With commentary by lead study author Jennifer Daubenmier, PhD, of the Osher Center for Integrative Medicine; Center for Obesity Assessment, Study and Treatment and the Department of Medicine at UCSF.
Could a simple walking meditation…or slowly savoring the crunch of a tart apple…or noticing whether you’re hungry as you reach for a cookie …help you lose weight, keep it off and lower diabetes risk? A new mindful-eating study from the University of California San Francisco suggests the answer is yes.
“We often find ourselves overeating not because we’re hungry, but because the food looks or tastes delicious, we’re distracted or we wish to soothe away unpleasant feelings. When we do overeat, we may feel guilt or shame for doing so, and overeating can spiral out of control,” says lead study author Jennifer Daubenmier , PhD, of the Osher Center for Integrative Medicine; Center for Obesity Assessment, Study and Treatment and the Department of Medicine at UCSF. “Practicing mindfulness can allow us to recognize patterns without judging ourselves, and to make more thoughtful food choices.”
Published in the March issue of Obesity, Dr. Daubenmier’s study tracked 194 obese adults ages 35 to 50 who joined a 5 ½-month weight-loss program. Most were women. In weekly classes the volunteers learned about choosing healthy foods and sidestepping processed junk food. They aimed to lose weight by cutting about 500 calories a day, walking and doing strength training exercises several times a week.
But 100 volunteers got something extra: Training in mindfulness-based stress reduction techniques such as meditation, mindful walking and yoga. And they worked on mindful eating strategies designed to boost pleasure and curb mindless eating. These included noticing food cravings and emotional eating triggers, becoming aware of feelings of hunger and fullness before grabbing a snack or second helping, and savoring the flavor, texture and aroma of favorite foods. Nothing in the pantry was off-limits. Volunteers were encouraged “to eat favorite foods in smaller portions that fit within their calorie goals,” the researchers note. In contrast, the other 94 study volunteers became a control group; they received extra information about nutrition and strength-training with exercise bands during their classes.
“One goal of mindful eating was to learn to eat like a gourmet chef. Be picky and choosy and really savor the food you’re eating,” Dr. Daubenmier says. “Research shows that after a few bites, we don’t really notice the taste of a food anymore. You can use that to control how much of a high-calorie treat you eat, by stopping instead of having more and more as you chase the sensations you felt with the first few bites.”
Volunteers’ weight, waist size, fasting blood sugar, cholesterol, triglycerides, blood pressure and C-reactive protein (a measure of inflammation) were checked at the beginning of the study, and again after 3, 6, 12, and 18 months.
The results? At first, the groups were very similar. After three months, people in both groups lost an average of 6 ½ pounds. But after the formal diet program ended and volunteers were on their own, some in the mindfulness group seemed to be more successful. After six months, mindfulness group members who worked with some instructors had lost an average of 11.4 pounds while the control group lost 7. After 18 months, the control group had regained several pounds – for a total loss of about 5 pounds, while those in the most successful mindfulness groups had lost 13.8 pounds.
Dr. Daubenmier explains that overall, weight loss differences between the mindfulness and control groups as a whole were not statistically significant. But there were other benefits:
• Reigning in rising blood sugar. Fasting blood sugar fell slightly for the mindfulness group while the control group’s average reading was 4 points higher by the end of the study – a difference the researchers say could increase their diabetes risk by as much as 8%.
• Better blood fats. The mindful group saw bigger improvements in their ratio of good HDL cholesterol to triglycerides (a blood fat that can increase heart disease risk), an improvement that could reduce risk for fatal heart disease.
• A healthier diet. The mindfulness volunteers cut back on sweets and stuck with it. At the start of the study, the mindfulness group got 12% of their daily calories from candy, cakes, sugary drinks and other sweet treats. By 18 months, it dropped steadily to 8.2%. In contrast, the control group got 15% of their calories from sweets at the start of the study, dropped to 9% after six months and back up to 11% after a year and a half. (The researchers published these results in a separate study to be published in April in the Journal of Behavioral Medicine. )
• Mindfulness group members learned to defuse cravings. In a separate study published online in the journal Appetite, the researchers discovered that not caving in to the lure of cupcakes, soda, ice cream and other indulgences was responsible for 47% of the mindfulness groups’ weight-loss success at one year. “They learned how to surf the urge, to acknowledge the craving, sit with it and see if it passes,” Dr. Daubenmier says. “To practice that, they brought in a favorite food to class and noticed their feelings and the intensity of their craving as they sat with it in front of them and as they periodically closed their eyes and breathed deeply.” The exercise, she says, can also point out the underlying trigger for a craving such as stress, tiredness or loneliness.
Those insights are at the heart of mindful eating, notes Michelle May, MD, a Phoenix, AZ, physician and developer of a mindful eating program called Am I Hungry? “Weight change is only one measure of the important changes that happen when you become more mindful about eating,” says Dr. May, author of Eat What You Love, Love What You Eat: A Mindful Eating Program to Break Your Eat-Repent-Repeat Cycle. “Mindful eating is not about willpower or being in control of cravings. It’s about learning to pause, notice whether you’re hungry or not and responding. Maybe you do need a snack. Or maybe you’re stressed-out and would feel better if you take a walk. Or you’re feeling lonely and can swing by and visit your best friend. Mindfulness opens your life to other possibilities, instead of being focused on food and whether or not you can eat it.”
Learning basic mindfulness techniques in a mindfulness-based stress reduction class (taught at many hospitals) can help, Dr. Daubenmier says. For more information on specific mindful eating strategies, she recommends the book The Joy of Half a Cookie: Using Mindfulness to Lose Weight and End the Struggle with Food by Jean Kristeller, PhD, one of the coauthors of the study and cofounder of the Center for Mindful Eating in West Nottingham, N.H.