Bulldog Obesity Exploring Mindfulness Based Eating for Dogs

Mindfulness, Eating Behaviours, and Obesity: A Review and Reflection on Current Findings

Abstract

Mindfulness and mindful eating have become popular in recent years. In this review, we first explore what mindfulness is in the context of psychological research, and why it offers promise for eating behaviours and weight loss. Second, we review the main empirical findings for weight loss in mindfulness-based intervention programmes. Third, contradictions in the findings are explored in more depth, and suggestions are made regarding why they may be occurring. Fourth, the benefits of adding self-compassion (and compassion) training to mindfulness practise to assist weight loss is discussed. Finally, the limitations of the research literature (and possible solutions) are explored. Overall, it is concluded that while mindfulness meditations that specifically focus on eating may be extremely helpful in promoting better eating behaviours, and assist in weight regulation, work is still needed to make such interventions appeal to a wider audience.

Keywords: Compassion; Eating behaviours; Meditation; Mindfulness; Obesity.

MeSH terms

• Eating* / psychology
• Emotions
• Empathy
• Feeding Behavior*
• Humans
• Meditation*
• Mindfulness*
• Obesity / etiology
• Obesity / prevention & control*
• Obesity / psychology
• Weight Loss*

The outcomes of mindfulness-based interventions for Obesity and Binge Eating Disorder: A meta-analysis of randomised controlled trials

Background: Mindfulness Based Interventions (MBIs) for weight loss and overeating-related behaviours have recently gained popularity. Previous systematic reviews and meta-analyses included studies of variable quality, which hinders interpretation of results. This meta-analysis examined only randomised controlled trials (RCTs) comparing the efficacy of MBIs with control groups primarily encouraging either dietary or exercise-based behavioural change in individuals with overweight/obesity and/or binge eating disorder (BED).

Methods: Using PRISMA guidelines, we systematically reviewed relevant articles in Medline, Psychinfo and EMBASE. Twelve eligible RCTs were identified, with three random-effects meta-analyses conducted on primary outcome measures of body mass (N = 11), mindfulness (N = 7) and BED symptoms (N = 3).

Results: MBIs were more efficacious than control in increasing mindfulness scores and decreasing BED symptoms from pre-to post-treatment. However, they were no more efficacious than control in reducing body mass which may be attributed to variability in the duration of interventions. Based on intervention duration, exploratory cumulative meta-analyses revealed that while shorter interventions (i.e., 6 weeks) showed greater reductions in body mass compared to longer interventions (i.e., 24 weeks), longer interventions led to greater improvements in mindfulness scores and BED symptoms.

Conclusions: These results highlight the potential of MBIs to improve obesity-related behaviours compared to lifestyle interventions, but their effects on short-term weight loss remain unclear. Future research with a rigorous methodology should consider long-term follow-ups including body mass and mindfulness-related outcome measures in order to establish the clinical potential of MBIs.

Mindfulness-Based Interventions for Obesity-Related Eating Behaviors: A Literature Review

