Mindfulness-Based Interventions have been applied in different fields to improve physical and psychological health. However, little is known about its applicability and effectiveness in Spanish adults with overweight and obesity. The aim of the present study protocol is to evaluate the feasibility and efficacy of an adapted MBI programme to reduce emotional eating in adults with overweight and obesity in primary care (PC) settings.
This study is a multi-centre, two-armed randomized controlled trial (RCT), with pre-treatment, post-treatment and 1-year follow-up measures, and a 1:1 allocation rate between groups. Patients from four mental health units in Zaragoza (Spain) will be randomly assigned to two different parallel conditions, with one psychological intervention group ('ME + TAU') and usual treatment ('TAU alone') managed by their general practitioner (GP), to test the superiority of 'ME + TAU' provision compared with 'TAU alone' provision. For ethical reasons, those patients allocated to 'TAU alone' will be offered the ME programme after finishing the trial at 1-year follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
76
The ME group will be composed by 7 weekly group sessions with a minimum duration of two hours, mixing theoretical contents with practices. Sessions will always be the same day of the week, except for bank holidays or eventualities, and will be conducted by a psychologist specially trained and certified in ME with experience in leading mindfulness groups. Group sizes will range between 10 and 12 participants. At the end of each session, participants will receive theoretical contents and homework activities to be practiced along the week.
Department of Psychiatry. Miguel Servet University Hospital
Zaragoza, Spain
The Dutch Eating Behavior Questionnaire
It was designed to measure eating styles that may attenuate or contribute to the development of overweight. It comprises three scales that measure emotional, external and restrained eating. The Spanish version of the DEBQ has 33 items, 13 of them referred to the emotional eating scale (e.g., "Desire to eat when irritated"), and 10 items referring to the external (e.g., "Eating when you feel lonely") and restrictive (e.g., "Difficult to resist delicious food") scales, respectively. The items can be rated on a five-point likert scale with 1 indicating "never" and 5 indicating "very often".
Time frame: Baseline in experimental and control groups.
The Dutch Eating Behavior Questionnaire
It was designed to measure eating styles that may attenuate or contribute to the development of overweight. It comprises three scales that measure emotional, external and restrained eating. The Spanish version of the DEBQ has 33 items, 13 of them referred to the emotional eating scale (e.g., "Desire to eat when irritated"), and 10 items referring to the external (e.g., "Eating when you feel lonely") and restrictive (e.g., "Difficult to resist delicious food") scales, respectively. The items can be rated on a five-point likert scale with 1 indicating "never" and 5 indicating "very often".
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
The Dutch Eating Behavior Questionnaire
It was designed to measure eating styles that may attenuate or contribute to the development of overweight. It comprises three scales that measure emotional, external and restrained eating. The Spanish version of the DEBQ has 33 items, 13 of them referred to the emotional eating scale (e.g., "Desire to eat when irritated"), and 10 items referring to the external (e.g., "Eating when you feel lonely") and restrictive (e.g., "Difficult to resist delicious food") scales, respectively. The items can be rated on a five-point likert scale with 1 indicating "never" and 5 indicating "very often".
Time frame: twelve-months follow-up in experimental and control groups
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Sociodemographic data Gender, age, marital status, education, occupation, economical level
Time frame: Baseline in experimental and control groups
Five Facet Mindfulness Questionnaire
The FFMQ-short form is a 24-item questionnaire that measures five aspects of mindfulness and there is a Spanish version based on it with appropriate psychometrics. The five facets the FFMQ measures are: observing (α = 81), describing (α = .87), acting with awareness (5 items, α = .83), non-judging to (5 items, α = .83) and non-reacting of (5 items, α = .75) inner experience. The participants indicate on a 5-point Likert scale the degree in which each item is generally true for them, ranging from 1 ("never or very rarely true") to 5 ("very often or always true").
Time frame: Baseline in experimental and control groups
Five Facet Mindfulness Questionnaire
The FFMQ-short form is a 24-item questionnaire that measures five aspects of mindfulness and there is a Spanish version based on it with appropriate psychometrics. The five facets the FFMQ measures are: observing (α = 81), describing (α = .87), acting with awareness (5 items, α = .83), non-judging to (5 items, α = .83) and non-reacting of (5 items, α = .75) inner experience. The participants indicate on a 5-point Likert scale the degree in which each item is generally true for them, ranging from 1 ("never or very rarely true") to 5 ("very often or always true").
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
Five Facet Mindfulness Questionnaire
The FFMQ-short form is a 24-item questionnaire that measures five aspects of mindfulness and there is a Spanish version based on it with appropriate psychometrics. The five facets the FFMQ measures are: observing (α = 81), describing (α = .87), acting with awareness (5 items, α = .83), non-judging to (5 items, α = .83) and non-reacting of (5 items, α = .75) inner experience. The participants indicate on a 5-point Likert scale the degree in which each item is generally true for them, ranging from 1 ("never or very rarely true") to 5 ("very often or always true").
