Theoretically driven smartphone-delivered behavioral interventions that target mechanisms underlying eating behavior are lacking. In this study, we administered a 28-day self-paced smartphone-delivered intervention rooted in an operant conditioning theoretical framework that targets craving-related eating using mindful eating practices. At pre-intervention and 1-month post-intervention, we assessed food cravings among adult overweight or obese women (N = 104; M age = 46.2 ± 14.1 years; M BMI = 31.5 ± 4.5) using ecological momentary assessment via text message (SMS), self-reported eating behavior (e.g., trait food craving), and in-person weight. Seventy-eight participants (75.0%) completed the intervention within 7 months (‘all completers’), and of these, 64 completed the intervention within 3 months (‘timely completers’). Participants experienced significant reductions in craving-related eating (40.21% reduction; p < .001) and self-reported overeating behavior (trait food craving, p < .001; other measures ps < .01). Reductions in trait food craving were significantly correlated with weight loss for timely completers (r = .30, p = .020), this pattern of results was also evident in all completers (r = .22, p = .065). Taken together, results suggest that smartphone-delivered mindful eating training targeting craving-related eating may (1) target behavior that impacts a relative metabolic pathway, and (2) represent a low-burden and highly disseminable method to reduce problematic overeating among overweight individuals.
ClinicalTrials.gov registration: NCT02694731.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Adam, T. C., & Epel, E. S. (2007). Stress, eating and the reward system. Physiology & Behavior, 91, 449–458.
Allman-Farinelli, M., Partridge, S. R., McGeechan, K., Balestracci, K., Hebden, L., Wong, A., et al. (2016). A mobile health lifestyle program for prevention of weight gain in young adults (TXT2BFiT): Nine-month outcomes of a randomized controlled trial. JMIR mHealth and uHealth, 4, e78.
Baker, R. C., & Kirschenbaum, D. S. (1993). Self-monitoring may be necessary for successful weight control. Behavior Therapy, 24, 377–394.
Bauer, U. E., Briss, P. A., Goodman, R. A., & Bowman, B. A. (2014). Prevention of chronic disease in the 21st century: Elimination of the leading preventable causes of premature death and disability in the USA. The Lancet, 384, 45–52.
Bennett, G. G., Steinberg, D. M., Stoute, C., Lanpher, M., Lane, I., Askew, S., et al. (2014). Electronic health (eHealth) interventions for weight management among racial/ethnic minority adults: A systematic review. Obesity Reviews, 15, 146–158.
Berkman, E. T., Giuliani, N. R., & Pruitt, A. K. (2014). Comparison of text messaging and paper-and-pencil for ecological momentary assessment of food craving and intake. Appetite, 81, 131–137.
Bland, J. M., & Altman, D. G. (1997). Statistics notes: Cronbach’s alpha. BMJ, 314, 572.
Bogg, T., & Roberts, B. W. (2013). The case for conscientiousness: Evidence and implications for a personality trait marker of health and longevity. Annals of Behavioral Medicine, 45, 278–288.
Boggiano, M. M. (2016). Palatable eating motives scale in a college population: Distribution of scores and scores associated with greater BMI and binge-eating. Eating Behaviors, 21, 95–98.
Boggiano, M. M., Wenger, L. E., Turan, B., Tatum, M. M., Morgan, P. R., & Sylvester, M. D. (2015a). Eating tasty food to cope. Longitudinal association with BMI. Appetite, 87, 365–370.
Boggiano, M., Wenger, L. E., Turan, B., Tatum, M. M., Sylvester, M. D., Morgan, P. R., et al. (2015b). Real-time sampling of reasons for hedonic food consumption: Further validation of the palatable eating motives scale. Name: Frontiers in Psychology, 6, 1–8.
Brewer, J. A., Elwafi, H. M., & Davis, J. H. (2013). Craving to quit: Psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychology of Addictive Behaviors, 27, 366–379.
Brewer, J. A., Mallik, S., Babuscio, T. A., Nich, C., Johnson, H. E., Deleone, C. M., et al. (2011). Mindfulness training for smoking cessation: Results from a randomized controlled trial. Drug and Alcohol Dependence, 119, 72–80.
Brewer, J. A., Sinha, R., Chen, J. A., Michalsen, R. N., Babuscio, T. A., Nich, C., et al. (2009). Mindfulness training and stress reactivity in substance abuse: Results from a randomized, controlled stage I pilot study. Substance Abuse, 30, 306–317.
