What is Mindful Eating and can it help with weight loss ?

What is Mindful Eating ?

Mindful eating includes awareness of physical hunger and satiety cues, environmental or emotional triggers to eat, and making healthier food choices ¹. Many people eat mindlessly at meal time or when they snack. It’s common to eat while watching television, while on the computer, and while driving. Eating more slowly and relishing each bite could help people eat less or eat healthier, according to Dr. Lilian Cheung, lecturer in the Department of Nutrition at Harvard School of Public Health. Dr. Cheung, who also is the editorial director of the department’s nutrition website, The Nutrition Source, co-authored the 2010 book Savor: Mindful Eating, Mindful Life with Vietnamese Buddhist monk Thich Nhat Hanh ². In Savor: Mindful Eating, Mindful Life, renowned spiritual leader Thich Nhat Hanh and Harvard nutritionist Dr. Lilian Cheung combine timeless Buddhist wisdom with nutrition science to deliver a new and insightful perspective on how people can end their struggles with weight for good.

In a recent literature review (published online 18 July 2017) involving sixty-eight publications: twenty-three interventions in obese/overweight populations; twenty-nine interventions in normal-weight populations; sixteen observational studies, three of which were carried out in overweight/obese populations. Mindfulness-based approaches appear most effective in addressing binge eating, emotional eating and eating in response to external cues ³. The authors found mindfulness-based approaches may prevent weight gain. Reduced food intake was seen in some of the studies in overweight and obese populations, but this was less apparent in the studies in normal-weight populations. Mindfulness appears to work by an increased awareness of internal, rather than external, cues to eat. Mindfulness and mindful eating have the potential to address problematic eating behaviours and the challenges many face with controlling their food intake. Encouraging a mindful eating approach would seem to be a positive message to be included in general weight management advice to the public ³.

This study ⁴ provides a description of mindfulness and mindful eating and addresses the application of mindful eating as a component of diabetes self-management education. Mindful eating helps individuals cultivate awareness of both internal and external triggers to eating, interrupt automatic eating, and eat in response to the natural physiological cues of hunger and satiety. Mindful eating interventions have been effective in facilitating improvement in dysregulated eating and dietary patterns. Through practice over time, eating mindfully can interrupt habitual eating behaviors and provide greater regulation of food choice.

Mindfulness is an ancient practice of “being completely aware of what’s happening in the present”—of all that’s going on inside and all that’s happening around you. It means not living your life on “autopilot.” Instead, you live your life “consciously in the present” in order to experience life as it unfolds moment to moment, good and bad, and without judgment or preconceived notions ⁵. “Many of us go through our lives without really being present in the moment,” being present in the now is the fundamental aspect of the spiritual practice to life and living.

As you start to learn how to be more mindful, it’s common and normal to realize how much your mind races and focuses on the past and future. You can just notice those thoughts and then return to the present moment. It is these little, regular steps that add up and start to create a more mindful, healthy life.

One National Institutes of Health-supported study found a link between mindfulness meditation and measurable changes in the brain regions involved in memory, learning and emotion. Another National Institutes of Health-funded researcher reported that mindfulness practices may reduce anxiety and hostility among urban youth and lead to reduced stress, fewer fights and better relationships ⁵.

The simple techniques involved in mindful eating—eating without watching the TV or computer, eating in silence, chewing slowly, taking breaths between bites—can help us focus more on what we are choosing to put into our bodies, and why, says Dr. Cheung ².

More recently, self-help guru like Oprah Winfrey ⁶ has become cheerleaders for the practice of mindful eating. On Oprah’s site, she shared tips to eat mindfully from a Cornell University, Prof. Brian Wansink, the author of “Mindless Eating: Why We Eat More Than We Think.”

