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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