Obesity is now recognized as the 2nd leading cause of preventable death in the U.S. and is associated with significant impairment. While structured behavioral regimes typically lead to significant weight loss, a burgeoning literature reveals less encouraging results for weight loss maintenance (WLM). Hence, innovative approaches to WLM are necessary to buffer against disease risks associated with weight regain. Interventions utilizing mindfulness meditation show promise in treating unhealthy eating behaviors and other obesity related problems, including mood, blood sugar control and addiction. By enhancing self-awareness and emotion regulation, such interventions may be particularly useful in facilitating the internalization of healthy behavior change. Our recent work shows that eating-focused meditation techniques assist obese binge-eaters to regulate intake patterns, mood metabolism, and to increase internalization of control, independent of weight change. The proposed study aims to extend our previous work on mindful approaches to eating by developing a novel intervention to promote WLM. Specifically, we will develop a 12-week Mindfulness-Based Weight Loss Maintenance (MBWLM) Intervention and test its efficacy against an attention/support control (ASC) condition in a two-arm RCT of overweight and obese (BMI>25) men and women (N=130) who recently lost at least 10% of their initial body weight via non-surgical means. The primary endpoint will be percent change in weight from baseline to 12-month follow-up. We are also interested in testing the efficacy of the MB WLM program on improving secondary outcomes, including obesity/adiposity, health behaviors, and psychological well-being. In the event that carryover funding is available from the original U01, we will also study the impact of MB WLM on glucose metabolism, appetite/food intake regulation, and systemic inflammation. Outcome data will be collected at baseline, post-intervention, 6- and 12-month follow-up. Multilevel (""""""""mixed-effects"""""""") modeling will be used to test between-group differences on primary and secondary endpoints. Further, path analysis will be used to investigate mechanisms underlying successful WLM. Taken together, these data could provide support for the integration of mindfulness meditation into comprehensive treatment programs for obesity and weight management.
