A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms

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Introduction

Excessive body weight is one of the most challenging public health issues of our time⁽¹⁾. Our relationship with food is important; a recent UK report on securing a positive 'Food Future' indicated that consumers feel a loss of connection with food that should be preserved⁽²⁾. Problematic food and eating behaviours, for example binge and emotional eating, have been characterised in obesity. In mindfulness, an individual observes their immediate experience using an open and non-judgemental stance⁽³⁾. One of the modern-day pioneers of mindfulness is Jon Kabat Zinn who developed the Mindfulness-Based Stress Reduction (MBSR) programme which is used in mainstream medicine internationally, particularly in the management of depression⁽⁴⁾. Recent reviews have examined the evidence for mindfulness in the management of pain^(5,6), depression^(7,8)and psychological well-being^(9,10).

In relation to eating behaviours, research began into the use of mindfulness in binge eating with early interventions in the late 1990s when Kristeller & Hallet⁽¹¹⁾undertook a pilot study among obese women with binge eating disorder using Mindfulness-Based Eating Awareness Training (MB-EAT). This intervention was later developed for obese populations with or without binge eating disorder⁽¹²⁾. In recent years there has been increased interest in using mindfulness and mindful eating in obese/overweight and normal-weight populations.

Mindful eating consists of making conscious food choices, developing an awareness of physical v. psychological hunger and satiety cues⁽¹³⁾, and eating healthfully in response to those cues⁽¹⁴⁾. It is conceptualised as being aware of the present moment when one is eating⁽¹⁵⁾, paying close attention to the effect of the food on the senses, and noting the physical and emotional sensations in response to eating⁽¹⁶⁾. There is no universal definition of mindful eating but these principles are consistent in the literature.

Intuitive eating is a discreet, but complementary term, often used interchangeably with mindful eating. Intuitive eating was originally defined by two US Registered Dietitians in 1995⁽¹⁷