At our recent membership weekend I ran a taster session with my friend and dietitian Michaela (Ki) James about the new Mindfulness Based Healthy Living Course that we have recently developed. One element of the course is Mindful eating and so I thought that I would review the research on Mindful eating and Mindfulness and eating behaviours, including weight loss or gain. I searched for meta-analyses or systematic reviews about this topic and this is what I found.
Mindfulness based approaches such as Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT) have been used in various studies as an approach to changing eating behaviours (Artiles et al, 2019).
Mindfulness Based Eating Awareness (MB-EAT) has been developed to specifically address the core issues of binge eating disorder, such as controlling responses to emotional states, supporting the making of conscious food choices, developing an awareness of hunger and satiety cues, as well as cultivating self-acceptance (Kristeller et al, 2011). A randomised control trial into this approach suggested that MB-EAT decreased binge eating and related symptoms, with the extent of the improvement related to the degree of Mindfulness practice undertaken (Kristeller et al, 2013). More recently by Oraki et al (2019) which showed that MB-EAT significantly decreased perceived stress and body mass index in overweight women, compared to a control group.
Warren et al, 2017 postulate that Mindfulness appears to work by increasing internal cues to eat, rather than external cues, such as emotional triggers. Grinder et al, 2021 reach a similar conclusion by stating that excessive food intake can result from stimuli that promote eating in the absence of the physiological need for food. They suggest that Mindful and intuitive eating approaches may help minimise the impact of external drivers of food intake by helping people to focus on the sensory properties of food and internal sensations of hunger and fullness.
Warren et al, 2017 is a structured literature review on the role of Mindfulness, Mindful eating and intuitive eating in changing eating behaviours. It explores the effectiveness of these approaches as well as potential mechanisms around how using these approaches might work. This review looked at 68 publications, including 23 interventions for obese or overweight groups and 29 interventions for normal weight groups. They conclude that Mindfulness-based approaches (MBAs) appear most effective in addressing binge eating, emotional eating and eating in response to external cues. They found a lack of evidence supporting Mindfulness for weight loss, but conclude that weight gain might be prevented. While reduced food intake was seen for some of the overweight/obese groups, this was not observed in normal weight groups.
Olson et al, 2015 is a systematic review of studies using Mindfulness based programs (MBPs) for weight loss. Of the 19 studies they considered, 13 documented significant weight loss. However, they question whether the change in Mindfulness was the mechanism responsible for the weight loss, primarily due to the quality of the research studies available for review.
Carriere et al, 2017 carried out an analysis to evaluate the efficacy of Mindfulness Based Interventions (MBIs) on weight loss and eating behaviours. The MBIs selected were Mindfulness based, directed at weight loss and included sufficient participants for a statistical analysis to be meaningful. 19 studies covering 1,160 participants were analysed to determine the effect size of the MBIs. Effect size is a number measuring the strength of the experimental effect of the intervention and in this study the effect sizes suggested moderate effectiveness. Larger effects were found for those interventions including daily life informal practices as well as formal daily meditation practice. They found a mean weight loss at the end of the treatment (typically 8 weeks) was 6.8lbs and at 7.5lb follow up. The continuing weight loss at follow up is encouraging as an indication that a mindful approach to eating might be sustainable.
Artiles et al, 2019 is a systematic review and meta-analysis which looked at ten randomised control trials for weight loss programs based on Mindful or intuitive eating. They found that there was a significant weight loss compared to controls who received no weight loss intervention over the short term. However, when compared to conventional diet programs there was no difference, again over the short term. Therefore, they conclude that Mindful eating might be a practical approach to weight control as it achieves similar results to common diet programs which tend to rely on limiting energy intake and/or restricting food choices.
Grinder et al, 2021 provides the most recent systematic review on the influences of Mindful or intuitive eating approaches on dietary intake, but draws a different conclusion. They looked at randomised control trials of Mindful or intuitive eating approaches on dietary intake, including energy intake or diet quality in overweight and normal weight adults without a diagnosis of an eating disorder. They considered 13 studies and found little evidence to suggest that Mindful or intuitive eating interventions influence energy intake or diet quality and that to provide adequate evidence better quality research is required.
So, while the jury is out, the consensus of evidence seems to be that a Mindful approach to eating might assist weight loss, especially in overweight or obese people and those who overeat in response to emotional triggers. The evidence also suggests that a mindful approach might be sustainable in the longer term and at least that it might help reduce weight gain!
For information about our next Mindfulness Based Healthy Living Course (which starts in January), please email Helen or Alan at info@mindfulnessassociation.net.
Written by Heather Regan-Addis
Heather Regan-Addis is a Founder Member and Director of the Mindfulness Association.
Heather delivers training for the Mindfulness Association on our two Post Graduate Master’s degree courses as well as on our regular courses in Mindfulness, Compassion, Insight and on our Teacher training programmes.
References
Artiles et al, 2019 – https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12918
Carriere et al, 2017 – https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12623
Grinder et al, 2021 -https://www.sciencedirect.com/science/article/abs/pii/S2212267220313903
Kristeller et al, 2011 – https://pubmed.ncbi.nlm.nih.gov/21181579/
Kristeller et al, 2013 – https://link.springer.com/article/10.1007/s12671-012-0179-1
Olson, et al, 2015 –
Oraki et al, 2019 – https://journals.sbmu.ac.ir/ijabs/article/view/28463