Brindal, E., Hendrie, G., Freyne, J., Coombe, M., Berkovsky, S., & Noakes, M. (2013). Design and pilot results of a mobile phone weight-loss application for women starting a meal replacement programme. Journal of Telemedicine and Telecare, 19, 166–174.
Burgess, E. E., Turan, B., Lokken, K. L., Morse, A., & Boggiano, M. M. (2014). Profiling motives behind hedonic eating: Preliminary validation of the palatable eating motives scale. Appetite, 72, 66–72.
Burke, L. E., Styn, M. A., Sereika, S. M., Conroy, M. B., Ye, L., Glanz, K., et al. (2012). Using mhealth technology to enhance self-monitoring for weight loss: A randomized trial. American Journal of Preventive Medicine, 43, 20–26.
Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-monitoring in weight loss: A systematic review of the literature. Journal of the American Dietetic Association, 111, 92–102.
Buscemi, J., Rybak, T. M., Berlin, K. S., Murphy, J. G., & Raynor, H. A. (2017). Impact of food craving and calorie intake on body mass index (BMI) changes during an 18-month behavioral weight loss trial. Journal of Behavioral Medicine, 40, 565–573.
Carroll, K. M., Ball, S. A., Martino, S., Nich, C., Babuscio, T. A., & Rounsaville, B. J. (2009). Enduring effects of a computer-assisted training program for cognitive behavioral therapy: A 6-month follow-up of CBT4CBT. Drug and Alcohol Dependence, 100, 178–181.
Carter, M. C., Burley, V. J., Nykjaer, C., & Cade, J. E. (2013). Adherence to a smartphone application for weight loss compared to website and paper diary: Pilot randomized controlled trial. Journal of Medical Internet Research, 15, e32.
Chao, A., Grilo, C. M., White, M. A., & Sinha, R. (2014). Food cravings, food intake, and weight status in a community-based sample. Eating Behaviors, 15, 478–482.
Chen, F., Su, W., Becker, S. H., Payne, M., Sweet, C. M. C., Peters, A. L., et al. (2016). Clinical and economic impact of a digital, remotely-delivered intensive behavioral counseling program on Medicare beneficiaries at risk for diabetes and cardiovascular disease. PLoS ONE, 11, e0163627.
Colby, S. L., & Ortman, J. M. (2015). Projections of the size and composition of the US population: 2014 to 2060. US Census Bureau, 9, 1–13.
Cooper, M. L. (1994). Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychological Assessment, 6, 117–128.
Czajkowski, S. M., Powell, L. H., Adler, N., Naar-King, S., Reynolds, K. D., Hunter, C. M., et al. (2015). From ideas to efficacy: The ORBIT model for developing behavioral treatments for chronic diseases. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 34, 971–982.
Dalen, J., Smith, B. W., Shelley, B. M., Sloan, A. L., Leahigh, L., & Begay, D. (2010). Pilot study: Mindful Eating and Living (MEAL): Weight, eating behavior, and psychological outcomes associated with a mindfulness-based intervention for people with obesity. Complementary Therapies in Medicine, 18, 260–264.
Dallman, M. F. (2010). Stress-induced obesity and the emotional nervous system. Trends in Endocrinology and Metabolism, 21, 159–165.
Daubenmier, J., Moran, P. J., Kristeller, J., Acree, M., Bacchetti, P., Kemeny, M. E., et al. (2016). Effects of a mindfulness-based weight loss intervention in adults with obesity: A randomized clinical trial. Obesity, 24, 794–804.
Dombrowski, S. U., Knittle, K., Avenell, A., Araújo-Soares, V., & Sniehotta, F. F. (2014). Long term maintenance of weight loss with non-surgical interventions in obese adults: Systematic review and meta-analyses of randomised controlled trials. BMJ, 348, g2646. doi:10.1136/bmj.g2646.
Elwafi, H. M., Witkiewitz, K., Mallik, S., IV, IV Thornhill, T. A., & Brewer, J. A. (2013). Mindfulness training for smoking cessation: Moderation of the relationship between craving and cigarette use. Drug and Alcohol Dependence, 130, 222–229.
