Improve Food Related Cognitive Processing in Patients with Eating Disorders with Mindfulness
By John M. de Castro, Ph.D.
“Practicing mindfulness techniques has proven to be extremely helpful in aiding individuals to understand the driving forces behind their eating disorder.” – Greta Gleissner
Around 30 million people in the United States of all ages and genders suffer from an eating disorder: either anorexia nervosa, bulimia, or binge eating disorder. 95% of those who have eating disorders are between the ages of 12 and 26. Eating disorders are not just troubling psychological problems, they can be deadly, having the highest mortality rate of any mental illness. Two example of eating disorders are binge eating disorder (BED) and bulimia nervosa (BN). BED involves eating a large amount of food within a short time-period while experiencing a sense of loss of control over eating. BN involves binge-eating and purging (e.g., self-induced vomiting, compensatory exercise).
Eating disorders can be difficult to treat because eating is necessary and cannot be simply stopped as in smoking cessation or abstaining from drugs or alcohol. One must learn to eat appropriately not stop. So, it is important to find methods that can help prevent and treat eating disorders. Contemplative practices, mindfulness, and mindful eating have shown promise for treating eating disorders. It is not known however, what processes are affected by mindfulness training to improve eating disorders.
In today’s Research News article “Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668447/ ) Sala and colleagues recruited adult participants who were diagnosed with either bulimia nervosa or binge eating disorder. They were on a wait-list for 8 weeks and then received weekly 2-hour sessions over 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT). MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. They were measured before and after therapy for mindfulness, eating behaviors, anxiety, and depression. In addition, the participants were presented cards printed in various colors with either neutral words or food related words and asked to name the color of the word as quickly as possible.
After Mindfulness-Based Cognitive Therapy (MBCT) there were significant improvements in mindfulness, anxiety, depression and eating behaviors, including nonreactivity, cognitive restraint, disinhibition, and hunger. In addition, the reaction times to food-related words was significantly shorter after MBCT. Path analysis revealed that MBCT affected eating behavior indirectly by altering the responses to the food-related words.
These results are interesting, but the study lacked a comparison (control) condition limiting the strength of the conclusions. But previous controlled research has demonstrated that mindfulness training improves eating disorders. So, the present results are likely due to the effects of Mindfulness-Based Cognitive Therapy (MBCT) and not to potential confounding variables.
The present study, though, has an interesting new finding. Mindfulness-Based Cognitive Therapy (MBCT) appears to affect the cognitive processing involved with eating. This includes nonreactivity, cognitive restraint, disinhibition, and hunger. These changes predict more healthful eating behavior and a reduction in disordered eating. In addition, MBCT affected these cognitive processes only indirectly by altering responses to food-related cues (words). This suggests that MBCT improves eating disorders by changing the thought processes in response to food cues. In other words, mindfulness improves eating disorders by altering how the individual processes information related to food. This interesting finding needs further research.
So, improve food related cognitive processing in patients with eating disorders with mindfulness.
“increasing mindful awareness of internal experiences and automatic patterns could be effective for the improvement of self-acceptance and emotional regulation, thereby reducing the problematic eating behaviors.” – Jinyue Yu
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are available on Twitter @MindfulResearch
Sala, L., Gorwood, P., Vindreau, C., & Duriez, P. (2021). Mindfulness-based cognitive therapy added to usual care improves eating behaviors in patients with bulimia nervosa and binge eating disorder by decreasing the cognitive load of words related to body shape, weight, and food. European psychiatry : the journal of the Association of European Psychiatrists, 64(1), e67. https://doi.org/10.1192/j.eurpsy.2021.2242
This study aimed to investigate the effectiveness of mindfulness-based cognitive therapy (MBCT) as a complementary approach in patients with bulimia nervosa (BN) or binge eating disorder (BED), and to assess how the reduction of the cognitive load of words related to eating disorders (ED) could constitute an intermediate factor explaining its global efficacy.
Eighty-eight women and men participated in clinical assessments upon inscription, prior to and following 8-week group MBCT. Mindfulness skills were assessed using the five facet mindfulness questionnaire; eating behaviors were assessed using the Three Factor Eating Questionnaire (TFEQ); comorbid pathologies were assessed using the beck depression index and the state-trait anxiety inventory. The cognitive load of words associated with ED was assessed through a modified version of the Stroop color naming task.
Mindfulness skills improved significantly (p < .05) after group MBCT. The improvement of TFEQ scores was accompanied by reduced levels of depressive mood and trait anxiety. The positive impact of MBCT on TFEQ score was directly related to an improvement of the performance in the Stroop task.
MBCT represents an interesting complementary therapy for patients with either BN or BED, at least when cognitive and behavioral domains are concerned. Such efficacy seems to be mediated by the reduction of the cognitive load associated with ED stimuli, which offers a possible explanation of how MBCT could reduce binge-eating behaviors. Other studies are needed, in independent centers, to focus more directly on core symptoms and long-term outcome.