A brief mindfulness-based intervention reduces eating disorder symptoms and improves eating self-efficacy and emotion regulation among adults seeking bariatric surgery

Abstract

Background Up to 64% of bariatric (weight-loss) surgery-seeking adults report eating disorder (ED) symptoms (i.e., binge eating, emotional eating, addictive-like eating, and grazing) that can interfere with surgery outcomes. Well-designed pre-surgical interventions targeting eating behaviours may reduce ED symptoms and protect against suboptimal surgery outcomes.

Objectives Provide proof-of-concept data to inform the design and optimization of a pre-surgical mindfulness-based intervention (MBI) for ED symptoms. Evaluate whether the MBI produces meaningful improvements in ED symptoms and clarify the mechanisms-of-action by which the MBI impacts ED symptoms.

Methods Twenty-one pre-surgical patients with obesity and ED symptoms referred to a MBI completed self-report measures of addictive-like eating, binge eating, emotional eating, grazing, mindful eating, eating self-efficacy, and emotion regulation pre-(T1) and post-(T2) MBI.

Results Repeated-measures ANOVAs revealed improvements in binge eating symptoms (F (1,20) = 30.38, ηp² = .60, p < .001) and grazing (F (1,20) = 7.57, ηp² = .28, p = .012), pre- to post-MBI. Adjusting for multiple comparisons, no significant improvements were found for addictive-like eating or emotional eating. Eating self-efficacy (F (1,20) = 29.70, ηp² = .60, p < .001) and emotion regulation (F (1,20) = 7.18, ηp² = .26, p = .014) improved, while mindful eating decreased (F (1,20) = 16.25, ηp² = .45, p = .001), following the MBI. Bivariate correlations found associations between improvements in the mechanism of eating self-efficacy and improvements in the ED symptom of grazing pre- to post-MBI (r = 0.46, p < .05).  As well, improvements in emotion regulation were associated with positive changes in binge and emotional eating and grazing (r = 0.55, p < .001, r = 0.66, p < .001, r = 0.61, p < .05, respectively).

Conclusions After participating in the MBI binge eating, grazing, eating self-efficacy, and emotion regulation abilities improved. Further work is needed to understand and mitigate deterioration in mindful eating. Moreover, acceptability and feasibility of the MBI should be assessed prior to testing the MBI in a large-scale efficacy trial. Future research should assess the the impact of this intervention on post-surgery weight-loss, weight-loss maintenance, and maintenance of improvements in ED symptoms.