Epel, E., Tomiyama, A. J., Mason, A., Laraia, B. A., Hartman, W., Ready, K., et al. (2014). The reward-based eating drive scale: A self-report index of reward-based eating. PLoS ONE, 9, e101350.
Forman, E. M., & Butryn, M. L. (2015). A new look at the science of weight control: How acceptance and commitment strategies can address the challenge of self-regulation. Appetite, 84, 171–180.
Forman, E. M., Butryn, M. L., Juarascio, A. S., Bradley, L. E., Lowe, M. R., Herbert, J. D., et al. (2013). The mind your health project: A randomized controlled trial of an innovative behavioral treatment for obesity. Obesity, 21, 1119–1126.
Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., et al. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: A systematic review. PLoS Med, 10, e1001362.
Garrison, K. A., Pal, P., Rojiani, R., Dallery, J., O’Malley, S. S., & Brewer, J. A. (2015). A randomized controlled trial of smartphone-based mindfulness training for smoking cessation: A study protocol. BMC Psychiatry, 15, 83.
Gilhooly, C. H., Das, S. K., Golden, J. K., McCrory, M. A., Dallal, G. E., Saltzman, E., et al. (2007). Food cravings and energy regulation: The characteristics of craved foods and their relationship with eating behaviors and weight change during 6 months of dietary energy restriction. International Journal of Obesity, 31, 1849–1858.
Godfrey, K. M., Gallo, L. C., & Afari, N. (2015). Mindfulness-based interventions for binge eating: A systematic review and meta-analysis. Journal of Behavioral Medicine, 38, 348–362.
Greeno, C. G., & Wing, R. R. (1994). Stress-induced eating. Psychological Bulletin, 115, 444.
Hutchesson, M. J., Rollo, M. E., Krukowski, R., Ells, L., Harvey, J., Morgan, P. J., et al. (2015). eHealth interventions for the prevention and treatment of overweight and obesity in adults: A systematic review with meta-analysis. Obesity Reviews, 16, 376–392.
Kabat-Zinn, J., & Hanh, T. N. (2009). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Random House LLC.
Katterman, S. N., Kleinman, B. M., Hood, M. M., Nackers, L. M., & Corsica, J. A. (2014). Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review. Eating Behaviors, 15, 197–204.
Kearney, D. J., Milton, M. L., Malte, C. A., McDermott, K. A., Martinez, M., & Simpson, T. L. (2012). Participation in mindfulness-based stress reduction is not associated with reductions in emotional eating or uncontrolled eating. Nutrition Research, 32, 413–420.
Klasnja, P., & Pratt, W. (2012). Healthcare in the pocket: Mapping the space of mobile-phone health interventions. Journal of Biomedical Informatics, 45, 184–198.
Lachin, J. M. (1981). Introduction to sample size determination and power analysis for clinical trials. Controlled Clinical Trials, 2, 93–113.
Lowe, M. R., & Levine, A. S. (2005). Eating motives and the controversy over dieting: Eating less than needed versus less than wanted. Obesity Research, 13, 797–806.
Mason, A., & Epel, E. (2015). Craving chocolate? A review of individual differences, triggers, and assessment of food cravings. In N. Avena (Ed.), Hedonic eating. Oxford: Oxford University Press.
Mason, A., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., et al. (2016a). Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial. Appetite, 100, 86–93.
Mason, A., Epel, E. S., Kristeller, J., Moran, P. J., Dallman, M., Lustig, R. H., et al. (2016b). Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: Data from the SHINE randomized controlled trial. Journal of Behavioral Medicine, 39, 201–213.
Mason, A., Laraia, B. A., Daubenmier, J., Hecht, F. M., Lustig, R. H., Puterman, E., et al. (2015). Putting the brakes on the “drive to eat”: Pilot effects of naltrexone and reward based eating on food cravings among obese women. Eating Behaviors, 9, 53–56.
Massey, A., & Hill, A. J. (2012). Dieting and food craving. A descriptive, quasi-prospective study. Appetite, 58, 781–785.
Meule, A., Hermann, T., & Kübler, A. (2014). A short version of the Food Cravings Questionnaire—Trait: The FCQ-T-reduced. Frontiers in Psychology, 5, 1–10.
Meule, A., Richard, A., & Platte, P. (2017). Food cravings prospectively predict decreases in perceived self-regulatory success in dieting. Eating Behaviors, 24, 34–38.
