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Kudlek L, Jones RA, Hughes C, Duschinsky R, Hill A, Richards R, Thompson M, Vincent A, Griffin SJ, Ahern AL. Experiences of emotional eating in an Acceptance and Commitment Therapy based weight management intervention (SWiM): A qualitative study. Appetite 2024; 193:107138. [PMID: 38016600 DOI: 10.1016/j.appet.2023.107138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Emotional eating is a barrier to weight management. Interventions based on Acceptance and Commitment Therapy (ACT) promote the acceptance of uncomfortable feelings, which can reduce the urge to use food as a coping mechanism. We aimed to explore how participants of an ACT-based weight management intervention (WMI) experience emotional eating and relevant intervention content. METHODS We conducted semi-structured telephone interviews with participants of a digital ACT-based guided self-help WMI. Fifteen participants were purposefully selected to represent a range of demographic characteristics and emotional eating scores. We used reflexive thematic analysis to explore experiences of emotional eating. RESULTS We generated five themes. Participants improved emotional eating by disconnecting emotions from behaviours though increased self-awareness (theme 1) and by implementing alternative coping strategies, including preparation, substitution, and acceptance (theme 2). Most participants maintained improvements in emotional eating over time but wished for more opportunities to re-engage with intervention content, including more immediate support in triggering situations (theme 3). Participants who struggled to engage with emotional eating related intervention content often displayed an external locus of control over emotional eating triggers (theme 4). The perceived usefulness of the intervention depended on participants' prior experiences of emotional eating, and was thought insufficient for participants with complex emotional experiences (theme 5). DISCUSSION This ACT-based WMI helped participants with emotional eating by improving self-awareness and teaching alternative coping strategies. Intervention developers may consider adding ongoing forms of intervention that provide both real-time and long-term support. Additionally, a better understanding of how to support people with an external locus of control and people with complex experiences of emotional eating is needed. Future research may explore ways of personalising WMIs based on participants' emotional needs.
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Affiliation(s)
- Laura Kudlek
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
| | - Rebecca A Jones
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Carly Hughes
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Robbie Duschinsky
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Hill
- Division of Psychological & Social Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Rebecca Richards
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Megan Thompson
- Obesity Voices, Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | - Ann Vincent
- Obesity Voices, Obesity Institute, Leeds Beckett University, Leeds, United Kingdom
| | - Simon J Griffin
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom; Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Amy L Ahern
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
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Loucks EB, Kronish IM, Saadeh FB, Scarpaci MM, Proulx JA, Gutman R, Britton WB, Schuman-Olivier Z. Adapted Mindfulness Training for Interoception and Adherence to the DASH Diet: A Phase 2 Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2339243. [PMID: 37917063 PMCID: PMC10623198 DOI: 10.1001/jamanetworkopen.2023.39243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/10/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Hypertension is a major cause of cardiovascular disease, and although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP), adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. Objective To evaluate the effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness and DASH adherence. Design, Setting, and Participants Parallel-group, phase 2, sequentially preregistered randomized clinical trials were conducted from June 1, 2017, to November 30, 2020. Follow-up was 6 months. Participants with elevated unattended office BP (≥120/80 mm Hg) were recruited from the population near Providence, Rhode Island. Of 348 participants assessed for eligibility, 67 did not meet inclusion criteria, 17 declined, and 63 did not enroll prior to study end date. In total, 201 participants were randomly assigned, 101 to the MB-BP program and 100 to the enhanced usual care control group, with 24 (11.9%) unavailable for follow-up. Outcome assessors and the data analyst were blinded to group allocation. Analyses were performed using intention-to-treat principles from June 1, 2022, to August 30, 2023. Interventions The 8-week MB-BP program was adapted for elevated BP, including personalized feedback, education, and mindfulness training directed to hypertension risk factors. Both MB-BP and control groups received home BP monitoring devices with instructions and options for referral to primary care physicians. The control group also received educational brochures on controlling high BP. Main Outcomes and Measures The primary outcome was Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire scores (range 0-5, with higher scores indicating greater interoceptive awareness), and the secondary outcome was DASH adherence scores assessed via a 163-item Food Frequency Questionnaire (range 0-11, with higher scores indicating improved DASH adherence), all compared using regression analyses. Results Among 201 participants, 118 (58.7%) were female, 163 (81.1%) were non-Hispanic White, and the mean (SD) age was 60.0 (12.2) years. The MB-BP program increased the MAIA score by 0.54 points (95% CI, 0.35-0.74 points; P < .001; Cohen d = 0.45) at 6 months vs control. In participants with poor baseline DASH adherence, the MB-BP program also significantly increased the DASH score by 0.62 points (95% CI, 0.13-1.11 points; P = .01; Cohen d = 0.71) at 6 months vs controls. The intervention was also associated with a 0.34-point improvement in the DASH diet score in all MB-BP participants from baseline (95% CI, 0.09-0.59 points; P = .01; Cohen d = 0.27), while the control group showed a -0.04 point change in DASH diet score from baseline to 6 months (95% CI, -0.31 to 0.24 points; P = .78; Cohen d = -0.03). Conclusions and Relevance A mindfulness program adapted to improving health behaviors to lower BP improved interoceptive awareness and DASH adherence. The MB-BP program could support DASH dietary adherence in adults with elevated BP. Clinical Trial Registration ClinicalTrials.gov Identifiers: NCT03859076 and NCT03256890.
