The Value of Teaching Mindful Eating to People with Diabetes: Part 1
Why discuss research that concluded Mindful Eating is ineffective? This article will review some common mistakes made when evaluating the effectiveness of mindful eating, including a 2021 study.
What is the real value of mindful eating for people with diabetes? In the 2021 systemic review, The Influence of Mindful Eating and/or Intuitive Eating Approaches on Dietary Intake: A Systematic Review concluded, “Little evidence suggests that Mindful Eating (ME) and Intuitive Eating (IE) interventions influence energy intake or diet quality. To draw strong conclusions about the effect of ME and IE on dietary intake, future research using study designs of high rigor are needed.”
Many assume Mindful Eating is a slow-down technique to reduce overall calorie intake. Some believe Mindful Eating increases awareness and overrides past and current emotional responses to food. Others simply don’t understand what mindful eating is and so measure what can be measured, resulting in studies like the one mentioned above, which continue to use calorie intake and weight change for the desired outcome of mindful eating.
Measuring What Matters
There are two validated mindful eating tools to measure the technique effectively: the Mindful Eating Questionnaire and the Mindful Eating Scale. Even so, many studies measure what is easy, including BMI and weight, which are neither behaviors nor qualities of mindful eating. Including these variables means that outcomes are based on judgmental and futuristic (i.e., not grounded in the present moment) measures, which bias the study, making the results inconclusive.
It takes time to understand mindful eating and how it can counter the growing reductionist view of food, eating, and health. The simplistic belief that a person primarily selects food because of the nutrients or calorie profile blinds us to the many conditions that impact food selection and ingestion. These include the internalized bias and resulting stigma regarding food, body size, body image, eating, gender, sexuality, and distress and shame of diabetes.
The Magic of Mindful Eating
Mindful Eating offers a dynamic way to look at food and allows us to see food and eating as an experience instead of an endpoint. While this view of food and eating is likely more accurate, for many researchers, the dynamic definition makes researching and defining the benefits of mindful eating difficult. Not only is mindful eating hard to define but the definition may not be universally understood.
The Center for Mindful Eating wrote the Principles of Mindful Eating to capture the nuanced understanding of mindfulness when applied to food. These are not rules but an understanding of the eating experience designed to open our minds to possibilities. Seeing food and eating in relationship to ourselves and our health helps us become aware of what is nurturing about eating.
These include positive and nurturing opportunities available through food selection and preparation. The relationship is formed by respecting your own inner wisdom.
Your relationship is grounded in the present moment because you practice mindful awareness by using all your senses to choose to eat food that is both satisfying and nourishing to your body. Adding to your relationship is the intention of nourishing self-care.
You acknowledge responses to food (likes, dislikes, or neutralities) without judgment and deepen your awareness of physical hunger and satiety cues to guide your decisions to begin and end eating.
This evolving relationship with food is unique to each person, meaning no two people have the same eating experience. Similarly, no two individuals eat mindfully in the same way, and this lack of uniformity can make researching mindful eating feel impossible.
Measuring What Isn’t Real
Research aims to report an outcome and to find a result, and this pull can make good researchers engage in bad science. While calories are easy to measure, does measuring them tell us anything? Looking at the pros and cons of dieting, one can see following a static diet isn’t a lifestyle change. The benefits of diets include that they are simplistic, definable, and measurable. However, diets are not a sustainable lifestyle change. In an effort to shift our nation’s thinking from a fixed mindset to a growth mindset, there is a place for mindful eating because fixed diets are unrealistic and limited and are a major factor in the development of internalized weight bias, disordered eating, and body dissatisfaction.
Thing: Diet | Process: Mindful Eating
The Benefits of Mindful Eating
Mindful Eating is a flexible approach to eating that seeks to resolve the complex and often conflicting feelings surrounding food and eating. For example, many people find ice cream delicious, but for those with lactose intolerance, the experience with dairy may not be all that fun. Yes, it tastes good, but in a bit, another experience comes that isn’t so enjoyable. The same can be said for blood sugar, cholesterol levels, etc. Some foods may be familiar and taste delicious, but then there comes a problem like heartburn, elevated blood sugar, or indigestion. Most people try to reconcile these feelings, and the “eat this, not that” approach doesn’t work long-term because we make decisions based on our current experiences, choices and options, and future experiences. Each person is shifting between the question of what has more importance, the present moment or the future? There isn’t a ‘right or wrong’ answer to our changing desires. There is understanding or awareness of our decision-making process, which requires a person to pause, reflect, and then discern what choice would work for them at this moment. Mindfulness actually takes a few seconds, but when explained, this somewhat drawn-out process is often ignored, bypassed, or viewed as “too hard to do.”
Where mindful eating can help.
It helps us be ‘with’ the complex feelings, and it helps us practice doing so nonjudgmentally, giving us the space and grace to understand not just what is happening but what choice will nourish the whole self. Mindful eating allows the eater to consider their larger values.
Research, like the systematic review noted above, cannot factor in how the felt experience surrounding food is important. The ‘felt’ experience refers to the unique somatic experience of each person. Mindfulness and mindful eating help us witness the present moment compassionately. Witnessing can be done by checking in with our felt experience, and it can be done before, during, and after eating.
The act of witnessing also includes listening and being with ourselves. Many people do not listen to their own experiences but rely on external information, including weight, food trackers, phone apps, and blood sugars. These external ‘experts’ are purported to be more accurate than a person’s own experience. The reliance on external information erodes self-trust and confidence, nourishes the seeds of self-doubt, and reinforces the belief that being with our experience isn’t helpful or valuable.