Less Binge Eating and Loss of Control over Eating Are Associated with Greater Levels of Mindfulness: Identifying Patterns in Postmenopausal Women with Obesity

Mechanisms underlying fNIRS-neurofeedback over the prefrontal cortex for participants with binge-eating disorder

OBJECTIVE

Despite the increasing popularity of neurofeedback (NF), aiming at voluntary modulation of dysfunctional prefrontal cortex (PFC) signals in the treatment of binge-eating disorder (BED) and/or overweight, mechanisms remain poorly understood.

METHODS

Based on a randomized-controlled trial offering 12 food-specific real-time functional near-infrared spectroscopy (rtfNIRS)-NF sessions to participants with BED (n = 22), this preregistered study examined (1) online regulation success as predictor for offline regulation success, defined by PFC signals during regulation versus watch, and subjective regulation success, and (2) changes in loss of control (LOC) eating after vs. before and across 12 rtfNIRS-NF-sessions.

RESULTS

Higher online regulation success expectedly predicted better subjective, but worse offline regulation success. LOC eating decreased after vs. before, but not over rtfNIRS-NF-sessions, and was not associated with subjective or offline regulation success.

CONCLUSIONS

The association between online and subjective regulation success confirmed the presumed mechanism of operant conditioning underlying rtfNIRS-NF-learning. The contrary association between online and offline regulation indicated differential PFC involvement upon subtraction of automatic food-specific responses from regulation signals for offline success. Decreased LOC eating after food-specific rtfNIRS-NF-sessions suggested the potential of NF in BED treatment.

SIGNIFICANCE

Results may guide the optimization of future NF studies in larger samples with BED.

Comparative effectiveness of mindfulness and mindful eating programmes among low-income overweight women in primary health care: A randomised controlled pragmatic study with psychological, biochemical, and anthropometric outcomes

Obesity is a chronic and multifactorial disease, with growing rates in the last 50 years worldwide, reaching pandemic levels. It is a major public health problem and is difficult to treat. Different approaches have been used to improve this scenario, including mindfulness-based interventions to enhance dietary behaviour and nutritional status. We compared the effectiveness of a 10-week mindful eating programme with that of a 10-week mindfulness programme and of a no-treatment control group. The sample was composed of adult, low-income women with a body mass index (BMI) ≥ 25 to < 40 receiving primary health care in São Paulo, Brazil. The participants (n = 284) were randomised into 3 groups: the control, mindfulness, and mindful eating. We took anthropometric and body composition measurements, applied psychometric measures, and performed biochemical tests at pre-intervention, post-intervention, and after 3 months. We estimated the regression coefficients among the analysis of adherent participants (per protocol: PP) and among those of all participants randomised to treatment (intention-to-treat: ITT) in addition to multiple imputation (MI). Both groups showed improvement in eating behaviour and reduction of binge eating both in the post-intervention and follow-up periods, but without significant changes in weight or most of the biological tests. Those in the mindful eating programme performed slightly better than those in the mindfulness and control groups in terms of improving eating behaviour and reducing binge eating among low-income overweight women.