program rationale

The Problem

The steadily rising obesity epidemic impacts women disproportionally. In the U.S., over 41% of women over 20 years old are now classified as obese (CDC, 2020). Overweight and obesity increase the risk of developing chronic illnesses such as type 2 diabetes, cardiovascular disease, several cancers, and sleep disorders, which profoundly impact quality of life (Pi-Sunyer, 2009). Women face additional disease risks unique to their gender, such as decreased fertility, pregnancy complications, polycystic ovarian syndrome, female specific-cancers, and adverse fetal outcomes (Templeton, 2015). The financial burden of this problem grows in parallel to the epidemic. Between 2005 and 2010, medical costs for obesity in adults rose 48%, from $212 billion to $315 billion (Biener et al., 2017). The medical costs associated with treating obesity-related preventable diseases are estimated to continue increasing an astounding $48 to $66 billion per year (Wang et al., 2011).

Developing Better Solutions

A dieting culture intended to remedy the problem only contributes with a misaligned focus on nutritional quantity over quality. The notion that a “calorie is a calorie” in terms of weight management largely ignores the physiological need for nutrients and how the body responds to nutritionally insufficient weight management practices (Lucan & DiNicolantonio, 2015). When an emphasis is placed on creating an energy deficit to achieve weight loss by prioritizing the reduced intake of specific foods, controlling portions, and counting calories, nutritional quality is often lost. These behaviors and eating patterns may reduce satiety and influence metabolism, further contributing to weight gain over time. It is becoming increasingly recognized that the narrative to improving the obesogenic environment needs to shift away from simple messages of reducing caloric intake of what is often low-quality foods (Fernandes et al., 2019).

Finding Balance with Fresh Choices

To navigate this challenging issue, the nutrition education program, Fresh Choices, has been designed for women between 30 and 50. Small cohorts of women will meet face-to-face for weekly sessions over three months in San Diego, California. Together, they will develop a nutrient-focused, health first mindset around weight management practices. Women will develop nutrition-related knowledge to understand why healthy eating patterns are superior to common dieting practices. Self-regulation skills will be a crucial component in successful behavior change for weight management. Women will have the opportunity to form supportive connections through shared experiences, providing feedback to one another, and helping each other overcome personal barriers to meeting their goals. Group cooking activities that emphasize whole foods and healthy cooking practices will further reinforce lesson concepts and foster social connections.

Fresh Choices will change the way women make food choices to maintain and achieve a healthy weight. Ensuring successful and desirable outcomes of Fresh Choices’ stakeholders, our women participants, evidence-based mediators of behavior change, and social connection that have been identified as successful components of nutrition education programs are to be implemented (Dunneram & Jeewan, 2015; Kahn et al., 2020). Research shows that self-efficacy increases and weight management is successful when nutrition programs incorporate self-regulatory skills (Annesi, 2018). People with social support are known to practice better health habits, and like-minded groups of individuals seeking similar outcomes can find these benefits amongst each other (Kahn et al., 2020). Together, on a common journey, women will develop new skills and gain the confidence needed to achieve their weight management goals.