Mindfulness-based eating in obesity and anxiety: a randomized controlled trial and feasibility assessment

IF 9.1 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2026-07-01 Epub Date: 2026-07-15 DOI:10.1016/j.lana.2026.101541

Natasha Kim de Oliveira da Fonseca, Gabriela Rocha dos Santos, Gabrielle Terezinha Foppa, Gabriella Nunes da Luz Morelo, Artur Zanelatto Santos, Gibson Weydmann, Brunna Boaventura, Stuart William Flint, Luciana Conceição Antunes, Elisa Brietzke, Gisele Gus Manfro

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Abstract

Background

There is a high prevalence of people living with obesity (LWO) and mental disorders, which could worsen stigma. Internalized weight stigma (IWS) impairs psychological functioning and eating behaviors. This study, therefore, evaluated the acute effects of a Mindfulness-based Eating (ME) intervention and the feasibility of incorporating IWS assessment into a randomized controlled trial for adults LWO and generalized anxiety disorder (GAD). It also explores associations between IWS, device use, and psychological outcomes.

Methods

Seventy adults LWO and GAD were randomized to a five-week ME group intervention (n = 36) or an asynchronous health educational video control (n = 34). The inhibitory control measured by the Go/No Go test was the primary RCT outcome. Post hoc feasibility outcomes were attendance and completion of the IWS assessment. The Weight Bias Internalization scale (WBIS) was applied alongside measures of body appreciation (BAS2), self-compassion (SCS), anxiety symptoms (GAD7), depressive symptoms (PHQ9), emotional dysregulation (DERS), shame (OAS), early memories (EMWSS), personality assessment (ER5FP), Mindful Eating (MEQ), binge eating (BES), impulsivity (BIS), and device use (smartphone/tablet). Associations were analyzed using correlation, regression and moderation; analyses of psychological outcomes were considered hypothesis-generating. NCT Number NCT06087185.

Findings

The ME group showed no clear improvement in inhibitory control on the food Go/No-Go task, but resulted in improvements across several psychological outcomes (p < 0.05). All participants completed the WBIS; retention in the RCT was 58.6%. WBIS was positively associated with GAD7 (B = 0.869, p = 0.005) and negatively with BAS2 (B = −0.619, p = 0.005). Device use moderated the association between BAS2 and WBIS at baseline (B = 0.116, p = 0.021), with body appreciation being more protective against IWS at lower device use.

Interpretation

ME shows promise for improving psychological outcomes linked to IWS. This study supports the feasibility of integrating IWS measures in trials examining obesity and GAD. Findings highlight the important effect of device use moderates the BAS2–IWS association. These findings can support clinicians and researchers in developing more effective, stigma-informed interventions for individuals LWO, particularly those with psychiatric disorders.

Funding

CAPES; CNPq; FIPE-HCPA (ROR: https://ror.org/010we4y38).

查看原文本刊更多论文

正念饮食对肥胖和焦虑的影响：一项随机对照试验和可行性评估。

背景：肥胖和精神障碍人群的患病率很高，这可能会加剧耻辱感。内化体重耻辱感（IWS）损害心理功能和饮食行为。因此，本研究评估了正念进食（ME）干预的急性效果，以及将IWS评估纳入成人LWO和广泛性焦虑障碍（GAD）的随机对照试验的可行性。它还探讨了IWS、设备使用和心理结果之间的联系。方法：70名LWO和GAD成人随机分为5周ME组干预（n = 36）和非同步健康教育视频对照组（n = 34）。通过Go/No Go测试测量的抑制控制是主要的RCT结果。事后可行性结果是参加和完成IWS评估。体重偏差内化量表（WBIS）与身体欣赏（BAS2）、自我同情（SCS）、焦虑症状（GAD7）、抑郁症状（PHQ9）、情绪失调（DERS）、羞耻（OAS）、早期记忆（EMWSS）、人格评估（ER5FP）、正念进食（MEQ）、暴食（BES）、冲动（BIS）和设备使用（智能手机/平板电脑）一起应用。采用相关、回归和调节分析相关性；对心理结果的分析被认为是假设生成。NCT06087185。研究结果：ME组在食物Go/ no -Go任务的抑制控制方面没有明显改善，但在几个心理结果上有所改善（p < 0.05）。所有参与者都完成了WBIS；RCT的保留率为58.6%。WBIS与GAD7呈正相关（B = 0.869, p = 0.005），与BAS2呈负相关（B = -0.619, p = 0.005）。在基线时，设备使用调节了BAS2和WBIS之间的关联（B = 0.116, p = 0.021），在低设备使用时，身体欣赏对IWS更有保护作用。解释：ME有望改善与IWS相关的心理结果。这项研究支持了在肥胖症和广泛性焦虑症试验中整合IWS措施的可行性。研究结果强调了设备使用调节BAS2-IWS关联的重要作用。这些发现可以支持临床医生和研究人员为LWO个体，特别是患有精神疾病的个体制定更有效的、了解耻辱感的干预措施。资金:斗篷;CNPq;FIPE-HCPA （ROR: https://ror.org/010we4y38）。

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

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0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.