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Affiliation(s)
- Eric B. Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Ian M. Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, New York
| | - Frances B. Saadeh
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, Rhode Island
| | - Jeffrey A. Proulx
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, Rhode Island
- Mindfulness Center at Brown University, Providence, Rhode Island
| | - Roee Gutman
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island
| | - Willoughby B. Britton
- Mindfulness Center at Brown University, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Mindfulness and Compassion, Cambridge, Massachusetts
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Loucks EB, Kronish IM, Saadeh FB, Scarpaci MM, Proulx JA, Gutman R, Britton WB, Schuman-Olivier Z. Effects of Adapted Mindfulness Training on Interoception and Adherence to the Dietary Approaches to Stop Hypertension (DASH) Diet: The MB-BP Randomized Clinical Trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.10.23289818. [PMID: 37292774 PMCID: PMC10246061 DOI: 10.1101/2023.05.10.23289818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Hypertension is a major cause of cardiovascular disease. The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP). However, adherence is typically low. Mindfulness training adapted to improving health behaviors that lower BP could improve DASH adherence, in part through improved interoceptive awareness relevant to dietary consumption. The primary objective of the MB-BP trial was to evaluate effects of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on interoceptive awareness. Secondary objectives assessed whether MB-BP impacts DASH adherence, and explored whether interoceptive awareness mediates DASH dietary changes. Methods Parallel-group phase 2 randomized clinical trial conducted from June 2017-November 2020 with 6 months follow-up. Data analyst was blinded to group allocation. Participants had elevated unattended office BP (≥120/80 mmHg). We randomized 201 participants to MB-BP (n=101) or enhanced usual care control (n=100). Loss-to-follow-up was 11.9%. Outcomes were the Multidimensional Assessment of Interoceptive Awareness (MAIA; range 0-5) score, and the DASH adherence score (range 0-11) assessed via a 163-item Food Frequency Questionnaire. Results Participants were 58.7% female, 81.1% non-Hispanic white, with mean age 59.5 years. Regression analyses demonstrated that MB-BP increased the MAIA score by 0.54 (95% CI: 0.35,0.74; p<.0001) at 6 months follow-up vs. control. MB-BP increased the DASH score by 0.62 (95% CI: 0.13,1.11; p=0.01) at 6 months vs. control, in participants with poor DASH adherence at baseline. Conclusions A mindfulness training program adapted to improving health behaviors that lower BP improved interoceptive awareness and DASH adherence. MB-BP could support DASH dietary adherence in adults with elevated BP. Clinical Trial Registration Clinicaltrials.gov identifier NCT03859076 (https://clinicaltrials.gov/ct2/show/NCT03859076; MAIA) and NCT03256890 (https://clinicaltrials.gov/ct2/show/NCT03256890; DASH diet adherence).
