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.

Regulating eating behavior

Duarte, Cristiana, José Pinto‐Gouveia, and R. James Stubbs. “Compassionate Attention and Regulation of Eating Behaviour: A pilot study of a brief low‐intensity intervention for binge eating.” Clinical Psychology & Psychotherapy, 2017, doi: 10.1002/cpp.2094, online 13 Jun 2017.

Abstract. A low-intensity 4-week intervention that included components of compassion, mindfulness, and acceptance was delivered to women diagnosed with binge eating disorder. Participants were randomly assigned to 1 of 2 conditions: intervention (n = 11) or waiting list control (n = 9).

Participants in the intervention condition were invited to practise mindfulness, soothing rhythm breathing, and compassionate imagery practices with a focus on awareness and acceptance of emotional states and triggers to binge eating and engagement in helpful actions.

Results revealed that, in the intervention group, there were significant reductions in eating psychopathology symptoms, binge eating symptoms, self-criticism, and indicators of psychological distress; there were significant increases in compassionate actions and body image-related psychological flexibility. Data suggest that developing compassion and acceptance competencies may improve eating behaviour and psychological well-being in individuals with binge eating disorder.

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.

Mindfulness and binge eating disorder

Randomized controlled trial of a 12-month computerized mindfulness-based intervention for obese patients with binge eating disorder: The MindOb study protocol. Full text. 

Background

Mindfulness-based interventions for healthy behaviors such as exercise and dietary modifications have aroused growing interest. This study aims to test the effectiveness of a mindfulness-based intervention for the reduction of impulsive eating and the improvement of motivation to exercise among obese individuals.

Methods

One-hundred and twenty obese outpatients, aged 18 to 65 years, diagnosed with a binge eating disorder, will be randomly assigned to one of the three following groups: mindfulness practice, sham meditation, or treatment as usual control. The tested intervention consists of a 1-year computerized mindfulness-based program. Mindfulness sessions are audio recordings that the patients are asked to listen to, 10 min every day. Self-reported questionnaires measuring impulsive eating, motivation to exercise, physical activity level, mood, and mindfulness skills are filled in at baseline, 1, 6, and 12 months. Physical activity, calories consumption, and biomarkers are measured with more objective measurement tools at baseline, 6 months and 12 months.

Conclusion

Mindfulness, as both a de-automation element and as a moderator of motivation to exercise, can lead to the reduction of impulsive eating and also to an increase in levels of physical activity. These effects could cause weight loss in obese patients suffering from binge eating disorder.

Mindfulness-based interventions for binge eating (review and meta-analysis)

Godfrey, K. M., Gallo, L. C., & Afari, N. (2014). Mindfulness-based interventions for binge eating: a systematic review and meta-analysis. Journal of Behavioral Medicine, 1-15.

From the Abstract. Mindfulness-based interventions are increasingly used to treat binge eating. The effects of these interventions have not been reviewed comprehensively. This systematic review and meta-analysis sought to summarize the literature on mindfulness-based interventions and determine their impact on binge eating behavior.

PubMED, Web of Science, and PsycINFO were searched using keywords binge eating, overeating, objective bulimic episodes, acceptance and commitment therapy, dialectical behavior therapy, mindfulness, meditation, mindful eating. Of 151 records screened, 19 studies met inclusion criteria.

Most studies showed effects of large magnitude. Results of random effects meta-analyses supported large or medium-large effects of these interventions on binge eating. Limitations and future research directions are discussed.