Alberts et al., 201019Age: 51.9 12.8Gender: 89.5% FemaleEthnicity: Not reportedBMI: 31.3 4.1RCT: MM (n=10) vs. control (n=9)Not reportedGroup sessions + independent work; 7 weeksBody scan to recognize bodily hunger and satiety cues and mindfulness meditations to increase awareness of eating behavior and cravings-related thoughts.Loss of control of eatingIntervention group reduced loss of control of eating (p=0.017, d=3.02).Intervention and control groups reduced weight (p<0.01, d=0.12; p=0.04, d=0.12).Alberts et al, 201226Age: Not reportedGender: 100% FemaleEthnicity: Not reportedBMI: 32.7 6.1RCT: MBCT modified for eating behavior (n=12) vs. waitlist control (n=14)Not reportedGroup sessions; 8 weeksBodyscan, sitting and walking meditation, mindful eating skills, acceptance of oneself and one's body, and dealing with the paradox of control.External eating, emotional eating, restrained eatingIntervention group decreased emotional eating (p=0.03, d=0.53) and external eating (p=0.03, d=0.6)Baer et al., 200510Age: 2365Gender: 100% FemaleEthnicity: Not reportedBMI: 2240Pretest-posttest, no control: MBCTApplication of Expectancy Theory and Emotion Regulation Model to problematic eating behaviorsGroup sessions; 10 weeksBody scan, mindful stretching, mindful eating, and sitting meditation.Binge eating, eating restraintDecreased binge eating (es =0.88) and eating restraint (es=0.42)Cavanagh et al., 201396Age: 19.7 4.7Gender: 100% FemaleEthnicity: Not ReportedBMI: 21.5 3.1RCT: Mindfulness vs. education and controlNot reportedGroup sessions; 1 sessionMindful awareness of sensory experiences during eating and mindful meditation.Excess energy intake in response to portion size (external eating)Mindfulness condition participants ate less than participants in other conditions but trend not significantCourbasson et al., 201138Age: 42 11Gender: 79% FemaleEthnicity: Not reportedBMI: Not reportedPretest-posttest, no control: MABCTNot reportedGroup sessions; 16 weeksDeveloping mindfulness to adopt a non-judgmental and non-striving stance, learning emotion regulation skills, and mindful eating to prevent consuming more food than intended and eating when not physically hungry.Binge eatingDecreased binge eating frequency (p=0.02, d=0.86)Dalen et al., 201010Age: 44 8.7Gender: 70% FemaleEthnicity: 60% White, 20% Hispanic/Latino, 20% Native AmericanBMI: 36.9 6.2Pretest-posttest, no control: MEALNot reportedGroup sessions; 6 weeksWalking meditations, sitting meditations, mindful eating, and yoga.Binge eatingDecreased weight (mean weight loss p<0.01) and binge eating (p=.003, d=1.3 at 6 weeks; p=.001, d=2.2 at 12 weeks)Daubenmier et al., 201147Age: 40.4 8Gender: 100% FEthnicity: 62% White, 15% Hispanic/Latino, 15% Asian/Pacific Islander, 9% OtherBMI: 31.2 (SD not reported)RCT: MBSR + MBCT + MB-EAT (n=24) vs waitlist control (n=23)Not reportedGroup sessions; 4 monthsBody scan, mindful yoga stretches, sitting and loving kindness meditations, mindful eating, and 3-minute breathing exercises.Emotional eating, external eatingIntervention group decreased external eating (p=0.02, d=-0.7) and emotional eating (marginal p=.08, d=-0.57).Intervention stabilized weight among those who were obese, while the control group gained a mean 1.7 kg during same time period (p=0.08).Jacobs et al., 201326Age: 21.4 4.8Gender: 77% FemaleEthnicity: 73% White, 12% Hispanic/Latino, 8% African American, 4% Asian, 4% BiracialBMI: 19.8 2.3Pretest-posttest, no control pilot studyNot reportedGroup sessions; 1 sessionMindful breathing, sitting meditation, and mindful eating meditation.Overconsumption of food during a standardized meal (external eating)86% of participants engaged in consumption of healthy amount of food during standardized meal. 14% of participants engaged in overconsumption during meal.Jenkins et al., 2013137Age: 20.5 2.4Gender: 71.5% FemaleEthnicity: Not reportedBMI: Not reportedPretest-posttest: cognitive defusion (n=45) vs. acceptance (n=45) vs. control (n=45)Not reportedIndependent work; 5 daysCognitive defusion and acceptanceReactivity to food cravingsLess consumption of study-provided chocolate (p=0.046) and other chocolate products (p=0.053) among cognitive defusion group compared to control groupKearney et al., 201248Age: 49 10.7Gender: 87.5% MaleEthnicity: 85.4% White, 4.2% African American, 6.3% Hispanic/Latino, 4.2% AsianBMI: Not reportedPretest-posttest, no control: MBSRTheoretical model of mindfulness by Shapiro et al, 2006, for mindfulness mechanisms of actionGroup sessions; 8 weeksBody scan, sitting meditation, gentle yoga, walking meditation, and loving-kindness meditation.Emotional eating, uncontrolled eating, dietary intakeNo changes in emotional eating or uncontrolled eating. No changes in dietary intake. Increased body weight (p<0.05, d=0.07 at 4 month follow-up) and BMI (p<0.05, d=0.06 at 4 month follow-up)Kidd et al., 201312Age: 51.8 9.1Gender: 100% FemaleEthnicity: 41.7% White, 58.3% African AmericanBMI: 44.7 6.9Pretest-posttest, no controlSelf-regulation theoryGroup sessions; 8 weeksMindful awareness, observation, shifting out of automatic behaviors, mindful environment and being in the moment, non judgment, letting go, practicing acceptance.Mindless eatingNo changes in mindful eating after intervention.Kristeller & Hallet, 199918Age: 46.5 10.5Gender:100% FemaleEthnicity: 90% WhiteBMI: 40.3 (SD not reported)Pretest-posttest, no control: MMNot reportedGroup sessions; 6 weeksGeneral mindfulness meditations, mini meditations, and mindful eating.Binge eating, hunger and satiety awarenessDecreased binge eating