An epidemic of obesity has been reported in the United States. Over 40% of Americans are classified as overweight and at elevated risk for diabetes, heart disease, and stroke. Obesity-associated medical costs are estimated at $147 billion yearly. Cognitive-behavioral programs are used in an attempt to support weight loss, but often fail because cognitive control over emotionally rewarding eating is difficult to sustain.
Mindful attention to eating, however, may reduce binge eating by lowering our expectations of just how rewarding eating a craved food will be. Taylor et al. [Journal of Behavioral Addictions] conducted two studies to test if mindfulness alters expectations of the reward of eating, and whether such changes result in decreased binge eating behavior.
In the first study, 64 overweight women (average age=53 years; 92% Caucasian; average BMI=33) participated in an 8-week app-based mindful eating program. The mindful eating app contained 28 self-paced sequential modules introducing mindfulness in brief video format. Modules were designed to help participants become mindful of eating triggers and learn mindful eating skills.
The app included a tool that participants used when they experienced cravings to binge eat. The tool had them rate their craving intensity, then imagine themselves eating the desired food and how that would make them feel, then rate their subsequent craving intensity, and finally decide whether or not to yield to the craving. If participants decided to go ahead and binge eat, they then rated how much food they ate and the level of contentment they felt after mindfully attending to their body, thoughts, and emotions.
The tool intended to help participants become aware of discrepancies between how they expected to feel and how they actually felt after yielding to cravings, and to ultimately update their expectancies in accordance with this realization.
Participants completed several eating-related self-report measures before and after the 8-week intervention. Results showed significant reductions in food craving (Cohen’s d=1.25) and stress-based (d=1.35) and reward-based (d=1.19) eating after the intervention. Decreases in the expected reward value of food were significantly associated with increased use of the app-based craving tool. The more frequently the participants used the tool, the less they binge ate.
The authors conducted a second naturalistic community-based study examining data from a pool of 1,119 mindfulness app users. The pool was subdivided into a “low use” group of 1,044 participants who used the craving tool <10 times (females=78%; average age=45 years) and a “high use” group of 75 participants who used the craving tool ≥10 times (females=79%; average age=49 years).
Results from the second study showed the more participants used the craving tool, the smaller their anticipated rewards from eating craved foods. Unlike the first study, binge eating did not decrease with increased tool use. A post-hoc analysis of the low use group showed binge eating increased for participants who used the craving tool 1-3 times and decreased for those using it 5 or more times.
These two studies showed a mindful eating app reduced the frequency and amount of binge eating in an experimental setting, but not in a naturalistic community setting. More use of the mindful craving tool resulted in lower reward expectancies about the benefit of eating, and to less binge eating for participants who used the tool at least five times. The study is limited by the absence of a control group.
Taylor, V. A., Moseley, I., Sun, S., Smith, R., Roy, A., Ludwig, V. U., & Brewer, J. A. (2021). Awareness drives changes in reward value which predict eating behavior change: Probing reinforcement learning using experience sampling from mobile mindfulness training for maladaptive eating. Journal of Behavioral Addictions.
Link to study