CLINICAL RESEARCH POSTER PRESENTATION ABSTRACTS
Please note: All posters will be displayed in
Salons 10-12.
THURSDAY, 5:30-6:15 PM
Wolever RO, Best JL*, Sheets VL, Davis J, Psujek J,
Liebowitz R, Kristeller JL.
Bio-behavioral outcomes of a mindfulness-based intervention
for binge eating disorder.
Duke Center for Integrative Medicine, Duke University
Medical Center jennifer.best@duke.edu
*Presenting author
Recent years have witnessed a surge of scientific
efforts targeting both prevention of and intervention for the growing
public health crisis of obesity. However, despite this modern trend,
several significant gaps in the literature remain. For example, limited
research has examined metabolic dysfunction in obesity as a function
of binge eating behavior and few studies have explored the benefits
of treatment for binge eating on metabolic regulation in obese community
samples. Moreover, there is an important need to continue to add to
the small though accumulating body of research which is evaluating the
effectiveness of mindfulness- and acceptance-based approaches in enhancing
eating regulation in obese binge eating populations. This study randomized
140 participants [88% female, 86% Caucasian, mean age=46 (s.d=12.1),
mean BMI=40 (s.d.=8.3), mean binge days/month=15 (s.d.=6.9)] to a 9-session
mindfulness meditation-based group (N=50), a psychoeducational group
(N=48), or a wait-list control group (N=42). A variety of psychosocial
and eating-related measures (including binge days/month) were assessed
at baseline, immediately following treatment, and at 4-month follow-up.
In addition, the following metabolic indicators were collected at all
three time points: total cholesterol, HDL, LDL, HbA1c, fasting, and
2-hour post-prandial glucose and insulin levels. The HOMA method was
used to estimate insulin resistance in both the basal and stimulated
states. Utilizing an intent-to-treat approach, Condition (3) x Time
(3) repeated measures ANOVAs were performed for the number of binge
days/month and for each of the log-transformed metabolic variables.
Analyses demonstrated that independent of weight change over time, both
the mindfulness (i.e. 15 down to 7) and the psychoeducational (i.e.
16 down to 9) groups yielded significantly greater reductions in the
average number of binge days/month at follow-up in comparison to the
wait-list control group (i.e. 14 down to 12) (P = 0.002). Regarding
the metabolic variables, results indicated a significant main effect
of Time for HbA1c (P=0.016), revealing a worsening over time. Despite
this, significant improvements in post-prandial glucose (P=0.006), insulin
(P=0.014), and insulin resistance measures (P=0.009) emerged for the
mindfulness group only. These findings remained robust while controlling
for baseline to follow-up weight change. No significant effects were
observed for the lipid variables. Baseline to post-treatment changes
across participants in binge days/month were correlated with change
in HbA1c (r=.19, p<0.05) and fasting glucose (r=.19, p<0.05), which
were also retained after controlling for change in weight. Thus, although
both active conditions were associated with improvements in binge eating
behavior over time, it appears that enhanced metabolic regulation may
be a specific benefit of applying mindfulness skills to eating. Future
efforts are needed to clarify the mechanisms of action underlying these
metabolic improvements.
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