A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms

Abstract The role of mindfulness, mindful eating and a newer concept of intuitive eating in modulating eating habits is an area of increasing interest. In this structured literature review, a summary of the current evidence is presented, together with details of interventions undertaken and the tools to measure outcomes. It is broad in scope given the emerging evidence base in this area. The review yielded sixty-eight publications: twenty-three interventions in obese/overweight populations; twenty-nine interventions in normal-weight populations; sixteen observational studies, three of which were carried out in overweight/obese populations. Mindfulness-based approaches appear most effective in addressing binge eating, emotional eating and eating in response to external cues. There is a lack of compelling evidence for the effectiveness of mindfulness and mindful eating in weight management. Mindfulness-based approaches may prevent weight gain. Reduced food intake was seen in some of the studies in overweight and obese populations, but this was less apparent in the studies in normal-weight populations. The evidence base for intuitive eating is limited to date and further research is needed to examine its potential in altering eating behaviours. Mindfulness appears to work by an increased awareness of internal, rather than external, cues to eat. Mindfulness and mindful eating have the potential to address problematic eating behaviours and the challenges many face with controlling their food intake. Encouraging a mindful eating approach would seem to be a positive message to be included in general weight management advice to the public.

[1]  N. Farb,et al.  Minding one's emotions: mindfulness training alters the neural expression of sadness. , 2010, Emotion.

[2]  Brandall Y. Suyenobu,et al.  Impact of mindfulness-based stress reduction training on intrinsic brain connectivity , 2011, NeuroImage.

[3]  Ann Knowles,et al.  Adding Mindfulness to CBT Programs for Binge Eating: A Mixed-Methods Evaluation , 2012, Eating disorders.

[4]  H. Madanat,et al.  Are Men More Intuitive When It Comes to Eating and Physical Activity? , 2012, American journal of men's health.

[5]  D. Hantula,et al.  Pre-ordering lunch at work. Results of the what to eat for lunch study , 2015, Appetite.

[6]  R. Ryan,et al.  The benefits of being present: mindfulness and its role in psychological well-being. , 2003, Journal of personality and social psychology.

[7]  S. Higgs,et al.  Focusing on food during lunch enhances lunch memory and decreases later snack intake , 2011, Appetite.

[8]  The Impact of Mindfulness-based Cognitive Therapy on Anthropometric Indices Balance in High-School Obese Girls’ Students in Iran , 2013 .

[9]  Michael E. Levin,et al.  Which facets of mindfulness are related to problematic eating among patients seeking bariatric surgery? , 2014, Eating behaviors.

[10]  Brian Wansink,et al.  From mindless eating to mindlessly eating better , 2010, Physiology & Behavior.

[11]  Kathryn M. Godfrey,et al.  Mindfulness-based interventions for binge eating: a systematic review and meta-analysis , 2015, Journal of Behavioral Medicine.

[12]  J. Polivy,et al.  The effect of portion size on food intake is robust to brief education and mindfulness exercises , 2014, Journal of health psychology.

[13]  Sarah Fischer,et al.  Mindfulness and Acceptance in the Treatment of Disordered Eating , 2005 .

[14]  F. Zeidan,et al.  Mindfulness meditation-related pain relief: Evidence for unique brain mechanisms in the regulation of pain , 2012, Neuroscience Letters.

[15]  S. Hayes,et al.  A Pilot Study of Acceptance and Commitment Therapy as a Workshop Intervention for Body Dissatisfaction and Disordered Eating Attitudes , 2012 .

[16]  Adama Brown,et al.  The effect of a mindful restaurant eating intervention on weight management in women. , 2012, Journal of nutrition education and behavior.

[17]  S. Higgs Manipulations of attention during eating and their effects on later snack intake , 2015, Appetite.

[18]  T. Simpson,et al.  Participation in mindfulness-based stress reduction is not associated with reductions in emotional eating or uncontrolled eating. , 2012, Nutrition research.

[19]  J. Best,et al.  Mindfulness-Based Approaches to Eating Disorders , 2009 .

[20]  M. Baime,et al.  Mindfulness Based Approaches to Obesity and Weight Loss Maintenance , 2012 .

[21]  J. Godsey The role of mindfulness based interventions in the treatment of obesity and eating disorders: an integrative review. , 2013, Complementary therapies in medicine.

[22]  Jennifer Mathieu,et al.  What should you know about mindful and intuitive eating? , 2009, Journal of the American Dietetic Association.

[23]  E. Epel,et al.  Mindfulness Intervention for Stress Eating to Reduce Cortisol and Abdominal Fat among Overweight and Obese Women: An Exploratory Randomized Controlled Study , 2011, Journal of obesity.

[24]  H. Madanat,et al.  The Relationship between Intuitive Eating and Health Indicators among College Women , 2005 .

[25]  H. Alberts,et al.  Coping with food cravings. Investigating the potential of a mindfulness-based intervention , 2010, Appetite.

