Proof-of-concept testing of a mobile application-delivered mindfulness exercise for emotional eaters: RAIN delivered as a step-by-step image sequence.

Background: Over fifty percent of individuals with overweight and obesity are emotional eaters. Emotional eating can be theorized as a conditioned response to eat for reasons that are not associated with physiological hunger. We conducted this proof-of-concept study to gather evidence that a mobile app that delivers a common non-meditative mindfulness exercise called RAIN, in a step-by-step image sequence can improve emotional eating and other outcomes over a 3-week period. Methods: Forty-nine Canadian adults who self reported as emotional eaters (mean age =30.7 years) were recruited through social media and participated in a workshop in which RAIN and its use on the app were introduced. Participants were asked to use the app every time that they experienced a non-homeostatic craving to eat for three weeks. Emotional eating, reactivity to food cravings, perceived loss of control around food, distress tolerance, and eating-specific mindfulness were assessed pre- and post-intervention. Results: Improvements on all outcomes were found (r-range, -0.58 to -0.28). The feasibility of the mobile application was demonstrated by a low attrition rate (8%), high user satisfaction, and strong app engagement metrics. Conclusions: The data provide proof-of-concept evidence that a mobile app that delivers a mindfulness exercise in a step-by-step image sequence has potential to be effective and thus identifies a new approach that may reduce emotional eating in an accessible and affordable manner.

Development and Validation of the Four Facet Mindful Eating Scale (FFaMES).

OBJECTIVES: Previous mindful eating scales stress the attentional domains of eating-specific mindfulness, such as present-moment attention to homeostatic cues of hunger and satiety while discounting other important domains such as non-judgment and decentering. The purpose of the series of studies was to develop and evaluate a multifaceted mindful eating scale that assesses several domains of eating-specific mindfulness. METHODS: A multistep process was used to construct the Four Facet Mindful Eating Scale (FFaMES). Study 1 outlined the initial scale construction and the development of a novel item pool (N = 480). Study 2 examined the internal structure of the observed variables using exploratory analysis (N = 445) and confirmatory analysis in a separate sample (N = 445). Reliability and validity were assessed in Study 3 (N = 166). RESULTS: The final scale consists of 29 items with 4 factors: Non-Reactance, Non-Judgment, External Awareness, and Internal Awareness. The FFaMES demonstrated good internal consistency, retest reliability as well as preliminary convergent and divergent validity. CONCLUSIONS: Our findings provide reliability evidence and initial support for the construct validity of the FFaMES and the continued study of multiple facets of eating-specific mindfulness. Future research should continue to investigate the differential effects of various aspects of eating-specific mindfulness in the prevention and treatment of obesity and its comorbidities.

The effects of if-then plans on weight loss: results of the 24-month follow-up of the McGill CHIP Healthy Weight Program randomized controlled trial.

BACKGROUND: Current evidence suggests that some of the most effective weight loss approaches are changes in dietary and physical activity behaviors through lifestyle modification programs. The Group Lifestyle Balance (GLB) program is a group-based behavior modification program aimed at changing diet and physical activity for weight loss. It was developed to be more cost-effective and easier to disseminate than its individually administered parent program, the Diabetes Prevention Program (DPP). However, the average weight loss following participation in the GLB is only approximately 3.5%, with low long-term weight loss maintenance. PURPOSE: We aimed to optimize the weight loss outcomes of the GLB to increase the efficacy already afforded by its cost-effectiveness and ease of dissemination. We did this by integrating the habit formation tool of if-then plans into the program. This program is called the enriched GLB or the McGill Comprehensive Health Improvement (CHIP) Healthy Weight Program. Results at 3 and 12 months of participation have already been published elsewhere. They showed no between-group differences between the standard and enriched GLB but higher weight loss in both groups compared to the DPP. This paper reports the long-term weight loss maintenance data following participation in the program. METHODS: Of the 172 participants enrolled at the beginning of the study, data from 110 participants were available and analyzed at 24 months, i.e., 12 months after the end of the 12-month intervention. RESULTS: No between-group difference in weight loss maintenance was observed. Pooled results showed a significant weight regain from 12 to 24 months, i.e., an average of 7.85 lbs. of the 20.36 lbs. lost. However, participants from both groups were still 12.51lbs or 6.13% lighter at 24 months than at baseline. CONCLUSION: If-then plans did not result in a higher percentage of weight loss at 24-month follow-up compared to the standard GLB. However, at 24 months, both groups did show a maintenance of a significant portion of the weight lost at the end of intervention. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02008435, registered 6 December 2013.

The Effects of If-Then Plans on Weight Loss: Results of the McGill CHIP Healthy Weight Program Randomized Controlled Trial.

