Effects of mindfulness and mindful eating on food intake and appetite: a systematic review and meta-analysis

Mindfulness, mindful eating and intuitive eating practices are associated with healthier eating and lower body weight. However, experimental research in this area has shown mixed effects on food intake and theoretical accounts are underdeveloped. This systematic review and meta-analysis aimed to examine the effect of mindfulness, mindful eating and intuitive eating interventions on food intake and appetite (hunger and fullness) in adults and children and compare effects across different subgroups to investigate potential mechanisms of action. Five electronic databases (PsycINFO, MEDLINE, EMBASE, Web of Science and Scopus) were searched for studies that experimentally manipulated mindfulness and/or mindful eating and/or intuitive eating, included a non-mindfulness control group and measured food intake (kcal or grams or percentage consumed or number of pieces consumed) and/or appetite (using visual analogue scales). Forty-one articles assessing mindfulness and mindful eating interventions were included (no relevant intuitive eating interventions were identified). Random-effects meta-analyses showed that mindfulness/mindful eating reduced food intake (n = 46 studies, SMD = -0.24, 95% CI [-0.35, -0.12], p < 0.001) but had no statistically significant effect on appetite (n = 11 studies). There were no significant subgroup differences observed between studies with different settings, interventions or food intake measures. However, effect sizes were substantially larger in laboratory-based studies. Overall, findings indicate that mindfulness and mindful eating reliably reduce food intake in controlled settings, but currently there is no evidence they influence appetite. The review underscores the need for higher quality and more ecologically valid studies using sensitive, real-world measures of appetite and food intake, and further work to clarify the mechanisms of action underpinning the effects of mindfulness and mindful eating.