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Affiliation(s)
- Eric B Loucks
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Frances B Saadeh
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Matthew M Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University School of Public Health, RI, USA
| | - Jeffrey A Proulx
- Department of Behavioral Sciences, Brown University School of Public Health, Providence, RI, USA
- Mindfulness Center at Brown University, Providence, RI, USA
| | - Roee Gutman
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Willoughby B Britton
- Mindfulness Center at Brown University, Providence, RI, USA
- Department of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Zev Schuman-Olivier
- Cambridge Health Alliance, Cambridge, MA, USA
- Harvard Medical School, Boston, MA, USA
- Center for Mindfulness and Compassion, Cambridge, MA, USA
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Prevention and early intervention in eating disorders: findings from a rapid review. J Eat Disord 2023; 11:38. [PMID: 36899428 PMCID: PMC9999654 DOI: 10.1186/s40337-023-00758-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/19/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Eating disorders (EDs) are complex psychological disorders, with low rates of detection and early intervention. They can lead to significant mental and physical health complications, especially if intervention is delayed. Given high rates of morbidity and mortality, low treatment uptake, and significant rates of relapse, it is important to examine prevention, early intervention, and early recognition initiatives. The aim of this review is to identify and evaluate literature on preventative and early intervention programs in EDs. METHODS This paper is one of a series of Rapid Reviews, designed to inform the Australian National Eating Disorders Research and Translation Strategy 2021-2031, funded, and released by the Australian Government. To provide a current and rigorous review, peer-reviewed articles between 2009 and 2021 published in English were searched across three databases: ScienceDirect, PubMed and Ovid/Medline. Priority was given to high-level evidence including meta-analyses, systematic reviews, Randomised Control Trials, and large population studies. Findings from selected studies pertaining to prevention and early intervention in EDs were evaluated and are presented in this review. RESULTS In total, 130 studies were identified in the current review, 72% relating to prevention and 28% to early intervention. Most programs were theory-driven and targeted one or more ED risk factors such as thin-ideal internalisation and/or body dissatisfaction. There is reasonable evidence to support prevention programs reducing risk factors, particularly as part of school or university-based programs, with established feasibility and relatively high acceptance among students. There is increasing evidence around the use of technology (to increase dissemination potential) and for use of mindfulness approaches (targeting emotional resilience). Few longitudinal studies assessing incident cases following participation in a prevention program exist. CONCLUSIONS Although several prevention and early intervention programs have been shown to significantly reduce risk factors, promote symptom recognition, and encourage help-seeking behaviour, most of these studies have been conducted in older adolescent and university aged students, past the age of peak ED onset. One of the most targeted risk factors, body dissatisfaction, is found in girls as young as 6 years old, indicating a need for further research implementing prevention initiatives at younger ages. Follow-up research is limited; thus, the long-term efficacy and effectiveness of studied programs is unknown. Greater attention should be paid to the implementation of prevention and early intervention programs in identified high-risk cohorts or diverse groups, where a more targeted approach may be necessary.
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Oliveira JPT, do Carmo SG, Aragão BDA, Cunha J, Botelho PB. Meditation practices and their relationship with eating behavior, weight changes, and mental health in adults from different regions of Brazil: A cross-sectional study. Nutrition 2023; 109:111972. [PMID: 36753914 DOI: 10.1016/j.nut.2023.111972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/19/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effect of different meditation practices on eating behavior, changes in body weight, and mental health. METHODS A virtual questionnaire was used to evaluate meditation practices and current and prepandemic weights. The questionnaire comprised specific and validated instruments to evaluate body image (silhouette scale), eating behavior (21-item three-factor eating questionnaire), current sleep quality (Pittsburgh Sleep Quality Index), and anxiety (Beck Anxiety Inventory). Initially, data from all the respondents were assessed (n = 764). Mindfulness was the most common type of meditation practice in most Brazilian regions. RESULTS Lower scores in uncontrolled eating (meditation practitioners = 32.19 ± 19.72 and non-meditation practitioners = 35.17 ± 20.50; P = 0.038) and higher weight loss (meditation practitioners = -0.77 ± 8.44 and non-meditation practitioners = 1.29 ± 6.39; P = 0.013) were observed among those who practiced some type of meditation. To verify the influence of weight, we analyzed the data of individuals who had body mass index ≥25 kg/m²; overweight individuals presented lower uncontrolled eating scores when they practiced meditation. However, no statistical difference was observed between meditation practitioners and non-practitioners when only adequate weight individuals were evaluated. The practice also influenced the perception of body image among men and resulted in lower uncontrolled eating scores on the 21-item three-factor eating questionnaire and greater weight loss during the pandemic among women. Those practicing meditation for >13 mo had a lower final score on the anxiety assessment instrument compared with those practicing for <12 mo (P = 0.002). CONCLUSIONS The findings indicate that the inclusion of meditation practice as part of the management of overweight may reduce dysfunctional eating behaviors and negative emotions, thereby contributing to weight loss, especially in the long term.
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Affiliation(s)
| | - Simone Gonzaga do Carmo
- Department of Nutrition, Faculty of Health Science, University of Brasília, Brasília, Brazil.