OBJECTIVE: The NIH-developed Diabetes Prevention Program (DPP) is successful in achieving clinically significant weight loss in individuals with overweight/obesity when delivered one-on-one. The group-based DPP is less effective, with average weight losses of only 3.5%. The objective of this study was to increase weight loss outcomes of the group-based DPP by integrating habit formation tools (i.e., if-then plans). This two-arm randomized controlled trial tested the efficacy of the habit formation-enhanced group-based DPP compared with the standard group-based DPP on changes in body weight (primary outcome). This study presents the 3- and 12-month results of this 24-month trial. METHODS: A total of 208 participants were randomly assigned to the standard or enhanced DPP, and 172 participated. Participants were men and women with overweight/obesity who self-reported less than 200 min/wk of exercise. RESULTS: Both groups achieved high weight losses at 3 (5.76%) and 12 (9.98%) months, with no differences between groups (χ2 < 1). Both groups improved in blood pressure and physical activity. CONCLUSIONS: If-then plans did not result in higher weight loss. Both program versions resulted in higher weight loss than the group-based DPP. This may suggest that cognitive behavioral therapy skills of the coaches (clinical psychology doctoral students) was a key factor in treatment outcome.

Daily Mindful Responding Mediates the Effect of Meditation Practice on Stress and Mood: The Role of Practice Duration and Adherence.

OBJECTIVE: Although meditation practice is an important component of many mindfulness-based interventions (MBIs), empirical findings of its effects on psychological functioning are mixed and the mechanisms for the effects remain unclear. Responding with mindfulness (i.e., returning one's attention back to a nonjudgmental, present-oriented awareness) is a fundamental skill practiced in meditations. With repeated meditation practice, this skill is thought to become internalized and be applied to one's daily life. We thus hypothesized that the extent to which individuals responded to daily events with mindfulness would mediate the effects of meditation practice (instance, duration, and adherence to instructions) on psychological well-being. METHOD: Using a daily diary methodology, we tracked the meditation practice, use of mindful responding during the day, and psychological outcomes (perceived stress, negative and positive affect) of 117 mindfulness-based stress reduction program participants. RESULTS: We found that on days when participants meditated, they responded with greater mindfulness to daily events, which accounted for the beneficial effects of meditating on psychological outcomes. Furthermore, findings suggest that on meditation days, longer and more closely adhered meditation practices were independently associated with increases in mindful responding, which in turn were associated with better psychological outcomes. CONCLUSION: These results suggest that regular, longer, and more closely adhered meditation practice is an important component of MBIs, in part because it leads to responding more mindfully in daily life, which promotes well-being.

Effectiveness of traditional meditation retreats: A systematic review and meta-analysis.

BACKGROUND: An increasing number of studies are investigating traditional meditation retreats. Very little, however, is known about their effectiveness. OBJECTIVE: To evaluate the effectiveness of meditation retreats on improving psychological outcomes in general population. DATA SOURCES: A systematic review of studies published in journals or as dissertations in PSYCINFO, PUBMED, CINAHL or Web of Science from the first available date until October 22, 2016. REVIEW METHODS: A total of 20 papers (21 studies, N=2912) were included. RESULTS: Effect-size estimates of outcomes combined suggested that traditional meditation retreats are moderately effective in pre-post analyses (n=19; Hedge's g=0.45; 95% CI [0.35, 0.54], p<0.00001) and in analyses comparing retreats to controls (n=14; Hedge's g=0.49; 95% CI [0.36, 0.61], p<0.00001). Results were maintained at follow-up. No differences were observed between meditation styles. Results suggested large effects on measures of anxiety, depression and stress, and moderate effects on measures of emotional regulation and quality of life. As to potential mechanisms of actions, results showed large effects on measures of mindfulness and compassion, and moderate effects on measures of acceptance. In addition, changes in mindfulness levels strongly moderated clinical effect sizes. However, heterogeneity was significant among trials, probably due to differences in study designs, types and duration of the retreats and assessed outcomes, limiting therefore the implications of the results. CONCLUSION: Meditation retreats are moderately to largely effective in reducing depression, anxiety, stress and in ameliorating the quality of life of participants.

How aging affects self-reports.

A lot of information used in aging research relies on self-reports. Surveys or questionnaires are used to assess quality of life, attitudes toward aging, experiences of aging, subjective well-being, symptomatology, health behaviors, financial information, medication adherence, etc. Growing evidence suggests that older and younger respondents are differentially affected by questionnaire features and the cognitive tasks that question answering pose. This research has shown that age-related changes in cognitive and communicative functioning can lead to age-related differences in self-reports that are erroneously interpreted as real age differences in attitudes and behaviors. The current review highlights how the processes underlying respondents' self-report change as a function of respondents' age; it updates our previous reviews of this literature.