The mind-eat program leads to greater improvements in mindful, emotional, and external eating compared to intuitive eating-oriented education in adults with overweight or obesity: a randomized controlled trial

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Abstract Background Mindful eating interventions target behavioral and emotional processes involved in eating, but most structured programs have been evaluated in English-speaking settings and often compared with passive controls. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured mindfulness-based intervention, versus treatment as usual consisting of a therapeutic patient education (TPE) program grounded in intuitive eating principles, in adults with overweight or obesity. Methods In this single-center trial, 66 adults with overweight or obesity were randomized (1:1) after oral agreement. Of these, 56 completed baseline assessment, and 46 with baseline and at least one post-baseline assessment were included in the modified intention-to-treat analysis. The Mind-Eat group completed eight weekly experiential sessions plus one follow-up session, while the comparator group followed the department’s usual TPE pathway. Assessments were conducted at baseline, post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured with the validated Mind-Eat Scale. Secondary outcomes included disordered and intuitive eating behaviors, psychological well-being, trait mindfulness, physical activity, and weight. Analyses used linear mixed-effects models. Results Significant Group × Time interactions favored the Mind-Eat group for mindful eating at week 8 (β = − 0.40, p = .002, d = − 1.32) and week 12 (β = − 0.31, p = .02, d = − 1.02). Compared with treatment as usual, Mind-Eat was also associated with greater reductions in emotional eating (and greater improvements in intuitive eating and trait mindfulness. Improvements were observed in both groups across several outcomes. No between-group differences were found for restrained eating, perceived stress, anxiety, depression, physical activity, or weight. Conclusions The Mind-Eat program was associated with greater improvements in mindful eating and key eating-related behaviors, particularly emotional and external eating, than an intuitive eating-oriented TPE program delivered as treatment as usual. These findings support the added value of structured mindfulness-based experiential training in obesity care. However, they should be interpreted in light of attrition and the absence of short-term weight effects. Trial registration The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411.

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