Mind Over Platter: Mental Exercises May Help Patients Maintain Weight Loss

Duke Integrative Medicine Research Demonstrates Success
in Changing Eating Behaviors

DURHAM, N.C. – September 26, 2007: Losing weight and keeping it off may have more to do with the dieter's state of mind than previously believed, according to experts at Duke Integrative Medicine who are studying the use of "mindfulness" techniques for weight loss and weight management. Areas currently being studied include training in awareness, meditation and the identification of the "emotional triggers" behind eating behaviors.

New research shows that the use of mindfulness techniques helps to regulate people's eating patterns. The research is funded by the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, and it is being conducted by Duke Integrative Medicine and other leading universities. Ongoing research is further exploring how mindfulness approaches can impact weight loss and help people who have lost weight keep it off.

The initial study, conducted by Ruth Q. Wolever, Ph.D., director of research at Duke Integrative Medicine, in collaboration with Principle Investigator and Indiana State University Psychologist Jean Kristeller, Ph.D., compared three different treatment groups for binge eating in significantly overweight people. Preliminary results show that a mindfulness-based eating program regulated the eating habits of participants as well as the psychoeducational approach did. Only the mindfulness-based program, however, led the participants to feel more in control around food and resulted in improved metabolic rates. In fact, the mindfulness participants showed an increase in their insulin sensitivity independent of changes in weight, suggesting that some aspect of the mindfulness treatment impacted the way the body metabolizes food in addition to impacting the way that participants eat. Final results of this study are expected to be published in the coming year.

"Over the course of this study, participants reduced the frequency of their binges from an average of four times a week to once a week, and the improvement was maintained for at least four months afterward," Wolever said. "Those who incorporated mindfulness techniques improved their ability to use insulin and metabolized their food better."

Duke Integrative Medicine's Mindful Eating Program includes basic meditation training and guided eating exercises related to the awareness of hunger and fullness and taste-specific satiety. It also addresses underlying problems in the self-regulation of food intake by helping patients tease out hunger and non-hunger reasons for eating. Much of this work is based on the application of mindfulness behavior to develop intrinsic skills and motivation.

The program combines established techniques with innovative approaches. For example, one of the objectives of the program is to help participants define what they want for their futures, and each is encouraged to develop a personal mission statement to reflect these desires. As patients are taught to make changes in the present moment, they begin to understand how their choices will ultimately have direct bearing on the attainment of their goals and fulfillment of their personal missions.

"Mindfulness helps people to understand the concept of reactivity and gives people skills they can use to access internal information," said Jennifer Davis, MA, LPC and Health Psychology Manager at Duke Integrative Medicine. "Whether it's a world event, an internal event or even feelings such as boredom, anger or stress, something triggers people to go on automatic pilot, and they turn to eating as a way to cope."

The effects of mindfulness treatment are being explored through research at Duke Integrative Medicine in a number of other areas, in addition to weight loss maintenance, and include applications to improve balance and decrease cardiovascular risk.

Duke Integrative Medicine's Wolever and Davis recommend following this six-step approach to mindful eating:

1. Find a calming, quiet environment in which to eat alone.

2. Create a plate that is appealing. Sit in front of the food and just look at it, noticing everything you can, as if you were an artist observing it for the first time.

3. Close your eyes and take 10 slow and easy breaths, focusing on the sensation of the breath moving in and out of the body. Observe any thoughts or emotions, without criticizing, and return your focus to the sensation of the breath.

4. Open your eyes and choose which bite to have first, being aware of how you make the choice. Look carefully at that bite, smell it, place it in your mouth and note all the flavors as you move it around. Notice any urges to swallow it.

5. Allow yourself to take one bite into the food, observing any shifts in flavor. Throughout this slow and focused process, continue to observe any thoughts or emotions that arise. Notice what they are without judging them.

6. Continue the meal in this careful way, observing all that you can about yourself and the food, and the interaction between the two.

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For more information, contact Emily Coghlan, APCO Worldwide, at 202-778-1025 or visit www.dukeintegrativemedicine.org.

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