Mindful EatingSandy Arner, RD, LDN

Clinical Dietitian/NutritionistJames H. Quillen VA Medical Center

Primary Care Conference, March 28, 2012

Disclosure Slides

Unapproved/Investigative Drugs Financial Interest

I, Sandra Arner, DO NOT anticipate discussing the unapproved/investigative use of a commercial product/device during this activity or presentation.

I, Sandra Arner, DO NOT have a financial interest/arrangement or affiliation with one or more organizations that could be perceived as real or apparent conflict of interest in the context of the subject of this presentation.

Define mindful eating Describe two domains of mindful eating Explain two benefits of mindful eating State one way to incorporate mindful eating

in a visit with a patient

Learning Objectives

Deliberately paying attention Being fully aware of what is happening Awareness without judgment or criticism

What is Mindfulness?

Improves overall mindfulness Is ancient mind-body practice Helps lead to more awareness of the

present moment

Meditation

Mindless Eating

Eating with awareness

◦ Being present for each sensation of the experience of eating

◦ Having a nonjudgmental awareness of physical and emotional sensations associated with eating

Source: Eat, Drink, and Be Mindful by Susan Albers

“Definition” of Mindful Eating

Acknowledges there is no right or wrong way to eat

Accepts one’s eating experiences are unique Directs awareness to all aspects of food and

eating Looks at immediate choices and direct

experiences associated with food and eating Experiences insights about how one can act

to achieve specific health goals, as is more attuned to the direct experience of eating and feelings of health

One Who Eats Mindfully

Disinhibition Awareness External Cues Emotional Responses Distraction

Source: Journal of the Academy of Nutrition and Dietetics. 2009,109:1439-44

Five Domains of Mindful Eating

Inability to stop eating when full Hunger/Fullness scales

Disinhibition

Physical Hunger/Fullness

Source: Megrette Fletcher, The Center for Mindful Eating

Hunger/Fullness Feelings

Source: www.move.va.gov

Being aware of effects of food on senses Being aware of how food affects internal

states

Awareness

Environmental triggers that promote overeating◦ Plate/glass size◦ Eating from bag/box/container◦ Eating in a group◦ “Family-style” and buffet meal eating◦ Having plates on or removed from table◦ Advertising

External Cues

Eating in response to feelings◦ Stress◦ Sadness◦ Happiness◦ Loneliness

Emotional Responses

Focusing on other things while eating◦ Watching TV◦ Working on the computer◦ Talking on the phone◦ Playing games (board games, on computer, on

IPhone)◦ Reading a book

Distractions

Awareness Observation Being in the moment Being mindful of environment Being nonjudgmental Letting go Acceptance

Source Eat, Drink, and Be Mindful by Susan Albers

Seven Skills of a Mindful Eater

Mindful Eating Plate

Eat, Drink & Be Mindful by Susan Albers

www.choosemyplate.gov

Eye Nose Mouth Stomach Cellular Mind Heart

Source Mindful Eating by Dr. Jan Chozen Bays

Seven “Hungers”

Eating Cycle Source: Eat What You Love, Love What You Eat by Dr. Michelle May

Eating Cycle Source: Eat What You Love, Love What You Eat by Dr. Michelle May

Eating Cycle Source: Eat What You Love, Love What You Eat by Dr. Michelle May

Eating Cycle Source: Eat What You Love, Love What You Eat by Dr. Michelle May

Sit comfortably in the chair. Place a raisin in your hand. Examine the raisin as if you had never seen it

before. Imagine it as its "plump self" growing on the vine

surrounded by nature. As you look at the raisin, become conscious of

what you see: the shape, texture, color, size. Is it hard or soft?

Bring the raisin to your nose and smell it. Are you anticipating eating the raisin? Is it

difficult not to just pop it in your mouth?

Raisin Medication of Kabat-Zinn

Kabat-Zinn, J. (2005). Coming to Our Senses. New York, NY: Hyperion

How does the raisin feel? How small it is in your hand?

Place the raisin in your mouth. Become aware of what your tongue is doing.

Bite ever so lightly into the raisin. Feel its squishiness.

Chew three times and then stop. Describe the flavor of the raisin. What is the

texture? As you complete chewing, swallow the raisin. Sit quietly, breathing, aware of what you are

sensing.

Raisin Medication of Kabat-Zinn (cont’d)

Kabat-Zinn, J. (2005). Coming to Our Senses. New York, NY: Hyperion

Research

Source: Using Mindful Eating to Promote Glycemic Control, Skelly Publishing

Benefits of Mindful Eating A non-diet approach Not scary Realistic and doable Advocates self-

acceptance and body acceptance

Lasts

Compassionate and nonjudgmental

For everybody Provides clarity Holistic Works

Weight Management Matters, Academy of Nutrition and Dietetics, Vol. 7, No. 4, Spring 2010

Using Mindful Eating in a Clinical Setting

Weight Management Matters, Academy of Nutrition and Dietetics, Vol. 7, No. 4, Spring 2010

Using Mindful Eating in a Clinical Setting

Carolyn has diabetes. She has seen you for two visits. She has not had her A1c rechecked yet and it was 7.5% four months ago. Before, 32% of her SMBG levels were in target, and now 65% of her SMBG levels are at target. She is walking her dog for 30 minutes each day. She has lost two pounds.

Is Carolyn “successful”? ◦ What questions related to mindful eating and

mindfulness could you ask her (or she ask herself) to know how she is doing?

Case Study—Carolyn

Food Messages

What Can We Gain From Mindful Eating?

HopeConfidence

PridePeace

RESOLVE

Respect

ASSURANCE

DelightGLOW

COURAGEPassion

Conviction

Self BeliefPizzazz

Zeal Oomph

From WHAT WILL YOU gain WHEN YOU LOSE WEIGHT?™ Kellogg’s Special K

SassPep

Joy

Bounce

www.tcme.org www.mindfuleating.org www.eatingmindfully.com www.comtemplativemind.org www.savorthebook.com www.vialean.com www.skellypublishing.com www.mindfuleats.com www.mindfuleating.net

Mindful Eating Web Sites

Albers, S. (2011) But I Deserve This Chocolate. Oakland, California: New Harbinger Publications, Inc.

Albers, S. (2009) Eat, Drink & Be Mindful. Oakland, California: New Harbinger Publications, Inc.

Albers, S. (2003) Eating Mindfully. Oakland, California: New Harbinger Publications, Inc.

Albers, S. (2006) Mindful Eating 101. New York, New York: Routledge Taylor & Francis Group.

Albers, S. (2009) 50 Ways to Soothe Yourself Without Food. Oakland, California: New Harbinger Publications, Inc.

Books About Mindful Eating

Bays, J.C. (2009) Mindful Eating. Boston, Massachusetts: Shambhala Publications, Inc.

May, M (2011) Eat What You Love, Love What You Eat. Oakland, California: New Harbinger Publications, Inc.

Nhat Hanh, T. (2011) Savor: Mindful Eating, Mindful Life. New York, New York: HarperOne Publishers.

Wansink, B. (2010) Mindless Eating. New York, New York: Random House, Inc.

Weil, A. (2011) The Joy of Eating Well. (CD) Boulder, Colorado: Sounds True, Inc.

Books About Mindful Eating

Mindful About Eating

Questions

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