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
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Many individuals with obesity report over eating despite intentions to maintain or lose weight. Two barriers to long-term weight loss are reward-driven eating, which is characterized by a lack of control over eating, a preoccupation with food, and a lack of satiety; and psychological stress. Mindfulness training may address these barriers by promoting awareness of hunger and satiety cues, self-regulatory control, and stress reduction. We examined these two barriers as potential mediators of weight loss in the Supporting Health by Integrating Nutrition and Exercise (SHINE) randomized controlled trial, which compared the effects of a 5.5-month diet and exercise intervention with or without mindfulness training on weight loss among adults with obesity. Intention-to-treat multiple mediation models tested whether post-intervention reward-driven eating and psychological stress mediated the impact of intervention arm on weight loss at 12- and 18-months post-baseline among 194 adults with obesity (BMI: 30-45). Mindfulness (relative to control) participants had significant reductions in reward-driven eating at 6 months (post-intervention), which, in turn, predicted weight loss at 12 months. Post-intervention reward-driven eating mediated 47.1% of the total intervention arm effect on weight loss at 12 months [β = -0.06, SE(β) = 0.03, p = .030, 95% CI (-0.12, -0.01)]. This mediated effect was reduced when predicting weight loss at 18 months (p = .396), accounting for 23.0% of the total intervention effect, despite similar weight loss at 12 months. Psychological stress did not mediate the effect of intervention arm on weight loss at 12 or 18 months. In conclusion, reducing reward-driven eating, which can be achieved using a diet and exercise intervention that includes mindfulness training, may promote weight loss (clinicaltrials.gov registration: NCT00960414).
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Emotional eating has been frequently observed among individuals with obesity and is associated with increased consumption of high calorie foods.
“Emotional eating has been frequently observed among individuals with obesity and is associated with increased consumption of high calorie foods [88,89].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [89]
Emotional eating, difficulties regulating emotions, episodes of loss of control overeating, and unplanned snacking are more frequently reported by individuals with obesity and may hinder adherence to recommendations.
“Emotional eating, difficulties regulating emotions, episodes of loss of control overeating, and unplanned snacking are more frequently reported by individuals with obesity and may hinder adherence to recommendations [88,89,90].”
From Dietary and Behavioral Strategies for Weight Loss and Weight Loss Maintenance: A Narrative Review (2025) · cites this paper as [89]
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- Authors
- Mason, A. E., Epel, E. S., Aschbacher, K., Lustig, R. H., Acree, M., Kristeller, J., Cohn, M., Dallman, M., Moran, P. J., Bacchetti, P., Laraia, B., Hecht, F. M., & Daubenmier, J.
- Affiliations
- University of California, San Francisco (US)
- Indiana State University (US)
- University of California, Berkeley (US)
- Corresponding author
- Mason, Ashley E.
- Daubenmier, Jennifer
- ORCID
- Venue
- Appetite
- Publisher
- Elsevier BV
- Published
- 2016-05
- Volume
- 100
- Pages
- 86-93
- ISSN
- 0195-6663 (ISSN-L)
- PMC
- PMC4799744
- OpenAlex
- W2286828557
- Cited by
- 125
- References
- 84
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 11 · 2023: 9 · 2022: 15 · 2021: 13 · 2020: 12 · 2019: 15 · 2018: 14 · 2017: 15 · 2016: 1
- FWCI
- 20.08
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Appetite (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (1P01AT005013, K24AT007827, K01AT004199, T32AT003997)
- National Institutes of Health (NHLBI) (U01HL097973)
- National Center for Advancing Translational Sciences
- UCSF-CTSI (UL1 TR000004)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- mindfulness training, weight loss, obesity, psychological stress, diet and exercise intervention, mediation analysis, satiety, hunger cues, self-regulation, SHINE trial
- MeSH terms
- Adult, Appetite Regulation, Combined Modality Therapy, Diet, Reducing, Feeding Behavior, Female, Group Processes, Humans, Hyperphagia, Male, Middle Aged, Obesity, Obesity, Morbid, Patient Compliance, Patient Education as Topic, Reward, San Francisco, Stress, Psychological, Weight Loss, Exercise, Body Mass Index, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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