studies were identified through initial database searches, with 10 included in the final analysis after exclusion criteria were applied. Data Extraction: Screening and eligibility assessment of studies followed the PRISMA protocol. The following outcomes were extracted: weight, body mass index, lipid and glucose variables, blood pressure, eating behavior, self-esteem, depression, quality of life, physical activity, and diet quality. Data Analysis: Studies were graded per the National Health and Medical Research Council (NHMRC) level-of-evidence tool and the Academy of Nutrition and Dietetics quality-evaluation tool. Effect sizes were examined as a meta-analysis of standardized and mean differences using a random-effects inverse-variance model with 95%CIs. Practice recommendations for each outcome were graded per NHMRC body-of-evidence guidelines. Conclusions: Weight-neutral approaches resulted in greater improvement in bulimia (P = 0.02), but no significant differences were observed for any other outcome. Weight-neutral approaches may be as effective as weight-loss methods for improving physical, psychological, and behavioral outcomes. Limitations include inconsistent definitions of both approaches and variable time frames of follow-up.

Background: The role of the gut microbiota in Anorexia nervosa (AN) has long been neglected by researchers, although the former is known to play an important role in health, disease and weight regulation. Overweight and underweight due to natural states of starvation and refeeding are normal in many vertebrates in their ecological niches. Objective: The aim of this review was to compare the similarities and differences between the gut microbiota in eating disorders with conditions of fasting and refeeding in other vertebrates. Method: A systematic literature search was conducted in Pubmed and Web of Science to find all relevant studies examining the gut microbiota in eating disorders and different states of fasting in vertebrates for this narrative review.