***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To explore the efficacy of a mindfulness-based weight loss intervention for women . Sixty-two women ( ages 19 - 64 ; BMI 22.5 - 52.1 ) who were attempting to lose weight were r and omised to an intervention or control condition . The former were invited to attend four 2-h workshops , the latter were asked to continue with their normal diets . Data were collected at baseline , 4 and 6 months . BMI , physical activity , mental health . At 6 months intervention participants showed significantly greater increases in physical activity compared to controls ( p<.05 ) but no significant differences in weight loss or mental health . However , when intervention participants who reported ' never ' applying the workshop principles at 6 months ( n=7 ) were excluded , results showed both significantly greater increases in physical activity ( 3.1 sessions per week relative to controls , p<.05 ) and significantly greater reductions in BMI ( 0.96 relative to controls , equivalent to 2.32 kg , p<0.5 ) . Reductions in BMI were mediated primarily by reductions in binge eating . Despite its brevity , the intervention was successful at bringing about change . Further refinements should increase its efficacy Psychological distress and elevated cortisol secretion promote abdominal fat , a feature of the Metabolic Syndrome . Effects of stress reduction interventions on abdominal fat are unknown . Forty-seven overweight/obese women ( mean BMI = 31.2 ) were r and omly assigned to a 4-month intervention or waitlist group to explore effects of a mindfulness program for stress eating . We assessed  mindfulness , psychological distress , eating behavior , weight , cortisol awakening response ( CAR ) , and abdominal fat ( by dual-energy X-ray absorptiometry ) pre- and posttreatment . Treatment participants improved in mindfulness , anxiety , and external-based eating compared to control participants . Groups did not differ on average CAR , weight , or abdominal fat over time . However , obese treatment participants showed significant reductions in CAR and maintained body weight , while obese control participants had stable CAR and gained weight . Improvements in mindfulness , chronic stress , and CAR were associated with reductions in abdominal fat . This proof of concept study suggests that mindfulness training shows promise for improving eating patterns and the CAR , which may reduce abdominal fat over time Background Obesity is a growing epidemic . Weight control interventions can achieve weight loss , but most is regained over time . Stigma and low quality of life are significant problems that are rarely targeted . Purpose A new model aim ed at reducing avoidant behavior and increasing psychological flexibility , has shown to be relevant in the treatment of other chronic health problems and is worth examining for improving the lives of obese persons . Methods Patients who had completed at least 6 months of a weight loss program ( N = 84 ) were r and omly assigned to receive a 1-day , mindfulness and acceptance-based workshop targeting obesity-related stigma and psychological distress or be placed on a waiting list . Results At a 3-month follow-up , workshop participants showed greater improvements in obesity-related stigma , quality of life , psychological distress , and body mass , as well as improvements in distress tolerance , and both general and weight-specific acceptance and psychological flexibility . Effects on distress , stigma , and quality of life were above and beyond the effects due to improved weight control . Mediational analyses indicated that changes in weight-specific acceptance coping and psychological flexibility mediated changes in outcomes . Conclusion Results provide preliminary support for the role of acceptance and mindfulness in improving the quality of life of obese individuals while simultaneously augmenting their weight control efforts The present study utilized an analog paradigm to investigate the effectiveness of two strategies for coping with food cravings , which was theorized to be critical to the maintenance of weight loss . Ninety-eight undergraduate students were given transparent boxes of chocolate Hershey 's Kisses and instructed to keep the chocolates with them , but not to eat them , for 48 h. Before receiving the Kisses , participants were r and omized to receive either ( a ) no intervention , ( b ) instruction in control-based coping strategies such as distraction and cognitive restructuring , or ( c ) instruction in acceptance-based strategies such as experiential acceptance and defusion techniques . Measures included the Power of Food Scale ( PFS ; a measure of psychological sensitivity to the food environment ) , self-report ratings of chocolate cravings and surreptitiously recorded chocolate consumption . Results suggested that the effect of the intervention depended on baseline PFS levels , such that acceptance-based strategies were associated with better outcomes ( cravings , consumption ) among those reporting the highest susceptibility to the presence of food , but greater cravings among those who scored lowest on the PFS . It was observed that craving self-report measures predicted chocolate consumption , and baseline PFS levels predicted both cravings and consumption . Results are discussed in terms of the implication s for weight loss maintenance strategies Objective To determine whether acceptance-based behavioral treatment ( ABT ) would result in greater weight loss than st and ard behavioral treatment ( SBT ) , and whether treatment effects were moderated by interventionist expertise or participants ’ susceptibility to eating cues . Recent research suggests that poor long-term weight control outcomes are due to lapses in adherence to weight control behaviors , and that adherence might be improved by enhancing SBT with acceptance-based behavioral strategies . Design and Methods Overweight participants ( n = 128 ) were r and omly assigned to 40 weeks of SBT or ABT . Results Both groups produced significant weight loss and , when administered by experts , weight loss was significantly higher in ABT than SBT at post-treatment ( 13.17 % v. 7.54 % ) and 6-month follow-up ( 10.98 % v. 4.83 % ) . Moreover , 64 % of those receiving ABT from experts ( v. 46 % for SBT ) maintained at least a 10 % weight loss by follow-up . Moderation analyses revealed a powerful advantage , at follow-up , of ABT over SBT in those potentially more susceptible to eating cues . For participants with greater baseline depression symptomology , weight loss at follow-up was 11.18 % in ABT vs. 4.63 % in SBT ; other comparisons were 10.51 % vs. 6.00 % ( emotional eating ) , 8.29 % v. 6.35 % ( disinhibition ) and 9.70 % v. 4.46 % ( responsivity to food cues ) . Mediation analyses produced partial support for theorized food-related psychological acceptance as a mechanism of action . Conclusions Results offer strong support for the incorporation of acceptance-based skills into behavioral weight loss treatments , particularly among those with greater levels of depression , responsivity to the food environment , disinhibition and emotional eating , and especially when interventions are provided by weight control experts . Trial Registration clinical trials.gov identifier : Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons . The current article specifies and vali date s an active control condition , the Health Enhancement Program ( HEP ) , thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction ( MBSR ) and for testing mindfulness as an active ingredient . 