[26]  L. Barsalou,et al.  Mindful Attention Prevents Mindless Impulses , 2022 .

[27]  S. Rydell,et al.  Two novel treatments to reduce overeating in overweight children: a randomized controlled trial. , 2011, Journal of consulting and clinical psychology.

[28]  Carla K. Miller,et al.  Comparison of a Mindful Eating Intervention to a Diabetes Self-Management Intervention Among Adults With Type 2 Diabetes , 2014, Health education & behavior : the official publication of the Society for Public Health Education.

[29]  J. Blechert,et al.  Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index , 2013, Appetite.

[30]  D. Spruijt-Metz,et al.  Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review , 2014, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[31]  David A. Lishner,et al.  Mindfulness and Eating: An Experiment Examining the Effect of Mindful Raisin Eating on the Enjoyment of Sampled Food , 2014 .

[32]  D. Neumark-Sztainer,et al.  Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors? , 2013, Appetite.

[33]  A. Hutchinson,et al.  Does mindfulness matter? Everyday mindfulness, mindful eating and self-reported serving size of energy dense foods among a sample of South Australian adults , 2013, Appetite.

[34]  A. Tolvanen,et al.  Psychological Flexibility and Mindfulness Explain Intuitive Eating in Overweight Adults , 2015, Behavior modification.

[35]  J. Kabat-Zinn,et al.  Full catastrophe living : using the wisdom of your body and mind to face stress, pain, and illness , 1990 .

[36]  B. Knäuper,et al.  The effects of three mindfulness skills on chocolate cravings , 2014, Appetite.

[37]  Alessandro Serretti,et al.  Mindfulness-based interventions for chronic pain: a systematic review of the evidence. , 2011, Journal of alternative and complementary medicine.

[38]  Brian P. Meier,et al.  Mindful eating: Trait and state mindfulness predict healthier eating behavior , 2014 .

[39]  M. Mantzios,et al.  Making concrete construals mindful: A novel approach for developing mindfulness and self-compassion to assist weight loss , 2014, Psychology & health.

[40]  G. Wilson,et al.  Assessment of eating disorders: interview versus questionnaire. , 1996, The International journal of eating disorders.

[41]  Y. Moriguchi,et al.  Neural Networks for Mindfulness and Emotion Suppression , 2015, PloS one.

[42]  M. Twohig,et al.  Acceptance and Commitment Therapy for Women Diagnosed With Binge Eating Disorder: A Case-Series Study , 2015 .

[43]  M. Hood,et al.  Development of a novel mindfulness and cognitive behavioral intervention for stress-eating: a comparative pilot study. , 2014, Eating behaviors.

[44]  D. Garner,et al.  The Eating Attitudes Test: psychometric features and clinical correlates , 1982, Psychological Medicine.

[45]  Leeann Cardaciotto,et al.  A pilot study of a single-session training to promote mindful eating. , 2013, Advances in mind-body medicine.

[46]  F. Bond,et al.  Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women , 2009, Appetite.

[47]  I. Nyklíček,et al.  Mindfulness and eating behaviour styles in morbidly obese males and females , 2015, Appetite.

[48]  W. McIntosh,et al.  Mindful Eating and Its Relationship to Body Mass Index and Physical Activity Among University Students , 2013 .

[49]  Jon May,et al.  Less food for thought. Impact of attentional instructions on intrusive thoughts about snack foods , 2010, Appetite.

[50]  A. Kristal,et al.  Development and validation of the mindful eating questionnaire. , 2009, Journal of the American Dietetic Association.

[51]  E. Hougaard,et al.  The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. , 2011, Clinical psychology review.

[52]  M. Butryn,et al.  A new look at the science of weight control: How acceptance and commitment strategies can address the challenge of self-regulation , 2015, Appetite.

[53]  Carla K. Miller,et al.  Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. , 2012, Journal of the Academy of Nutrition and Dietetics.

[54]  A. Serretti,et al.  Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. , 2009, Journal of alternative and complementary medicine.

[55]  Richard A. Brown,et al.  An acceptance-based behavioral intervention for weight loss: a pilot study. , 2012, The Behavior Therapist.

[56]  R. Baer Mindfulness-based treatment approaches , 2015 .

[57]  S. Rydell,et al.  An intervention based on Schachter's externality theory for overweight children: the regulation of cues pilot. , 2014, Journal of pediatric psychology.

[58]  M. Van Loan,et al.  Size acceptance and intuitive eating improve health for obese, female chronic dieters. , 2005, Journal of the American Dietetic Association.

[59]  J. Kristeller,et al.  An Exploratory Study of a Meditation-based Intervention for Binge Eating Disorder , 1999, Journal of health psychology.

[60]  Bruce W. Smith,et al.  A Preliminary Study of the Effects of a Modified Mindfulness Intervention on Binge Eating , 2006 .

