REF2021 04Z_ICS_B: Mindful Construal Reflection: A novel intervention which promotes healthier eating habits

    Impact: Quality of life impacts

    Description of impact

    Dr Mantzios and Dr Egan developed a novel mindfulness-based intervention to help overweight people make the necessary lifestyle changes needed in order to lose and maintain weight.

    With obesity a prevalent global concern– costing health services in excess of £1 trillion every year, Mantzios and Egan worked with clinicians to implement their Mindful Construal Reflection tool, which demonstrated a sustained change in patients’ eating behaviours and attitudes towards food. Participants in trials testified that using the tool has helped them improve their diets and quality of life. The tool has been adopted into clinical practice across UK and international organisations.

    Details of Impact

    The team’s Mindful Construal Diary and online version, the Mindful Construal Reflection tool has been adopted for clinical use across the UK, by organisations including University Hospitals Birmingham NHS Foundation Trust. Beyond the UK, Mantzios and Egan’s work has influenced clinician’s practice of care in internationally:

    Mindful Construal Reflection (MCR) Clinical Trial:

    Mantzios and Egan partnered with clinicians at University Hospital Birmingham Foundation Trust’s Heartland’s Hospital to explore how 60 patients’ responded to clinicians adopting the MCR into practice (S01). Results from these trials conducted within the bariatric clinic, found that patients who engaged with the MCR at least 3 times a day were statistically more likely to think about what they were eating and how snacking made them feel (on the emotional sub-scale). The results of the trial also revealed that engagement with the MCR raised participants’ awareness to when their eating was a response to emotional stressors. Moreover, patients’ reported significantly engaging more frequently with mindful eating practices, including lower non-distractibility and unstructured eating and higher non-reactivity and acceptance behaviour. These effects were medium in size and ranged from d = 0.46 to d = 0.59. Such findings laid the foundations for participants and users of the MCR to identify and modify their own eating behaviours – in particular with grazing and how frequently they comfort ate unhealthy foods. (S02)

    Qualitative trial data showed that the tool changed patients’ eating behaviour and relationship with food, regardless of how frequently they used the MCR. These changes included a renewed enjoyment and pleasure in eating, and an increased intake of healthier foods in both patient groups. Patients noted the utility of the MCR in helping them to embed mindful eating practices into their routine, through enabling them to evaluate the taste, smell and texture of their meals and their food intake (S03, S04):

    “That [MCR] card is brilliant because I can hear it in my head saying ‘how does it taste, how does it smell and you can smell it which I can I really can smell the smells better and taste it better, whereas [before] I [would] just wuff it [eat it very fast] and think that was alright and I didn’t taste it” - Participant 11b (S03).

    “[using the MCR was] [b]etter because I was in control. You would eat but you didn’t realise that you were eating…so you were overeating but being mindful you know yeah I’ve had this so you are more in control of what you need to do” – Participant 4 (S03)

    Such comments demonstrate that the MCR is changing clinicians’ practice of care and this is improving patients’ experience of such care.

    Changing practice and improving health outcomes

    Clinicians outside the UK have also engaged with the tool and found it beneficial to their practice and their patient’s outcomes.

    “I am a dietitian, and I utilise Dr Michael Mantzios’ research findings in my practice, which allows me to exploit the most effective elements in designing mindful eating groups. In particular, I utilise the Mindful Construal Diary (e.g., Mantzios & Wilson, 2015; Mantzios, 2018; Mantzios, Skillett, & Egan, 2019) with clients to foster mindful eating. I regularly see in my practice that the mindful eating diary is appraised as very helpful by my clients in aiding them to change their diet behaviour” – Dietitian from Corfu (S05)

    “I have including mindful eating practices (specifically, MCR) in my services. I've also held workshops on mindful eating”. – Spanish Healthcare professional (S06)

    Feedback on the use of the tool with clinically obese patients has proven to have directly contributed to the healthcare professional’s own practice. Implementation of the tool helped service users to support their weight regulation and established a change in their eating behaviours.

    Based on research findings of prof. M. Mantzios I have desighed [sic] and run a 8-week mindful eating intervention, called EATT […]The EATT intervention had helped, since 2016, more than 70 people to change their relationship with their food and their body. The EATT intervention still running twice per year. – Greek dietician (S06)

    “Dr Mantzios' work has greatly informed my clinical practice, including both the assessment, diagnosis and treatment of eating disorders. Dr Mantzios' published work had encouraged my use of mindfulness and compassion-focused therapy approaches for clients with eating disorders” – Clinical psychologist in Australia (S08)

    Patients reported benefits in the way they ate and successfully reshaped maladaptive eating behaviours that were responsible for gaining weight:

    My portion sizes have gone down a lot er:m and like (.) the takeaways and stuff I could demolish one on my own (.) which I don’t do anymore – Participant 47 (S03)

    The MCR tool was provided online free of charge and directed to a small number clinicians (N=9), who were then invited to complete a survey to evaluate the usefulness of the tool for their practice. We discovered that all the clinicians surveyed found the tool useful and after reviewing the tool have already begun to adopt the MCR into their own practice and research:

    “By giving scientific knowledge and useful tools wich [sic] helps me to support my mindful approach to eating behaviour [sic] and to introduce and implement practices in my one on one and group sessions.” – UK healthcare professional (S06)

    “It has provided scientific support to some of the mindful eating practices I was already using and it provided me with new tools to use.” – Spanish healthcare professional (S06)

    Obesity is a global health problem and the work of Dr Mantzios and Dr Egan has changed clinicians’ practice of care, enabling them to adopt new easy to use approaches focussing on mindfulness, and implement an innovative evidence based practical tool in the MCR , with a view to improving the lifestyle and wellbeing experiences of obese and overweight people.
    Impact date20142020
    Category of impactQuality of life impacts