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Mindful Eating, General Mindful Awareness, and Acceptance as Predictors of Weight Loss

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Abstract

Objectives

The goal of the present study was to determine whether baseline mindful eating, general mindful awareness, or acceptance was most strongly associated with short- and long-term weight loss in a lifestyle modification program.

Methods

Data were from 178 participants (baseline BMI = 40.9 ± 5.9 kg/m2, age = 44.2 ± 11.2 years; 87.6% female; 71.3% black) who enrolled in a two-phase trial. All participants attended an initial 14-week lifestyle modification program that included a meal replacement diet. Participants who had lost ≥ 5% of initial weight (N = 137) were then randomized to 52 weeks of lifestyle modification with lorcaserin or placebo. Linear mixed models examined whether mindful eating (Mindful Eating Questionnaire) and general mindful awareness and acceptance (Philadelphia Mindfulness Scale) predicted short-term weight loss at week 14 in the full sample and long-term weight loss at the end of the trial in the subsample of randomized participants.

Results

In the full sample, higher baseline acceptance predicted greater short-term weight losses (p = 0.004). At week 14, individuals low in acceptance (− 1SD) lost an average of 8.7 kg (SE = 0.6) compared with 11.2 kg (SE = 0.6) among those high in acceptance (+ 1SD). In the subsample of participants who successfully lost weight in phase 1, the independent effect of acceptance on total losses at the end of the trial did not reach statistical significance (p = 0.058). Neither mindful eating nor general mindful awareness independently predicted weight loss at either time point.

Conclusions

Acceptance was a stronger predictor than either general or eating-specific awareness of weight loss with lifestyle modification.

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Data Accessibility

The raw data supporting the conclusions of this manuscript will be made available by the authors, without undue reservation, to any qualified researcher for the purpose of replicating the analyses reported in the present manuscript. The datasets for this manuscript are not publicly available because the research team has not yet completed initial data analyses. Requests to access the datasets should be directed to Dr. Thomas Wadden (wadden@pennmedicine.upenn.edu).

Funding

This research was supported by an Investigator-Initiated Study award (Wadden) from Eisai Inc. Dr. Tronieri was supported, in part, by a K23 Mentored Patient Oriented Research Award (K23DK116935) from the National Institutes of Health (NIH)/National Institute of Diabetes Digestive and Kidney Disease. Dr. Pearl’s collaboration was supported in part by a K23 Award from the NIH/National Heart, Lung, and Blood Institute (K23HL140176). Dr. Chao was supported in part by the National Institute of Nursing Research of the NIH (K23NR017209).

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Authors

Contributions

JST provided trial oversight, organized the database, performed the statistical analysis, and wrote the first draft of the present manuscript. TAW was responsible for the conception and design of the parent randomized controlled trial and provided trial oversight. RLP provided behavioral weight loss treatment, and RIB, NA, and AMC provided medical monitoring to patients during the randomized trial. All authors contributed to manuscript revision and read and approved the submitted version.

Corresponding author

Correspondence to Jena S. Tronieri.

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Conflict of Interest

JST and NA have served as consultants to Novo Nordisk. TAW reports serving on advisory boards for Novo Nordisk and WW (Weight Watchers). RIB serves as a consultant to Eisai Pharmaceutical, and AMC has consulted with Shire Pharmaceutical. The other authors declare no conflict of interest.

Ethical Approval

This study was approved by Institutional Review Board at the University of Pennsylvania and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All participants provided informed consent prior to their inclusion in the study.

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Tronieri, J.S., Wadden, T.A., Pearl, R.L. et al. Mindful Eating, General Mindful Awareness, and Acceptance as Predictors of Weight Loss. Mindfulness 11, 2818–2827 (2020). https://doi.org/10.1007/s12671-020-01493-5

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