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Eating with Wisdom: Cultivating Mindful Eating. Jean L. Kristeller, Ph.D. Center for the Study of Health, Religion, and Spirituality The Center for Mindful Eating www.tcme.org Dept. Of Psychology, Indiana State University j-kristeller@indstate.edu. Acknowledgments.

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eating with wisdom cultivating mindful eating

Eating with Wisdom:Cultivating Mindful Eating

Jean L. Kristeller, Ph.D.

Center for the Study of Health, Religion, and Spirituality

The Center for Mindful Eating

www.tcme.org

Dept. Of Psychology, Indiana State University

j-kristeller@indstate.edu

slide2

Acknowledgments

Indiana State UniversityBrendan Hallett, Psy.D. and Virgil Sheets, Ph.D.Juli Buchanan, M.A., Brandy Dean, M.A., and Janis Leigh, B.A.

Duke UniversityRuth Quillian-Wolever, Ph.D. Sasha Loring, M.S.W., Jennifer Davis, M.S., and Jennifer Best, Ph.D.

Richard Surwit, Ph.D. and Richard Liebowitz, M.D.

slide8

MINDFULNESS: a cognitive state, marked by attentional stability, that disengages habitual reactions and allows for inner wisdom to emerge.

meditation mechanisms and misunderstandings
Meditation:Mechanisms and Misunderstandings
  • Meditation is NOT primarily a trance state.
  • Meditation is NOT primarily a relaxation tool.
  • Meditation is FUNDAMENTALLY a cognitive-attentional process that promotes self-regulation.
  • It has potential effects across MULTIPLE DOMAINS of psychological functioning: cognitive, physiological, emotional, behavioral, relation to self/others, and spiritual.
usual processing conditioning model eating problems
Usual Processing: Conditioning Model & Eating Problems

Usual Thoughts and Experiences

Conditioning ~~ Survival ~~ Attachment/Avoidance

XX

Cognition/Attention

Emotions

Self/Others

Physiology/Health

Spiritual

Behavior

the six domain model eating mindlessly
The Six Domain Model: Eating Mindlessly
  • Cognitive: Preoccupation with food/eating; black and white thinking.
  • Physiological: 1) hyper-reactivity around food. 2) Disconnect from normal hunger and satiation cues.
  • Emotional: Depression; craving; anxiety.
  • Behavioral: Binge eating; highly conditioned responses to food; general overeating.
  • Relationship to Self/Others: Poor self-acceptance; self-hatred; anger at others; over-valuing thinness.
  • Spiritual: No wise eating; spirituality does not engage honoring body; value and meaning attached to food abundance.
psychiatric criteria for binge eating disorder dsm iv
Psychiatric Criteria for Binge Eating Disorder (DSM-IV)
  • Recurrent binges, characterized by:
    • Eating, in a discrete period of time, much more than most people would eat.
    • A sense of lack of control during the episode.
  • At least two episodes of binge eating per week for six months.
  • Associated with eating more rapidly, eating until uncomfortably full, eating without being physically hungry &/or feeling very guilty or depressed afterwards.
  • Marked distress regarding binge eating.
3500 kcalories overeating vs bingeing
Overeating Pattern

Time KCal

7 am 2 eggs, bacon

2 slices toast

OJ 450

10 am Doughnut 150

Noon Whopper

Medium Fries 1130

6 pm 6 oz. Steak

Baked potato

2 vegies, roll

Apple pie 1320

10 pm 2 oz. Doritos

1 beer 450

TOTAL 3500

Bingeing Pattern

Kcal

Cereal/milk

OJ 260

Salad/diet dressing

Roll

Diet Coke 300

3 oz steak

Baked potato

2 vegies 500

2 pieces Apple pie

7 oz. Doritos

1 pint ice cream 2440

TOTAL 3500

3500 KCalories: Overeating vs. Bingeing
mb eat mindfulness based eating awareness training
MB-EAT:Mindfulness-Based Eating Awareness Training
  • Mindfulness meditation
  • Eating experience meditations:
    • Awareness of binge triggers
    • Awareness of hunger
    • Awareness of satiety (taste-specific, fullness)
  • Food-related meditations: raisin, chocolate, cheese/crackers, pot luck meal/buffet.
  • Mini-meditations with daily meals and snacks.
  • Forgiveness and wisdom meditations
  • Homework: meditation practice, mindful eating.
mb eat outline of sessions
MB-EAT: Outline of Sessions
  • Introduction to mindfulness meditation. Mindfully eating a raisin.
  • Introduction to “mini-meditation”. Mindfully eating cheese and crackers.
  • Binge trigger meditation. Mindfully eating sweet, high fat food.
  • Hunger Signals meditation (physical vs. emotional hunger).
  • Taste-Specific Satiation Signals meditation. Chips and cookies.
  • Stomach Fullness Satiety meditation. Pot luck meal.
  • Forgiveness meditation.
  • Wisdom meditation.
  • Have others noticed?; where do you go from here?
nih trial
NIH Trial
  • NCCAM-funded randomized clinical trial with 3 groups: Meditation-based; Psycho-educational; Waiting List.
  • Two-site design (ISU and Duke).
  • 9 week manualized intervention
  • 1 and 4 month followups
  • More extensive measures including process measures and change in biological markers of self-regulation (lipid and metabolic profiles)
sample
Sample
  • Sample size: N = 150 evaluated on all baseline measures; 14% men.
  • Approximately 14% African-American recruitment
  • Average age = 47.5; Avg. Wt. = 240 lbs.; Avg. BMI = 39.
treatment effects on the three factor questionnaire disinhibition
Treatment Effects on the Three Factor Questionnaire: Disinhibition

p<.001

MM vs. PE: p <.01

(N =85)

results in relation to the multi domain model
Results in Relation to the Multi-Domain Model
  • Cognitive: Disengagement from food preoccupation.
  • Physiological: Normalization of hunger and satiation cues; improvement in physiological/metabolic regulation.
  • Emotional: Decreased depression.
  • Behavioral: Decreased binging, interruption of highly conditioned responses.
  • Relationship to Self/Others: Improved self-acceptance; anecdotally, forgiveness of others.
  • Spiritual: Anecdotally, sense of connecting with the higher, wiser self; using meditation as prayer time.
slide27
Current NIH Study: MB-EAT IIMindfulness Meditation: Regulating Eating and ObesityPI: Jean L. Kristeller, Ph.D., ISU
  • NCCAM-funded randomized clinical trial with 2 groups: MB-EAT vs. Wait List Control.
  • Focus on obesity - moderately to morbidly obese (BMI>34).
  • 12 week manualized intervention with increased focus on weight loss, plus 3 month support followup.
  • 6 month total followup.