A preliminary investigation of sex differences and the mediational role of food thought suppression in the relationship between stress and weight cycling

Telehealth acceptance and commitment therapy for weight loss: Protocol of the WeLNES full scale randomized controlled trial

Behavioral interventions delivered via one-on-one telephone coaching (hereafter referred to as telehealth) for weight loss have had great population-level reach but to date limited efficacy. Acceptance and Commitment Therapy (ACT) has promise to improve behavioral weight loss treatment efficacy by addressing the fundamental challenges of weight loss and maintenance: overeating in response to internal (e.g., stress) and external (e.g., high calorie foods) cues. Here we describe the Weight Loss, Nutrition, and Exercise Study (WeLNES) randomized controlled trial that is testing the efficacy of an ACT-based telehealth coaching intervention for weight loss in comparison to a Standard Behavioral Therapy (SBT)-based telehealth coaching intervention. A total of 398 adults with overweight or obesity are being recruited and randomized to either ACT or SBT telehealth coaching. Participants in both arms are offered twenty-five telehealth coaching sessions in year one and nine booster sessions in year two. All participants receive a Bluetooth-enabled scale to self-monitor weight and a Fitbit Inspire + Fitbit app for tracking diet and physical activity. The primary aim is to determine whether a greater proportion of ACT participants will achieve a clinically significant weight loss of ≥10% compared with SBT participants at 12-months. Secondary outcomes include change in weight from baseline to 6, 12, and 24-months. Whether the effect of ACT on weight loss is mediated by ACT processes and is moderated by baseline factors will also be examined. If ACT proves efficacious, ACT telehealth coaching will offer an effective, broadly scalable weight loss treatment-thereby making a high public health impact.

A Randomized Pilot Study of a Phone-Based Mindfulness and Weight Loss Program

This study evaluated the feasibility and efficacy of integrating mindfulness training into a phone-based weight loss program to improve outcomes in those with high levels of emotional eating. Participants were 75 enrollees into an employer-sponsored weight loss program who reported high levels of overeating in response to thoughts and feelings. Seventy-five overweight and obese participants (92% female, 65% Caucasian, aged 26 to 68 years) were randomized to the new mindfulness weight loss program (n = 50) or the standard behavioral weight loss program (n = 25). Both programs consisted of 11 coaching calls with health coaches and registered dietitians with supplemental online materials. Satisfaction, engagement, and percent weight lost did not significantly differ for intervention vs. control at six months. Intervention participants had significantly better scores at six-month follow-up on mindful eating, binge eating, experiential avoidance, and one mindfulness subscale. Exploratory analyses showed that improvements on several measures predicted more weight loss in the intervention group. This pilot study found that integrating mindfulness into a brief phone-based behavioral weight loss program was feasible and acceptable to participants, but did not produce greater weight loss on average, despite hypothesized changes in mindful eating. Only one third of intervention participants reported participating in mindfulness exercises regularly. Mechanisms of change observed within the intervention group suggest that for adults with high levels of emotional eating those who embrace mindful eating and meditation may lose more weight with a mindfulness intervention.

Food Thought Suppression Inventory: Test-retest reliability and relationship to weight loss treatment outcomes

This study examined the test-retest reliability of the Food Thought Suppression Inventory (FTSI) and its relationship with weight loss during weight loss treatment. Participants were 89 adults with and without binge eating disorder (BED) recruited through primary care for weight loss treatment who completed the FTSI twice prior to starting treatment. Intra-class correlations for the FTSI ranged from .74-.93. Participants with BED scored significantly higher on the FTSI than those without BED at baseline only. Percent weight loss from baseline to mid-treatment was significantly negatively correlated with the FTSI at baseline and at post-treatment. Participants reaching 5% loss of original body weight by post-treatment had significantly lower FTSI scores at post assessment when compared to those who did not reach this weight loss goal. While baseline binge-eating episodes were significantly positively correlated with baseline FTSI scores, change in binge-eating episodes during treatment were not significantly related to FTSI scores. The FTSI showed satisfactory one week test-retest reliability. Higher levels of food thought suppression may impair individuals' ability to lose weight while receiving weight loss treatment.

When thought suppression backfires: its moderator effect on eating psychopathology

Recently, several studies have pointed the importance of thought suppression as a form of experiential avoidance in different psychopathological conditions. Thought suppression may be conceptualized as an attempt to decrease or eliminate unwanted internal experiences. However, it encloses a paradoxical nature, making those thoughts hyper accessible and placing an extra burden on individuals. This avoidance process has been associated with several psychopathological conditions. However, its role in eating psychopathology remains unclear. The present study aims to explore the moderation effect of thought suppression on the associations between body image-related unwanted internal experiences (unfavorable social comparison through physical appearance and body image dissatisfaction) and eating psychopathology severity in a sample of 211 female students. Correlational analyses showed that thought suppression is associated with psychological inflexibility and eating disorders' main risk factors and symptoms. Moreover, two independent analyses revealed that thought suppression moderates, as it amplifies, the impact of unfavorable social comparisons through physical appearance (model 1) and body image dissatisfaction (model 2) on disordered eating attitudes and behaviors. Hence, for the same level of these body-related internal experiences, young females who reveal higher levels of thought suppression present higher eating psychopathology. Taken together, these findings highlight the key role of thought suppression in eating psychopathology and present important clinical implications.

Association between Mindfulness and Weight Status in a General Population from the NutriNet-Santé Study

Background

Mindfulness is defined as non-judgmental awareness of the present moment. There is some evidence of the efficacy of mindfulness-based interventions in weight loss. However, this psychological concept has only been rarely explored in observational studies, and no study to date has examined the association between dispositional mindfulness and weight status in a large population-based sample.

Objective

We aimed to examine the relationship between mindfulness scores and weight status in a large sample of the adult general population in France.

Design and Methods

A total of 14,400 men and 49,228 women aged ≥18 y participating in the NutriNet-Santé study were included in this cross-sectional analysis. We collected mindfulness data using the Five Facet Mindfulness Questionnaire as well as self-reported weight and height. The association between weight status and dispositional mindfulness, as well as its subscales (observing, describing, acting with awareness, non-judging and non-reactivity), was assessed using multinomial logistic regression models adjusted for socio-demographic and lifestyle factors.

Results

Women with higher dispositional mindfulness scores were less likely to be overweight (excluding obesity) (OR quartile 4 vs. 1 = 0.84, 95% CI: 0.79-0.90) and obese (OR quartile 4 vs. 1 = 0.71, 95% CI: 0.65-0.78). In addition, overall, in this group, all subscales were inversely associated with weight status, with the strongest association found for the “observing” subscale. In men, higher mindfulness was associated only with lower odds of obesity (OR quartile 4 vs. 1 = 0.81 (0.69, 0.96)), and only the “observing” and “non-reactivity” subscales were significantly inversely associated with weight status.

Conclusion

Results support the interest of a shift in perspective that takes into account positive psychological and cognitive factors such as dispositional mindfulness in the investigation of obesity and its associated factors.

Examining the relationship between food thought suppression and binge eating disorder

Food thought suppression, or purposely attempting to avoid thoughts of food, is related to a number of unwanted eating- and weight-related consequences, particularly in dieting and obese individuals. Little is known about the possible significance of food thought suppression in clinical samples, particularly obese patients who binge eat. This study examined food thought suppression in 150 obese patients seeking treatment for binge eating disorder (BED). Food thought suppression was not associated with binge eating frequency or body mass index but was significantly associated with higher current levels of eating disorder psychopathology and variables pertaining to obesity, dieting, and binge eating.