Here are seven essential tips from Prof. Brian Wansink from Oprah.com ⁶:

1. People who stock up at discount stores eat up to 48 percent more. If you buy in bulk, put pretzels and other snacks in portion-size Baggies. Never, never, ever eat out of the box.
2. The longer you sit at the table, the more you’ll eat. Dine with one friend, you’ll eat about 35 percent more. With a group of seven, you’ll eat 96 percent more. if you’re trying to lose weight, eat alone or with the smallest group possible, and pace yourself with the lightest eater.
3. If you pre-plate your food in the kitchen, you’ll eat 14 percent less than if you serve yourself a smaller portion at the table and then take seconds.
4. Brian’s rule of two: When eating at a buffet, put only two items at a time on your plate. Even if you make repeated trips, you’ll eat a lot less.
5. Always eat in the same room of your house (but not in front of a TV or computer). You won’t snack as much.
6. Don’t leave serving dishes on the table unless they’re filled with vegetables.
7. Physical hunger builds gradually. Emotional hunger develops suddenly.

Simply put, mindful eating is learning to pay attention and eating with intention. Instead of eating mindlessly (and sometimes emotionally), putting food into your mouth almost unconsciously, not really tasting the food you’re eating, you notice your thoughts, feelings, and sensations. The look, smell, taste, feel of the food you’re eating.

Mindful eating is not a diet, or about giving up anything at all. It’s about experiencing food more intensely — especially the pleasure of it. You can eat a cheeseburger mindfully, if you wish. You might enjoy it a lot more. Or you might decide, halfway through, that your body has had enough. Or that it really needs some salad.

Eating is a natural, healthy, and pleasurable activity for satisfying hunger. However, in our food-abundant, diet-obsessed culture, eating is often mindless, consuming, and guilt-inducing instead. Mindful eating is an ancient mindfulness practice with profound modern implications and applications for resolving this troubled love-hate relationship with food.

Studies have shown that thinking about food and the way we eat it means we consume less. A small yet growing body of research suggests that a slower, more thoughtful way of eating could help with weight problems and maybe steer some people away from processed food and unhealthy choices.

This alternative approach has been dubbed “mindful eating.” It’s based on the Buddhist concept of mindfulness, which involves being fully aware of what is happening within and around you at the moment. Mindfulness techniques have also been offered as a way to relieve stress and alleviate problems like high blood pressure and chronic gastrointestinal difficulties.

Applied to eating, mindfulness includes noticing the colors, smells, flavors, and textures of your food; chewing slowly; getting rid of distractions like TV or reading; and learning to cope with guilt and anxiety about food. Some elements of mindful eating hark back to Horace Fletcher, an early 20th century food faddist who believed chewing food thoroughly would solve many different kinds of health problems.

The mind–gut connection

Digestion involves a complex series of hormonal signals between the gut and the nervous system, and it seems to take about 20 minutes for the brain to register satiety (fullness). If someone eats too quickly, satiety may occur after overeating instead of putting a stop to it. There’s also reason to believe that eating while we’re distracted by activities like driving or typing may slow down or stop digestion similar to how the “fight or flight” response does. And if we’re not digesting well, we may be missing out on the full nutritive value of some of the food we’re consuming.

When you eat mindfully, you slow down the process of eating, turn off autopilot, and focus on the present moment. Increasing your awareness of the present moment helps you become more conscious of your food choices, and requires you to use all five of your senses. This helps you truly taste and enjoy your food – without stuffing yourself. When you eat mindfully, it also makes you more aware of your body’s cues that tell you how hungry or full you are ⁷.

A starter kit for mindful eating

• Awareness of your physical and emotional cues (your emotions during and after eating).
• Recognition of your non-hunger triggers for eating (why you feel like eating, and what emotions or needs might be triggering the eating).
• Learning to meet your other needs in more effective ways than eating
• Choosing food for both enjoyment and nourishment (what you’re eating, and whether it is healthy or not).
• Eating for optimal satisfaction and satiety (the look, smell, taste, feel of the food you’re eating).
• Using the fuel you’ve consumed to live the vibrant life you crave (how full (or sated) you are before, during and after eating).
• Where the food came from, who might have grown it, how much it might have suffered before it was killed, whether it was grown organically, how much it was processed, how much it was fried or overcooked, etc.

This broad application makes mindful eating a powerful tool for developing a healthier, happier relationship with food, which could result in healthy and long term weight loss.

