Mindfulness Based Interventions for Eating Disorders

The recent death at 38 of Big Brother star Nikki Grahame sadly highlights how those living with anorexia are prone to relapse.  Nikki tried very hard overcome her anorexia.  Yet despite support from her family and friends – and from well-wishers who raised tens of thousands of pounds for her treatment – she was unable to avoid further episodes.

This sad news made me wonder about the possibility of mindfulness being used to enable people to avoid compulsive habits like eating disorders.

I found a 2020 paper from University College London which describes a systematic review of randomised controlled trials (RCTs) on this subject:  “Effects of Mindfulness-Based Intervention on the Treatment of Problematic Eating Behaviors: A Systematic Review” by Yu et al and published in the Journal of Alternative and Complementary Medicine. (Here)

The research identified RCTs investigating the impact of Mindfulness Based Interventions on eating disorders.  Nine out of 426 studies met the quality criteria of the review.  In the majority of qualifying studies, participants in “Mindfulness Based Intervention groups” showed a significant reduction in emotional eating (eating in response to emotional events), external eating (overeating because of availability or adjacency of food), binge eating, and weight and shape concern.

The studies suggested that increasing “mindful awareness of internal experiences” improved self-acceptance and emotional regulation, thereby reducing the problematic eating behaviours.  I.e. subjects became less preoccupied with their body-shape and more able to set aside emotions or negative thoughts… and hence less likely to adopt problematic behaviours.

So, Mindfulness Based Interventions can enhance the individual’s self-acceptance and reduce negativity relating to body appearance through self-criticism and judgment that may trigger uncontrolled eating; and in fact previous research has shown that although mindfulness is not primarily focused on helping people to reach their ideal body shape, it does encourage people to accept their present state and to worry less about it.

However, the results were not so promising for excessive dieting.  Six of the studies included measures of “restrained eating behaviour”. Some of these studies found an increase in dietary restraint within Mindfulness Based Intervention groups as distinct from control groups.

Why should this be? It might be that “restrained eating” has both external and internal drivers, while the MBIs may be more effective in promoting internal awareness and self-regulation they did not address the external drivers for such behaviour.  Personally, I worry that some participants were able to use mindfulness techniques to set aside hunger pangs and thoughts of food – such that mindfulness skills may be a tool that can assist such dysfunctional behaviour.  My own conclusion is that those with anorexia require speciality counselling and should not embark on casual mindfulness interventions.

Overall, the researchers conclude: “Mindfulness practices can boost self-regulation, improve the ability to tolerate distress, and deter psychologically induced dysfunctional behaviours, thereby reducing the amount of problematic eating behaviours.”

So, if someone is prone to overeating, “emotional eating” or “external eating” then mindfulness will help.  It will help people to be lees concerned about body shape and self-image.  Yet where someone is prone to restricting their eating then specialist help should be sought.

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