Weight acceptance in people with obesity

Meyer, L. B., et al. (2018). (Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance. Qualitative health research. First published online: April 11, 2018.

Abstract. Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark.

The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others.

Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.

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Potential antitode to stress-induced eating

Masih, Tasmiah, et al. “Stress-induced eating and the relaxation response as a potential antidote: A review and hypothesis.” Appetite, online 5 Aug 2017. 

Abstract. There is an accumulating body of evidence to indicate that stress leads to the consumption of unhealthy, energy-dense, palatable food, potentially contributing to the alarming global prevalence of chronic diseases, including obesity. However, comparatively little research has been devoted to addressing how best to remedy this growing problem.

We provide an overview of the influence of stress on dietary intake, and then explore the novel, yet simple, possibility that regular elicitation of the relaxation response may effectively reduce stress-induced eating via both physiological and psychological pathways. If shown to be effective, the regular practice of relaxation may provide a convenient, cost efficient, patient-centered therapeutic practice to assist in the prevention of unhealthy weight gain and other negative consequences of unhealthy food intake.

All-you-can-eat buffets and mindful eating

Ali, Zeeshan, et al. “All you can eat Buffets, obesity, mindfulness, and mindful eating: An exploratory investigation.” Journal of Psychology and Psychiatry, vol 1, no. 1, 2017, pp. 1-5. Full text.

Abstract. Obesity has been mostly explained through the change in our everyday environments and the increased availability of foods. All-You-Can-Eat-Buffets (AYCEB) is a typical example of the developing ‘obesogenic’ environment, but there is a paucity of research, which fails to explore both internal and external contributing aspects to eating behaviour.

In two studies, the frequency of visits at AYCEB is investigated against the Body Mass Index (BMI), psychological traits (i.e., mindfulness and selfcompassion, (n=210) and eating behaviors (i.e., mindful eating, n=183) which have been found to assist weight regulation.

Results indicated that frequency of visits and BMI are unrelated. Significant relationships were found only with two subscales, where buffet visits negatively correlated with awareness within mindful eating, while a positive correlation was found between buffet visits and self-kindness. While results fit within the limited literature available, the generic future applicability of mindfulness-based constructs and interventions in eating behaviours is discussed.

Mindful eating and early stage chronic kidney disease

Timmerman, Gayle M., et al. “Self-management of dietary intake using mindful eating to improve dietary intake for individuals with early stage chronic kidney disease.” Journal of Behavioral Medicine, vol. 1, no. 10.

From the Abstract Using mindful eating to improve specific dietary recommendations has not been adequately studied. This feasibility study examined an intervention, self-management of dietary intake using mindful eating, with 19 participants that had mild to moderate chronic kidney disease, using a prospective, single group, pretest–posttest design.

The intervention had six weekly classes focused on self-management using mindful eating, goal-setting, problem-solving, and food label reading. Weight, body mass index (BMI), 3-day 24-h dietary recalls and fasting blood samples were measured.

Participants improved significantly in mean weight but not in dietary intake nor blood measures with the exception of cis-beta-carotene levels, which correlates to fruit and vegetable servings. These promising results warrant further testing of the intervention in randomized control trials.

Association between mindfulness and disinhibited eating

Sala, Margarita, and Cheri A. Levinson. “A Longitudinal Study on the Association Between Facets of Mindfulness and Disinhibited Eating.” Mindfulness, 2016, pp. 1-10, DOI: 10.1007/s12671-016-0663-0. 

From the abstract. Disinhibited eating (i.e., emotional and external eating), as well as associated features such as binge eating, bulimic symptoms, and eating concern are inversely associated with the mindfulness facets of acting with awareness, observing, and non-reactivity. However, it is unclear whether higher mindfulness is a precursor to lower disinhibited eating behaviors and symptoms or whether lower disinhibited eating behaviors and symptoms are a precursor to higher mindfulness (or both).

The current study examined if acting with awareness, non-reactivity, and observing (describing and non-judging were not assessed) prospectively predicted several disinhibited eating features (emotional eating, external eating, bulimic symptoms, binge eating, and eating concern) and vice-versa across 6 months. Young adult women (N = 300) completed measures of these constructs at baseline and 6 months later. Non-reactivity inversely predicted binge eating and bulimic symptoms across 6 months.

Stress obesity in children

Sato, A. F., & Fahrenkamp, A. J. (2016). From Bench to Bedside: Understanding Stress-Obesity Research Within the Context of Translation to Improve Pediatric Behavioral Weight Management. Pediatric Clinics of North America, 63(3), 401-423. Abstract.

KEY POINTS

  • Stress, including chronic stress and acute stress reactivity, is associated with pediatric obesity risk.
  • Stress has been associated with weight-related outcomes in basic research, yet translational research is needed to inform the development of pediatric behavioral weight control (BWC) trials.
  • Mechanisms through which mindfulness interventions may benefit weight management include reduction of stress, enhancing self-regulatory behaviors, and acceptance of discomfort.
  • There is a need for future pediatric BWC research examining mindfulness-based approaches, because these may be useful for decreasing the negative impacts of stress on weight management (eg, eating in response to stress).

Eating mindfully without caloric cost

Arch, Joanna J., et al. “Enjoying food without caloric cost: The impact of brief mindfulness on laboratory eating outcomes.” Behaviour Research and Therapy (2016). Abstract.

Highlights

  • We assessed the sensory and behavioral benefits of tasting food mindfully.
  • Across two lab studies, brief mindfulness enhanced enjoyment of tasting food.
  • Brief mindfulness led to lower caloric consumption of ‘junk’ foods.
  • Greater tasting enjoyment mediated the impact of mindfulness on lower consumption.
  • These studies suggest potential benefits of mindfulness in the context of eating.

Objective. Mindfulness-based interventions have been increasingly applied to treat eating-related problems ranging from obesity to eating disorders. Yet few studies have empirically examined the mechanisms of a mindful approach to eating. The current studies examine the potential of brief mindfulness instructions to enhance the psychological and behavioral dimensions of eating.

Methods. In three experiments (total N = 319), we examined whether brief mindfulness instructions would enhance the positive sensory experience involved in tasting food as well as healthy eating behaviors.

Results. Relative to distraction control instructions, the first two studies demonstrated that brief mindfulness instructions increased the enjoyment of a commonly pleasurable food (chocolate; Study 1), and a food with generally more mixed associations (raisins; Study 2). The third study replicated and extended these findings to show that brief mindfulness instructions also led to lower calorie consumption of unhealthy food relative to distracted or no-instruction control conditions, an effect mediated by greater eating enjoyment.

Conclusions. Findings demonstrated the power of brief mindfulness instructions to positively impact both health-relevant behavior and sensory experience associated with eating food. Implications for both theory and clinical applications of mindfulness are discussed.