Mindful Eating, General Mindful Awareness, and Acceptance as Predictors of Weight Loss
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ORIGINAL PAPER
Mindful Eating, General Mindful Awareness, and Acceptance as Predictors of Weight Loss Jena S. Tronieri 1 & Thomas A. Wadden 1 Ariana M. Chao 1,4
&
Rebecca L. Pearl 1
&
Robert I. Berkowitz 1,2
&
Naji Alamuddin 1,3 &
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objectives The goal of the present study was to determine whether baseline mindful eating, general mindful awareness, or acceptance was most strongly associated with short- and long-term weight loss in a lifestyle modification program. Methods Data were from 178 participants (baseline BMI = 40.9 ± 5.9 kg/m2, age = 44.2 ± 11.2 years; 87.6% female; 71.3% black) who enrolled in a two-phase trial. All participants attended an initial 14-week lifestyle modification program that included a meal replacement diet. Participants who had lost ≥ 5% of initial weight (N = 137) were then randomized to 52 weeks of lifestyle modification with lorcaserin or placebo. Linear mixed models examined whether mindful eating (Mindful Eating Questionnaire) and general mindful awareness and acceptance (Philadelphia Mindfulness Scale) predicted short-term weight loss at week 14 in the full sample and long-term weight loss at the end of the trial in the subsample of randomized participants. Results In the full sample, higher baseline acceptance predicted greater short-term weight losses (p = 0.004). At week 14, individuals low in acceptance (− 1SD) lost an average of 8.7 kg (SE = 0.6) compared with 11.2 kg (SE = 0.6) among those high in acceptance (+ 1SD). In the subsample of participants who successfully lost weight in phase 1, the independent effect of acceptance on total losses at the end of the trial did not reach statistical significance (p = 0.058). Neither mindful eating nor general mindful awareness independently predicted weight loss at either time point. Conclusions Acceptance was a stronger predictor than either general or eating-specific awareness of weight loss with lifestyle modification. Keywords Obesity . Weight loss . Mindfulness . Acceptance
Mindfulness interventions have been increasingly applied to the treatment of obesity in the hopes that these skills will facilitate behavior change and improve weight loss. Mindfulness can be defined as “paying attention in a particular way: on
* Jena S. Tronieri [email protected] 1
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
2
Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
3
Royal College of Surgeons, Ireland-Bahrain, Busaiteen, Bahrain
4
Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
purpose, in the present moment, and nonjudgmentally” (Kabat-Zinn 1994, p. 4) and has been operationalized as having two components: awareness and acceptance (Bishop et al. 2004; Cardaciotto et al. 2008). Awareness refers to sustained attention to the present exp
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