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.

Craniopharyngiomas are low-grade suprasellar intracranial tumours associated with hypothalamic-pituitary axis dysfunction and obesity. This scoping review aimed to explore the potential impact of hyperphagic eating behaviour and appetitive factors on the development of craniopharyngioma-associated obesity and to identify areas for future intervention. PRISMA-ScR and JBI methodology was followed. Five databases and two trial registries were searched. All published studies of patients with childhood or adult-onset craniopharyngioma that addressed eating behaviours in conjunction with pharmaceutical/surgical interventions, neuroimaging, endocrine responses, energy expenditure, sleep and/or neuropsychology were included in this review. Evidence surrounding eating behaviours in craniopharyngioma patients was sparce with only 10 of the 50 included papers using validated eating behaviour assessments. Eating behaviour was included as a primary outcome (n=7), secondary outcome (n=12) or commented on without formal measurement (n=31). Few studies included patients with adult-onset craniopharyngioma (n=8) or compared patients with craniopharyngioma with and without obesity (n=2), and no papers were identified that attempted to modify eating behaviours as an intervention for craniopharyngioma-related obesity. Further understanding of eating behaviour in craniopharyngioma patients through longer-term research with validated measures will improve our understanding of mechanisms underlying craniopharyngioma-associated obesity and inform clinical practice by allowing treatments tailored for patient-centred care.

Childhood obesity levels continue to rise, with significant impact on individuals and the NHS. The 'Complications of Excess Weight' (CEW) clinics provide support to young people with complications of their weight. Our objective was to co-develop, with young people, a new intervention; AIM2Change, to enable young people to develop their intrinsic motivation to manage weight, using Acceptance and Commitment Therapy (ACT), with a person-centred approach. Young people from the Care of Childhood Obesity (CoCO) clinic in Bristol, UK, were recruited to co-develop this intervention. The study was registered on ISRCTN (ISRCTN16607863). The seven-session, ACT-based intervention was delivered one-to-one, securely online. Qualitative interviews were conducted after each intervention session was delivered. Qualitative data were coded and reviewed regularly to make iterative changes to individual sessions and the overall programme. Fourteen co-developers were recruited, of whom nine completed the co-development process (female = 4; median age (IQR)=15(1.5); 4 with a parent; Indices of Multiple Deprivation (IMD) median = 3.5, range = 1-10). Iterative changes made during co-development included introducing an earlier focus on eating behaviour and body image, with more practical activities to increase engagement. Thematic analysis of co-developer feedback identified four themes: theoretical understanding; delivery and receipt of therapy; view of strategies and engagement; real world benefits of co-development process. Framework analysis was conducted to map data pertaining to these themes into matrices according to each participant and session. Insights from the co-development process have shaped AIM2Change to optimise the intervention's value, relevance and acceptability. Findings suggest that AIM2Change meets an unmet need in delivery of current childhood weight management services.

OBJECTIVE:This study investigated the safety, tolerability, and preliminary efficacy of Sirona, a novel gastro-retentive, dual-network polymer for weight management. METHODS:This pilot trial comprised a randomized, parallel-group, double-blind, placebo-controlled (3:1 ratio), 12-week period, with a 12-week open-label extension (OLE), in participants with BMI of 30-40 kg/m2. Primary endpoints were feasibility, tolerability, and safety; secondary endpoints included weight loss and dietary intake, tested using Hedge's g [95% CI] as a measure of effect size. RESULTS:Participants received Sirona (n = 29/38) or Placebo (n = 9/38) (mean [SD] age = 40.9 [8.4]; weight = 101.7 [12.9] kg; BMI = 35.6 [3.0]; 29/38 female and 23/38 White British). Dosing was well tolerated (RCT Sirona: 95.2 [11.0]%; RCT Placebo: 97.8 [3.5]%; RCT + OLE Sirona: 93.1 [13.0]%). No serious adverse events occurred. Of the adverse events, nausea was most prominent (74.8%), mostly graded mild (79.3%) and requiring no intervention (84.4%). Percentage total body weight loss was greater for Sirona compared to Placebo after 12 weeks (3.9 [3.0]% versus 1.0 [2.1]%, g = 0.96 [-1.81, -0.10]). Weight loss continued in the OLE (change from baseline = 4.4 [3.8]%). Dietary intake reduced from baseline after 12 weeks of treatment (-382.5 [519.3] kcal; Placebo = 93.5 [670.3] kcal, g = -0.8 [-1.7, 0.0]) and after 24 weeks (-338.2 [486.7] kcal, g = 0.7 [0.2, 1.1]). CONCLUSIONS:Sirona was well tolerated, with mild, primarily gastrointestinal side effects. Reduced weight and dietary intake suggest Sirona is suitable as a nonpharmacological treatment for weight management. TRIAL REGISTRATION:ISRCTN14083641 (https://doi.org/10.1186/ISRCTN14083641).

