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Mindful Eating for Severe Obesity

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Psychiatric Care in Severe Obesity

Abstract

The purpose of this chapter is to review mindful eating interventions for adults with severe obesity. Mindfulness interventions that specifically target problematic eating behaviors such as overeating, binge eating, grazing, and emotional eating will be the focus of this chapter rather than mindfulness interventions like mindfulness-based stress reduction [1] or mindfulness-based cognitive therapy [2, 3] that are used with other mental health conditions like depression and anxiety. Also, we will not include integrative interventions such as acceptance and commitment therapy [4] or dialectical behavior therapy [5], which incorporate mindfulness into protocols that are primarily focused on skills and techniques to increase acceptance and skillful regulation of emotion.

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Notes

  1. 1.

    The term problem eating will be used to refer to eating and overeating in response to cues other than physical hunger and past the point of satiety, including painful or aversive emotions, grazing or frequently eating small amounts of food throughout the day, night eating, and dysregulated or chaotic eating patterns characterized by irregular meal times such as eating once per day or an absence of regular meal times.

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Author information

Authors and Affiliations

  1. Toronto Western Hospital Bariatric Surgery Program, University Health Network, 399 Bathurst Street, Toronto, ON, Canada, M5T 2S8

    Susan Wnuk B.A., M.A., Ph.D. & Chau Du

Authors
  1. Susan Wnuk B.A., M.A., Ph.D.
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  2. Chau Du
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Corresponding author

Correspondence to Susan Wnuk B.A., M.A., Ph.D. .

Editor information

Editors and Affiliations

  1. Toronto Western Hospital Bariatric Surgery Program, Centre for Mental Health, University Health Network, Toronto, Ontario, Canada

    Sanjeev Sockalingam

  2. Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada

    Raed Hawa

Appendix

Appendix

1.1 Script 1: Mindful Eating Meditation

This meditation is designed to help you cultivate mindful eating by engaging in all of your five senses while eating. This practice is also a helpful way for you to develop a healthy and pleasurable relationship with food.

Prior to eating a meal or snack, please take a few moments to settle into a relaxed sitting position, with your food placed in front of you, either on a table or on your lap (10 s).

Allow your back to adopt an erect and comfortable posture (5 s). If you are sitting on a chair, place your feet flat on the floor, with your legs uncrossed (5 s). If you feel comfortable, gently close your eyes fully or partially ( 5 s).

Take three deep breaths to settle into your body and into this present moment ( 5 s).

YOU CAN BEGIN BY NOTICING the way your breath is moving in the body (10 s). Breathe from your diaphragm, or lower stomach, rather than the chest (10 s). If you like, you can put your hand on your stomach and feel the way it moves with the breath (10 s). You may notice that as you breathe in the stomach rises…and as you breathe out it falls (5 s). Spend a few more moments exploring these breathing sensations (5 s) .

On you next in-breath, focus your attention on your stomach and assess your baseline hunger. Ask yourself: On a scale of 0–10, with 0 being “not hungry at all” and 10 being “extremely hungry,” how hunger am I? And how do I know?

SIGHT: When you are ready, open your eyes and imagine that you are seeing these food(s) for the first time, being open and curious to whatever arises (10 s). As you breathe in and out, notice the colors , shapes, and textures of the food in front of you (10 s).

TOUCH: Breathing in, focus your attention now to your sense of touch. Using utensils or your hands, pick up the food and either feel the texture against your lips or between your fingertips (5 s). Continue to pay attention to your sensation of touch for the next few moments (10 s).

SMELLS: On your next in-breath, shift your concentration to noticing the smells of the particular food(s) (10 s). Bring the food(s) to your nose and inhale deeply. Continue to breathe and focus on the slightest of scents…allowing them to come to you. As best as you can, be aware of any feelings, sensations, or thoughts that are arising and let them be just as they are, without trying to change it (10 s) .

TASTE: When you are ready, shift your attention from awareness of smells to awareness of taste (10 s). Place the food(s) in your mouth and begin to chew, observing any flavors that arise. Allow yourself to experience and savor the taste. As best as you can, pay attention to how the texture of the food(s) change as you are chewing and breaks down with every bite.

SOUNDS: While you are chewing, notice the sound(s) that the food(s) is making. Be open and receptive to those sounds that may arise while you are eating, without naming or labeling them. Whenever you become aware that the mind has wandered, gently acknowledge where the mind has gone to and as best as you can, return to your practice of eating mindfully. Continue to chew your food(s). When you are ready to swallow, feel the sensation as the food(s) slides down your throat. If you like, you can imagine the food in your stomach.

Now rate your hunger levels on a scale from 0 to 10. Do you notice any changes?

You can continue to eat in this way for another few bites or if you like, until you finish your snack/meal. Remember that you can always return to this mindful eating practice anytime you wish .

1.2 Checklist 1 : Remember “MANGER” (French = To Eat)

  1. 1.

    Mindful check in with one’s body, emotions, thoughts, and hunger levels (Scale, 1–10, with 1 being “not hungry” at all and 10 being “starving”).

  2. 2.

    Access, observe, and savor food with five senses: sight, smell, sound, taste, and touch.

  3. 3.

    Nourish your body with “just enough” food.

  4. 4.

    Gently investigate your hunger throughout eating.

  5. 5.

    Eat slowly and chew thoroughly.

  6. 6.

    Recognize and listen to your inner and outer wisdom .

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Wnuk, S., Du, C. (2017). Mindful Eating for Severe Obesity. In: Sockalingam, S., Hawa, R. (eds) Psychiatric Care in Severe Obesity. Springer, Cham. https://doi.org/10.1007/978-3-319-42536-8_17

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