Interviews

Mindful Eating Research Phase I:
Interview with Jean Kristeller, Ph.D.
October 2005

By Richard Mahler

Jean Kristeller, Ph.D., is a professor of psychology at Indiana State University and director of ISU's Center for the Study of Health, Religion, and Spirituality. In 2004 her program received a $1.8-million, four-year grant from the National Institutes of Health for research into the use of mindfulness as a means of controlling binge eating. The study has followed 170 obese binge eaters over a period in which they were taught mindfulness techniques. In previous years, Kristeller has conducted two similar but smaller studies which, like the NIH research, suggested that mindfulness can be an effective complement to other interventions.

Richard: Do you believe mindfulness can be an effective tool to control binge eating? If so, why?

Jean: Eating is a wonderful arena within which to explore how powerful our cravings and automatic responses can become. This is true for everyone, but for binge eaters, the pull of food, the sense of helplessness, and automatic reactivity which kicks in become extreme. It is also particularly likely to happen when other feelings, such as anxiety or anger, are operating, as a way to avoid or hide from them.

Mindfulness practice, even for a few moments, helps in various ways: it heightens and centers awareness, increases a sense of focus, and within that, a feeling of choice, heightens self-acceptance, and reduces emotional reactivity. We also find that mindfulness practice can help cultivate greater appreciation and enjoyment of the food that is eaten, further helping with a sense of acceptance and positive choice. Finally, with practice, a greater sense of wisdom emerges around making food choices - and often in other parts of people's lives.

Richard: Would you briefly summarize the key early findings from your ongoing NIH study of mindfulness and binge eating?

Jean: The individuals in the MB-EAT program (Mindfulness-Based Eating Awareness Treatment) significantly decreased their binging over a two month period and generally maintained that improvement for another four months. They also reported decreases in depression and less inner conflict around eating. There was a strong - and statistically significant - relationship between the amount of mindfulness practice they reported and improvement, including weight loss.

Richard: How does the mindfulness regimen compare with the effectiveness of dieting?

Jean: While we haven't directly compared the MB-EAT program to "dieting," this is an issue that is central to considering the value of this approach. Dieting usually refers to imposing rigid outside rules on food choice for a certain period of time ("I'm going on this diet for a month and lose 10 pounds"), but also includes use of black-and-white thinking (ice cream is bad, yogurt is good) and making sensible choices (which we refer to as "outer wisdom") about portion control and basic nutritional information.

When "dieting" refers to rigid, all-or-nothing thinking, the MB-EAT program can provide an extraordinary sense of relief and awareness that there is an alternative to short-term efforts that rarely provide long term effectiveness. At the same time, we have individuals who go through our program and then find they can use an approach like Weight Watchers much more effectively, by combining "outer wisdom" with "inner wisdom."

Richard: How do our habits influence how we eat?

Jean: Habits are conditioning, and conditioning affects every aspect of our lives. We couldn't live without it. So habits affect our choices of food, our preferences, the amount we eat, when we eat, and how we eat. We try to help people realize they can become more aware of these choices and that through minfulness practice, they have a powerful tool that can help them step back, observe, and introduce a moment of choice between the impulse and the behavior. This can affect what food to choose, when to eat, when to stop, and how to feel about those choices.

Richard: I read that there is a "trip to the buffet" exercise built into the program you used in your study. Would you please describe it?

Jean: Yes, the "trip to the buffet" is very powerful, and sometimes anxiety-laden. For many individuals in our groups, buffet situations virtually always lead to binge, or at least to overeating. They may protest that they don't go to buffets for this reason. Yet we come across buffets at parties, family get-togethers, or even when we open our own cupboards. One woman noted she loved to go on cruises, but stopped because of how out of control she would feel when faced with the many buffets. So we see it as a way to challenge their fear that they can't control their choices in this kind of situation. We build up to the buffet with many mindful eating exercises over about a six-week period, always emphasizing the importance of listening to and learning from one's own inner wisdom. By the time someone actually goes to the buffet, they have learned to become more aware of the difference between emotional hunger and physical hunger, to be attuned to the sensory pleasure - or distaste - associated with eating a particular food, and how to recognize and use physical sensations of fullness or satiation, to make the decision to stop eating. When they go to the buffet, they are instructed to be aware of choosing the foods they most desire - in small quantities, planning to go back a second time - but mindfully, and to practice leaving food on their plates if they feel they have eaten enough, either because they are getting no further satisfaction from it or because they are becoming full. This is a wonderful example of choosing "quality" over "quantity." Most of our participants report that this is a very powerful experience to be able to bring wisdom to managing this kind of situation. The woman I mentioned earlier went on a cruise several months later and returned ecstatic. She said she had actually lost weight during the cruise, instead of gaining it. She enjoyed the cruise more because she used the buffets as opportunities to eat only foods she really enjoyed.

Richard: What has your follow-up evaluation of study participants revealed about their long-term use of mindfulness in connection with eating?

Jean: Our longer term evaluation is informal at this point, but we found that many participants let us know that their experience with MB-EAT had lasting benefits. Many then combine it with other approaches, such as Weight Watchers or even bariatric surgery, but do so with a greater sense of anticipating positive outcomes, realizing that they have the power to make different choices.

Richard: What other mindfulness research have you been engaged in lately or have planned for the future?

Jean: My research continues in the area of evaluating the MB-EAT program, specifically looking for ways that it can be combined with "wise" dieting approaches to facilitate weight loss. I'm also finishing up a book that reviews broader questions about how mindfulness practices can be used therapeutically.

Richard Mahler is an independent editor, writer, and teacher. He has published 11 books and written for publications such as the Los Angeles Times, Chicago Tribune, Los Angeles Daily News, Alternative Medicine, Miami Herald, San Francisco Chronicle, Albuquerque Journal, Toronto Globe and Mail, Houston Chronicle, and E/The Environment Magazine.