frequency (p<0.001). Increased hunger awareness (p<0.001) and satiety awareness (p<0.001). Increased awareness of satiety cues related to reduction in binges (r=0.53, p<0.025).Kristeller et al., 2013150Age: 46.6 (SD note reported)Gender: 88% FemaleEthnicity: 14% African American or HispanicBMI: 40.3 (SD not reported)RCT: MB-EAT (n= 53) vs. PECB (n= 50) vs. waitlist control (n=47)Not reportedGroup sessions; 12 weeksGeneral (breath/open awareness) mindfulness meditation, guided eating meditations, and mini-meditationsBinge eating95% of MB-EAT, 76% of PECB. 48% of control participants no longer had BED at 4 month follow-up. Size of binges for those who reported still binging at follow-up were smallest for MB-EAT condition (60% binges by MB-EAT = small, 59% binges by PECB = medium, 85% binges by control = medium or large. In MB-EAT condition, more meditation associated with better binge eating outcomes and greater weight loss (r=0.33, p<0.05).Leahey et al., 20087Age: 4964Gender: 85.7% FemaleEthnicity: 85.7% WhiteBMI: 35.052.4Pretest-posttest, no control: MBCTNot reportedGroup sessions; 10 weeksNot engaging in any other activities while eating (to facilitate ability to attend to sight, smell, texture, and taste of food) and cueing into bodily sensations while eating.Binge eating, emotional eatingReduced binge eating (d=1.47, significance not reported), emotional eating (d=0.90, significance not reported), Deviations in expected weight loss after bariatric surgery improved (significance not reported).Miller et al., 201252Age: MB-EAT 53.9 8.2, DSME 54.0 7.0Gender: MB-EAT 63% Female, DSME 64% FemaleEthnicity: MB-EAT 81.5% White, 18.5% African American, DSME 72% White, 24% African American, 4% AsianBMI: Not reportedRCT: MB-EAT (n=27) vs. DSME (n=25)Not reportedGroup sessions; 3 monthsMindful meditation, mindful eating, body awareness.Dietary intakeReduced energy intake, glycemic index, and glycemic load in both groups from baseline to study end and baseline to 3 month follow-up (all p <0.05).Decreased weight and BMI from baseline to post-intervention and from baseline to study end in both groups (all p=0.01).Niemeier et al., 201221Age: 52.2 7.6Gender: 90% FemaleEthnicity: 90% White, 4.8% Hispanic, 4.8% OtherBMI: 32.8 3.4Pretest-posttest, no control: Acceptance-based behavioral programNot reportedGroup sessions; 24 weeksBeing mindful of thoughts and feelings without trying to change them, cognitive defusion, acceptance.Internal disinhibition (emotional eating)Decreased internal disinhibition (F(2, 26.5)=21.3, p<.0001) over time.Average weight loss of 12.0 kg (SE = 1.4) after 6 months and 12.1 kg (SE=1.9) at 3 month follow-up. Decreased weight over time (F(2, 25.1)=37.7, p<0.0001) Decreased BMI over time (F(2, 34.1)=40.0, p<.0001)Smith et al., 200625Age: 47.8 13.1Gender: 80% FemaleEthnicity: Not reportedBMI: 27.9 7.4Pretest-posttest, no control: MBSR modified for eating behaviorsNot reportedGroup sessions; 8 weeksBreathing exercises, body scans, meditation, mindful eating, and gentle Hatha yoga.Binge eatingDecreased binge eating (d=0.36, p<0.01)Smith et al., 200850Age: 44.9 13.7Gender: 80% FemaleEthnicity: Not reportedBMI: Not reportedPretest-posttest, no control with 2 groups: MBSR (n= 36) vs. CBSR (n= 14)Not reportedGroup sessions; 8 weeksMeditation, gentle yoga, body scanning exercises, and mindful eating.Binge eatingMBSR group decreased binge eating (p<0.0001, d=0.43). CBSR group did not decrease binge eating.Tapper et al., 200962Age: 41 13Gender: 100% FemaleEthnicity: Not reportedBMI: 31.6 6.06RCT: ACT (n=31) vs. no treatment control (n=31)Not reportedGroup sessions; 4 monthsCognitive diffusion, acceptance/willingness, and self-awareness/mindfulness.Emotional eating, external eating, binge eatingIntervention group decreased binge eating (p<.05) at follow-up. No significant differences in BMI,, emotional eating, or external eating between conditions at 6 month follow-up. When intervention participants who reported never applying workshop principles were excluded from analyses, intervention group had greater reductions in BMI than control group (p=0.031, es=0.20).Timmerman & Brown, 201235Age: 49.6 6.8Gender: 100% FemaleEthnicity: 54% White, 29% Hispanic/Latino, 17% African AmericanBMI: 31.8 6.8RCT: Mindful Eating (n=19) vs. waitlist control (n=16)Health Promotion Model by ^{Pender et al., 2006}, guiding theory for behavior changeGroup sessions; 6 weeksMindful eating that focuses on awareness of the sight, smell, and texture of the eating experience and a series of guided mindfulness meditations that focus on awareness on hunger, satiety, and eating triggers.Emotional eating, daily caloric/fat intake, caloric/fat intake consumed at restaurantsIntervention group had lower daily caloric intake (p=0.002), and lower daily fat intake (p=0.001) than control group. Intervention group had no significant decrease in caloric or fat intake per restaurant eating episode or in emotional eating at follow-up. Intervention group had significantly less weight gain at follow-up than control group (p=0.03).Woolhouse et al., 201230Age: 32.2 7.9Gender: 100% FemaleEthnicity: Not reportedBMI: Not reportedPretest-posttest, no control group: Mindful Eating + CBTNot reportedGroup sessions; 10 weeksMindful eating, formal sitting meditation, informal mindfulness practices, body scan, loving-kindness mediation, walking meditation, and lake meditation.Binge eating, emotional eating, external eatingReduced binge eating (p<0.0001, pes=0.62), emotional eating (p<0.0001, pes=0.42) and external eating (p<0.0001, pes=0.38).