Mindful Eating Tips

In your busy live, you often rush through meals sometimes not even pausing to sit while you eat. This hurried way of eating certainly deprives you of the pleasure of the meal, but could it also be impacting your health ? Could it be causing harm to our environment ? A new approach suggests that mindful eating may help you improve your health and the health of the planet through the practice of enjoying food with understanding and compassion. To understand this new philosophy, consider each of the four key principals:

• how you eat mindfully,
• what you eat,
• why you eat, and
• how much you eat.

How To Eat Mindfully

Eating more mindfully can start with something as simple as sitting down at a table for your meals. Eliminate distractions by removing your phone, television, computer or anything else that may compete for your attention. With typical distractions removed, you will be forced to focus on what is in front of you, your food. Enjoy how it looks, smells, feels and tastes. You can even listen to how it sounds when you chew it. You may notice something new about a food you have been eating for years.

Before you even put the food in your mouth, look at it closely. Notice the color, the texture, and the smell. Then, put the food in your mouth and let it sit on your tongue. Use your tongue to explore the shape and texture. You may even want to close your eyes at this point, so you can solely focus on the food in your mouth. Then, start to chew slowly and notice the flavors, textures, and smells that come in and out as the food breaks down. All this time, stay in the present moment. Think about the current taste of the food instead of anticipating the next bite or having more. Before reaching for another bite, notice whether you are doing so out of craving or because you are physically hungry.

A major benefit of mindfulness is that it encourages you to pay attention to your thoughts, your actions and your body. For example, studies have shown that mindfulness can help people achieve and maintain a healthy weight. It is so common for people to watch TV and eat snack food out of the box without really attending to how much they are eating. With mindful eating, you eat when you’re hungry, focus on each bite, enjoy your food more and stop when you’re full.

Once you’ve gotten a feel for it, try eating more mindfully at one meal or snack each day. Over time, you can gradually make it a habit that you practice at all meals of the day. You’ll find that you are actually tasting your food, enjoying meal time, and are more in control of what and how much you eat.

What You Eat

You know that the foods you choose will have an impact your personal health, in both the short and long term. Choosing more healthful foods like fruits, vegetables, beans, nuts, seeds and whole grains also has the added benefit of being more sustainable.

When You Eat

Sit down to eat. Avoid distractions like reading, the television, or the computer at meals and snacks. Don’t multi-task while you are eating.

Consciously tell yourself to slow down before eating. Take smaller bites and chew your food well. To slow down the process of eating, try putting your fork down between bites. You can also try eating with your opposite hand.

Eat from a smaller plate or bowl. Doing so actually makes us feel like we are eating more. When you eat from a larger plate or bowl, most people tend to fill it up and eat more.

Remember that you can’t eat what’s not there. If you have trouble with overeating or mindlessly eating certain foods, try not to buy them. Save them for a special occasion or just enjoy them when you are out to eat.

Why You Eat

Many factors influence why you eat. Nourishing your bodies and providing fuel for your daily activities should be the primary reason. Practicing mindfulness can help you filter out the other factors that may distract you (e.g. stress, anxiety, tiredness, boredom, fear, sadness, anger, depressed, lack of sleep, poor self-esteem, etc).

If you have recently eaten and find yourself craving food again, do a quick emotional check. Do you want food because you are hungry—or to fill an emotional need? Here are some tips to keep your eating in check:

• Remember which emotions and situations trigger you to eat.
• Write a list of other things to do to fulfill that emotional need, for example, call a friend, take a walk, drink some water or another zero-calorie beverage, send an email to a pal, or do a few yoga stretches.
• Assess your physical hunger using the Hunger-Satiety Rating Scale.
• Remember that food will not make your emotions go away (it won’t fix anything).
• Track the food you eat, how hungry you are when you eat, and how you feel at the time. You may get a better idea of which emotions trigger eating when you are not physically hungry.
• If you are having a hard time, reach out for help. Involve family members and friends to help support your weight loss efforts. Support groups, therapy, and members of your health care team can also help.

