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Background: Adolescent obesity has tripled over the last three decades and is associated with an 80 percent risk of adult obesity, hypertension, diabetes, hypercholesterolemia, and decreased life expectancy. Current adolescent obesity medical recommendations include bariatric surgery and appetite suppressants which lower BMI, but present serious health risks. Nutrition and exercise interventions promote health, however, meta-analysis reveal do not lower BMI. Mindful eating, a behavioral skill, reconnecting eating to satiety cues, and has potential as an anti-obesity intervention which lowers BMI, while promoting health. Study Aims: Aim 1: To determine the effect of a mindful eating intervention compared to usual diet and exercise information on BMI of obese female adolescents. Aim 2: To determine if the effect of a mindful eating intervention on BMI of obese female adolescents is sustained over time. Aim 3: To determine the feasibility of conducting a group mindful eating intervention over six weeks for obese adolescent girls in their school setting. Methods: Obesity was measured by Body Mass Index (BMI) = Weight in Pounds / Height in inches x Height in inches x 703. The sample included adolescent females aged 14-17 years with BMI>90th%. Participants were randomized to an intervention group receiving a 6 week mindful eating intervention and a comparison group receiving the usual care of nutrition and physical activity handouts. Participants' BMI was measured at baseline, immediately post intervention and at 4 week follow up assessing intervention effectiveness. Results: ANOVA results demonstrate a statistically significant difference in BMI between the experimental and comparison groups F(1,2)=22.24, p<.001. On average, the experimental group's BMI decreased 0.71, whereas the comparison group's BMI increased by 1.1 over the 6 week intervention. The experimental group's BMI continued to decline at the 4 week follow up. Attrition from the study was 38%, below the 45% set feasibility threshold. A group mindful eating intervention over six weeks for obese adolescent girls was effective in lowering BMI sustained over time is feasible. Teaching the behavioral skill of mindful eating holds great promise for combatting obesity in adolescents. Future study should include a school based intervention with a larger more diverse sample.

El presente trabajo de investigación, aborda las tendencias mundiales hacia una alimentación saludable, en conjunción con los hábitos de consumo de los peruanos, combinando el placer y la salud. Nuestra propuesta es brindar una solución como una pastelería de la sociedad y en la industria alimentaria, como es la pastelería saludable. Existiendo una tendencia hacia los hábitos de consumo de productos saludables por parte de la población con creciente interés en alimentación consciente, demanda de nuevos productos que no contengan insumos nocivos para la salud, entre los que se encuentran personas que padecen enfermedades relacionadas al sobrepeso, diabetes, hipertensión, entre otras que hacen necesario contar con alternativas que ofrezcan productos bajos en azúcar, grasas trans, gluten, lactosas, otros. Se realizó una encuesta al target identificado como, personas que pertenecen al nivel socioeconómico A, B y C+ que residen en los distritos tradicionales de la ciudad de Arequipa, cuya edad fluctúa entre 20 y 60 años, que padecen de alguna enfermedad tales como diabetes, hipertensión, sobrepeso y aquellos que son saludables, pero cuyo estilo de vida considera la alimentación como un elemento importante, para mantener la salud y un buen estado físico. El resultado de esta encuesta mostró que el 97 % se encuentra interesado en consumir productos de características saludables. Dentro del análisis financiero, se tiene una estructura de financiamiento, donde el 44% de capital es de aporte propio y el 56% será financiado. En cuanto a los indicadores se ha obtenido un valor actual neto (VANE) de S/ 189,359 calculado con una tasa de descuento de 14.75% (WACC) y una Tasa de retorno (TIRE) de 51.94% con un período de recuperación de inversión (PAY BACK) de tres años, lo cual hace viable financieramente el plan de negocios. / This research work addresses global trends towards healthy eating, in conjunction with Peruvians' consumption habits, combining pleasure and health. Our proposal is to provide a solution to society and the food industry, through a healthy bakery shop. There is a trend of habits of consumption of healthy products by the population with increasing interest in mindful eating, demand for new products that do not contain harmful ingredients to health, among which are people with diseases related to overweight, diabetes, hypertension among others, which make it necessary to have alternatives that offer sugar-free products, also free or low in: trans fats, gluten, lactose, among others. A target survey was conducted identified as people belonging to socioeconomic level A, B and C+ residing in the traditional districts of the city of Arequipa, whose age fluctuates between 20 and 60 years, who suffer from some disease such as diabetes, hypertension, overweight and those who are healthy, but whose lifestyle considers food as an important element, to maintain health and fitness. The result of this survey showed that 97% are interested in consuming products from a healthy food. Within the financial analysis there is a financing structure where 44% of capital is its own contribution and 56% will be financed. In terms of indicators, a net present value (VANE) of S/ 189,359 has been obtained calculated at a discount rate of 14.75% (WACC) and a return rate (TIRE) of 51.94% with a three-year investment recovery period (PAY BACK), which makes the business plan financially viable. / Trabajo de investigación

Text in English / In order to address the paucity of knowledge in regard to the psychological and physiological processes associated with lifelong weight loss (>20 years), this study adopts a qualitative approach informed by phenomenology to explore the experience of lifelong weight loss and maintenance of women who participated in the ITAND Programme. The research questions guiding the exploration of the current research are: (i) Which strategies from the ITAND Programme do women perceive as assisting with initial weight loss? (ii) What are the processes mediating lifelong weight loss? (iii) What strategies and skills mediate the maintenance of lifelong weight loss? (iv) What feelings or beliefs motivate women to continue attempts to lose weight after experiencing multiple failures on diets? and (v) Which psychological, cognitive and behavioural processes are identified as mediating lifelong weight loss? Eight overweight and obese women were invited to write their narratives and engage in interviews in regard to exploring their relationships with food, their bodies and their weight, after a period of more than 20 years following their participation in an integrative, transactional analysis, anti-diet programme (the ITAND Programme). Narratives were used to explore their beliefs about constructs, processes and strategies mediating long-term weight loss maintenance. The participants’ narratives and interviews were analysed through applying narrative analysis and interpretive phenomenological analysis. In addition to a non-diet paradigm, four processes definingweight loss maintenance were identified, including the adult learning process of transformative learning, the psychological process of transactional analysis, the physiological process of intuitive eating and the cognitive-behavioural processes relating to weight loss maintenance. This study contributes an integrative, transactional analysis, non-diet treatment model (ITAND model) which is enabled by the processes of transformative learning, intuitive eating and cognitive-behaviour modification to the successful long- term treatment of overweight and obesity. This model may be applied in whole or in part in a primary health care or community context. The findings of this study may be used to inform future research into the development and implementation of non-diet weight loss maintenance interventions in the treatment of overweight andobesity. / Psychology / D.Litt. et Phil. (Psychology)