Hospitals are starting to use mindful eating in weight loss programs
One participant says the practice helped her drop 62 pounds
It happened by accident.
Kathryn Hutchinson, a 52-year-old retired teacher, was accompanying her father to a doctor’s appointment last year when his doctor recommended that Hutchinson make an appointment of her own.
Hutchinson was diagnosed with prediabetes at the time and was obese, with severe arthritis and a history of depression. Her father’s doctor knew an endocrinologist who could help her.
“My knees were killing me. I’ve already had my hips replaced. It was horrible, and that’s when he said, ‘You know what, there’s a person you need to talk to,’ ” Hutchinson said.
Her father’s doctor proceeded to escort her down the hallway to meet the endocrinologist.
Hutchinson said that appointment, at Lenox Hill Hospital in New York, changed her life. Tears filled her eyes and her voice cracked with emotion at the recollection.
“I’m starting to tear (up) a little bit only because that was the first time I saw somebody who saw me on the inside – me as a person, not my weight,” she said. “That was really my first feeling of hope that my life could be something different, that it actually could turn around and be good again.”
On the spot, the endocrinologist Dr. Maria Pena enrolled Hutchinson, a Bronx resident, in the hospital’s weight loss program, called Core4. The program employs the unconventional approach of “mindful eating” to counsel participants.
Before the program, Hutchinson said, she’d never heard of mindful eating.
Now, after she learned more about the practice and applied it to her eating habits over the past six months, it has led to a healthier lifestyle.
In a meeting with her nutritionist on Monday, Hutchinson said, she learned that she now weighs 198 pounds. About six months ago, she weighed 260 pounds.
“I hugged her,” Hutchinson said of her nutritionist. “I was in tears.”
’Over time, eating can become habitual’
Mindful eating is rooted in the idea of mindfulness, an ancient practice that promotes being aware of your thoughts, feelings, bodily sensations and environment instead of living your life on autopilot.
When applied to diet, mindful eating involves focusing on chewing your food, taking your time, being in tune with when your body signals that you are hungry or full, and being aware of how your food appears, smells and tastes.
“Over time, eating can become habitual. … We don’t even check in to see if we’re hungry. It’s, ‘Oh, I’m watching a movie? It’s time for popcorn,’ ” said Dr. Judson Brewer, an associate professor at the University of Massachusetts Medical School and director of research for the university’s Center for Mindfulness.
“There’s that push and pull that comes with life. We either eat mindlessly, or we eat based on cravings,” he said. “Mindfulness comes in, in this way, where we can notice that push and pull. We notice the cravings, the habits … and mindfulness helps us be with those feelings to say, ‘do that’ or ‘don’t do that.’ “
Some experts point to Horace Fletcher’s claims in the late 1800s and early 1900s as evidence of when some mindful eating concepts emerged in the United States.
Today, mindful eating concepts have been introduced in hospital programs and health care facilities across the country.
A hospital turns a spotlight on mindfulness
Lenox Hill has been using mindful eating in its Core4 weight loss program for the past five years. The program starts with patients attending 10 weekly weight loss sessions, followed by nine monthly sessions. Participants then have the option to continue monthly sessions afterward.
The program’s growing emphasis on mindful eating has allowed the practice to emerge recently as a key component to success, said Antonella Apicella, the nutritionist who counsels Hutchinson and leads the hospital’s program.
For instance, mindful eating can help mitigate fluctuations in calorie intake. Big shifts in how much you consume can promote weight gain, Apicella said.
“Having a control over your eating or practicing mindful eating gives you more of a streamlined type of eating pattern, which prevents those fluctuations from occurring,” she said. “It really is a long-term solution to achieving loss weight and weight management.”
In addition to losing weight, Hutchinson said, she is no longer prediabetic since incorporating mindful eating into her everyday life.
She spends less time isolated at home and more time doing the activities she enjoys, spending time with friends and traveling, she said.
“My summer plans? I’d like to get down to North Carolina. That’s where my family is having a reunion,” said Hutchinson, who is about halfway through the yearlong weight loss program at Lenox Hill.
Brewer, who has no relation to Lenox Hill, said that as a clinician, he thinks incorporating mindfulness into weight loss programs at hospitals could be a positive and effective approach.
As a scientist, however, he has some questions and would like to see more research data proving its effectiveness in a health care setting.
The frustrations and challenges of mindfulness
For a mindful eating program to be successful, Brewer said, participants will have to be appropriately taught how to apply mindfulness in their everyday lives, outside a hospital setting. Learning to do this can be complex.
“Teaching the nuances of mindfulness is not trivial. That’s why people have to go through years and years of training to become a certified mindfulness instructor here at the Center for Mindfulness,” Brewer said. “So with all of those caveats, the key is to be able to take something out of the hospital with you.”
For both counselors and participants, “the first thing to know is that it won’t come easy. There’s no magic bullet,” Brewer said of mindfulness. “The key here is really understanding how the process works.”
A challenge for Hutchinson has been to remain mindful when surrounded by distractions, such as in a social setting with a group of friends, she said. In those scenarios, she typically will consider beforehand what types of foods will be in the setting and then plan what she will and won’t eat.
Going to a ballgame? She will plan whether to have peanuts and Cracker Jack, but only when she is hungry.
“So the mindfulness has to go in before that, and so you plan those kinds of things,” Hutchinson said. “There are times when you’re going to say, ‘OK, I’m actually going to plan to indulge in this food.’ “
Apicella aims to encourage her participants to be patient and in tune with themselves so that they can plan for such scenarios. She also encourages them to notice when their bodies signal that they are hungry or whether they are just eating out of habit or to be social.
After all, mindful eating can come with frustrations.
“It does take time to connect with those signals, so some participants might feel frustrated in the very beginning because they feel like they’re not able to connect,” Apicella said.
“Those signals have always existed, but we have found that many of the program’s participants have been out of tune with them. Most of them don’t think about their stomach signals – hunger and fullness,” she said. “Our program helps participants get back in tune with these vital but easily ignored signals.”
Such awareness separates mindful eating from other typical diet fads, which tend to result in yo-yo dieting, said Brewer, who developed a mindfulness eating app Eat Right Now.
Rather, he said, being more aware of your eating habits might help you restructure your brain’s response not only to food but to other triggers such as stress.
“Our system isn’t calibrated to eat excessively. It’s calibrated to stop eating when we’re full. That’s how it works, and actually, it’s not set up to eat when we’re stressed-out,” Brewer said.
“When we’re stressed, the typical, the normal physiological response is … eating less,” he said. “If we’re running from the proverbial saber-toothed tiger, that’s not the time when our brain is like, ‘You know what, you should grab a cupcake as you go.’ It’s amazing how we’ve completely overwritten our normal physiological responses.”
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For Hutchinson, she plans to continue practicing mindful eating. Her goal was to weigh less than 200 pounds in time for her birthday in July, to plan more travels and to find pleasure in healthy eating. On Monday, she reached that goal.
“I could never have imagined it would be anything like this,” she said. “Suddenly, you have power over food.”