How Much Do You Eat

Rushing to fill your plates without consideration of how much you really need can lead to both overeating and increased food waste. Being more mindful during mealtime can help you pay attention to your hunger cues and understand when you are satisfied.

Studies suggest that mindfulness practices may help people manage stress, cope better with serious illness and reduce anxiety and depression. Many people who practice mindfulness report an increased ability to relax, a greater enthusiasm for life and improved self-esteem.

Finding time for mindfulness in our culture, however, can be a challenge. We tend to place great value on how much we can do at once and how fast. Still, being more mindful is within anyone’s reach.

You can practice mindfulness throughout the day, even while answering e-mails, sitting in traffic or waiting in line. All you have to do is become more aware—of your breath, of your feet on the ground, of your fingers typing, of the people and voices around you. So, before you roll your eyes again, take a moment and consider mindfulness.

Being Mindful

Research on mindfulness supports the idea that cultivating greater attention, awareness, and acceptance through meditation practice is associated with lower levels of psychological distress, including less anxiety, depression, anger, and worry ⁸, ⁹, ¹⁰, ¹¹. Furthermore, studies have begun to elucidate how mindfulness training can reduce distress. One observational study found that more time spent on formal meditation practices (body scan, yoga, sitting meditation) at home during an 8-week intervention led to increased mindfulness, which, in turn, explained decreased psychological distress and increased psychological well-being ¹². A recent randomized controlled trial in students showed that 4 weeks of mindfulness meditation training, relative to somatic relaxation training or a nonintervention control group, reduced distress by decreasing rumination, a cognitive process associated with depression and other mood disorders ¹³. Another clinical study found that 8 weeks of mindfulness meditation training significantly reduced ruminative thinking in persons with a history of depression ¹⁴. Together, these studies indicate that one beneficial mechanism of mindfulness appears to involve reshaping ways of thinking that engender improved emotional well-being.

Research further suggests that people with higher levels of mindfulness are better able to regulate their sense of well-being by virtue of greater emotional aware
ness, understanding, acceptance, and the ability to correct or repair unpleasant mood states ¹⁵, ⁹, ¹⁶. The
ability to skillfully regulate one’s internal emotional experience in the present moment may translate into good mental health long-term.

The concept of mindfulness is simple, but becoming a more mindful person requires commitment and practice. Here are some tips to help you get started:

• Take some deep breaths. Breathe in through your nose to a count of 4, hold for 1 second and then exhale through the mouth to a count of 5. Repeat often.

• Enjoy a stroll. As you walk, notice your breath and the sights and sounds around you. As thoughts and worries enter your mind, note them but then return to the present.

• Practice mindful eating. Be aware of taste, textures and flavors in each bite, and listen to your body when you are hungry and full.

• Find mindfulness resources in your local community, including yoga and meditation classes, mindfulness-based stress reduction programs and books. A great book to start with is the “The Power of Now: A Guide to Spiritual Enlightenment” by Eckhart Tolle.

Emotions and Eating

Emotions can influence what, when, and how much we eat. For example, you have probably heard that some people eat to cope with stress. Others eat to preoccupy themselves when they feel bored ¹⁷.

When you eat based on your emotions, it can hinder your weight loss efforts. Often, situations that trigger certain negative emotions prompt eating. Find out which emotions trigger your desire to eat using the chart below.

1. Review the words below.
2. Think about each of the emotions.
3. Note any emotions that trigger your desire for food.
4. Add any other emotions or situations that trigger you to eat.

Afraid, Alone, Angry, Anxious, Bad, Blue, Bored, Content, Depressed, Disappointed, Fat, Fearful, Frustrated, Good, Grief, Guilty, Happy, Hate, Hungry, Insecure, Jealous, Lonely,  Lust, Nervous, Peer Pressure, Regret, Sad, Scared, Self-pity, Shame, Sleepy, Stress, Time to eat, Tired, Unsure, Worried.

How does mindful eating help solve eating issues ?

Many people who struggle with food react mindlessly to their unrecognized or unexamined triggers, thoughts, and feelings. In other words, they re-act-repeating past actions again and again-feeling powerless to change. Mindfulness increases your awareness of these patterns without judgment and creates space between your triggers and your actions.

