Prof. Dunn and colleagues evaluated the effectiveness of increasing mindful eating in an online weight management program called Eat Smart, Move More, Weigh Less (ESMMWL), developed by NC State University and the NC Division of Public Health.
Obesity is a global public health problem that affects more than twice as many people today as it did in 1980.
According to estimates for 2014, more than 1.9 billion adults worldwide are thought to be overweight, including 600 million with obesity. In fact, most people now live in regions of the world where obesity is a bigger killer than being underweight.
Obesity is a major public health concern not only because it reduces quality of life, but also because it raises the risk of poor mental health and chronic diseases such as type 2 diabetes, heart disease, stroke, and some cancers.
In the United States, where more than 1 in 3 adults (37 percent) have obesity, the condition is a huge burden on the economy. The total medical bill for treating obesity in the U.S. in 2008 came to $147 billion.
Focus on food and eating
Although it is preventable, obesity is not an easy problem to solve; many causes and contributing factors – including behavior, environment, and genetic predisposition – work together to initiate and maintain the disease.
Individual behavior affects diet, amount of physical activity or inactivity, and medication use. Environmental factors – such as availability of a range of foods, opportunity for physical activity, education, and food marketing – also have a big impact.
Mindfulness is a type of Buddhist meditation during which a person focuses on their present thoughts, feelings, and sensations, and what is in their environment “right now.”
An important feature of mindfulness is to pay attention without judgement or evaluation – there is no right or wrong thought or feeling, there is only the awareness of what it is right now.
Mindfulness entered the mainstream as a therapeutic practice in the 1980s through the work of people such as Jon Kabat-Zinn and his Mindfulness-Based Stress Reduction program at the University of Massachusetts Medical School in Worcester, where there is now a Center for Mindfulness.
In his book Coming to Our Senses, Kabat-Zinn writes that when we pay mindful attention to the sense of taste, “even the simplest of foods provide a universe of sensory experience.”
Mindful eating in online weight management program
ESMMWL, the 15-week online program evaluated in the new study, uses the idea of “planned behavior” to help participants to alter habits that are known to be linked to weight management.
A live instructor delivers training online at the same time each week to a group of participants who link up via their computer, tablet, or smartphone.
To evaluate the effect of adding mindful eating to the program, the researchers asked participants to fill in a 28-item questionnaire called the Mindful Eating Questionnaire (MEQ). The MEQ assesses five different areas of mindful eating.
The program uses an approach to mindful eating where the participant is invited to focus on many facets of dealing with and interacting with food, such as paying attention to how it tastes, noticing hunger and fulness cues, and planning mealtimes and snacks.
Mindful eating also invites you to just have “one or two bites” of foods that are higher in calories and “just savor the flavor.”
For their study – which takes the form of a randomized controlled trial – the researchers asked people looking to enrol on the ESMMWL if they would be willing to take part.
Of the 80 participants who said yes, 42 were randomly assigned to the intervention group and 38 to the control group (they were effectively placed on a waiting list).
The results showed that the participants who completed the program (28 in all) lost more weight than the 36 who remained in the control group for the duration.
The average weight loss in the group that completed the program was 1.9 kilograms (4.2 pounds) compared with 0.3 kilograms (0.7 pounds) average weight loss in the control group – a result that the researchers describe as “statistically significant.”
All participants completed the MEQ, but the before and after differences in the total score and the scores on the subscales were significantly larger in the group that completed the program than the control group. The authors remark on their findings: “Results suggest that there is a beneficial association between mindful eating and weight loss. The current study contributes to the mindfulness literature as there are very few studies that employed rigorous methodology to examine the effectiveness of an intervention on mindful eating.”