When I work with clients that overeat from stress, emotion or tension, I find mindfulness-based therapy to be a powerful approach to treating problems with food, eating and body image. What is mindfulness? How does it work?
Is this approach also effective with patients experiencing a full-blown eating disorder? I recently discussed these issues in an interview with Dr. Lesley Williams at Remuda Ranch, a well-respected residential eating disorder treatment facility based in Arizona.
“Food is an amazing drug – it decreases pain.”
What is mindfulness?
Dr. Anderson: “Mindfulness” simply means paying attention, in a relaxed way, to what is happening in the present moment. The cultivation of mindfulness involves the heart as well as the mind — a non-judgmental awareness that is friendly, curious and compassionate. Mindfulness is a powerful way to take a break from stressful thoughts and gain perspective before you react or respond. It helps you keep from ruminating about the past or dwelling on negative thoughts, and can decrease anxiety about the future.
Dr. Williams: Mindfulness-Based Stress Reduction(MBSR) has been found to be a useful method for improving mental health and reducing symptoms of stress, anxiety and depression and Mindfulness-Based Cognitive Therapy (MBCT) has specifically been found to be helpful for problems with food and body image.
How do mindfulness-based therapies help with problems with food and eating?
Dr. Williams: Food is an amazing drug – it decreases pain. Overeating, bingeing and even starving are tools that eating disorder patients use to disconnect from their bodies, numb out and cope with underlying issues, whether it serves to mask the pain of a less than nurturing childhood or express emotions that the person cannot verbalize. One aspect of eating disorders that is unique when compared to substance abuse is the inability to completely abstain from the substance of choice – food. The eating disorder patient must navigate use of their “drug of choice” up to six times a day. The challenge is like asking alcoholic to drink six cocktails daily and maintain control.
“Mindfulness helps create a state of sufficient calm, strength and receptivity that food is no longer needed to numb or distract.”
Dr. Anderson: Mindfulness is useful in dealing with the need to eat and yet maintain control at the same time. For example, the slowing down of the eating process that happens in mindful eating allows the food to be fully tasted, savored and enjoyed. My observation is that evidence-based therapies like MBSR and MBCT also create a state of sufficient calm, strength and receptivity to experience and process feelings and experiences that may be uncertain, unfamiliar, and uncomfortable. Food is no longer needed to numb or distract.
Are MBSR and MBCT effective treatments for patients with a clinical diagnosis of anorexia, bulimia or compulsive eating disorder?
Dr. Williams: During the acute phase of anorexia, mindfulness doesn’t work across the board. The bodies and brains of patients with anorexia are so starved that they cannot integrate sensory data. However, with weight restoration the brain begins to fire on all cylinders. At that point, mindfulness-based therapy can be very helpful, for example, in somatic experiencing of the food, such as identifying how the food feels and tastes, and in post-meal processing. For the treatment of bulimia and compulsive overeating, mindfulness practices can be helpful from the beginning, as a way to help the patient relax, slow down and really taste their food, expose the patient to normal eating habits during treatment, transition into the “real world” after treatment and to help maintain the lifestyle change.
What is Mindful Eating?
Dr. Anderson: From my own mindfulness meditation practice, I was delighted to discover this relaxed, fully present ‘here and now’ mindset is available in many everyday activities of life, including eating. Mindful Eating is not about dieting, deprivation or giving up the foods you enjoy – It’s about limiting distractions while eating and experiencing food more completely. It’s rather paradoxical in that by slowing down, tasting and enjoying your food more, you tend to end up eating less. I enjoy sharing this approach with clients that overeat from emotion, stress and tension. I also appreciate how these therapies cultivate a more functional and less ornamental view of the body, which can be quite healing for women with body image issues.