Improve Weight-Related Eating Behaviors with a Mindfulness App
By John M. de Castro, Ph.D.
“a slower, more thoughtful way of eating could help with weight problems and maybe steer some people away from processed food and unhealthy choices.” – Harvard Health
Eating is produced by two categories of signals. Homeostatic signals emerge from the body’s need for nutrients, is associated with feelings of hunger, and usually work to balance intake with expenditure. Non-homeostatic eating, on the other hand, is not tied to nutrient needs or hunger but rather to the environment and or to the pleasurable and rewarding qualities of food. These cues can be powerful signals to eat even when there is no physical need for food.
Mindful eating involves paying attention to eating while it is occurring, including attention to the sight, smell, flavors, and textures of food, to the process of chewing and may help reduce intake by affecting the individual’s response to non-homeostatic cues for eating. Indeed, high levels of mindfulness are associated with lower levels of obesity. Hence, mindful eating may counter non-homeostatic eating.
Mindfulness training programs over the internet and with smartphone apps have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. These online and smartphone app trainings have been shown to be effective. It is not known if a mindful eating smartphone app may be effective in reducing body weight and weight-related eating behaviors.
In today’s Research News article “The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479283/), Lyzwinski and colleagues recruited college students and randomly assigned them to receive apps for their smartphones for either mindfulness or a self-monitoring diet and exercise diary for an 11 week period. The mindfulness app consisted of body scan, diaphragmatic breathing, observing the breath, loving kindness meditation, concentration meditation, choiceless awareness mindfulness meditation, and Hatha yoga all adapted from the Mindfulness-Based Stress Reduction (MBSR) program. The students were measured before and after the 11-week training for body size, physical activity, eating behavior, mindful eating, mindfulness, perceived stress, and participant retention and adherence.
They found in comparison to baseline and to the diet and exercise diary group, the mindfulness group had significant increases in mindfulness and mindful eating, and significant decreases in emotional eating, uncontrolled eating, and perceived stress levels. The diet and exercise diary group had significantly higher levels of exercise. There were no significant changes in body size for either group. 80% of the participants completed the program and of the mindfulness app group only 14% reported completing all modules, while 61% reported sporadic use, and 23% reported using it very seldom.
The results are encouraging and suggest that the mindfulness smartphone app is a feasible and acceptable method of increasing mindfulness and improving weight-related eating behaviors. Although retention is good, adherence was not. The students recruited, though, were not particularly motivated to lose weight or practice mindfulness. Perhaps, a more motivated group of participants would have resulted in better adherence. There also may be a need to modify the app to make participation more interesting and fun.
The fact there no changes in weight were observed was no surprising as the 11-week period is short to detect significant changes in weight. A long-term study is needed here. In addition, maintaining a diet and exercise diary has been shown to reduce food intake and increase exercise. A comparison of the mindfulness app to a group participating in nutrition education ap might be better able to demonstrate changes in body size. Regardless, the results are encouraging and suggest that an app, training students in mindfulness, may be a convenient and inexpensive means to develop better eating habits.
So, improve weight-related eating behaviors with a mindfulness App.
“Increased mindful eating has been shown to help participants gain awareness of their bodies, be more in tune to hunger and satiety, recognize external cues to eat, gain self compassion, decrease food cravings, decrease problematic eating, and decrease reward-driven eating.” – Carolyn Dunn
CMCS – Center for Mindfulness and Contemplative Studies
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Lyzwinski, L. N., Caffery, L., Bambling, M., & Edirippulige, S. (2019). The Mindfulness App Trial for Weight, Weight-Related Behaviors, and Stress in University Students: Randomized Controlled Trial. JMIR mHealth and uHealth, 7(4), e12210. doi:10.2196/12210
University students are at risk of weight gain during their studies. Key factors related to weight gain in this population include unhealthy weight-related behaviors because of stress. Mindfulness holds promise for weight management. However, there has not been any previous trial that has explored the effectiveness of a student-tailored mindfulness app for stress, weight-related behaviors, and weight. There is limited evidence that current mindfulness apps use evidence-based mindfulness techniques. A novel app was developed that combined evidence-based, mindfulness-based stress reduction and mindful eating (ME) techniques that were tailored to university students, with student-relevant themes for targeting weight behaviors, weight, and stress.
The aim of this study was to test the effectiveness, acceptability, and feasibility of a student-tailored mindfulness app for weight, weight-related behaviors, and stress. Testing this app in a rigorous randomized controlled trial (RCT) for these outcomes is a novelty and contribution to this emerging field.
A 2-arm RCT of an 11-week duration was undertaken at the University of Queensland. Students were either randomized to the mindfulness app (n=45) or to a behavioral self-monitoring electronic diary (e-diary; n=45) for diet and exercise. Analysis of covariance was used to compare differences in weight, stress, mindfulness, ME, physical activity, and eating behaviors between both groups.
Neither the mindfulness app group nor the e-diary group lost weight and there were no differences between the groups at follow-up. The mindfulness app group had significantly lower stress levels (P=.02) (adherers only), lower emotional eating (P=.02), and uncontrolled eating (P=.02) as well as higher mindfulness (P≤.001) and ME levels overall (P≤.001). The e-diary group had higher metabolic equivalents of moderate activity levels (P≤.01). However, the effect sizes were small. Regular adherence to mindfulness exercises in the app was low in the group. The majority of students (94%) liked the app and found it to be acceptable. Compared with other exercises, the most helpful reported meditation was the short breathing exercise observing the breath (39.4% [13/33] preferred it).
This was the first RCT that tested a mindfulness app for weight and weight-related behaviors in students. The modest level of user adherence likely contributes to the lack of effect on weight loss. However, there was a small, albeit promising, effect on weight-related eating behavior and stress.
A mindfulness app demonstrated effectiveness for stress, eating behaviors, mindfulness, and ME, but the effect sizes were small. Future studies should be conducted over longer periods of time and with greater participant compliance.