Lately I have become very interested in the application of mindfulness to eating behaviours. Mindfulness seems to have really crept into the public conscious these days and I am forever seeing new articles on its varied applications cropping up. Although there is a danger that it is being seen as a panacea and could be viewed as a bit of a fad, my own personal experience of mindfulness has been resoundingly positive. I completed the MBSR (mindfulness based stress reduction) 8 week course a couple of years ago and can honestly say that I found it life changing. During the course we practiced mindfulness breathing exercises which help you to develop awareness and acceptance of the present moment. I found that by simply noticing moment by moment body sensations, thoughts, feelings and emotions I became more grounded and seemed to shed a lot of the general anxieties and stress I had been experiencing. At risk of sounding all hippy dippy I think the key breakthrough was realising that thoughts coming and going and are just thoughts and it’s a choice whether you jump on an emotional roller coaster and go with them. You are taught to ‘turn towards’ difficult thoughts and feelings allowing them to ‘pass through the landscape of your mind like clouds floating by in the sky’ –well quite! I know it’s not everyone’s bag but for me it’s been great.
A mindfulness based eating intervention might be a good idea for several reasons. One of the things that has struck me from my experience of working with overweight and obese patients is the number who overeat or binge due to an emotional trigger. Many of those trying to lose weight and struggling might identify themselves as ‘stress eaters’. I had a chat with a lady a while ago who had had gastric bypass surgery and lost a huge amount of weight but had found that slowly it crept back on and she had rebounded to her original size. She said to me ‘they should have operated on my brain, not my stomach’ which left me feeling quite sad as no doubt this patient has been let down by our current weight management services. So a mindful eating intervention might be useful if it helps people to recognise and find new ways of dealing with their emotional eating cues. Mindfulness may also be helpful in emotional regulation and bringing down overall anxiety and stress levels. It might also be useful for fostering self compassion. In a recent NHS-delivered weight loss group which I was visiting I became really aware of how hard people were being on themselves. There was so much negative talk about ‘being rubbish at dieting’ or negative statements around body image that I went away feeling a real heaviness about how much of a hard time people were giving themselves. At the heart of mindfulness is compassion, non-judgement and self acceptance and my personal favourite mindfulness exercise is a ‘loving kindness’ meditation where you foster compassion for all living beings, remembering that you too are a living being! And not to be too hard on yourself. An increase in compassion might also mean an increase in self esteem and overall acceptance which can help a person to feel better about themselves which might ultimately help them to feel that their health is worthwhile prioritising. Other benefits of mindful eating might be becoming more attuned to internal cues for hunger and recognising and reducing automatic eating.
How can dietitians incorporate mindfulness into their practice?
This is the question I have been grappling with. There seems to be a general feeling amongst mindfulness teachers that in order to preserve the integrity of the intervention it should be delivered by trained mindfulness professionals who have had their own professional practice for at least 2 years. I can understand this point of view, just as dietitians buckle at the thought of people taking 1 day nutrition courses and setting up shop as nutritional therapists, mindfulness teachers are also expected to adhere to a high standard of training. However, the mindfulness training courses I have seen seem to be very expensive (approx £9k!!), full of silent residential retreats (impossible with a 1 year old at home!) and the commitment seems to be at least 2 years full time. Whilst I would love to do this, I don’t feel the need to become a fully accredited mindfulness teacher rather I would just like to be able to use elements of mindfulness if working with a patient and it seemed appropriate. So, I’m not sure what the middle ground is. In the US there seems to be some ‘off the peg’ mindfulness programmes such as MB-EAT (mindfulness based eating awareness training) which will qualify dietitians to deliver a specially designed course but I have not been able to find anything of good quality in the UK. For wider dissemination of mindful eating interventions, there does seem to be a need for further research into whether they are actually effective (obviously the first priority – emerging evidence does seem very positive for short term weight reduction), who should be delivering them and how those people should be trained? I am very interested in this, and hoping to do some research into this area myself. Watch this space!
Mindfulness – a practical guide to finding peace in a frantic world– Mike Williams http://www.amazon.co.uk/Mindfulness-practical-guide-finding-frantic-ebook/dp/B004XCFJ3E/ref=sr_1_1?ie=UTF8&qid=1423064508&sr=8-1&keywords=mindfulness+mark+williams
Centre for mindful eating website http://www.thecenterformindfuleating.org/