The role of mindfulness based interventions in the treatment of obesity and eating disorders: An integrative review

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Summary

More than one-third of U.S. adults over the age of 20 years are classified as obese and nearly two-thirds are overweight or obese. The prevalence of obesity among U.S. children and adolescents has almost tripled since 1980, with 17% of all youth and children now considered obese. Nine million children aged 6–19 years are overweight, making obesity the largest health care threat facing today's children. Historically, the arsenal against obesity has been primarily focused on interventions that increase physical activity and decrease caloric intake. American weight loss strategies that incorporate dietary modifications and exercise have proven effective in achieving weight loss, but most of the weight is regained over time. Mindfulness based interventions, combined with other traditional weight loss strategies, have the potential to offer a long-term, holistic approach to wellness. However, research reports examining the complementary addition of mindfulness based approaches in the treatment obesity and eating disorders are relatively scarce in the empirical literature. This paper describes what is currently known about the role of mindfulness based interventions when used alone, or in combination with, other traditional approaches in the treatment of obesity and eating disorders.

Introduction

The 2011–2015 strategic plan released by the National Center of Complementary and Alternative Medicine (NCCAM) includes strategies for increasing the number of empirical studies that describe the impact of Complementary and Alternative Medicine (CAM) when used to supplement healthy behaviors or facilitate behavior change. The NCCAM report notes that “mindfulness practices may be associated with greater psychological well-being, less disordered eating, greater weight loss and improved metabolic function”.1

There is mounting evidence to support the effectiveness of mindfulness based therapies in the psychological treatment of anxiety and depressive disorders.2, 3 Eating disorders are treatable medical conditions that frequently co-exist with depression and anxiety disorders.4 However, to date, little research has been devoted to exploring the effect of mindfulness, when used alone, or in combination with other traditional forms of weight management protocols to address the psychological component of obesity and other eating disorders.5

Section snippets

Research question

This paper describes what is currently known about the role of mindfulness based interventions when used alone or in combination with other traditional approaches in the treatment of obesity and eating disorders. An integrative review was conducted to examine the following question:

  • What is the role of mindfulness-based interventions in the treatment of obesity and eating disorders?

Eating disorders

Eating disorders are most commonly characterized as dietary disturbances that result in excessive intake or strict avoidance of food.4 Anorexia nervosa, bulimia, and binge-eating make up some of the most common types of eating disorders.4 Bulimia and anorexia nervosa occur more commonly among women, who make up approximately 85–90% of individuals with these diseases. Census data reveals a mortality rate for individuals with anorexia nervosa to be 12 times the death rate for all causes of death

Design of literature search

Electronic searches were conducted of journal articles written in the English language. Due to the relatively low number of articles available on the chosen topic, the period of publications searched included a period of 9 years (2003–2012), with preference given to research studies occurring during the last five years. Reference pages of journal articles relative to the topic under study were also reviewed and some were accessed and used. Articles were included if they demonstrated how

Results

Results of this literature review produced mindfulness based interventions that most commonly centered on yoga, meditation, cognitive therapy, and eating awareness training. An abundance of the research on mindfulness based practices naturally fell to one of the oldest practices combining the mind–body experience — yoga. Studies have repeatedly confirmed the positive effects of yoga on balance, flexibility, leg and arm strength, heart rate and blood pressure.18 Decreased symptoms of eating

Discussion

Mindfulness is relevant to cognition and learning and is an essential component of holistic obesity treatment.25, 26 Mindfulness encourages individuals to “understand the experience and expression of emotions, so they can identify and challenge their beliefs and attend and respond to their emotions adaptively”.16 Recent studies indicate that mindfulness approaches can improve or extend long term health outcomes in persons with eating disorders and is also associated with a reduction in overall

Conflict of interest statement

None declared.

References (29)

  • National Institutes of Health

    National Center for Complementary and Alternative Medicine: what is CAM?

    (2012)
  • Z.V. Segal et al.

    The mindfulness-based cognitive therapy adherence scale: inter-rater reliability, adherence to protocol and treatment distinctiveness

    Clinical Psychology and Psychotherapy

    (2002)
  • L. Roemer et al.

    An open trial of an acceptance-based behavior therapy for generalized anxiety disorder

    Behavior Therapy

    (2007)
  • National Institute of Mental Health

    Eating disorders

    (2012)
  • R. Chambers et al.

    Mindful emotion regulation: an integrative review

    Clinical Psychology Review

    (2009)
  • CDC

    Youth risk behavior surveillance system, 2011: United States, High School Youth Risk Behavior Survey

    (2012)
  • CDC

    Data and statistics: overweight and obesity. Rates among all children in the United States

    (2012)
  • C. Ogden et al.

    Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010

    Journal of the American Medical Association

    (2012)
  • National Center for Health Statistics

    Health, United States: 2010 with special feature on death and dying

    (2011)
  • American Health Association

    Obesity and overweight children: the hidden epidemic

    (2012)
  • S. Daniels

    The consequences of childhood obesity

    Future of Children Journal

    (2006)
  • American Heart Association

    Overweight and obesity statistical fact sheet: 2012 update

    (2012)
  • J. Kabat-Zinn

    Mindfulness-based interventions in context: past, present, and future

    Clinical Psychology: Science and Practice

    (2003)
  • J. Daubenmier et al.

    Mindfulness intervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: an exploratory randomized controlled study

    Journal of Obesity

    (2011)
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