Improve Eating Regulation and Emotions in the Obese with Mindfulness
By John M. de Castro, Ph.D.
“Researchers are learning that teaching obese individuals mindful eating skills—like paying closer attention to their bodies’ hunger cues and learning to savor their food—can help them change unhealthy eating patterns and lose weight. And, unlike other forms of treatment, mindfulness may get at the underlying causes of overeating—like craving, stress, and emotional eating—which make it so hard to defeat.” – Jill Suttie
Obesity has become an epidemic in the industrialized world. In the U.S. the incidence of obesity, has more than doubled over the last 35 years to currently around 35% of the population, while two thirds of the population are considered overweight or obese (Body Mass Index; BMI > 25). Although the incidence rates have appeared to stabilize, the fact that over a third of the population is considered obese is very troubling. This is because of the health consequences of obesity. Obesity has been found to shorten life expectancy by eight years and extreme obesity by 14 years. This occurs because obesity is associated with cardiovascular problems such as coronary heart disease and hypertension, stroke, metabolic syndrome, diabetes, cancer, arthritis, and others.
Obviously, there is a need for effective treatments to prevent or treat obesity. But, despite copious research and a myriad of dietary and exercise programs, there still is no safe and effective treatment. Mindfulness is known to be associated with lower risk for obesity, alter eating behavior and improve health in obesity. Mindfulness training is also known to increase spirituality. This suggests that mindfulness training may be an effective treatment for overeating, overweight, and obesity. The relationship of spirituality to mindfulness and eating has not been previously explored.
In today’s Research News article “Mindful Eating: Connecting With the Wise Self, the Spiritual Self.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01271/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_755938_69_Psycho_20180904_arts_A ), Kristeller and colleagues recruited obese adults (BMI>35) and randomly assigned them to either receive Mindfulness-Based Eating Awareness Training (MB-Eat) or to a wait-list control condition. Mindfulness-Based Eating Awareness Training (MB-Eat) was delivered in 12, 2-hour sessions, once a week for 10 weeks and 2 monthly booster sessions. The participants were trained in meditation, including general mindfulness meditation, guided eating meditations, and “mini-meditations” used at meal time and throughout the day. They also received instructions on recognizing inner experiences related to hunger and food intake and also on nutritional and healthy eating. Participants were measured before, during and immediately after training and also at 1, 2, and 4 months later for eating and weight related issues, emotional regulation, state mindfulness, depression, anxiety, and spiritual well-being.
They found that in comparison to baseline and the wait-list group, the participants who received Mindfulness-Based Eating Awareness Training (MB-Eat) had increased spiritual well-being particularly in the meaning/peace and faith factors that continued to grow all the way to the 2-month follow-up. They also found that the greater the increase in the meaning/peace and faith factors, the greater the decrease in depression, anxiety, and binge eating. Finally, they performed a mediation analysis that showed that increases in mindfulness were associated with decreases in both depression and binge eating directly and indirectly by being associated with increases in spiritual well-being meaning/peace which in turn was significantly related to decreases in both depression and binge eating.
These results suggest that obese individuals benefit from Mindfulness-Based Eating Awareness Training (MB-Eat) training by developing mindfulness which helps develop spiritual well-being and these factors both contribute to an improved emotional state and less disordered eating. It appears that the effect of mindfulness on the benefits is in part mediated by spiritual well-being. Mindfulness training has been shown previously to improve eating behavior and reduce depression. This study, however, is the first to indicate that the effectiveness of mindfulness is in part due to its effects on the individual’s spirituality.
So, improve eating regulation and emotions in the obese with mindfulness.
“Some of the simplest, safest lessons to help adolescents combat obesity may be raising their awareness of what they are eating and whether they are even hungry.” – Phil Jones
CMCS – Center for Mindfulness and Contemplative Studies
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Kristeller JL and Jordan KD (2018) Mindful Eating: Connecting With the Wise Self, the Spiritual Self. Front. Psychol. 9:1271. doi: 10.3389/fpsyg.2018.01271
In the Mindfulness-Based Eating Awareness Training program (MB-EAT) (Kristeller and Wolever, 2014; Kristeller and Wolever, in press), mindfulness practice is taught, mindful eating is cultivated, and self-acceptance and spiritual well-being are enhanced. An integrative concept is the value of cultivating ‘wisdom’ in regard to creating a new and sustainable relationship to eating and food. ‘Wisdom’ refers to drawing on personal experience and understanding in a flexible, insightful manner, rather than strictly following external rules and guidelines. Several clinical trials involving variations of MB-EAT have documented substantive improvement in how people relate to their eating, including individuals with both binge eating disorder (BED) and subclinical eating issues. Based on the traditional value of contemplative practices for cultivating spiritual engagement, and on evidence from related research showing that spiritual well-being increases in the Mindfulness-Based Stress Reduction (MBSR) program and is related to other effects, we hypothesized that the MB-EAT program would also engage this aspect of experience, as assessed by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being subscale (FACIT-Sp), and that increases in spiritual well-being would relate to other measures of adjustment such as emotional balance and improvement in disordered eating. Participants (N = 117) with moderate to morbid obesity, including 25.6% with BED, were randomly assigned to MB-EAT or a wait-list control, and assessed on the FACIT-Sp and other measures at baseline, immediate post (IP), and 2-month followup (F/Up). Both FACIT-Sp factors [Meaning/Peace (M/P) and Faith] increased significantly in the MB-EAT group and were stable/decreased in the control group. Increases in these factors related to improvement in emotional adjustment and eating regulation at IP and at F/Up, and to increases in aspects of mindfulness measured by the Five Facet Mindfulness Questionnaire (FFMQ). Increases in M/P during treatment mediated effects of the FFMQ Observe factor on eating regulation and depression at IP. Results are discussed in terms of the role that mindfulness practice plays in cultivating ‘wise mind’ and the related value of spirituality. It is argued that the core elements of the MB-EAT program lead to meaningful spiritual engagement, which plays a role in people’s ability to improve and maintain overall self-regulation.