Terra Sigillata

I’m not sure whether this story qualifies as alternative medicine or religion, or neither. I throw it out to you because I and other sci/med bloggers widely criticize the infiltration of so-called alternative medicine in our academic medical centers.

But here in today’s Health Journal section of the Wall Street Journal, Melinda Beck tells us of the application of mindfulness, a practice derived from Buddhism, to overcoming binge-eating disorders. Sure, this may be considered alternative medicine but it’s really an application of psychology under the auspices of integrative medicine:

In a randomized controlled trial at Duke and Indiana State University, binge eaters who participated in a nine-week mindful-eating program went from binging an average of four times a week to once, and reduced their levels of insulin resistance, a precursor to diabetes. More NIH-funded trials are under way to study whether mindful eating is effective for weight loss, and for helping people who have lost weight keep it off.

I cannot yet find the original literature citation for this work, but the approach may be of use for all of us who are looking to lose a couple pounds. Beck gives us her firsthand experience:

First, ask yourself how hungry you are, on a scale of 1 (ravenous) to 7 (stuffed).

Next, take time to appreciate the food on your plate. Notice the colors and textures.

Take a bite. Slowly experience the tastes on your tongue. Put down your fork and savor.

“Most people don’t think about what they’re eating — they’re focusing on the next bite,” says Sasha Loring, a psychotherapist at Duke Integrative Medicine, part of Duke University Health System here. “I’ve worked with lots of obese people — you’d think they’d enjoy food. But a lot of them say they haven’t really tasted what they’ve been shoveling down for years.”

Over lunch, Ms. Loring is teaching me how to eat mindfully — paying attention to what you eat and stopping just before you’re full, ideally about 5½ on that 7-point scale. Many past diet plans have stressed not overeating. What’s different about mindful eating is the paradoxical concept that eating just a few mouthfuls, and savoring the experience, can be far more satisfying than eating an entire cake mindlessly.

It sounds so simple, but it takes discipline and practice. It’s a far cry from the mindless way many of us eat while walking, working or watching TV, stopping only when the plate is clean or the show is over.

It’s also a mind-blowing experience: I’m full and completely satisfied after three mindful bites.

Well, Ms. Beck, I doubt seriously that I would be “full and completely satisfied” after three mouthfuls of anything. but simply moving my eating from in front of the TV and using smaller plates when eating takeaway food has helped me in my battle against metabolism in the fifth decade. This mindful eating thing might be worth thinking about.

The article is currently free as is a discussion forum moderated by Melinda Beck on this article. Take a look while it’s free – it has links to other mindfulness eating sources on the web and in print.

Comments

  1. #1 ringo
    May 13, 2008

    Sure, this may be considered alternative medicine but it’s really an application of psychology under the auspices of integrative medicine…

    I’m not sure “is really” is the right term to use here. How about “This is an excellent example of convergence between alternative medicine and modern Western paradigms.”

    Mindfullness wasn’t something that was made up to cloak an application of psychology in woo woo mystery. It’s been around for quite some time…

  2. #2 R
    May 13, 2008

    Interesting timing as I’m just filling out an application for a phd in mindfulness and health. There is plenty of evidence in the literature at the moment on the applications of mindfulness in physical and mental health.

    I wouldn’t even call it ‘alternative’ at this stage as it’s becoming fairly mainstream in psychology at the moment. Partially because it fits neatly with cognitive behavioural therapy, one of the more dominant(and evidenced based) psychotherapies on the market at the moment.

    Of course there is still work to do on what are the mechanisms that are helpful with regard to mindfulness-is it just attention training or is there more going on? Some of the fMRI studies of practising buddhist monks and novice mindfulness mediators will probably be helpful here.

    Mindfulness is looking more and more like an efficent and cheap supplement to other interventions, particularly as it can be taught in groups well. It’s still hard and requires practise and discipline-but generally worth the effort.

  3. #3 Susan Brassfield Cogan
    May 14, 2008

    I have been reading this with interest in various places around the web. Mindfulness in general is a good idea and mindful eating has huge potential.

    And it leads to something else I’ve been thinking about for years–that compulsive over eating is a form of OCD and that a Buddhist/mindfulness type meditation format can help it. Also OCD drugs might be helpful. I have found no science to back me up, this is just an intuition. I’ll follow these links and find out if anybody else has made this connection.

  4. #4 AnnR
    May 14, 2008

    If you teach your child to stop and consider the consequences before they get in a fight (and in trouble) is that alternative medicine? I think not.

    I think it is hard to separate “psychology” and it’s applications from Woo. The Woo folks count on this a bit in their pitches.

  5. #5 usagi
    May 14, 2008

    Funny, that second blockquote is essentially the same sequence offered on I Can Make You Thin that aired recently on TLC. And in a personal anecdote, applying it does make a difference.

    Most of the target audience seemed to be people who were very overweight (50+ lbs) and had eating issues. I was about 5 pounds heavier than I could stand and 10 from where I wanted to be. I didn’t have many of the experiences with “emotional eating”, but practically everyone raised their hands on the question, “Did your parent use the ‘Clean your plate. There are starving children in Africa’ line on you?” That did resonate strongly. Doing cardio I can actually keep up regularly and not feeling obligated to finish everything on my plate unless I’m actually hungry has me over halfway to my target weight in about 3 months.

    I stopped watching after he starting going on about activating acupuncture points to stop emotional eating, but the paying a little attention and eating when you’re hungry and stop eating when you’re not seems to work very well for me.