A key component of mindful eating is paying attention to the sensory properties of one's food as one eats ("sensory eating"). Some studies have found this reduces subsequent food intake while others have failed to replicate these effects. We report four laboratory studies that (a) examine effects of sensory eating on subsequent intake and (b) explore potential mechanisms of action. In each study, participants ate a small high-calorie snack with or without sensory eating and, 5-15 min later, were given larger snack portions from which they could eat freely. Sensory eating reduced intake of the second snack and could not be explained by increased sensory-specific satiety or priming of health-related goals. However, this effect disappeared when we controlled eating rate for the first snack. Given evidence that slower eating increases satiation and reduces intake, we conclude that sensory eating reduces intake by slowing eating rate. Exploratory analyses also revealed that (among nondieters) effects of sensory eating were pronounced when participants reported higher hunger. Thus, for weight management, sensory eating may be most beneficial for those who are naturally fast eaters and/or in situations where people are inclined to eat more quickly, for example, when hungry or in a hurry. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Time-limited eating (TLE) improves body weight and metabolic health in adults; however, little is known about effects in younger populations (YP). TLE in adolescents can reduce calorie consumption, but studies have not demonstrated superior weight loss compared to other dietary practices. Minimal research exists into associations between eating window (EW) in YP and health outcomes. Methods: Three-day diet diaries (ages 7, 13 years) collected in the Avon Longitudinal Study of Parents and Children (ALSPAC) were used to calculate EW. Height, weight, body composition, blood pressure, and fasting bloods were recorded during clinic visits at ages 7, 13, and 24. Linear or logistic regression models were used to analyse cross-sectional and longitudinal associations, accounting for potential confounders. Results: Mean EW was 10.9 h (standard deviation 1.1) and 11.1 h (1.8) at ages 7 and 13, respectively. At age 7 (N = 4799), a longer EW was positively associated with body mass index z-score (BMIz) (beta coefficient (β) 0.04 (95% confidence interval 0.01, 0.07) p = 0.01), whilst at age 13 (N = 4712) a longer EW showed inverse associations with BMIz (β −0.026 (−0.046, −0.006) p = 0.01), waist to height ratio (WtHR) (β −0.001 (−0.002, −0.000) p = 0.005), waist circumference (WC) (cm) (β −0.211 (−0.370, −0.053) p = 0.009), diastolic blood pressure (DBP) (mmHg) (β −0.132 (−0.254, −0.009) p = 0.04), and fat mass (FM) (%) (β −0.447 (−0.607, −0.286) p < 0.001). Longitudinally, a longer EW at age 13 (N = 2534) was inversely associated with FM (%) at age 24 (β −0.307 (−0.487, −0.127) p < 0.001). Conclusions: A longer EW in adolescence was associated cross-sectionally with lower BMIz, WtHR, WC, DBP, and FM and longitudinally with lower FM at age 24, albeit with small effect sizes.

Self-reported physical activity is associated with lower brain food cue responsiveness in reward-related regions, but relationships utilizing objective physical activity measurement tools have not been explored. This cross-sectional study examined whether device-measured moderate-to-vigorous intensity physical activity and sedentary time are related to neural responses to visual food cues using functional magnetic resonance imaging. Fifty-one healthy adults (30 men, 21 women; mean ± SD: age 26 ± 6 years; body mass index 24.1 ± 3.0 kg/m 2 ) underwent a functional magnetic resonance imaging scan after an overnight fast while viewing images of high/very high-energy density foods (HED), very low/low-energy density foods (LED) and non-food objects. Free-living moderate-to-vigorous intensity physical activity and sedentary time were measured for seven consecutive days using an ActiGraph wGT3X-BT and activPAL4 accelerometer, respectively. Associations of behavioural variables with brain food cue reactivity were examined in regression models controlling for physiological and behavioural covariates. After adjusting for age, sex, body mass index and device weartime, moderate-to-vigorous intensity physical activity was negatively associated with reactivity to LED versus non-food cues in the precentral gyrus, hippocampus, posterior insula, and amygdala, which may diminish inhibitory-related responses towards healthier lower energy value foods. Time spent in moderate-to-vigorous intensity physical activity was positively associated with reactivity to LED versus non-food cues in the dorsal striatum, a region implicated in food motivation. A positive association was identified between sedentary time and reactivity to HED versus non-food cues in the dorsal division of the posterior cingulate gyrus that has been implicated in attention allocation. These findings suggest that moderate-to-vigorous intensity physical activity may enhance the appeal of and motivation to consume LED foods, whereas sedentary time may promote attention towards HED foods, highlighting the potential for engaging in greater physical activity and less sedentary time to positively influence the central (brain) appetite control system.

