There is a significant health crisis with rates of obesity continuing to increase despite research and clinical standard behavioral weight loss programs (SBWP). Mindfulness meditation (MM), with demonstrated benefits on physical, psychological health, and self-regulation behaviors was explored with SBWP.
Forty-six adults (BMI=32.5±3.7 kg/m2; age=45.2±8.2 years, 87 % female, 21.7 % African American) were randomly assigned to a 6-month SBWP only (n=24) or SBWP+MM (n=22) at a university-based physical activity and weight management research center in a northeastern US city. Participants were instructed to decrease intake (1200–1500 kcal/day), increase physical activity (300 min/wk), and attend weekly SBWP or SBWP+MM sessions. SBWP+MM had the same SBWP lessons with addition of focused MM training. Outcome measures collected at 0, 3, and 6 months included: weight, Block Food Frequency Questionnaire, Eating Behavior Inventory, Eating Inventory and Paffenbarger Physical Activity Questionnaire. Data were analyzed using linear mixed modeling for efficacy analysis of weight (primary) and eating, exercise and mindfulness (secondary outcomes).
Retention rate was 76.1 % (n=35). A significant group by time interaction (p=0.03) was found for weight, with weight loss favoring SBWP+MM (−6.9 kg+2.9) over SBWP (−4.1 kg+2.8). Eating behaviors (p=0.02) and dietary restraint (p=0.02) improved significantly in SBWP+MM, compared to SBWP. MM enhanced weight loss by 2.8 kg potentially through greater improvements in eating behaviors and dietary restraint.
These findings support further study into the use of MM strategies with overweight and obese adults. The use of this low-cost, portable strategy with standard behavioral interventions could improve weight management outcomes.
The study material is original and has not been presented previously. The authors want to thank the 46 women and men who participated in this research pilot and dedicated staff of the Physical Activity and Weight Management Research Center.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: University of Pittsburgh, Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, Pittsburgh, Pennsylvania, USA. Author John M. Jakicic, PhD has received research grant funding from the National Institutes of Health and the American Heart Association in the past.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
 Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315:2284–91.10.1001/jama.2016.6458Search in Google Scholar PubMed
 Wadden TA, Webb VL, Moran CH, Bailer BA. Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy. [Research Support, N.I.H., Extramural Review]. Circulation. 2012;125:1157–70.10.1161/CIRCULATIONAHA.111.039453Search in Google Scholar PubMed
 Jeffery RW, Drewnowski A, Epstein LH, Stunkard AJ, Wilson GT, Wing RR, et al. Long-term maintenance of weight loss: current status. Health Psychol. 2000;19:Suppl:5–16.10.1037/0278-6133.19.Suppl1.5Search in Google Scholar
 Jensen MD, Ryan DH, Apovian CM, Loria CM, Ard JD, Millen BE, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. [Practice Guideline]. Circulation. 2014;129:S102–38.10.1161/01.cir.0000437739.71477.eeSearch in Google Scholar
 Jensen MD, Ryan DH, Apovian CM, Loria CM, Ard JD, Millen BE, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American college of cardiology/American heart association task force on practice guidelines and the obesity society. J Am Coll Cardiol. 2014;63:2985–3023.10.1016/j.jacc.2013.11.004Search in Google Scholar
 Knowler WC, Barrett-Connor E, Fowler SE, Famman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.10.1056/NEJMoa012512Search in Google Scholar PubMed
 Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–47.10.1016/0163-8343(82)90026-3Search in Google Scholar PubMed
 Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, P.H.S. Validation Studies]. J Pers Soc Psychol. 2003;84:822–48.10.1037/0022-35126.96.36.1992Search in Google Scholar PubMed
 Carlson LE, Speca M, Faris P, Patel KD. One year pre-post intervention follow-up of psychological, immune, endocrine and blood pressure outcomes of mindfulness-based stress reduction (MBSR) in breast and prostate cancer outpatients. Brain Behav Immun. 2007;21:1038–49.10.1016/j.bbi.2007.04.002Search in Google Scholar PubMed
