Does Mindfulness Training Aid Weight Loss?

 
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The popularity of mindfulness training is growing among healthcare practitioners. Mindfulness training generally includes meditation practices to deal with stress especially associated with eating and exercise. It is designed to increase awareness and self-regulation of hunger, fullness, satisfaction of taste and cravings, and other emotions believed to undermine adherence to adopting and sticking with a healthier diet and exercise program. However, questions remain about its efficacy.

To further our understanding of the effectiveness of mindfulness training on weight loss a study led by Dr. Jennifer Daubenmier at the University of California San Francisco examined the impact of adding mindfulness training on top of a fairly typical weight loss training program. The 194 obese adults were randomized to a 5 and a half month diet and exercise program with or without mindfulness. Study participants were examined at baseline and then at 3, 6, 12, and 18 months. All participants had a BMI of 30 to 45.9 at the start of the study. The primary outcome for the study was weight change at 18 months. Both interventions included diet and exercise components; there were 16 sessions that lasted 2 or more hours over the study, and diet and exercise guidelines were presented for about 45 minutes each session. The guidelines recommended that participants reduce calories (by about 500 kcal per day), reducing consumption of calorie-dense and nutrient-poor foods, decreasing simple carbohydrates, and increasing whole grains, fresh fruit, vegetables, healthy oils, and proteins.

The experimental group also included “mindfulness walking” to increase awareness of surroundings, encouragement to eat meals mindfully, to meditate most days week for ½ hour, and to use mini-meditations in stressful situations. Another intervention controlled for attention, social support, expectations of benefit, food given during the mindfulness intervention, and other factors in the mindfulness group, whereas those in the control group received instead additional nutrition and physical activity information, snacks, strength training exercises, and participated in discussions about weight loss and some cognitive-behavioral training. Attendance in the two groups was similar (74.7% in the mindfulness group versus 71.2% in the control group). The mindfulness participants reported meditating about 2.1 hours per week on average and eating most of their meals mindfully. The study would have been more informative had the authors provided more comprehensive dietary information about what the subjects in the two groups were actually eating during and after their diet and exercise training programs.

The mindfulness group lost 1.9 kg more than the control group at 12 months (95% CI -4.5 to 0.8; P=0.17) and 1.7 kg more at the end of 18 months (95% CI -4.7 to 1.2; P=0.24), but these differences weren’t statistically significant. The mindfulness group also saw a slight advantage when it came to triglyceride/high-density lipoprotein cholesterol ratio at 12 months (-0.57 more in the mindfulness group, 95% CI -0.95 to -0.18; P=0.004) and at 18 months (-0.36, 95% CI -0.74 to 0.03; P=0.07). In addition, between group differences in waist circumference, blood pressure, and C-reactive protein were not significant. “While no significant differences in weight loss were found between groups during the intervention or follow-up, the article nonetheless makes a useful contribution to this literature,” wrote Joyce Corsica, PhD at Rush University Medical Center in Chicago, and colleagues, in an editorial accompanying the study. Dr. Corsica concluded: “There is not strong empirical evidence for mindfulness in improving weight loss.” She also noted the findings are weakened because the authors didn’t correct for multiple comparisons of numerous variables. By looking at so many different variables the few modestly significant differences they observed may have been due to chance alone. is supported by the fact that they do not occur during the active intervention when such findings would be expected),” they wrote.

Two recent reviews of the best prior research found mindfulness training is often associated with modest improvements in at least some health parameters. However, most of the better designed mindfulness interventions trials and observational studies have failed to find any significant additional weight loss for mindfulness training groups compared to a comparable diet and exercise program without the mindfulness training (1).

Bottom Line: Neither this study nor the preponderance of prior research on the efficacy of adding mindfulness training to a weight loss program has demonstrated significantly greater weight loss or better long term weight control than a typical weight loss program incorporating diet, exercise, and some cognitive behavioral training for getting patients to lose more weight or keep off the lost weight. So while mindfulness training may help some people deal better with emotional eating issues that undermine compliance to adopting and sticking with a healthier diet and lifestyle, it is clear that mindfulness training is far from universally effective. More research is needed to perhaps identify those individuals who are most likely to be helped by the addition of mindfulness training to a weight loss program. There are certainly many people resistant to mindfulness training and those individuals are unlikely to benefit from such training.

By James J. Kenney, PhD, FACN

References:

  1. Olsson KL, Emery CF. Mindfulness and weight loss: A systemic review. Psychosomatic Medicine 2015;77:59-67], Katterman S, Hood M, Nackers L, Corsica J. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss. A systemic review. Eat Behav 2014;15:197-204.
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