OA09.02 LB
Purpose: To estimate the long-term effects of adding mindfulness-based eating and stress management practices to a diet-exercise program on metabolic risk factors in obesity.
Methods: We randomized 194 adults (BMI>30; 80% female) to a diet-exercise program with or without mindfulness-based eating and stress reduction components. Programs were matched for diet-exercise guidelines. Both arms received 17 group sessions over 22 weeks and were followed for 18m from intervention initiation. Intent-to-treat analyses were conducted with all available data.
Results: Participants in the standard (n=94) and mindfulness (n=100) arms had similar baseline mean BMIs (35.6 and 35.4), fasting glucose levels, insulin resistance as assessed by homeostatic model assessment (HOMA), and triglyceride/HDL ratios. Change in weight (standard vs. mindfulness) was −4.4% vs. −5.5% at 6m (p=.19) and −3.6% vs. −5.3% at 18m (p=.21). Change in fasting glucose was 0.74 vs. −0.17 mg/dl at 6m (p=.46) and 3.11 vs. −0.44 mg/dl at 18m (p=.017), change in HOMA was 0.00 vs. −0.28 at 6m (p=.32) and 0.50 vs. −0.11 at 18m (p=.08), and change in triglyceride/HDL ratio was −0.15 vs. −0.58 at 6m (p=.019) and 0.09 vs. −0.33 at 18m (p=.036). In secondary analyses, we found evidence that metabolic outcomes differed among the 3 mindfulness-group instructors. For example, ANOVA for 18m weight change by instructor group was significant (p=.049). Follow-up tests revealed that weight change for participants led by instructor A was −3.3% vs. −7.3% for those led by instructors B & C (95% CI: −0.5, −7.8, p=.03).
Conclusion: We observed clinically significant improvements in metabolic health indices related to insulin resistance and lipids consistent with improvement of the metabolic syndrome and a non-statistically significant trend toward improved weight loss maintenance in the mindfulness arm. Mindfulness enhancements to diet-exercise programs may improve long-term metabolic health in obesity.
Contact: Frederick Hecht, rhecht@php.ucsf.edu