Mindful Eating

What Is It?

Mindful eating stems from the broader philosophy of mindfulness, a widespread, centuries-old practice used in many religions. Mindfulness is an intentional focus on ones thoughts, emotions, and physical sensations in the present moment. Mindfulness targets becoming more aware of, rather than reacting to, ones situation and choices. Eating mindfully means that you are using all of your physical and emotional senses to experience and enjoy the food choices you make. This helps to increase gratitude for food, which can improve the overall eating experience. Mindful eating encourages one to make choices that will be satisfying and nourishing to the body. However, it discourages judging ones eating behaviors as there are different types of eating experiences. As we become more aware of our eating habits, we may take steps towards behavior changes that will benefit ourselves and our environment.

How It Works

Mindful eating focuses on your eating experiences, body-related sensations, and thoughts and feelings about food, with heightened awareness and without judgment. Attention is paid to the foods being chosen, internal and external physical cues, and your responses to those cues. [1] The goal is to promote a more enjoyable meal experience and understanding of the eating environment. Fung and colleagues described a mindful eating model that is guided by four aspects: what to eat, why we eat what we eat, how much to eat, and how to eat. [1]

Mindful eating:

• considers the wider spectrum of the meal: where the food came from, how it was prepared, and who prepared it
• notices internal and external cues that affect how much we eat
• notices how the food looks, tastes, smells, and feels in our bodies as we eat
• acknowledges how the body feels after eating the meal
• expresses gratitude for the meal
• may use deep breathing or meditation before or after the meal
• reflects on how our food choices affect our local and global environment