For example, whenever you notice that you feel like eating and pause to ask the question, “Am I hungry?”, you are able to observe your thoughts and choose how you will respond. Instead of reacting mindlessly, mindfulness gives you response-ability. That is how mindful eating empowers you to finally break old automatic or habitual chain reactions and discover options that work better for you.

• You learn to eat when you’re hungry, and stop when you’re sated.
• You learn to really taste food, and to enjoy the taste of healthy food.
• You slowly start to realize that unhealthy food isn’t as tasty as you thought, nor does it make you feel very good.
• As a result of the above three points, you will often lose weight if you’re overweight.
• You begin to sort through the emotional issues you have around food and eating. This takes a bit longer, but it’s important.
• Social overeating can become less of a problem — you can eat mindfully while socializing, with practice, and not overeat.
• You begin to enjoy the eating experience more, and as a result enjoy life more, when you’re more present.
• It can become a mindfulness ritual you look forward to.
• You learn how food affects your mood and energy throughout the day.
• You learn what food best fuels your exercise and work and play.

A treatment for bingers

Several studies have shown mindful eating strategies might help treat eating disorders and possibly help with weight loss. Psychologists at Indiana State University and colleagues at Duke University conducted an NIH-funded study of mindful eating techniques for the treatment of binge eating.

The randomized controlled study included 150 binge eaters and compared a mindfulness-based therapy to a standard psychoeducational treatment and a control group. Both active treatments produced declines in binging and depression, but the mindfulness-based therapy seemed to help people enjoy their food more and have less sense of struggle about controlling their eating. Those who meditated more (both at mealtimes and throughout the day) got more out of the program.

Experts suggest starting gradually with mindful eating, eating one meal a day or week in a slower, more attentive manner. Here are some tips (and tricks) that may help you get started:

• Set your kitchen timer to 20 minutes, and take that time to eat a normal-sized meal.
• Try eating with your non-dominant hand; if you’re a righty, hold your fork in your left hand when lifting food to your mouth.
• Use chopsticks if you don’t normally use them.
• Eat silently for five minutes, thinking about what it took to produce that meal, from the sun’s rays to the farmer to the grocer to the cook.
• Take small bites and chew well.
• Before opening the fridge or cabinet, take a breath and ask yourself, “Am I really hungry?” Do something else, like reading or going on a short walk.

As you can see, mindful eating is much more than “eating slowly, without distraction.” While that’s certainly an important part of it, at Am I Hungry? Mindful Eating Programs and Training, we believe that mindful eating encompasses the entire process of eating.

Mindful Eating and Weight Loss

There is a growing evidence suggesting intervention techniques that enhance mindful self-awareness improve well-being, including anxiety and depression ¹⁸, eating disorders ¹⁹, ²⁰, food cravings ²¹ and weight loss ²². Mindfulness-based interventions employ systematic procedures for developing greater awareness of moment-to-moment experience of physical sensations, affective states, and thoughts without judgment ²³. Mindful eating, as taught in Mindfulness-Based Eating Awareness Training ²⁴, includes making conscious food choices, developing awareness of physical vs. psychological hunger and satiety cues, and eating healthfully in response to those cues.

In a pilot study (a small scale preliminary study conducted in order to evaluate feasibility prior to performance of a full-scale study) on mindful eating and living (MEAL) involving 10 obese adults with a BMI of 36.9 kg/m² and average age of 44 yrs over 6 weeks ²⁵. The mindful eating and living intervention involve six weekly two-hour group classes (with two monthly follow-up classes). Content included training in mindfulness meditation, mindful eating, and group discussion, with emphasis on awareness of body sensations, emotions, and triggers to overeat. At the end of the 12 week trial, participants had statistically significant weight loss, eating disinhibition, binge eating, depression, perceived stress, physical symptoms, negative affect, and C-reactive protein ²⁵.

