Being mindful of each mouthful

So there we sat, 28 of us, on a recent summer evening, munching ever so slowly on, and paying exquisite attention to, the surprisingly complex tastes and textures of gorp, that mixture of dried fruit and nuts so popular with hikers.

“Notice whether you’re already salivating,” prompted the workshop instructor, Jean Fain, a psychotherapist and teaching associate at Harvard Medical School, as we held dried cranberries, cashews or almonds in our fingers. “Slowly, very slowly, begin to notice the taste, the texture. Allow yourself to feel pleasure as you chew.”

I do, and am struck by the difference between this tranquil, Buddhist moment -- my entire focus on one little cranberry -- and the way, half an hour earlier, I had wolfed down a calzone in the car, barely tasting it. The first cranberry gave me a burst of sweetness, the second, a small blast of tanginess. The cashew, unsalted, was boring.

The point of this workshop, Fain said, was to apply some of the techniques of mindfulness meditation -- such as quieting the mind by focusing on the breath -- to the process of eating and, ultimately, weight control.

The approach is such a potentially useful weapon against obesity that the National Institutes of Health is spending $1.8 million over four years on studies of it.

Dr. David Heber, director of the UCLA Center for Human Nutrition, supports the idea of mindful eating, particularly for people who overeat in response to certain foods. Meditation, he said, also should be “linked to a nutritional plan and an exercise plan.”

Philosophically similar to the book “French Women Don’t Get Fat,” by Mireille Guiliano, who advocates focusing on quality, not quantity, in food, the mindful-eating program does not involve willpower, dieting or counting calories. Nor does it eschew certain foods while allowing an unlimited supply of others.

It does involve a very brief meditation to center you before eating and an emphasis on eating with full attention -- “getting pleasure from food and noticing when you’ve had enough,” said the program’s originator, psychologist Jean Kristeller of Indiana State University, who has studied meditation for decades.

Among other things, mindful eating means learning to tell when you feel full enough or when you’ve reached “taste-specific satiety.” This is the phenomenon by which, after four or five bites, taste buds lose their sensitivity to the chemicals in food that make it taste good. It is this taste-specific satiety that explains why the first bites of chocolate taste better than later ones and why, when you cannot manage another bite of steak, you have plenty of enthusiasm for ice cream. Once you recognize that you’re losing the pleasure of a certain taste, it’s easier to stop eating.

“Our culture is so externalized that we don’t even realize what our body signals are,” said clinical psychologist Ruth Quillian-Wolever from the Duke Center for Integrative Medicine. “When you teach people to be quiet enough to see what’s going on inside, they can get an incredible amount of satisfaction from a small piece of chocolate.”

To be sure, the published evidence in favor of mindful eating is slim.

Kristeller did a pilot study a few years ago of 18 obese women who binged (loosely defined as feeling out of control about eating and ingesting a huge amount of food in one session). Her team found that, with meditation and coaching on how to distinguish real hunger from anger- or boredom-triggered eating, binging dropped from an average of four times a week to one and a half. Participants also reported being less preoccupied with food.

Armed with a $250,000 government grant, Kristeller and Quillian-Wolever studied 85 male and female obese bingers. They were randomly assigned to the mindful eating program, no intervention, or a control group, which received the same amount of attention from teachers as the mindful group and used material from Duke’s diet and fitness center, but got no meditation training.

The data are still unpublished, but encouraging. Though neither the mindful eating nor the control group, on average, lost weight, both groups reduced binging substantially. On standardized psychological tests, the mindful eaters also reported feeling more in control around food. Just as important, the mindfulness program, even in people who lost no weight, was linked to lower fasting blood sugar levels and less insulin resistance, problems that often lead to diabetes.

“So we know it works to change eating patterns,” Quillian-Wolever said. The next step is to figure out how to translate this into weight loss.

This summer, Kristeller, Quillian-Wolever and Dr. Michael Baime, director of the Penn Stress Management Program at the University of Pennsylvania, will begin to enroll about 225 obese people, some of them bingers, to see whether mindful eating plus coaching on portion control and other weight-loss tactics results in lasting weight loss. Baime also plans to use brain scans to see what, if anything, is changing in the brains of people in the meditation group.

People can’t sustain diets “if it’s just willpower,” Baime said. “Meditation does not require willpower at all. It requires awareness. If you actually listen to your body better, you’ll know whether you’re really hungry or not.”