Researchers often use trait-based questionnaires to characterise dietary restraint, but it is unclear how this relates to real-life appetite and eating behaviour. Advances in technology have facilitated the development of ecological momentary assessment (EMA), an approach which captures everyday experiences in real-time. The aim of this study was to use our novel EMA tool (Momentary appetite capture; MAC) to investigate appetite and prospective portion-size selection throughout the day in 'trait-based' restrained eaters, and to explore whether 'state-based' dietary restraint can be measured using MAC and how this relates to BMI. Ninety-four participants (mean BMI = 22.4, 78 females) received seven text message MAC prompts per day for two consecutive weekdays. Each MAC measured current appetite, portion-size selection, and state-based dietary restraint. For each appetite measure, and each participant, we calculated a daily area-under-the-curve and daily range. For state-based restraint, the percentage of occasions that participants reported not eating a food they were tempted by but trying to avoid was calculated. We found that trait-based dietary restraint (TFEQ-18) was negatively correlated with daily area under the curve for hunger (r(83) = -0.25, p = .022), and prospective portion-size selection (r(83) = -0.27, p = .013), as well as daily range for prospective portion-size selection (r(93) = -0.24, p = .021). Exploratory analysis revealed a negative relationship (ρ = -0.40, p = .003, N = 53) between our MAC state-based measure of dietary restraint and BMI. These findings highlight the utility of MAC to measure fluctuations in appetite and state-based dietary restraint throughout the day. This study also demonstrates the potential to apply this work to understand how real-world dietary restraint impacts BMI.

Abstract Objectives Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre‐registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four “positive controls”: restraint, disinhibition, emotional eating, plate clearing) and self‐reported BMI. The timing of data collection (April–May 2020) during the SARS‐CoV‐2 pandemic enabled an investigation of the impact of stay‐at‐home restrictions imposed on the UK population on the measures of eating behavior. Methods An online survey was completed, including: (i) demographic data (e.g., self‐reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID‐19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ). Results A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ‐total score) was associated with a lower self‐reported BMI (β = −0.12; 95% CI = −0.20, −0.04; p = 0.004), whereas disinhibited eating was associated with a higher self‐reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating. Conclusions These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action.

Introduction: Craniopharyngiomas are rare brain tumours (incidence 1.1–1.7 cases/million/year). Although non-malignant, craniopharyngioma causes major endocrine and visual morbidities including hypothalamic obesity, yet mechanisms leading to obesity are poorly understood. This study investigated the feasibility and acceptability of eating behaviour measures in patients with craniopharyngioma to inform the design of future trials. Methods: Patients with childhood-onset craniopharyngioma and controls matched for sex, pubertal stage, and age were recruited. After an overnight fast, participants received the following measures: body composition, resting metabolic rate, oral glucose tolerance test including magnetic resonance imaging (patients only), appetite ratings, eating behaviour, and quality of life questionnaires, ad libitum lunch, and an acceptability questionnaire. Data are reported as median ± IQR, with effect size measure (Cliff’s delta) and Kendall’s tau for correlations, due to the small sample size. Results: Eleven patients (median age = 14 years; 5 F/6 M) and matched controls (median age = 12 years; 5 F/6 M) were recruited. All patients had received surgery, and 9/11 also received radiotherapy. Hypothalamic damage post-surgery was graded (Paris grading): grade 2 n = 6; grade 1 n = 1; grade 0 n = 2. The included measures were deemed highly tolerable by participants and their parent/carers. Preliminary data suggest a difference in hyperphagia between patients and controls (d = 0.5), and a relationship between hyperphagia with body mass index standard deviation score (BMISDS) in patients (τ = 0.46). Discussion: These findings demonstrate that eating behaviour research is feasible and acceptable to craniopharyngioma patients and there is an association between BMISDS and hyperphagia in patients. Thus, food approach and avoidance behaviours may be useful targets for interventions to manage obesity in this patient group.