Time frame: twelve-months follow-up in experimental and control groups
Self-Compassion Scale
It is the most used self-report instrument to measure self-compassion and it is divided into six subscales: Self-Kindness; Self-Judgment; Common Humanity; Isolation; Mindfulness; and Over-Identification. The items can be rated on a five-point Likert-type scale with 1 indicating "almost never" and 5 indicating "almost always". After reversing the negatively formulated items, a total score can be calculated, which may range from 24 to 120, with higher scores indicating greater self-compassion
Time frame: Baseline in experimental and control groups
Self-Compassion Scale
It is the most used self-report instrument to measure self-compassion and it is divided into six subscales: Self-Kindness; Self-Judgment; Common Humanity; Isolation; Mindfulness; and Over-Identification. The items can be rated on a five-point Likert-type scale with 1 indicating "almost never" and 5 indicating "almost always". After reversing the negatively formulated items, a total score can be calculated, which may range from 24 to 120, with higher scores indicating greater self-compassion
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
Self-Compassion Scale
It is the most used self-report instrument to measure self-compassion and it is divided into six subscales: Self-Kindness; Self-Judgment; Common Humanity; Isolation; Mindfulness; and Over-Identification. The items can be rated on a five-point Likert-type scale with 1 indicating "almost never" and 5 indicating "almost always". After reversing the negatively formulated items, a total score can be calculated, which may range from 24 to 120, with higher scores indicating greater self-compassion
Time frame: twelve-months follow-up in experimental and control groups
Mindful Eating Scale
The MES scale has 28 items, including six factors: acceptance (α = .89), awareness (α = .82), non-reactivity (α = .77), act with awareness (α = .81), routine (α = .75) and unstructured eating (α = .60). Items can be rated on a 4-point Likert-type scale, with 1 indicating "never" and 4 indicating "very often".
Time frame: Baseline in experimental and control groups
Mindful Eating Scale
The MES scale has 28 items, including six factors: acceptance (α = .89), awareness (α = .82), non-reactivity (α = .77), act with awareness (α = .81), routine (α = .75) and unstructured eating (α = .60). Items can be rated on a 4-point Likert-type scale, with 1 indicating "never" and 4 indicating "very often".
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
Mindful Eating Scale
The MES scale has 28 items, including six factors: acceptance (α = .89), awareness (α = .82), non-reactivity (α = .77), act with awareness (α = .81), routine (α = .75) and unstructured eating (α = .60). Items can be rated on a 4-point Likert-type scale, with 1 indicating "never" and 4 indicating "very often".
Time frame: twelve-months follow-up in experimental and control groups
Bulimic Investigatory Test
The BITE is very used to measure the presence and severity of bulimic symptoms in nonclinical samples. Normative values for BITE total and sub-scale scores in clinical and non-clinical samples are reported. The scale includes in the Symptoms subscale (30 yes-no items; range =0-30) and Severity subscale (6 dimensional items addressing specific bulimic behaviors; range=0-39). In addition to these standars scores, another measure was derived from the BITE-the reported frequency of bingeing
Time frame: Baseline in experimental and control groups
Bulimic Investigatory Test
The BITE is very used to measure the presence and severity of bulimic symptoms in nonclinical samples. Normative values for BITE total and sub-scale scores in clinical and non-clinical samples are reported. The scale includes in the Symptoms subscale (30 yes-no items; range =0-30) and Severity subscale (6 dimensional items addressing specific bulimic behaviors; range=0-39). In addition to these standars scores, another measure was derived from the BITE-the reported frequency of bingeing
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
Bulimic Investigatory Test
The BITE is very used to measure the presence and severity of bulimic symptoms in nonclinical samples. Normative values for BITE total and sub-scale scores in clinical and non-clinical samples are reported. The scale includes in the Symptoms subscale (30 yes-no items; range =0-30) and Severity subscale (6 dimensional items addressing specific bulimic behaviors; range=0-39). In addition to these standars scores, another measure was derived from the BITE-the reported frequency of bingeing
Time frame: twelve-months follow-up in experimental and control groups
Eating Attitude test (EAT-26)
The EAT-26 had three subscales Dieting, Bulimia and Food Preocupation, and Oral Control. It is and abbreviated version of the original EAT-40, having an excellent correlation. In the EAT-26 each item is answered on a 6-point Lickert scale and if the scoring is 20 or higher the patient should look for professional advice. The Eat-26 had an elevated reliability
Time frame: Baseline in experimental and control groups
Eating Attitude test (EAT-26)
The EAT-26 had three subscales Dieting, Bulimia and Food Preocupation, and Oral Control. It is and abbreviated version of the original EAT-40, having an excellent correlation. In the EAT-26 each item is answered on a 6-point Lickert scale and if the scoring is 20 or higher the patient should look for professional advice. The Eat-26 had an elevated reliability
Time frame: Post-treatment 8 weeks from baseline in experimental and control groups
Eating Attitude test (EAT-26)