From

SAVOR: Mindful Eating, Mindful Life

[2]

1. Honor the food. Acknowledge where the food was grown and who prepared the meal. Eat without distractions to help deepen the eating experience.
2. Engage all senses. Notice the sounds, colors, smells, tastes, and textures of the food and how you feel when eating. Pause periodically to engage these senses.
3. Serve in modest portions. This can help avoid overeating and food waste. Use a dinner plate no larger than 9 inches across and fill it only once.
4. Savor small bites, and chew thoroughly. These practices can help slow down the meal and fully experience the foods flavors.
5. Eat slowly to avoid overeating. If you eat slowly, you are more likely to recognize when you are feeling satisfied, or when you are about 80% full, and can stop eating.
6. Dont skip meals. Going too long without eating increases the risk of strong hunger, which may lead to the quickest and easiest food choice, not always a healthful one. Setting meals at around the same time each day, as well as planning for enough time to enjoy a meal or snack reduces these risks.
7. Eat a plant-based diet, for your health and for the planet. Consider the long-term effects of eating certain foods. Processed meat and saturated fat are associated with an increased risk of colon cancer and heart disease. Production of animal-based foods like meat and dairy takes a heavier toll on our environment than plant-based foods.

The Research So Far

The opposite of mindful eating, sometimes referred to as mindless or distracted eating, is associated with anxiety, overeating, and weight gain. [3] Examples of mindless eating are eating while driving, while working, or viewing a television or other screen (phone, tablet). [4] Although socializing with friends and family during a meal can enhance an eating experience, talking on the phone or taking a work call while eating can detract from it. In these scenarios, one is not fully focused on and enjoying the meal experience. Interest in mindful eating has grown as a strategy to eat with less distractions and to improve eating behaviors.

Intervention studies have shown that mindfulness approaches can be an effective tool in the treatment of unfavorable behaviors such as emotional eating and binge eating that can lead to weight gain and obesity, although weight loss as an outcome measure is not always seen. [5-7] This may be due to differences in study design in which information on diet quality or weight loss may or may not be provided. Mindfulness addresses the shame and guilt associated with these behaviors by promoting a non-judgmental attitude. Mindfulness training develops the skills needed to be aware of and accept thoughts and emotions without judgment; it also distinguishes between emotional versus physical hunger cues. These skills can improve ones ability to cope with the psychological distress that sometimes leads to binge eating. [6]

Mindful eating is sometimes associated with a higher diet quality, such as choosing fruit instead of sweets as a snack, or opting for smaller serving sizes of calorie-dense foods. [1]

• A literature review of 68 intervention and observational studies on mindfulness and mindful eating found that these strategies improved eating behaviors such as slowing down the pace of a meal and recognizing feelings of fullness and greater control over eating. [8] Slower eating was associated with eating less food, as participants felt fuller sooner. Mindfulness and mindful eating interventions appeared most successful in reducing binge eating and emotional eating. However, the review did not show that these interventions consistently reduced body weight. Limitation of the studies included small sample sizes, limited durations of about 6 months or less, lack of focus on diet quality, and lack of follow-up so that longer-term success was not determined.
• A randomized controlled trial following 194 adults with obesity (78% were women) for 5.5 months looked at the effects of a mindfulness intervention on mindful eating, sweets consumption, and fasting glucose levels. The participants were randomly assigned to one of two groups: a diet and exercise program with mindfulness concepts (stress reduction, chair yoga, meditation, affirmations) or the same program but without mindfulness concepts. After 12 months, the mindfulness group showed a decreased intake of sweets and maintenance of fasting blood glucose, as opposed to the control group showing increased fasting blood glucose. [9] The research authors also evaluated weight loss with these participants, but did not find a significant difference in weight changes between the mindfulness group and control group. [10]
• A small controlled trial of 50 adults with type 2 diabetes were randomized to either a 3-month mindful eating intervention that was focused on reducing overeating and improving eating regulation or to a diabetes self-management education (DSME) intervention that was focused on improving food choices. Both groups showed significant improvements in measures of depression, nutrition self-efficacy, and controlling overeating behaviors. Both groups lost weight during the intervention but there was no difference in amount of weight loss between groups. [11]

It is important to note that currently there is no standard for what defines mindful eating behavior, and there is no one widely recognized standardized protocol for mindful eating. Research uses a variety of mindfulness scales and questionnaires. Study designs often vary as well, with some protocols including a weight reduction component or basic education on diet quality, while others do not. Additional research is needed to determine what behaviors constitute a mindful eating practice so that a more standardized approach can be used in future studies. [1] Standardized tools can help to determine the longer-term impact of mindful eating on health behaviors and disease risk and prevention, and determine which groups of people may most benefit from mindfulness strategies. [1]

Are mindful eating strategies applicable in youth?

