For Healthcare Professionals
Mindfulness Based-Eating Awareness Training has been developed over the past 10 years by Jean L. Kristeller, Ph.D., Indiana State University; C. Brendan Hallett Psy.D., Department of Psychology, Indiana State University; Ruth A. Baer, Department of Psychology, University of Kentucky; Ruth Quillian-Wolever, Center for Integrative Medicine, Duke University.
The following is excerpted from Ruth Baer's book, Mindfulness and acceptance-based interventions: Conceptualizations, application, and empirical support (2006):
Mindfulness-based eating awareness training (MB-EAT) was developed by integrating elements from Mindfulness Based Stress Reduction (MBSR) and cognitive behavioral therapy with guided eating meditations. The program draws on traditional mindfulness meditation techniques as well as guided meditation to address specific issues pertaining to shape, weight, and eating-related self-regulatory processes such as appetite, and both gastric and taste-specific satiety. The meditative process is integrated into daily activity related to food craving and eating. It is informed by our current knowledge of processes in food intake regulation, including the role of hunger and satiety cues, and places primary attention on underlying eating patterns. Patterns of overeating, particularly bingeing, can be viewed as symptomatic of a prototypical dysregulation syndrome, involving disturbances of affect regulation, cognitive and behavioral dysregulation, and physiologoical dysregulation. Mindfulness meditation is conceptualized as a way of training attention to help individuals first to increase awareness of automatic patterns and then to disengage undesirable reactivity. It is also viewed as a way to heighten awareness of potentially more healthy aspects of functioning, in this case physiologically-based hunger and satiety cues, and to use such awareness to more "wisely" inform behavior and experience, (Kristeller, 2003)...
Interventions that incorporate mindfulness meditation, with a goal of increasing general psychological and physiological self-regulation, are particularly well-suited to the complexity of behavioral, emotional and cognitive dysregulation observed in eating disorders. This model is consistent with other perspectives on dysfunctional eating patterns: the chronic dieting model, (e.g., Herman & Polivy, 1980), affect regulation models, (e.g., Wilson , 1984), and the escape model, (Heatherton & Baumeister, 1991)
The dysregulation model, which forms the theoretical basis of MB-EAT, synthesizes key aspects of the aforementioned models into a comprehensive explanation of a binge cycle. This model posits that the chronic dieting that many binge eaters engage in makes them susceptible to binge triggers that include physical stimuli, distorted cognitions, and negative affect. While it is informed by the affect regulation model, it gives more attention to introducing skills and awareness-related processes to food intake per se. Chronic dieting, patterns of binge eating, and use of food for non-nutritive reasons (i.e., emotional eating) are not only symptoms of underlying dysfunction, but actively contribute to it. Emotionally, dieting may lead to frustration and deprivation, and dysphoria due to negative self-awareness. Once a dietary rule is violated (such as by eating a "forbidden" food or eating at an inappropriate time), the individual may give up control altogether, judging that they have "blown it", and binge, in a pattern consistent with the abstinence violation effect (AVE; Marlatt & Gordon, 1985). This is further compounded by a lack of physiological awareness of satiety. (Hetherington & Rolls, 1988) that also leaves one vulnerable to binge eating in that normal cues to stop eating are ignored or not experienced. The binge may bring some immediate physical and emotional gratification but is likely to be followed by physical discomfort and guilt. This then leads to continued negative self-evaluation and a reinstatement of dietary restraint. The binge cycle may vary by person, and some may not experience all of these components.
While cognitive behavioral approaches address some aspects of this model, such as the distorted thinking of the AVE and the use of behavioral substitutions for emotional eating, the MB-EAT program may attenuate or interrupt more aspects of this cycle, and do so in a way that is more effective in internalizing and maintaining change...
Heatherton, T.F. & Baumeister, R.F. (1991). Binge eating as escape from self awareness. Psychological Bulletin, 110, 86-108.
Herman, C.& Polivy, J. (1980). Restrained eating. In A. Stunkard (Ed.), Obesity. Philadelphia :Saunders.
Hetherington, M.&Rolls, B. (1988). Sensory specific satiety and food intake in eating disorders. In B. Walsh (Ed.), Eating
Behaviors in eating disorders. Washington , D.C. :American Psychiatric Press.
Kristeller, J.L. (2003) Mindfulness, wisdom and eating: Applying a multi-domain model of meditation effects. Journal of
Constructivism In the Human Sciences, 8 (2), 107-118.
Marlatt, G.A.& Gordon, J. (1985). Determinants of relapse: Implications for the maintenance of behavior change. New York:
Wilson , G.T. (1984). Toward the understanding and treatment of binge eating. In R. Hawkins, W, Gremouw, & P. Clement (Eds.)
The binge purge syndrome. New York : Springer.
For more information, please visit The Center for Mindful Eating.