Manipulating mindful breathing versus mindful eating: examining the effect of specific mindfulness mechanisms on food intake and eating disorder symptoms.

Background. Understanding which specific mindfulness practices contribute to improvements in ED symptoms, as well as the mechanisms of action by which this change occurs, may help improve MBTs for EDs. The current study aims to compare the effects of various brief mindfulness exercises on state ED symptoms and food intake and to test whether a reduction in state rumination and state difficulties in emotion dysregulation and an increase in awareness of hunger, fullness, and satiety cues mediate these effects. Methods. Two hundred and two undergraduate females participated in the experiment. Participants were randomized to listen to one of the four 15-minute audio recordings: Mindful eating, mindful breathing, mixed mindfulness (mindful eating and breathing), and control (a story about produce transportation). Next, participants were left alone with snacks (popcorn, apples, chocolate, and chips) for 10 minutes, and food intake was measured. Participants completed state surveys at three time points during the experiment. Results. All four conditions led to a significant reduction of state ED symptoms short-term, but not two weeks later. Mindful breathing consistently had larger effects on most outcomes and resulted in both higher awareness of hunger, fullness, and satiety cues and greater high-density food intake compared to all other conditions. No indirect effects of the reduction in state rumination and state difficulties in emotion dysregulation and an increase in awareness of hunger, fullness, and satiety cues on state ED or food intake were found. Conclusions. A variety of mindfulness and related practices (i.e., audio story) may be helpful in reducing ED cognitions and urges. Individuals with clinical or subclinical levels of ED may benefit most from practices combining both mindful eating and mindful breathing. Specifically, mindful breathing practice may result in higher congruency between hunger cues and food intake by increasing awareness of hunger, fullness, and satiety cues. More studies on mechanisms of action are needed