Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial
Section snippets
Design
The current study reports on data from the Supporting Health by Integrating Nutrition and Exercise (SHINE) clinical trial (Clinicaltrials.gov registration: NCT00960414). Adults with obesity (BMI 30–45) were randomized in a 1:1 ratio to a 5.5-month diet and exercise weight-loss program with or without mindfulness training for eating awareness, stress management, and emotion regulation. See (Daubenmier et al., In Press) for detailed study design and methodology. The University of California, San
Participant characteristics and attrition
Participants (N = 194) in the two intervention arms were similar on baseline variables (Table 1). The majority of participants were female (82%) and White (59%). The average age was 47.0 ± 12.7 years and the average BMI was 35.5 ± 3.6. See (Daubenmier et al., In Press) for additional participant details. Retention was similar for the mindfulness and control participants at 6 months (84.0% and 77.0%; p = .21), 12 months (79.0% and 74.0%, p = .50), and 18 months (81.0% and 71.0%, p = .13). See
Discussion
We examined reward-driven eating and psychological stress as two mechanisms by which a 5.5-month diet and exercise intervention with or without adjuvant mindfulness training might impact long-term weight loss in adults with obesity. Mindfulness participants reported significantly lower levels of reward-driven eating than control participants at post-intervention (6 months). Furthermore, reductions in reward-driven eating at 6 months mediated the effect of intervention arm on weight loss at 12
Conclusion
These analyses suggest that integrating mindfulness components into a diet-exercise weight loss intervention leads to greater reductions in reward-driven eating. These reductions in reward-driven eating, in turn, are associated with greater weight loss, suggesting that decreases in reward-driven eating are a mechanism by which interventions impact weight change. Future interventions should target reductions in reward-driven eating so as to improve weight loss outcomes.
Acknowledgment
This research was supported by funding from the National Institutes of Health (NCCIH) to Frederick M. Hecht (1P01AT005013; K24AT007827) and Jennifer Daubenmier (K01AT004199). Ashley E. Mason was supported by The National Institutes of Health (NCCIH) (T32AT003997). This research was also supported by funding from the National Institutes of Health (NHLBI) to Elissa S. Epel (U01HL097973). This publication was supported by the National Center for Advancing Translational Sciences, National
References (79)
- et al.
Coping with food cravings. Investigating the potential of a mindfulness-based intervention
Appetite
(2010) - 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
Appetite
(2012) - et al.
Eating tasty food to cope. Longitudinal association with BMI
Appetite
(2015) - et al.
Profiling motives behind hedonic eating: preliminary validation of the palatable eating motives scale
Appetite
(2014) Psychological aspects of weight maintenance and relapse in obesity
Journal of Psychosomatic Research
(2002)Stress-induced obesity and the emotional nervous system
Trends in Endocrinology & Metabolism
(2010)- et al.
A new biomarker of hedonic eating? A preliminary investigation of cortisol and nausea responses to acute opioid blockade
Appetite
(2014) - et al.
From motivation to behaviour: a model of reward sensitivity, overeating, and food preferences in the risk profile for obesity
Appetite
(2007) - et al.
Sensitivity to reward: implications for overeating and overweight
Appetite
(2004) - et al.
Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior
Psychoneuroendocrinology
(2001)
Food reinforcement, delay discounting and obesity
Physiology & Behavior
A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation
Appetite
Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up
Journal of the American Dietetic Association
The assessment of binge eating severity among obese persons
Addictive Behaviors
Brief guided imagery and body scanning interventions reduce food cravings
Appetite
Stress influences appetite and comfort food preferences in college women
Nutrition Research
Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review
Eating Behaviors
Stress-related eating and drinking behavior and body mass index and predictors of this behavior
Preventive Medicine
A brief mindfulness intervention reduces unhealthy eating when hungry, but not the portion size effect
Appetite
Acute responses to opioidergic blockade as a biomarker of hedonic eating among obese women enrolled in a mindfulness-based weight loss intervention trial
Appetite
Profits and pandemics: prevention of harmful effects of tobacco, alcohol, and ultra-processed food and drink industries
The Lancet
Of human bondage: food craving, obsession, compulsion, and addiction
Physiology & Behavior
Stress as a common risk factor for obesity and addiction
Biological Psychiatry
The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger
Journal of Psychosomatic Research
Comfort food is comforting to those most stressed: evidence of the chronic stress response network in high stress women
Psychoneuroendocrinology
Relationship between stress, eating behavior, and obesity
Nutrition
Stress eating and health. Findings from MIDUS, a national study of US adults
Appetite
Reward, dopamine and the control of food intake: Implications for obesity
Trends in Cognitive Sciences
Food selection changes under stress
Physiology & Behavior
Comparative effectiveness of weight-loss interventions in clinical practice
New England Journal of Medicine
The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations
Journal of Personality and Social Psychology
Maintenance of weight loss after lifestyle interventions for overweight and obesity, a systematic review
Obesity Reviews
Regression towards the mean
BMJ: British Medical Journal
Psychosocial stress and change in weight among US adults
American Journal of Epidemiology
Real-time sampling of reasons for hedonic food consumption: further validation of the palatable eating motives scale
Name: Frontiers in Psychology
Applied multiple regression/correlation analysis for the behavioral sciences
Who's stressed? Distributions of psychological stress in the United States in probability samples from 1983, 2006, and 20091
Journal of Applied Social Psychology
A global measure of perceived stress
Journal of Health and Social Behavior
Effects of a mindfulness-based weight loss program in obese adults: a randomized clinical trial
Obesity
Cited by (0)
- 1
Contributed equally as co-senior authors.