Mindfulness: Magical Thinking or Real Outcomes?

Mindfulness has become a pop culture buzzword. Apparently, it’s useful for selling everything from beer to wellness. Headline writers tell us that mindfulness helps engineers solve problems, eases stress and depression, helps people in a war zone, and causes worry for conservative Christians. We even have a mindful brewpub nearby. But our focus is nutrition, health, and weight. And for this purpose, mindfulness certainly has a big fan club.

Despite its popularity – or perhaps because of it – we’ve often wondered: Does solid data support the almost magical expectations that some people have for mindfulness to promote healthy eating behaviors?

Late in December, the JCOEM published a study of mindfulness techniques in a tier-3 UK obesity clinic. The results were encouraging.

Improvements in Eating Behaviors

Petra Hanson and colleagues claim they have “the first evidence for clinical benefit of adopting mindfulness strategies into group sessions within the context of a tier 3 obesity management service in the UK.” Specifically, they found significant improvements in eating behaviors. Their patients also lost more weight than a retrospectively matched control group.

On the other hand, this data has important limitations. First, it was observational. The control group was assigned retrospectively – not randomized from the start. Also, the eating behaviors and weight outcomes were self-reported. So the study falls short of offering definitive evidence.

Other Encouraging Studies

We have other evidence that mindful techniques can be helpful for eating behaviors. The case for mindfulness to enhance weight loss is not hard and fast, though.

Some of the most positive results come from a well-controlled study published in 2016. Evan Forman and colleagues randomly assigned 190 patients to receive a year of either standard behavioral therapy (SBT) or acceptance-based therapy (ABT) for obesity. The ABT program used mindfulness techniques. The SBT did not.

In the SBT group, people lost 9.8 percent of their weight after a year – a good result. But the ABT group did even better, losing 13.3 percent. They also had better odds of maintaining ten percent reduction in weight at the end of the year. Other studies (here and here) have also found encouraging results for ABT.

But No Magic Bullet

However, a broader systematic review and meta-analysis of mindfulness offers reasons for caution. Alexis Ruffault and colleagues found good evidence that mindfulness helps reduce bingeing and impulsive eating. It also helps people increase their physical activity. But they did not find that mindfulness training had an effect on weight loss outcomes.

Why these different findings? Simply put, the devil is in the details. How it’s incorporated into a behavioral support program really matters. At one extreme, it’s a bit of jargon that sounds great, but has no effect. At the other, it’s carefully conceived and integrated into a sound program, like ABT.

Mindfulness is a useful tool, but it’s hardly magic. To people selling magic beans or magic mind tricks for health, we say no thanks.

Click here for more on the latest study and here for further perspective on mindful eating and weight management.

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.

January 6, 2019