63 participants were r and omized to either MBSR ( n = 31 ) or HEP ( n = 32 ) . Compared to HEP , MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition ( η(2 ) = .18 ) . There were significant improvements over time for general distress ( η(2 ) = .09 ) , anxiety ( η(2 ) = .08 ) , hostility ( η(2 ) = .07 ) , and medical symptoms ( η(2 ) = .14 ) , but no effects of intervention . Practice was not related to change . HEP is an active control condition for MBSR while remaining inert to mindfulness . These cl aims are supported by results from a pain task . Participant-reported outcomes ( PROs ) replicate previous improvements to well-being in MBSR , but indicate that MBSR is no more effective than a rigorous active control in improving these indices . These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR Mindful eating may be an effective intervention for increasing awareness of hunger and satiety cues , improving eating regulation and dietary patterns , reducing symptoms of depression and anxiety , and promoting weight loss . Diabetes self-management education ( DSME ) , which addresses knowledge , self-efficacy , and outcome expectations for improving food choices , also may be an effective intervention for diabetes self-care . Yet few studies have compared the impact of mindful eating to a DSME-based treatment approach on patient outcomes . Adults 35 to 65 years old with type 2 diabetes for ≥1 year not requiring insulin therapy were recruited from the community and r and omly assigned to treatment group . The impact of a group-based 3-month mindful eating intervention ( MB-EAT-D ; n = 27 ) to a group-based 3-month DSME “ Smart Choices ” ( SC ) intervention ( n = 25 ) postintervention and at 3-month follow-up was evaluated . Repeated- measures ANOVA with contrast analysis compared change in outcomes across time . There was no significant difference between groups in weight change . Significant improvement in depressive symptoms , outcome expectations , nutrition and eating-related self-efficacy , and cognitive control and disinhibition of control regarding eating behaviors occurred for both groups ( all p < .0125 ) at 3-month follow-up . The SC group had greater increase in nutrition knowledge and self-efficacy than the MB-EAT-D group ( all p < .05 ) at 3-month follow-up . MB-EAT-D had significant increase in mindfulness , whereas the SC group had significant increase in fruit and vegetable consumption at study end ( all p < .0125 ) . Both SC and MB-EAT-D were effective treatments for diabetes self-management . The availability of mindful eating and DSME-based approaches offers patients greater choices in meeting their self-care needs OBJECTIVES The purpose of this study was to pilot a brief ( 6-week ) group curriculum for providing mindfulness training to obese individuals , called Mindful Eating and Living ( MEAL ) . SETTING AND DESIGN Participants were recruited through a local Young Men 's Christian Association ( YMCA ) in spring 2006 . Data was collected at three time points : baseline , completion of intervention ( 6 weeks ) , and 3-month follow-up ( 12 weeks ) . INTERVENTION Six weekly two-hour group classes ( with two monthly follow-up classes ) . Content included training in mindfulness meditation , mindful eating , and group discussion , with emphasis on awareness of body sensations , emotions , and triggers to overeat . MAIN OUTCOME MEASURES Key variables assessed included changes in weight , body-mass index ( BMI ) , eating behavior , and psychological distress . In addition , physiological markers of cardiovascular risk were evaluated including C-reactive protein ( hsCRP ) , adiponectin , low-density lipoprotein ( LDL ) , and plasminogen activator inhibitor-1 ( PAI-1 ) . RESULTS Ten obese patients enrolled with a mean BMI of 36.9 kg/m² [ SD±6.2 ] . The mean weight was 101 kg/m² and the mean age was 44 years ( SD=8.7 ; range=31 - 62 ) . Compared to baseline data , participants showed statistically significant increases in measures of mindfulness and cognitive restraint around eating , and statistically significant decreases in weight , eating disinhibition , binge eating , depression , perceived stress , physical symptoms , negative affect , and C-reactive protein . CONCLUSIONS This study provides preliminary evidence that a eating focused mindfulness-based intervention can result in significant changes in weight , eating behavior , and psychological distress in obese individuals Recent research has identified that mindfulness meditation in group setting s supports people who are trying to lose weight . The present research investigated mindfulness meditation in group and individual setting s , and explored the potential impact on weight loss and other factors ( i.e. mindfulness , impulsivity , and avoidance ) that may assist or hinder weight loss . Specifically , the hypotheses tested were that the group setting assisted dieters more than the individual setting by reducing weight , cognitive-behavioral avoidance , and impulsivity and by increasing mindfulness . Participants ( n = 170 ) who were trying to lose weight were r and omly assigned to practice meditation for 6 weeks within a group or independently . Measurements in mindfulness , cognitive-behavioral avoidance , impulsivity , and weight occurred twice ( pre- and post-intervention ) . Results indicated that participants in the group setting lost weight and lowered their levels of cognitive-behavioral avoidance , while impulsivity and mindfulness remained stable . On the other h and , participants in the individual condition lost less weight , while there was an increase in cognitive-behavioral avoidance and mindfulness scores , but a decrease in impulsivity . Seeing that benefits and limitations observed in group setting s are not replicated when people meditate alone , this study concluded that mindfulness meditation in individual setting s needs to be used with caution , although there are some potential benefits that could aid future weight loss research 
    Output:
    
However , studies do not clarify the degree to which changes in mindfulness are a mechanism responsible for weight loss in mindfulness interventions .