(PS12-B32) Mindfulness as a Direct Predictor of Quality of Life in Behavioral Weight Loss Interventions

An increasing number of behavioral weight loss programs have begun to incorporate mindfulness and acceptance-based treatment (MABT) to improve outcomes. Within the context of a behavioral weight loss intervention, mindfulness may impact quality of life through two mechanisms. First, mindfulness could lead to increased weight loss, which then leads to higher quality of life. Specifically, mindfulness promotes awareness of hunger/satiety cues, nonjudgmental, nonreactive responding to emotions/cognitions (stress, boredom, etc.) that can lead to overeating and subsequent weight gain, and willingness to engage in weight loss behaviors (portion control, calorie tracking, etc.) despite the presence of negative internal experiences, improving weight loss outcomes. This increased weight loss subsequently improves health and encourages engagement in valued life activities, leading to a higher quality of life. The other mechanism supposes that mindfulness has a direct relationship to quality of life even when accounting for weight loss. Nonjudgement and nonreactivity to negative internal experiences, in addition to increased awareness of positive experiences, should lead to more neutral/positive cognitive appraisals of life situations (including those not related to weight), which then leads to increased quality of life broadly. The aims of this study were to 1) test the hypothesis that mindfulness is capable of explaining a significant degree of variance in quality of life beyond that explained by changes in weight, and 2) examine which of the five facets of mindfulness (observing, describing, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience) best predict quality of life. This study used data collected from a parent study in which participants with overweight or obesity (N = 288) were randomized to one of eight 12-month treatment conditions in a 2 x 2 x 2 factorial design. Each treatment condition contained a combination of standard behavioral weight loss treatment and one or more components of MABT: mindful awareness, mindful acceptance, and values awareness. A hierarchical multiple linear regression demonstrated that percent weight change from mid-treatment to post-treatment had a significant, negative relationship to quality of life at post-treatment (β = -.22, t(223) = -3.31, p = .001, sr2 = .05) and explained 4% of the variance (adjusted R2 = .04, F(1, 223) = 10.97, p = .001). The addition of the five facets of mindfulness as measured at mid-treatment had a significant effect on the model, explaining 20% more of the variance (adjusted R2 Change = .20, F(6, 218) = 12.99, p < .001). Of the five facets of mindfulness, acting with awareness (β = .15, t(218) = 2.31, p = .02, sr2 = .02) and nonreactivity to inner experience (β = .22, t(218) = 3.12, p = .002, sr2 = .03) had significant, positive relationships to quality of life. This study is the first to establish a direct relationship between mindfulness and quality of life in the context of a behavioral weight loss intervention, suggests that mindfulness training can potentially promote overall well-being even when clinically meaningful weight loss is not achieved, and also has implications for which aspects of mindfulness should be emphasized in treatment.