In a small randomised study involving 52 people with type 2 diabetes for more than 1 year with a body mass index (BMI) of ≥ 27.0 and glycosylated hemoglobin ≥ 7.0% (Hba1c), age 35 to 65 years not on insulin therapy ²⁶. The participants were divided into 2 groups, group 1 to receive mindful eating intervention and group 2 were given the diabetes self-management education, which addresses knowledge, self-efficacy, and outcome expectations for improving food choices. Food was not provided to participants in the current study. Instead, participants purchased and prepared their own food and were encouraged to modify intake based on awareness of hunger and satiety cues in mindful eating or self-selected goals in the Diabetes Self-Management Intervention. Both mindful awareness of hunger and goal setting strategies were effective in helping participants reduce energy intake and lose weight. At the end of 3 months study period, there was significant reduction in energy intake for both groups following the interventions. There was no significant difference between groups with regard to the change in weight, body mass index (BMI), waist circumference, fasting glucose, A1c, or insulin at study end. In addition, significant improvement in intake of trans fats, fiber and glycemic load occurred. Physical activity and prescribed medications were similar between groups throughout the study and did not change significantly ²⁶.

Mindful Eating and Type 2 Diabetes

In a small randomised study involving 52 people with type 2 diabetes for more than 1 year with a body mass index (BMI) of ≥ 27.0 and glycosylated hemoglobin ≥ 7.0% (Hba1c), age 35 to 65 years not on insulin therapy ¹. The participants were divided into 2 groups, group 1 to receive mindful eating intervention and group 2 were given the diabetes self-management education, which addresses knowledge, self-efficacy, and outcome expectations for improving food choices. At the end of the 3 months study, there was no significant difference between groups with regard to the change in weight at study end, both groups lost weight. The weight loss findings have been discussed in more detail in the mindful eating and weight loss detailed above ²⁶. Moreover, participants in both groups reported greater ability to minimize overeating in various situations. Correlational findings from the current study are consistent with these prior reports. Impulsivity or acting without thinking, was associated with higher scores on the disinhibition scale ²⁷, suggesting a tendency to act impulsively is associated with a tendency to overeat. Training in mindful eating and the Diabetes Self-Management goal-based approach both raised conscious control of eating behaviors and reduced perceptions of uncontrolled eating in this study ¹.

1. Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a Mindful Eating Intervention to a Diabetes Self-Management Intervention Among Adults With Type 2 Diabetes: A Randomized Controlled Trial. Health education & behavior : the official publication of the Society for Public Health Education. 2014;41(2):145-154. doi:10.1177/1090198113493092. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4217158/[↩][↩][↩]
2. Harvard School of Public Health. Lilian Cheung. https://www.hsph.harvard.edu/lilian-cheung/[↩][↩]
3. Warren JM, Smith N, Ashwell M. Nutr Res Rev. 2017 Jul 18:1-12. doi: 10.1017/S0954422417000154. [Published online: 18 July 2017]. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. https://www.cambridge.org/core/journals/nutrition-research-reviews/article/structured-literature-review-on-the-role-of-mindfulness-mindful-eating-and-intuitive-eating-in-changing-eating-behaviours-effectiveness-and-associated-potential-mechanisms/351A3D01E43F49CC9794756BC950EFFC[↩][↩]
4. Miller CK. Diabetes Spectr. 2017 May;30(2):89-94. doi: 10.2337/ds16-0039. Mindful Eating With Diabetes. https://www.ncbi.nlm.nih.gov/pubmed/28588374[↩]
5. National Institutes of Health. Mindfulness Matters – Can Living in the Moment Improve Your Health ? https://newsinhealth.nih.gov/issue/Jan2012/feature2[↩][↩]
6. Oprah.com. 7 Ways to Eat Mindfully. http://www.oprah.com/health/Mindful-Eating[↩][↩]
7. American Diabetes Association. Eat More Mindfully. http://www.diabetes.org/mfa-recipes/tips/2014-10/mindful-eating-at-meals.html[↩]
8. Baer, R. A. (2003). Mindfulness training as clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125-143.[↩]
9. Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for salutary effects. Psychological Inquiry, 18, 211-237.[↩][↩]
10. Greeson, J., & Brantley, J. (2008). Mindfulness and anxiety disorders: Developing a wise relationship with the inner experience of fear. In F. Didonna (Ed.), Clinical handbook of mindfulness (pp. 171-188). New York, NY: Springer[↩]
11. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits. A meta-analysis. Journal of Psychosomatic Research, 57, 35-43.[↩]
12. Carmody, J., & Baer, R. A. (2008). Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. Journal of Behavioral Medicine, 31, 23-33.[↩]
13. Jain, S., Shapiro, S. L., Swanick, S., Roesch, S. C., Mills, P. M., Bell, I., et al. (2007). A randomized controlled trial of mindfulness meditation versus relaxation training: Effects on distress, positive states of mind, rumination, and distraction. Annals of Behavioral Medicine, 33, 11-21.[↩]
14. Ramel,W.,Goldin,P.R.,Carmona,P.E.,&McQuaid,J.R.(2004). The effects of mindfulness meditation training on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28, 433-455[↩]
15. Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15, 329-342.[↩]
16. Feldman, G., Hayes, A., Kumar, S., Greeson, J., & Laurenceau, J-P. (2007). Mindfulness and emotion regulation: The development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). Journal of Psychopathology and Behavioral Assessment, 29, 177-190.[↩]
17. American Diabetes Association. Emotions and Eating. http://www.diabetes.org/food-and-fitness/weight-loss/getting-started/emotions-and-eating.html[↩]
18. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. Hofmann SG, Sawyer AT, Witt AA, Oh D. J Consult Clin Psychol. 2010 Apr; 78(2):169-83. https://www.ncbi.nlm.nih.gov/pubmed/20350028/[↩]
19. The application of mindfulness to eating disorders treatment: a systematic review. Wanden-Berghe RG, Sanz-Valero J, Wanden-Berghe C. Eat Disord. 2011 Jan-Feb; 19(1):34-48. https://www.ncbi.nlm.nih.gov/pubmed/21181578/[↩]
20. An Exploratory Study of a Meditation-based Intervention for Binge Eating Disorder. Kristeller JL, Hallett CB. J Health Psychol. 1999 May; 4(3):357-63. https://www.ncbi.nlm.nih.gov/pubmed/22021603/[↩]
21. Coping with food cravings. Investigating the potential of a mindfulness-based intervention. Alberts HJ, Mulkens S, Smeets M, Thewissen R. Appetite. 2010 Aug; 55(1):160-3. https://www.ncbi.nlm.nih.gov/pubmed/20493913/[↩]
22. Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Dalen J, Smith BW, Shelley BM, Sloan AL, Leahigh L, Begay D. Complement Ther Med. 2010 Dec; 18(6):260-4. https://www.ncbi.nlm.nih.gov/pubmed/21130363/[↩]
23. Mindfulness-based stress reduction and health benefits. A meta-analysis. Grossman P, Niemann L, Schmidt S, Walach H. J Psychosom Res. 2004 Jul; 57(1):35-43. https://www.ncbi.nlm.nih.gov/pubmed/15256293/[↩]
24. Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Kristeller JL, Wolever RQ. Eat Disord. 2011 Jan-Feb; 19(1):49-61. https://www.ncbi.nlm.nih.gov/pubmed/21181579/[↩]
25. Dalen J, Smith BW, Shelley BM, Sloan AL, Leahigh L, Begay D. Complement Ther Med. 2010 Dec;18(6):260-4. doi: 10.1016/j.ctim.2010.09.008. Epub 2010 Nov 11. Pilot study: Mindful Eating and Living (MEAL): weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity.[↩][↩]
26. 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. Journal of the Academy of Nutrition and Dietetics. 2012;112(11):1835-1842. doi:10.1016/j.jand.2012.07.036. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485681/[↩][↩][↩]
27. Impulsivity is associated with the disinhibition but not restraint factor from the Three Factor Eating Questionnaire. Yeomans MR, Leitch M, Mobini S. Appetite. 2008 Mar-May; 50(2-3):469-76. https://www.ncbi.nlm.nih.gov/pubmed/18069081/[↩]