Meule, A., Westenhöfer, J., & Kübler, A. (2011). Food cravings mediate the relationship between rigid, but not flexible control of eating behavior and dieting success. Appetite, 57, 582–584.
Mitchell, A., Gottfried, J., Barthel, M., & Shearer, E. (2016). 1. Pathways to news. Retrieved from http://www.journalism.org/2016/07/07/pathways-to-news/
Moritz, S., Veckenstedt, R., Andreou, C., Bohn, F., Hottenrott, B., Leighton, L., et al. (2014). Sustained and “sleeper” effects of group metacognitive training for schizophrenia: A randomized clinical trial. JAMA Psychiatry, 71, 1103–1111.
O’Reilly, G. A., Cook, L., Spruijt-Metz, D., & Black, D. S. (2014). Mindfulness-based interventions for obesity-related eating behaviours: A literature review. Obesity Reviews, 15, 453–461.
Ogden, C. L., Carroll, M. D., Fryar, C. D., & Flegal, K. M. (2015). Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief, 219, 1–8.
Pearson, E. S. (2012). Goal setting as a health behavior change strategy in overweight and obese adults: A systematic literature review examining intervention components. Patient Education and Counseling, 87, 32–42.
Potenza, M. N., & Grilo, C. (2014). How relevant is food craving to obesity and its treatment? Eating Behavior, 5, 164.
Richard, A., Meule, A., Reichenberger, J., & Blechert, J. (2017). Food cravings in everyday life: An EMA study on snack-related thoughts, cravings, and consumption. Appetite, 113, 215–223.
Serre, F., Fatseas, M., Swendsen, J., & Auriacombe, M. (2015). Ecological momentary assessment in the investigation of craving and substance use in daily life: A systematic review. Drug and Alcohol Dependence, 148, 1–20.
Skinner, B. F. (1963). Operant behavior. American Psychologist, 18, 503.
Smith, A. (2015). U.S. smartphone use in 2015. Retrieved April 3, 2015, from http://www.pewinternet.org/2015/04/01/us-smartphone-use-in-2015/
Smithson, E. F., & Hill, A. J. (2017). It is not how much you crave but what you do with it that counts: Behavioural responses to food craving during weight management. European Journal of Clinical Nutrition, 71, 625–630.
Thomas, J. G., & Wing, R. R. (2013). Health-E-Call, a smartphone-assisted behavioral obesity treatment: Pilot study. JMIR mHealth and uHealth, 1, e3.
Turner-McGrievy, G., & Tate, D. (2011). Tweets, Apps, and Pods: Results of the 6-month Mobile Pounds Off Digitally (Mobile POD) randomized weight-loss intervention among adults. Journal of Medical Internet Research, 13, e120.
van Strien, T., & Ouwens, M. A. (2003). Counterregulation in female obese emotional eaters: Schachter, Goldman, and Gordon’s (1968) test of psychosomatic theory revisited. Eating Behaviors, 3, 329–340.
Volkow, N. D., Wang, G.-J., Fowler, J. S., & Telang, F. (2008). Overlapping neuronal circuits in addiction and obesity: Evidence of systems pathology. Philosophical Transactions of the Royal Society of London B: Biological Sciences, 363, 3191–3200.
Wadden, T. A. (1993). The treatment of obesity. In A. J. Stunkard & T. A. Wadden (Eds.), Obesity: Theory and therapy (pp. 197–217). New York: Raven Press.
Wayne, N., & Ritvo, P. (2014). Smartphone-enabled health coach intervention for people with diabetes from a modest socioeconomic strata community: Single-arm longitudinal feasibility study. Journal of Medical Internet Research, 16, e149.
This study was supported by a K23 award (1K23 HL133442) from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (Ashley E. Mason); foundational funds at the UMASS Medical School (Judson A. Brewer), and by the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI Grant Number UL1 TR000004 (Ashley E. Mason). This publication’s contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Conflict of interest
Ashley E. Mason, Kinnari Jhaveri, and Michael Cohn declare that they have no conflicts of interest. Judson A. Brewer owns stock in Claritas MindSciences, the company that produced the app.
Human and animal rights and Informed consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Mason, A.E., Jhaveri, K., Cohn, M. et al. Testing a mobile mindful eating intervention targeting craving-related eating: feasibility and proof of concept. J Behav Med 41, 160–173 (2018). https://doi.org/10.1007/s10865-017-9884-5