This abstract was awarded the Student Competition prize.Time-limited eating is a dietary intervention whereby calorie intake is limited to a specific window of time during the day(1). The usual eating windows (EW) of adults, and how this can be manipulated for dietary interventions, is well documented(2). However, there is a paucity of data on the usual EW of children and adolescents, which may be a useful intervention for reducing obesity.The primary objective was to systematically review existing literature on the usual EW of children and adolescents. Secondary objectives were to identify average clock times of first and last food/drink intakes and also variations in EW and clock times by age, nationality or weight status subgroups, if available data allowed.Two databases (Medline and Embase) were searched for eligible papers published between February 2013 and February 2023. Included papers were forward searched using the citation network on Web of Science. 6347 papers were identified, and after deduplication 4569 papers were screened by two independent reviewers. Methodological quality was assessed using a Joanna Briggs Institute checklist(3).Ten studies were included, with both observational and experimental designs. These studies had a total population of 4,589 participants, with individual study sample sizes ranging from 22 to 2195. Ages of participants ranged from 6 – 20 years, with six studies involving adolescents alone (≥10 years), and four involving children and adolescents. There were four studies from the USA, two from Germany and one each from Brazil, India, The Netherlands and pan-European.Narrative synthesis showed large variations in average eating windows from 9.7 to 16.4 hours. Only four studies included clock times of intake, with large variations in both first and last intake times. Five studies were included in a random-effects meta-analysis, in which heterogeneity was considerable (I2 = 95.8%), and pooled duration of usual daily eating was 11.3 hours (95% confidence interval (CI) 10.95, 11.73). Sources of heterogeneity included differences in study design and populations, variation in dietary assessments methods and definition of eating windows. Narrative synthesis of an adolescent sub-group showed eating windows increased as children got older. Four studies were included in a random-effects sub-group meta-analysis, with a pooled EW of 11.2 hours (95% CI 10.27, 12.05; I2 = 96.6%) in adolescents. Insufficient data prevented further subgroup analysis.In conclusion large variations in eating windows exist across different study populations, with limited data available on first and last intake times; however, the pooled data suggest it may be possible to design time-limited eating interventions in paediatric populations aimed at reducing eating windows. Further high-quality research, of eating windows and associations with health outcomes, is needed.

Time-limited eating is a dietary intervention whereby eating is limited to a specific window of time during the day. The usual eating windows of adults, and how these can be manipulated for dietary interventions, is well documented. However, there is a paucity of data on eating windows of young people, the manipulation of which may be a useful intervention for reducing obesity. This paper reviewed the existing literature on the eating windows of children and adolescents, aged 5–18 years, plus clock times of first and last intakes and variations by subgroup. Two databases (Medline and Embase) were searched for eligible papers published between February 2013 and February 2023, with forward searching of the citation network of included studies on Web of Science. Articles were screened, and data extracted, in duplicate by two independent reviewers. Ten studies were included, with both observational and experimental designs. Narrative synthesis showed large variations in eating windows with average values ranging from 9.7 h to 16.4 h. Meta-analysis, of five studies, showed a pooled mean daily eating window of 11.3 h (95% CI 11.0, 11.7). Large variations in eating windows exist across different study populations; however, the pooled data suggest that it may be possible to design time-limited eating interventions in paediatric populations aimed at reducing eating windows. Further high-quality research, investigating eating windows and subsequent associations with health outcomes, is needed.