Mindfulness is a strategy used to address unfavorable eating behaviors in adults, and there is emerging interest in applying this method in adolescents and children due to the high prevalence of unhealthy food behaviors and obesity in younger ages. More than one-third of adolescents in the U.S. have overweight or obesity. Youth who have overweight/obesity are likely to experience weight-related stigma and bullying by their peers, which in turn can negatively affect eating behaviors and lead to eating disorders. [12] Studies have found that eating disorders are developing at younger ages, with an increased number of children younger than 12 years of age presenting for treatment. [12]

• A review of 15 studies of mindfulness-based interventions in adolescents found that mindfulness techniques were associated with reduced concerns about body shape, less dietary restraint, decreased weight, and less binge eating. [12] However, interestingly, the overall acceptability of the mindfulness-related interventions was rated low by the participants, compared with general health education. It is likely that the way mindful strategies are presented to younger ages needs better understanding as it may be different than in adults. An example could be using new online technologies that are specific to their developmental age and learning ability. The review also found that mindfulness in the form of meditation and mindful breathing can have significant effects on disordered eating through better stress management and reduced overeating caused by depression and anxiety.
• Studies are still scarce in children, but novel programs are emerging. A pilot mindful eating intervention was tested in a low-income school in California involving third-through-fifth grade children including Hispanic and non-Hispanic children. [13] The goal was to foster healthy eating behaviors in the children and their parents. The program included topics such as Master Mindless Munching, Getting to Know Hunger and Fullness, and Sensational Senses, and provided take-home activities to do with their parents. Surveys at the end of the program showed that the children and parents liked the activities, and there was an increase in parents serving nutritious meals and practicing mindfulness during meals (e.g., recognizing when hungry vs. full).

Potential Pitfalls

• Mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders. Neurochemical imbalances are a risk factor for developing eating disorders such as bulimia and anorexia nervosa, and although mindfulness may be an effective component of a treatment plan, it should not be used as a sole treatment.
• May not be effective as a weight loss strategy on its own, but rather a complement to a weight loss program. Mindful eating embraces making food choices that promote well-being and increasing enjoyment of the eating experience. Traditional weight loss regimens focus on following a structured meal plan that may not necessarily be satisfying or enjoyable. Combining mindfulness with a meal plan under the guidance of a registered dietitian may reduce the risk of emotional overeating or binge eating. [14] Research has not consistently shown that mindfulness strategies lead to weight loss, but this may be due to the study design not including education on healthy eating choices as part of the mindfulness intervention.

Bottom Line

Mindful eating is an approach to eating that can complement any eating pattern. Research has shown that mindful eating can lead to greater psychological wellbeing, increased pleasure when eating, and body satisfaction. Combining behavioral strategies such as mindfulness training with nutrition knowledge can lead to healthful food choices that reduce the risk of chronic diseases, promote more enjoyable meal experiences, and support a healthy body image. More research is needed to examine whether mindful eating is an effective strategy for weight management.

As COVID-19 lockdowns began, reports of food stockpiling by consumers (with trends toward shelf-stable, energy-dense comfort foods) fueled concern that adults may increase their overall food intake during extended isolation, thus leading to weight gain. [15] Along with the potential for increased emotional eating due to the numerous stressors brought on by the pandemic, researchers noted that home confinement provides an altered exposure to food cues, which may enhance impulsive eating behaviors. [16] The simultaneous loss of social eating opportunities was also flagged for its potential to reduce mindful eating practices, which could negatively influence food choice and promote overeating. [16] All said, the full impacts at a population-level remain to be seen amidst varying degrees of lockdown mandates and compliance with social-distancing measures worldwide.

