Academic journal article Journal of Mental Health Counseling

Mindfulness Based Approaches to Obesity and Weight Loss Maintenance

Academic journal article Journal of Mental Health Counseling

Mindfulness Based Approaches to Obesity and Weight Loss Maintenance

Article excerpt

Counselors may encounter clients who wish to make such lifestyle changes as healthy eating and weight management. Mindfulness, defined here as the practice of nonjudgmentally attending to the present moment while monitoring reactivity, has been adapted for use in treating many self-regulation disorders; mindfulness-based eating approaches support intuitive or attuned eating, an approach to weight management that helps individuals recognize internal cues in support of enhanced self-regulation. One program for developing mindfulness skills in individuals who want to maintain weight loss is the Enhancing Mindfulness for the Prevention of Weight Regain (EMPOWER) Program. Participants report changes in eating behavior, thinking patterns, emotional reactions, and physical activity and increased acceptance of personal responsibility for making choices, planning, asserting needs, and accomplishing personal goals. The article reviews key mindfulness skills for clinical practice.

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Addressing healthy eating and weight management are of increasing importance in counseling practice because the national rate of obesity in the United States has been rising rapidly for two decades (Centers for Disease Control and Prevention, 2010). Behavioral and environmental factors are believed to contribute to the epidemic. Intensive, structured behavioral programs for obesity can result in significant reductions in weight (Anderson, Konz, Frederich, & Wood, 2001). Unfortunately, maintaining that weight loss is very difficult. Body weight is a result of not just behavioral choices but also genetic, hormonal, and metabolic factors (Comuzzie, 2001; Tataranni & Ravussin, 2002). Wing and Phelan (2005) estimated that no more than 20% of individuals who lost weight during a standard behavioral weight loss program maintained the losses over time. Short-term weight loss is most often accomplished through substantial reductions in caloric intake, but successfully maintaining weight depends on different skills and lifestyle changes, such as more moderate calorie restriction and significant and sustained increases in the frequency and intensity of physical activity (Hill, Thompson, & Wyatt, 2005).

One major reason why dieters are unlikely to keep weight off is that a diet based on significant caloric restriction requires that the dieter learn to ignore somatic cues associated with hunger. Accurate perceptions of these internal cues, and appropriate responses to them, are necessary for successfully regulating eating behavior. An alternative to the dieting paradigm is the intuitive or attuned eating approach. This strategy focuses on changes in health behavior rather than on weight loss alone (Bacon, 2003; Cogan & Ernsberger, 1999; Robison, 2005); there is evidence that lifestyle changes, even without weight change, can reverse or minimize morbidities associated with obesity, among them cardiovascular disease and diabetes (Bacon, Stern, Van Loan, & Keim, 2005; Gaesser, 1999; Miller, 1999).

Self-regulation is vital to healthy lifestyle choices. Mindfulness, defined as nonjudgmentally attending to the present moment while monitoring reactivity (e.g., Kabat-Zinn, 1994), has been adapted to treat many self-regulation disorders, including substance abuse, depression, stress management, chronic pain, and self-injurious behavior (Baer, 2003; Greeson, 2009; Hofman, Sawyer, Witt, & Oh, 2010). Mindfulness and mindful eating are also proving to be useful strategies within interventions designed to create healthy lifestyle choices and support maintenance of weight loss (e.g., moderating eating behavior and exercising more). The purpose of this article is to review the literature on mindfulness-based approaches to treating eating-related disorders and then present a mindfulness-based program for preventing weight regain.

TREATMENT OF DISORDERED EATING

Theoretical Considerations

Cognitive-behavioral therapy (CBT) has been shown to be effective in treating eating disorders as well as in short-term weight loss (Cooper et al. …

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