This preregistered review sought to appraise what interventions have been developed and trialled applying acceptance and commitment therapy (ACT) for weight management in adolescents with regard to the acceptability, feasibility of and benefit that such interventions offer to participants. The impact of ACT on eating behaviour, weight management and wellbeing were of particular interest. Studies based on ACT interventions as a treatment for adolescents (age 11–18 years) with overweight or obesity were included in this review. No limits to language or search date were implemented. Systematic searches of the literature were conducted using the following databases – Medline, Scopus, Embase, Web of Science and PsycInfo. International Standard Randomised Controlled Trial Number, Clinical-Trials.gov, Cochrane Central Register of Controlled Trials, National Institute for Health and Care Excellence and OpenGrey were also searched. The studies were collated, data was extracted, and a narrative analysis was conducted. Cincinnati Children's Hospital Medical Centre's Let Evidence Guide Every New Decision evidence evaluation tools and resources were used for assessing studies' quality. Searches identified 267 texts that were retrieved for screening. Following review by two independent authors, 13 texts detailing the work of six ACT interventions were included. The quality assessment showed that there is currently a low body of evidence for recommending ACT for the treatment of adolescents with overweight or obesity. Yet, the acceptability of ACT based interventions was high, with strong attendance and high retention rates. Participation in ACT-based interventions demonstrated some evidence that key ACT processes may yield support for weight change. For example, improvements in outcomes such as psychological flexibility and weight-related experiential avoidance indicate improved aspects of self-regulation. These findings in adolescents align with similar research in adults. While only six ACT-based interventions for weight management in adolescents have been developed to date, evaluating the related findings generated thus far offers opportunities to optimise the delivery and measurement of ACT approaches in future intervention designs. High quality, fully powered trials are now needed to increase the evidence for the beneficial effects of ACT for weight management.

Previously, narrative reviews have considered the effects of intermittent fasting on appetite. One suggestion is that intermittent fasting attenuates an increase in appetite that typically accompanies weight loss. Here, we conducted the first systematic review and meta-analysis to quantify the effects of intermittent fasting on appetite, when compared to a continuous energy restriction intervention. Five electronic databases and trial registers were searched in February 2021 and February 2022. Abstracts (N = 2800) were screened and 17 randomized controlled trials (RCTs), consisting of a variety of intermittent fasting regimes, met our inclusion criteria. The total number of participants allocated to interventions was 1111 and all RCTs were judged as having either some concerns or a high risk of bias (Cochrane RoB 2.0 tool). Random effects meta-analyses were conducted on change-from-baseline appetite ratings. There was no clear evidence that intermittent fasting affected hunger (WMD = −3.03; 95% CI [−8.13, 2.08]; p = 0.25; N = 13), fullness (WMD = 3.11; 95% CI [−1.46, 7.69]; p = 0.18; N = 10), desire to eat (WMD = −3.89; 95% CI [−12.62, 4.83]; p = 0.38; N = 6), or prospective food consumption (WMD = −2.82; 95% CI [−3.87, 9.03]; p = 0.43; N = 5), differently to continuous energy restriction interventions. Our results suggest that intermittent fasting does not mitigate an increase in our drive to eat that is often associated with continuous energy restriction.

Background: A multidisciplinary approach to weight management is offered at tier 3 pediatric weight management services in the United Kingdom. Encouraging dietary change is a major aim, with patients meeting with dieticians, endocrinologists, psychologists, nurse specialists, and social workers on average every other month.Objective: This research sought to trial an inhibitory control training smartphone app-FoodT-with the clinic population of a pediatric weight management service. FoodT has shown positive impacts on food choice in adult users, with resulting weight loss. It was hoped that when delivered as an adjunctive treatment alongside the extensive social, medical, psychological, and dietetic interventions already offered at the clinic, the introduction of inhibitory control training may offer patients another tool that supports eating choice. In this feasibility trial, recruitment, retention, and app use were the primary outcomes. An extensive battery of measures was included to test the feasibility and acceptability of these measures for future powered trials.Methods: FoodT was offered to pediatric patients and their parents during a routine clinic appointment, and patients were asked to use the app at home every day for the first week and once per week for the rest of the month. Feasibility and acceptability were measured in terms of recruitment, engagement with the app, and retention to the trial. A battery of psychometric tests was given before and after app use to assess the acceptability of collecting data on changes to food choices and experiences that would inform future trial work.Results: A total of 12 children and 10 parents consented (22/62, 35% of those approached). Further, 1 child and no parents achieved the recommended training schedule. No participants completed the posttrial measures. The reasons for not wanting to be recruited to the trial included participants not considering their weight to be connected to eating choices and not feeling that the app suited their needs. No reasons are known for noncompletion.Conclusions: It is unclear whether the intervention itself or the research processes, including the battery of measures, prevented completion. It is therefore difficult to make any decisions as to the value that the app has within this setting. Important lessons have been learned from this research that have potential broad relevance, including the importance of co-designing interventions with service users and avoiding deterring people from early-stage participation in extensive data collection.