Stress is a common problem for women. You may be a mother juggling extraordinary demands on the home front, or a woman trying to balance work and home life. Most women will confide that when stress hits, they grab food, potentially leading to stress-related weight gain and other health issues. A study published in the July 2017 issue of the journal Obesity examined the impact of mindfulness-based therapy on this pattern.
In the clinical trial, 86 women who were overweight or diagnosed with obesity were randomly assigned to either health-education sessions or mindfulness-based stress reduction (MBSR) sessions. All participants were told that the focus of the study was stress reduction and not weight reduction.
Each group received eight weeks of intervention. Participants were then followed for 16 weeks. The researchers used the Toronto Mindfulness Scale to evaluate primary outcomes and measured secondary outcomes using the Perceived Stress Scale-10, fasting blood-glucose levels, and blood-pressure assessments.
Compared to the health-education group, the women who received MBSR demonstrated:
- Significantly improved mindfulness and awareness by week eight
- Significantly reduced “perceived stress” by week 16
- Significantly reduced fasting blood-sugar levels by week eight, and had further reductions by week 16
- A reduction in triglyceride levels
However, the MBSR group saw no significant changes in weight,blood pressure, or insulin resistance.
The more than two-thirds of U.S. adults diagnosed as overweight or having obesity face significantly elevated risk of diabetes and cardiac disease. Experts know that stress can lead to overeating and can also cause generalized inflammation, and both can increase the risk of packing on pounds. Currently there are few affordable and effective therapies for intercepting stress-related obesity.
MBSR is one of the most well-researched mindfulness interventions, and the researchers who published the study in Obesity were somewhat convinced that this intervention could have meaningful impact on stress and associated obesity. MBSR had been shown to have the potential to lower cortisol and catecholamine levels, which typically increase in the presence of stress. MBSR and other mindfulness intervention programs have been shown to decrease stress in different patient populations. In fact, mindfulness-based eating-awareness training has had some success in reducing binge-related eating patterns, helping patients improve self-control and even to lose weight.
If there was no weight reduction in the MBSR group, why did fasting blood-sugar levels improve? The researchers postulate that the increased mindfulness may have made it easier for the MBSR group to follow diet and exercise guidelines. Being aware simply made them more compliant. The researchers note that one limitation of the study was that it did not specifically evaluate whether changes in dietary habits directly helped to lower the fasting blood-sugar levels in the MBSR group.
If you think about the elements of this study, it gives one pause regarding the effectiveness of health education. Certainly, most experts will tell you that an informed patient is a wiser patient. But when it comes to the education having direct impact on certain aspects of health, additional knowledge may not equate with better health outcomes. In this case, learning about stress — how it happens, why it happens, why you may be especially vulnerable to stress, how it can cause weight gain — did not translate into stress reduction.
One other limitation of the study was the rate of participation. Only 71 percent of the 86 participants completed the eight-week study period and only 62 percent completed the full 16-week study. So the actual research group was quite small. The majority of dropouts were in the health-education group. In contrast, in the MBSR group, 83.3 percent fulfilled the eight-week study portion and 73.8 percent completed the full 16-week study. One could say that health education is not that inspiring or motivating, at least given the focus and goals of this study. I would offer that health education might enhance the outcomes of a therapy like MBSR.
MBSR appears to significantly increase mindfulness and decrease perceived stress when compared to health education, in women diagnosed as overweight or obese. Insurers should consider covering the cost of a program like this. Research should now focus on the long-term effectiveness of a short course in MBSR on stress levels in this group.