 Edelman D, Oddone EZ, Liebowitz RS, Yancy WSJ, Olsen MK, Jeffreys AS, et al. A multidimensional integrative medicine intervention to improve cardiovascular risk. J Gen Intern Med. 2006;21:728–34.10.1111/j.1525-1497.2006.00495.xSearch in Google Scholar PubMed
 Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985;8:163–90.10.1007/BF00845519Search in Google Scholar PubMed
 Miller JJ, Fletcher K, Kabat-Zinn J. Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry. 1995;17:192–200.10.1016/0163-8343(95)00025-MSearch in Google Scholar PubMed
 Singh NN, Lancioni GE, Singh AN, Winton AS, Singh J, McAleavey KM, et al. A mindfulness-based health wellness program for an adolescent with Prader-Willi syndrome. Behav Modif. 2008;32:167–81.10.1177/0145445507308582Search in Google Scholar PubMed
 Dalen J, Smith BW, Shelley BM, Sloan AL, Leahigh L, Begay D. Pilot study: mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. [Clinical Trial]. Complement Ther Med. 2010;18:260–64.10.1016/j.ctim.2010.09.008Search in Google Scholar PubMed
 Mantzios M, Wilson JC. Making concrete construals mindful: A novel approach for developing mindfulness and self-compassion to assist weight loss. [Randomized Controlled Trial]. Psychol Health. 2014;29:422–41.10.1080/08870446.2013.863883Search in Google Scholar PubMed
 Miller CK, Kristeller JL, Headings A, Nagaraja H, Miser WF. Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study. [Comparative Study Randomized Controlled Trial Research Support, N.I.H., Extramural]. J Acad Nutr Diet. 2012;112:1835–42.10.1016/j.jand.2012.07.036Search in Google Scholar PubMed PubMed Central
 Yanovski SZ. Binge eating disorder and obesity in 2003: could treating an eating disorder have a positive effect on the obesity epidemic? Int J Eat Disord. 2003;34:Suppl:S117–20.10.1002/eat.10211Search in Google Scholar PubMed
 Masheb RM, Grilo CM. Emotional overeating and its associations with eating disorder psychopathology among overweight patients with binge eating disorder. Int J Eat Disord. 2006;39:141–46.10.1002/eat.20221Search in Google Scholar PubMed
 Pinaquy S, Chabrol H, Simon C, Louvet JP, Barbe P. Emotional eating, alexithymia, and binge-eating disorder in obese women. Obes Res. 2003;11:195–201.10.1038/oby.2003.31Search in Google Scholar PubMed
 Forman EM, Butryn ML, Juarascio AS, Bradley LE, Lowe MR, Herbert JD, et al. The mind your health project: A randomized controlled trial of an innovative behavioral treatment for obesity. Obesity (Silver Spring). 2012;21:1119–26.10.1002/oby.20169Search in Google Scholar PubMed PubMed Central
 Timmerman GM, Brown A. The effect of a mindful restaurant eating intervention on weight management in women. [Randomized Controlled Trial Research Support, N.I.H., Extramural]. J Nutr Educ Behav. 2012;44:22–28.10.1016/j.jneb.2011.03.143Search in Google Scholar PubMed PubMed Central
 Lillis J, Hayes SC, Bunting K, Masuda A. Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. [Randomized Controlled Trial]. Ann Behav Med. 2009;37:58–69.10.1007/s12160-009-9083-xSearch in Google Scholar PubMed
 Niemeier HM, Leahey T, Palm Reed K, Brown RA, Wing RR. An acceptance-based behavioral intervention for weight loss: a pilot study. [Research Support, N.I.H., Extramural]. Behav Ther. 2012;43:427–35.10.1016/j.beth.2011.10.005Search in Google Scholar PubMed PubMed Central
 Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. [Randomized Controlled Trial Research Support, Non-U.S. Gov’t]. Appetite. 2009;52:396–404.10.1016/j.appet.2008.11.012Search in Google Scholar PubMed
 Kristeller JL, Hallett CB. An exploratory study of a meditation-based intervention for binge eating disorder. J Health Psychol. 1999;4:357–63.10.1177/135910539900400305Search in Google Scholar PubMed
 Alberts HJ, Thewissen R, Raes L. Dealing with problematic eating behaviour. The effects of a mindfulness-based intervention on eating behaviour, food cravings, dichotomous thinking and body image concern. [Randomized Controlled Trial]. Appetite. 2012;58:847–51.10.1016/j.appet.2012.01.009Search in Google Scholar PubMed
 Daubenmier J, Kristeller J, Hecht FM, Maninger N, Kuwata M, Jhaveri K, et al. Mindfulness intervention for stress eating to reduce cortisol and abdominal fat among overweight and obese women: an exploratory randomized controlled study. J Obes. 2011;ID 651936:1–13.10.1155/2011/651936Search in Google Scholar PubMed PubMed Central
 Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review. [Review]. Eat Behav. 2014;15:197–204.10.1016/j.eatbeh.2014.01.005Search in Google Scholar PubMed
 Godsey J. The role of mindfulness based interventions in the treatment of obesity and eating disorders: an integrative review. Complement Ther Med. 2013;21:430–39.10.1016/j.ctim.2013.06.003Search in Google Scholar PubMed
 Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing, 1991.Search in Google Scholar
 Kabat-Zinn J. Coming to our senses: healing ourselves and the world through mindfulness. New York: Hyperion, 2005.Search in Google Scholar
 Kristeller J. Know your hunger. Spirituality & Health, 2005;8(2): 28–35.Search in Google Scholar
 Kristeller JL, Baer RA, Quillian RW. Mindfulness-based approaches to eating disorders. In: Baer RA, editor. Mindfulness and acceptance-based interventions: conceptualization, application, and empirical support. San Diego, CA: Elsevier, 2006: 75–91.Search in Google Scholar
 Subar AF, Thompson FE, Kipnis V, Midthune D, Hurwitz P, McNutt S, et al. Comparative validation of the Block, Willett, and National Cancer Institute food frequency questionnaires : the Eating at America’s Table Study. Am J Epidemiol. 2001;154:1089–99.10.1093/aje/154.12.1089Search in Google Scholar PubMed
 Block G, Woods M, Potosky A, Clifford C. Validation of a self-administered diet history questionnaire using multiple diet records. J Clin Epidemiol. 1990;43:1327–35.10.1016/0895-4356(90)90099-BSearch in Google Scholar PubMed
 O’Neil PM, Rieder S. Utility and validity of the eating behavior inventory in clinical obesity research: a review of the literature. [Review]. Obes Rev. 2005;6:209–16.10.1111/j.1467-789X.2005.00192.xSearch in Google Scholar PubMed
 Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985;29:71–83.10.1016/0022-3999(85)90010-8Search in Google Scholar PubMed
 Foster GD, Wadden TA, Swain RM, Stunkard AJ, Platte P, Vogt RA. The Eating Inventory in obese women: clinical correlates and relationship to weight loss. [Research Support, U.S. Gov’t, P.H.S.]. Int J Obes Relat Metab Disord. 1998;22:778–85.10.1038/sj.ijo.0800659Search in Google Scholar PubMed
 Paffenbarger RSJ, Blair SN, Lee IM, Hyde RT. Measurement of physical activity to assess health effects in free-living populations. Med Sci Sports Exerc. 1993;25:60–70.10.1249/00005768-199301000-00010Search in Google Scholar PubMed
 Paffenbarger RSJ, Hyde RT, Wing AL, Hsieh CC. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986;314:605–13.10.1056/NEJM198603063141003Search in Google Scholar PubMed
 Alberts HJ, Mulkens S, Smeets M, Thewissen R. Coping with food cravings. Investigating the potential of a mindfulness-based intervention. Appetite. 2010;55:160–63.10.1016/j.appet.2010.05.044Search in Google Scholar PubMed
 Daubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, et al. Effects of a mindfulness-based weight loss intervention in adults with obesity: A randomized clinical trial. Obesity. 2016;24:794–804.10.1002/oby.21396Search in Google Scholar
 Beshara M, Hutchinson AD, Wilson C. Does mindfulness matter? Everyday mindfulness, mindful eating and self-reported serving size of energy dense foods among a sample of South Australian adults. Appetite. 2013;67:25–29.10.1016/j.appet.2013.03.012Search in Google Scholar PubMed
 Westenhoefer J, Stunkard AJ, Pudel V. Validation of the flexible and rigid control dimensions of dietary restraint. Int J Eat Disord. 1999;26:53–64.10.1002/(SICI)1098-108X(199907)26:1<53::AID-EAT7>3.0.CO;2-NSearch in Google Scholar PubMed
 Wadden TA, Stunkard JA, Eds.. The treatment of obesity: an overview. New York: The Guilford Press, 2002.Search in Google Scholar
 Ainsworth BE, Leon AS, Richardson MT, Jacobs DR, Paffenbarger RS, Jr. Accuracy of the college alumnus physical activity questionnaire. [Research Support, U.S. Gov’t, P.H.S.]. J Clin Epidemiol. 1993;46:1403–11.10.1016/0895-4356(93)90140-VSearch in Google Scholar PubMed
 Johansson G, Wikman A, Ahren AM, Hallmans G, Johansson I. Underreporting of energy intake in repeated 24-hour recalls related to gender, age, weight status, day of interview, educational level, reported food intake, smoking habits and area of living. [Research Support, Non-U.S. Gov’t]. Public Health Nutr. 2001;4:919–27.10.1079/PHN2001124Search in Google Scholar PubMed
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