| | - Bruna de Almeida Aragão
- Department of Nutrition, Faculty of Health Science, University of Brasília, Brasília, Brazil
| | - Juliana Cunha
- Faculty of Nutrition, Federal University of Goias, Goiânia, GO, Brazil
| | - Patrícia Borges Botelho
- Department of Nutrition, Faculty of Health Science, University of Brasília, Brasília, Brazil
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Salvo V, Schveitzer MC, Sanudo A, Favarato ML, Demarzo M. Exploring perceptions about Mindfulness and Mindful Eating Programs for low-income women with overweight in primary health care. Nutr Health 2022; 29:319-329. [PMID: 35138182 DOI: 10.1177/02601060221075537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Obesity and overweight are public health problems of multifactorial etiology, aggravated by the challenge that is maintaining weight loss. Used in the context of general health, mindfulness-based interventions (MBIs) have also showed positive effects when targeting changes to overweight-related eating behaviors. Methods: This study consists of a pragmatic randomized controlled trial conducted with 284 women from primary health care units. Data were collected from the last session with 16 focus groups, considering each intervention group (mindfulness or mindful eating) Aim: This article aims to present the perceptions of low-income overweight women who participated in Mindfulness and Mindful Eating intervention groups in primary health care according to each type of intervention. Results: Seven themes were identified: course challenges; valorization of the teacher's attitudes; mindfulness understanding; self-awareness development; change of expectations; development of a different food-weight relationship; and discover of a wide range of benefits. Conclusion: Mindfulness and Mindful eating interventions affect not only an individual's relationship with body and food, but also life and human relations. The results indicate the feasibility of the intervention, which addresses a large number of patients who lack treatment options for overweight or emotional and psychological issues associated with this condition. MBIs such as mindful eating are applicable in primary health care facilities, targeting overweight women and supporting treatment by addressing a repressed demand in the system. Similar to mind-body therapies, these interventions allow for comprehensive care.ClinicalTrials.gov, (NCT02893150) on 30 March 2017.
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Affiliation(s)
- Vera Salvo
- 28105Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariana Cabral Schveitzer
- Department of Preventive Medicine, 28105Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Adriana Sanudo
- Department of Preventive Medicine, 28105Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria Lucia Favarato
- 28105Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo Demarzo
- 28105Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Ghafouri S, Abdollahi A, Suksatan W, Chupradit S, Asmundson AJN, Thangavelu L. Psychometric comparison of the Persian Salzburg Emotional Eating Scale and Emotional Eater Questionnaire among Iranian adults. J Eat Disord 2022; 10:17. [PMID: 35123581 PMCID: PMC8817508 DOI: 10.1186/s40337-022-00541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/24/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Salzburg Emotional Eating Scale (SEES) and the Emotional Eater Questionnaire (EEQ) are self-reported measures developed to evaluate emotional eating in adults in Western countries. To date, the psychometric properties of the SEES and the EEQ have not been studied among Iranian adults. The aim of the current study is to translate the SEES and the EEQ from English to Persian and examine the psychometric properties of the SEES and EEQ. METHOD The sample of this study comprised of 489 Iranian adults who completed the SEES and the EEQ questionnaires online. RESULTS Findings of face, content, and construct validity tests confirmed that the SEES and the EEQ had acceptable validity and appropriate reliability. The results from confirmatory factor analysis showed acceptable goodness-of-fit indices for two measures. CONCLUSION Results of Average Variance Extracted, Construct Reliability, and goodness-of-fit indices showed that the SEES was better for evaluating emotional eating among Iranian adults than the EEQ.
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Affiliation(s)
- Sahar Ghafouri
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Abbas Abdollahi
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Supat Chupradit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | | | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Science, Saveetha University, Chennai, India
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Negative Mood and Food Craving Strength Among Women with Overweight: Implications for Targeting Mechanisms Using a Mindful Eating Intervention. Mindfulness (N Y) 2021; 12:2997-3010. [PMID: 34584574 PMCID: PMC8460847 DOI: 10.1007/s12671-021-01760-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 12/20/2022]
Abstract
Objectives When experiencing negative mood, people often eat to improve their mood. A learned association between mood and eating may cultivate frequent food cravings, detracting from health goals. Training in mindful eating may target this cycle of emotion-craving-eating by teaching individuals to manage urges when experiencing negative mood. We examined the impact of a mobile mindful eating intervention on the link between negative mood and food cravings among overweight women. Methods In a single-arm trial, participants (n = 64, M age = 46.1 years, M BMI = 31.5 kg/m2) completed ecological momentary assessments of negative mood and food cravings 3 times/day for 3 days pre- and post-intervention, as well as 1-month post-intervention. Using multilevel linear regression, we compared associations between negative mood and food craving strength at pre- vs. post-intervention (model 1) and post-intervention vs. 1-month follow-up (model 2). Results In model 1, negative mood interacted with time point (β = − .20, SE = .09, p = .02, 95% CI [− .38, − .03]) to predict craving strength, indicating that the within-person association between negative mood and craving strength was significantly weaker at post-intervention (β = 0.18) relative to pre-intervention (β = 0.38). In model 2, negative mood did not interact with time point to predict craving strength (β = .13, SE = .09, p = .10, 95% CI − .03, .31]); the association did not significantly differ between post-intervention and 1-month follow-up. Conclusions Training in mindful eating weakened the mood-craving association from pre- to post-intervention. The weakened association remained at follow-up. Our findings highlight the mood-craving link as a target-worthy mechanism of mindful eating that should be assessed in clinical trials. Trial Registration NCT02694731 Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01760-z.
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