Obesity is epidemic and is one of our most serious public health problems. Many of obesity's unfavorable health effects are more strongly related to central (abdominal and upper trunk) adiposity than to peripheral adiposity. Central adiposity is closely linked to other components of metabolic syndrome: increased cholesterol, hypertension, and insulin resistance. Adverse stress hormone patterns appear to favor central fat deposition. In addition, adverse stress responses may drive eating patterns that lead to obesity. The overall goal of this project is to test whether a meditation based intervention that can shift stress hormone patterns, when added to a diet and exercise program, improves fat distribution and enhances weight loss and maintenance of weight loss. We have developed an intervention that applies mindfulness meditation practices to obesity and metabolic syndrome, Craving and Lifestyle Modification through Mindfulness (CALMM). The intervention draws on Mindfulness Based Stress Reduction and Mindfulness Based Eating Awareness Training.
CALMM aims to decrease adverse stress responses, improve sensitivity to hunger satiety cues, and develop mindful eating practices. Initial data suggests that CALMM supports gradual weight loss, improvements in stress cortisol responses, and decreased abdominal fat. The diet component of CALMM+ aims for a modest calorie reduction (typically 500 Kcal/day) and focuses on healthy diet choices that facilitate caloric reduction. The exercise component of CALMM+ focuses on moderate exercise, primarily through increased daily walking as well as through structured exercise time. Both the diet and exercise components of CALMM+ incorporate mindfulness, e.g. mindful walking exercise and mindful eating. We have also developed a program, Diet-Ex, that uses the diet and exercise components from CALMM+, without the integration of mindfulness practices into diet and exercise. In this project, 200 participants will be randomized in a 1:1 ratio to CALMM+ or Diet-Ex. Groups will meet for 16 weekly sessions, then monthly during a 4 month maintenance phase. We will compare the effects of each intervention on weight loss and its maintenance, fat distribution, insulin sensitivity, and perceived stress and mood over an 18 month period. We hypothesize that the CALMM+ group will achieve greater improvements in fat distribution and maintain the most weight loss over 18 months. The results of the study will provide important new information about whether a mind-body intervention targeted to reduce adverse stress reactions and improve awareness of eating behaviors is useful in treating obesity and altering features of the metabolic syndrome.

Public Health Relevance

If the intervention we are testing is effective, these studies will help to address obesity and metabolic syndrome, which are key public health problems. Through carefully testing the effects of meditation and stress on hormones patterns, weight loss, fat distribution, and the immune system, we will help better understand how stress and mind-body interventions may affect health.

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Research Program Projects (P01)
Project #
5P01AT005013-04
Application #
8094377
Study Section
Special Emphasis Panel (ZAT1-SM (11))
Program Officer
Glowa, John R
Project Start
2008-09-30
Project End
2013-05-31
Budget Start
2011-06-01
Budget End
2012-05-31
Support Year
4
Fiscal Year
2011
Total Cost
$1,158,102
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
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Adler, Elizabeth; Dhruva, Anand; Moran, Patricia J et al. (2017) Impact of a Mindfulness-Based Weight-Loss Intervention on Sleep Quality Among Adults with Obesity: Data from the SHINE Randomized Controlled Trial. J Altern Complement Med 23:188-195
Mason, Ashley E; Epel, Elissa S; Aschbacher, Kirstin et al. (2016) Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial. Appetite 100:86-93
Mason, Ashley E; Epel, Elissa S; Kristeller, Jean et al. (2016) Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J Behav Med 39:201-13
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