The EAT-26 had three subscales Dieting, Bulimia and Food Preocupation, and Oral Control. It is and abbreviated version of the original EAT-40, having an excellent correlation. In the EAT-26 each item is answered on a 6-point Lickert scale and if the scoring is 20 or higher the patient should look for professional advice. The Eat-26 had an elevated reliability
Time frame: twelve-months follow-up in experimental and control groups
Weight
Weight measurement will be quantified in kilograms using a digital scale
Time frame: Baseline in experimental and control groups
Weight
Weight measurement will be quantified in kilograms using a digital scale
Time frame: twelve-months follow-up in experimental and control groups
Abdominal perimeter
Abdominal perimeter measurement will be quantified in centimetres using a measuring tape
Time frame: Baseline in experimental and control groupsw-up in experimental and control groups
Abdominal perimeter
Abdominal perimeter measurement will be quantified in centimetres using a measuring tape
Time frame: twelve-months follow-up in experimental and control groups
Height
Height measurement will be quantified in centimetres using a measuring tape
Time frame: Baseline in experimental and control groups
Height
Height measurement will be quantified in centimetres using a measuring tape
Time frame: twelve-months follow-up in experimental and control groups
Cholesterol total
Cholesterol total measurement will be quantified mg/dL using a blood test
Time frame: Baseline in experimental and control groups
Cholesterol total
Cholesterol total measurement will be quantified mg/dL using a blood test
Time frame: twelve-months follow-up in experimental and control groups
LDL
LDL measurement will be quantified mg/dL using a blood test
Time frame: Baseline in experimental and control groups
LDL
LDL measurement will be quantified mg/dL using a blood test
Time frame: twelve-months follow-up in experimental and control groups
HDL
HDL measurement will be quantified mg/dL using a blood test
Time frame: Baseline in experimental and control groups
HDL
HDL measurement will be quantified mg/dL using a blood test
Time frame: twelve-months follow-up in experimental and control groups
Glucose
Glucose measurement will be quantified mg/dL using a blood test
Time frame: Baseline in experimental and control groups
Glucose
Glucose measurement will be quantified mg/dL using a blood test
Time frame: twelve-months follow-up in experimental and control groups
Alanine aminotransferase
Alanine aminotransferase measurement will be quantified U/L using a blood test
Time frame: Baseline in experimental and control groups
Alanine aminotransferase
Alanine aminotransferase measurement will be quantified U/L using a blood test
Time frame: twelve-months follow-up in experimental and control groups
Glycated haemoglobin
Glycated haemoglobin measurement will be quantified in percentage (%) using a blood test
Time frame: Baseline in experimental and control groups
Glycated haemoglobin
Glycated haemoglobin measurement will be quantified in percentage (%) using a blood test
Time frame: twelve-months follow-up in experimental and control groups
General Anxiety Disorder
It is one of the most frequently used diagnostic self-report scales for screening, diagnosis and anxiety disorder severity assessment, defined as an excessive anxiety and worry (apprehensive expectation) related to a number of events or activities, associated to experiencing difficulties to control that worry. Items are rated on a 4-point Likert-type scale (between 0 = "not at all" and 3 = "nearly every day"). The GAD-7 inquires about events happening over the last two weeks, in order to know how often the patient has been bothered by them
Time frame: Baseline in experimental and control groups
General Anxiety Disorder
It is one of the most frequently used diagnostic self-report scales for screening, diagnosis and anxiety disorder severity assessment, defined as an excessive anxiety and worry (apprehensive expectation) related to a number of events or activities, associated to experiencing difficulties to control that worry. Items are rated on a 4-point Likert-type scale (between 0 = "not at all" and 3 = "nearly every day"). The GAD-7 inquires about events happening over the last two weeks, in order to know how often the patient has been bothered by them
Time frame: twelve-months follow-up in experimental and control groups
Patient Health Questionnaire
This scale is one of the most widely used questionnaires that assess the intensity of depression in pharmacological and psychological studies, it is useful to monitor changes experienced by patients over time. Through items like "Little interest or pleasure in doing things" and using a Liker-type scale from 0 ("not at all") to 3 ("nearly every day"), the PHQ-9 reflects the experience of participants during the last two weeks.
Time frame: Baseline in experimental and control groups
Patient Health Questionnaire
This scale is one of the most widely used questionnaires that assess the intensity of depression in pharmacological and psychological studies, it is useful to monitor changes experienced by patients over time. Through items like "Little interest or pleasure in doing things" and using a Liker-type scale from 0 ("not at all") to 3 ("nearly every day"), the PHQ-9 reflects the experience of participants during the last two weeks.
Time frame: twelve-months follow-up in experimental and control groups
The diastolic blood pressure (DBP) and the systolic blood pressure (SBP)
In order to evaluate the vital signs we will use a vascular screening system, in the version VaSera VS-1500.
Time frame: Baseline in experimental and control groups
The diastolic blood pressure (DBP) and the systolic blood pressure (SBP)
In order to evaluate the vital signs we will use a vascular screening system, in the version VaSera VS-1500.
Time frame: twelve-months follow-up in experimental and control groups