[61]  E. Papies,et al.  A brief mindfulness intervention reduces unhealthy eating when hungry, but not the portion size effect , 2014, Appetite.

[62]  L. Jäncke,et al.  Mindfulness and emotion regulation--an fMRI study. , 2014, Social cognitive and affective neuroscience.

[63]  Z. Zadeh,et al.  Mindful Eating and it's Relationship with Mental Well-being , 2014 .

[64]  Jon May,et al.  Brief guided imagery and body scanning interventions reduce food cravings , 2013, Appetite.

[65]  Leah B. Shapira,et al.  Mindfulness-Action Based Cognitive Behavioral Therapy for Concurrent Binge Eating Disorder and Substance Use Disorders , 2010, Eating disorders.

[66]  Tatjana van Strien,et al.  The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior , 1986 .

[67]  TeriSue Smith Mph,et al.  Intuitive Eating, Diet Composition, and The Meaning of Food in Healthy Weight Promotion , 2006 .

[68]  E. Epel,et al.  Acute responses to opioidergic blockade as a biomarker of hedonic eating among obese women enrolled in a mindfulness-based weight loss intervention trial , 2015, Appetite.

[69]  Blair Kidwell,et al.  Emotional Ability Training and Mindful Eating , 2015 .

[70]  T. Petrie,et al.  Dieting, exercise, and intuitive eating among early adolescents. , 2013, Eating behaviors.

[71]  E. Meintjes,et al.  The neural substrates of mindfulness: An fMRI investigation , 2011, Social neuroscience.

[72]  Ashley R. Morgan,et al.  Coping with brief periods of food restriction: mindfulness matters , 2012, Front. Ag. Neurosci..

[73]  Virgil Sheets,et al.  Mindfulness-Based Eating Awareness Training (MB-EAT) for Binge Eating: A Randomized Clinical Trial , 2014 .

[74]  Drew A. Anderson,et al.  Is level of intuitive eating associated with plate size effects? , 2015, Eating behaviors.

[75]  Z. Segal,et al.  Mindfulness: A Proposed Operational Definition , 2004 .

[76]  H. Madanat,et al.  Intuitive eating for a healthy weight: Lauren Outland and colleagues explain why dieters should be educated about getting neither too full nor too hungry , 2013 .

[77]  S. Danoff-Burg,et al.  Mindfulness and Health Behaviors: Is Paying Attention Good for You? , 2010, Journal of American college health : J of ACH.

[78]  T. Leahey,et al.  A Cognitive-Behavioral Mindfulness Group Therapy Intervention for the Treatment of Binge Eating in Bariatric Surgery Patients , 2008 .

[79]  J. Dalen,et al.  A pilot study comparing the effects of mindfulness-based and cognitive-behavioral stress reduction. , 2008, Journal of alternative and complementary medicine.

[80]  E. Robinson,et al.  Eating ‘attentively’ reduces later energy consumption in overweight and obese females , 2014, British Journal of Nutrition.

[81]  H. Alberts,et al.  Dealing with problematic eating behaviour. The effects of a mindfulness-based intervention on eating behaviour, food cravings, dichotomous thinking and body image concern , 2012, Appetite.

[82]  K. Tapper,et al.  Resisting chocolate temptation using a brief mindfulness strategy. , 2014, British journal of health psychology.

[83]  Lisa M. Nackers,et al.  Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. , 2014, Eating behaviors.

[84]  Bruce W. Smith,et al.  Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. , 2010, Complementary therapies in medicine.

[85]  A mindful eating group intervention for obese women: a mixed methods feasibility study. , 2013, Archives of psychiatric nursing.

[86]  Britta K. Hölzel,et al.  Mindfulness practice leads to increases in regional brain gray matter density , 2011, Psychiatry Research: Neuroimaging.

[87]  D. Hinton,et al.  Loving-kindness and compassion meditation: potential for psychological interventions. , 2011, Clinical psychology review.

[88]  Aileen M. Pidgeon,et al.  The Moderating Effects of Mindfulness on Psychological Distress and Emotional Eating Behaviour , 2013 .

[89]  Debra Creedy,et al.  Efficacy of mindfulness-based interventions on depressive symptoms among people with mental disorders: a meta-analysis. , 2012, International journal of nursing studies.

[90]  O. Matvienko,et al.  Impact of an Intuitive Eating Education Program on High School Students' Eating Attitudes. , 2015 .

[91]  C. Emery,et al.  Mindfulness and Weight Loss: A Systematic Review , 2015, Psychosomatic medicine.

[92]  C. Gerweck,et al.  The Real Weighty Issue: Losing Is Just the Beginning , 2010 .

[93]  E. Rasmussen,et al.  Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals. , 2013, Behaviour research and therapy.

[94]  T. Tylka,et al.  The Intuitive Eating Scale-2: item refinement and psychometric evaluation with college women and men. , 2013, Journal of counseling psychology.