In the meantime, individuals may consider incorporating any number of mindful eating strategies in their daily lives alongside other important measures to help stay healthy during COVID-19. For example:

• If youre working from home and find that office time blends into all hours of the day, schedule times in your calendar to only eat: a lunch break away from your computer, a reserved time for dinner with your family, etc.
• If you find yourself standing in your pantry or staring in your refrigerator, pause and ask yourself: am I truly hungry, or am I just bored or stressed? If hungry, eat. If boredom or stress is the source, reroute your attention to an activity you enjoy, call a friend, or simply spend some time breathing.
• If you have a craving for comfort foods, pause and take a few in-breaths and out-breaths to be fully present with your craving. Take a portion of the food from the container (a handful of chips, a scoop of ice cream) and put it on a plate. Eat mindfully, savoring each bite.

A note about eating disorders: The COVID-19 pandemic may raise unique challenges for individuals with experience of eating disorders. [17] In the U.S., the National Eating Disorders Association has reported a significant increase in calls and messages for help as compared to a year ago. As noted, mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders. If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237, or text NEDA to 741-741.

A note about food insecurity: Many individuals may be facing food shortages because of unemployment or other issues related to the pandemic. If you (or someone you know) are struggling to access enough food to keep yourself or your family healthy, there are several options to help. Learn more about navigating supplemental food resources.

Related

Hear from Dr. Lilian Cheung as she discusses mindful eating onDuke Universitys Leading Voices in Food podcast, hosted by Dr. Kelly Brownell.

References

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2. Hanh TN, Cheung L. Savor: Mindful Eating, Mindful Life. HarperCollins Publishers. 2010.
3. Stanszus LS, Frank P, Geiger SM. Healthy eating and sustainable nutrition through mindfulness? Mixed method results of a controlled intervention study. Appetite. 2019 Oct 1;141:104325.
4. Ogden J, Coop N, Cousins C, Crump R, Field L, Hughes S, Woodger N. Distraction, the desire to eat and food intake. Towards an expanded model of mindless eating. Appetite. 2013 Mar 1;62:119-26.
5. Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eating behaviors. 2014 Apr 1;15(2):197-204.
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7. Ruffault A, Czernichow S, Hagger MS, Ferrand M, Erichot N, Carette C, Boujut E, Flahault C. The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis. Obesity research & clinical practice. 2017 Sep 1;11(5):90-111.
8. Warren JM, Smith N, Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutrition research reviews. 2017 Dec;30(2):272-83.*Disclosure: Studywasfunded by Mondelez International.
9. Mason AE, Epel ES, Kristeller J, Moran PJ, Dallman M, Lustig RH, Acree M, Bacchetti P, Laraia BA, Hecht FM, Daubenmier J. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. Journal of behavioral medicine. 2016 Apr 1;39(2):201-13.
10. Daubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, Dallman M, Lustig RH, Grunfeld C, Nixon DF, Milush JM. Effects of a mindfulnessbased weight loss intervention in adults with obesity: A randomized clinical trial. Obesity. 2016 Apr;24(4):794-804.
11. Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a randomized controlled trial. Health Education & Behavior. 2014 Apr;41(2):145-54.
12. Omiwole M, Richardson C, Huniewicz P, Dettmer E, Paslakis G. Review of mindfulness-related interventions to modify eating behaviors in adolescents. Nutrients. 2019 Dec;11(12):2917.
13. Wylie A, Pierson S, Goto K, Giampaoli J. Evaluation of a mindful eating intervention curriculum among elementary school children and their parents. Journal of nutrition education and behavior. 2018 Feb 1;50(2):206-8.
14. Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009 Apr 1;52(2):396-404.
15. Bhutani S, Cooper JA. COVID19 related home confinement in adults: weight gain risks and opportunities. Obesity. 2020 May 19.
16. Clemmensen C, Petersen MB, Srensen TI. Will the COVID-19 pandemic worsen the obesity epidemic?. Nature Reviews Endocrinology. 2020 Sep;16(9):469-70.
17. Branley-Bell D, Talbot CV. Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders.Journal of Eating Disorders.2-2020 Aug;8(44).

Last reviewed September 2020

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