  6. #6 CanadianChick
    May 14, 2008

    “mindfulness” isn’t just a Buddhist philosophy – it’s also part of cognitive therapy.

    I’m also proof that mindful eating can help overcome eating disorders – after finally acknowledging that I had an atypical eating disorder, I began seeing a therapist who uses mindfulness as part of her therapy. It works – just paying attention to what you eat and your satiety cues can help overcome a lot of problems related to mindless eating.

    There have been some interesting studies on mindless eating – I don’t know how scientifically valid the methodology was, but the results were compelling – indicating that a lot of people have no idea how to tell when they’re satisfied and/or full.

  7. #7 Abel Pharmboy
    May 15, 2008

    @ringo, I certainly recognize that mindfulness has been around, fat long than any academic alternative medicine programs, in fact. Cardiologists have been studying mindfulness as a practice to relieve stress and depression after acute MI or even transplants. My point is more the caution that practices/modalities that “sound” alternative, but work, are often co-opted by the alternative medicine community as their own despite, as you say, the fact they have been used in other areas of medicine, and cultures, for years.

    @R, your example is great and emphasizes further the mainstreaming of mindfulness as a useful adjunct to pharmacotherapy.

    @Susan, SSRI antidepressants with dual indications for OCD have actually been used with some success as part of treatment for eating disorders. (Fluoxetine, the generic name of Prozac, has been FDA-approved for treatment of bulimia nervosa). Atypical antipsychotic agents continue to be investigated as well. However, drug therapy is only part of an overall treatment plan that includes behaviorial modifications.

    @AnnR, excellent point as to where we draw the line in defining alternative medicine.

    @usagi, I had not known of that TLC program. Count me as another “clean your plate” indoctrinate! Great news to hear about how you’ve applied this approach with success. I agree, mindfulness is not just for the morbidly obese. Michael Pollan and the Slow Food Movement are just two sources I know of who espouse mindful eating in the name of health.

    @CanadianChick, congratulations! That is great news. Cognitive behavioral therapy has really come on strong as a great approach not only in anxiety and depression but in all sorts of issues independent of (or sometimes comorbid with) traditional issues where therapy is indicated. (btw, the Pharmboy loves the support of his Canadian readers!)

  8. #8 Lassi Hippel�inen
    May 15, 2008

    Here’s another mindful buddhist eating experiment:

    “It was revealed last night that the Burmese tyrant blocking aid to his cyclone-devastated people is being advised by ASTROLOGERS.”

    “The news came as the death toll from Cyclone Nargis was estimated at 216,000 � with fears it could hit 1.5MILLION unless help arrives fast.”

    “Bizarrely, Shwe ordered farmers to plant thousands of acres of “psychic nuts” on the recommendation of a mystic.”

    The Sun may not be the most reliable of news sources, but still…
    http://www.thesun.co.uk/sol/homepage/news/article1150321.ece

  9. #9 Coturnix
    May 15, 2008

    I eat like that anyway. No need to tie it to Buddhism for me, I guess. Just was raised like this. Being a supertaster as a kid helped, too, I reckon.

  10. #10 Janet004
    May 28, 2008

    Regardless of whether or not mindfulness is a product of Buddhism or psychology or both, I think it has been found to be effective in the treatment of a number of health problems including obesity and addiction. The important thing is that claims made to this regard are supported by clinical trials performed in a controlled setting by reputable agencies. Here is some more info on clinical trials and obesity that I found this morning. Doesn’t mention anything about mindfulness, but this site sets very stringent standards as regards what is considered scientifically supported and what is not.

    http://www.rvita.com/conditions/obesity.html

  11. #11 sanju86
    January 16, 2009

    Every country wanted to better infrastructure for our country.Infrastructure Development show the country status and flourish status.The State Government recognizes infrastructure as a key facilitator of economic development. The state would adopt an integrated approach to develop industrial & supportive infrastructure and will also encourage private participation in this sector.

    In the Industrial Policy of 1999 an integrated approach to develop industrial infrastructure was adopted. However, private participation in Infrastructure Development could not be achieved in the absence of policy guidelines. The present policy will encourage private participation in development of infrastructure on Build and Transfer, Build Operate and Transfer and Build Own Operate and Maintain basis.

    Gems & Jewellery has been identified as an industry having good potential for development in the state. Government will develop a Gems and Jewellery Park Complex at Udyog Vihar to promote this sector. It will be endeavour of the Government to seek SEZ status for this park.
    ——————
    sanju
    Drug Intervention Missouri-Drug Intervention Missouri

  12. #12 neetugarg37
    January 22, 2009

    Of course there is still work to do on what are the mechanisms that are helpful with regard to mindfulness-is it just attention training or is there more going on? Some of the f MRI studies of practicing Buddhist monks and novice mindfulness mediators will probably be helpful here.

    There have been some interesting studies on mindless eating – I don’t know how scientifically valid the methodology was, but the results were compelling – indicating that a lot of people have no idea how to tell when they’re satisfied and/or full.

    Mindfulness is looking more and more like an efficient and cheap supplement to other interventions, particularly as it can be taught in groups well. It’s still hard and requires practice and discipline-but generally worth the effort.
    ———–
    neetu
    ——–
    Drug Intervention West Virginia-Drug Intervention West Virginia

The site is currently under maintenance and will be back shortly. New comments have been disabled during this time, please check back soon.