The Mind-Eat Program Improves Mindful Eating and Related Behaviors in Adults with Overweight or Obesity: A Randomized Controlled Trial

The Mind-Eat Program Improves Mindful Eating and Related Behaviors in Adults with Overweight or Obesity: A Randomized Controlled Trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Mind-Eat Program Improves Mindful Eating and Related Behaviors in Adults with Overweight or Obesity: A Randomized Controlled Trial Marion Van Beekum, Angélique Rodhain, Rebecca Shankland, Soumeya Chetouane, and 13 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7456763/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Mindful eating interventions can reduce maladaptive eating behaviors, yet most structured programs have been tested in English-speaking countries, often using passive control groups. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured, mindfulness-based group intervention, compared to an active, intuitive eating–oriented education program in a clinical population with overweight or obesity. Methods In this single-center trial, 46 adults (BMI 25–50 kg/m²) consulting for the first time in a hospital nutrition unit were randomly assigned (1:1) to either the Mind-Eat program or an active control group receiving therapeutic patient education (TPE). The Mind-Eat group completed eight weekly experiential sessions and one follow-up session one month later. Assessments occurred at baseline (week 0), post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured using the validated Mind-Eat Scale. Secondary outcomes included intuitive and disordered eating behaviors, trait mindfulness, psychological well-being, physical activity, and weight. Results Mixed-effects models showed a significant Group × Time interaction for mindful eating scores at post-intervention (β = –.40, p = .002, d = − 1.32) and follow-up (β = –.31, p = .02, d = − 1.02), favoring the Mind-Eat group. Greater improvements were also found for intuitive eating, emotional and external eating, and trait mindfulness. No significant between-group differences were observed for cognitive restraint, psychological well-being, physical activity, or weight. Conclusions The Mind-Eat program improved mindful and intuitive eating beyond intuitive eating–oriented education. Weight stability is consistent with the program's behavioral rather than weight-loss focus. Trial registration The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411. Mindful Eating Eating Behavior Emotional Eating Intuitive Eating Overweight Obesity Randomized Controlled Trial Figures Figure 1 Figure 2 Figure 3 1. Introduction Traditional weight management interventions, which focus on caloric restriction and physical activity, often yield only short-term benefits, partly due to a lack of sustained behavioral change and emotional regulation ( 1 , 2 ). Recent studies have highlighted the role of psychological and behavioral factors in eating habits. Disordered patterns such as emotional, external, and non-hunger-related eating are prevalent among individuals with overweight or obesity. They are linked to impaired interoceptive awareness and reduced sensitivity to internal cues ( 3 ). Mindfulness-based interventions (MBIs) promote non-judgmental awareness of internal experiences, including hunger, satiety, and emotions. They have shown promise in reducing binge eating and improving self-regulation in people with overweight or obesity ( 4 – 7 ). Mindful eating (ME), a specific application of MBIs to eating behavior, focuses on restoring an attuned relationship with food through interoceptive and emotional awareness ( 8 , 9 ). However, previous ME studies often relied on passive comparators and lacked standardized, validated tools to measure change ( 10 , 11 ). To address these limitations, we developed the Mind-Eat program, a structured, group-based ME intervention tailored to individuals with overweight or obesity. It was adapted from a validated protocol ( 12 ) and refined through qualitative feedback from patients in our clinical setting. The program was designed for implementation in real-life care pathways and evaluated using the Mind-Eat Scale, a validated, multidimensional instrument measuring key components of mindful eating ( 13 ). Importantly, we compared the Mind-Eat program to an active control group receiving structured therapeutic patient education (TPE) aligned with intuitive eating principles ( 14 , 15 ). This approach allowed us to isolate the added value of mindfulness-based experiential training beyond standard non-diet, cue-focused education. This randomized controlled trial aimed to evaluate the effectiveness of the Mind-Eat program in improving mindful eating and related behaviors. The primary outcome was the change in mindful eating score, measured using the Mind-Eat Scale. Secondary outcomes included intuitive and disordered eating behaviors, psychological well-being, physical activity, and weight. 2. Methods 2.1 Study design, data collection and ethical considerations This study was a single-center, two-arm randomized controlled trial (RCT) conducted at the Nutrition-Diabetes Department of Montpellier University Hospital (France). It forms part of the MIND-EAT research project, supported by the French Institute for Public Health Research (IReSP), which aims to develop and evaluate mindful eating tools and interventions. The study adhered to the principles of the Declaration of Helsinki and received ethical approval from the Institutional Ethics Committee of Bicêtre University Hospital (ID CAAE: 23.03237.000242) on November 14, 2023. It was registered on ClinicalTrials.gov (NCT06157411). Initial oral consent was obtained from all participants, followed by written informed consent during the first study visit. Study data were collected and managed using Aviitam®, a GDPR-compliant and HDS-certified health data platform. 2.2 Participants Eligible participants were adults aged 18 years or older with a body mass index (BMI) between 25 and 50 kg/m² who were consulting the nutrition department for the first time for the management of overweight or obesity. Exclusion criteria included genetic/syndromic obesity, weight-affecting medications, bariatric surgery, severe psychiatric disorders, pregnancy/breastfeeding, insufficient French fluency, and concurrent study participation. Participants were excluded from the analysis if they became pregnant during the study, initiated any medication affecting weight, or did not attend a minimum number of intervention sessions. To ensure sufficient exposure to the interventions while respecting their structural differences, minimum attendance thresholds were defined (≥ 3 core workshops for TPE and ≥ 5 sessions for Mind-Eat). Sensitivity analyses were conducted to assess the robustness of findings with respect to these thresholds. Both arms included interventions aimed at improving eating regulation through interoceptive awareness, making this study a comparison between two contemporary non-diet approaches. 2.3 Randomization and blinding All outcomes were self-reported through online questionnaires, except for body weight, which was measured by staff blinded to group allocation. Participants were randomized (1:1) to either the mindful eating intervention (Mind-Eat group) or a control group receiving standard nutritional education and TPE. Randomization was conducted centrally using the ENNOV Clinical platform (CSRandomization module), programmed and overseen by the hospital’s Clinical Research Unit. Allocation occurred at the end of the baseline visit after eligibility confirmation and consent. A schematic overview of the study design and participant flow is provided in Fig. 1 . 2.4 Interventions All participants, irrespective of group assignment, underwent a comprehensive baseline assessment conducted during a single day of outpatient hospitalization. This included four individual consultations (approximately 45 minutes each) with a physician, a dietitian, a therapeutic education nurse, and, depending on individual needs, either a physical activity specialist or a psychologist. All professionals, particularly the dietitian, adopted an approach grounded in intuitive eating, fostering interoceptive awareness and promoting the recognition of internal hunger and satiety cues. The two interventions differed in format and degree of standardization. The Mind-Eat program followed a fixed 8-week structure with a ninth follow-up session 4 weeks later. Participants were expected to attend at least five of the eight core sessions (Mind-Eat) or a minimum of three core workshops (TPE) to be considered adherent to the protocol, in line with French national guidelines and funding criteria. Mind-Eat group. The Mind-Eat program is a structured, experiential group intervention developed as part of the MIND-EAT research project. It was adapted from the protocol by Alberts et al. (2010) to meet the needs of individuals with overweight or obesity and further refined through qualitative feedback from former participants ( Supplemental data 1 ). The intervention consisted of eight weekly 90-minute group sessions delivered by a facilitator with dual expertise in mindfulness and clinical nutrition. Each session included (i) formal mindfulness practice (e.g., body scan, mindful breathing), (ii) experiential eating exercises (e.g., mindful eating of a raisin or biscuit), (iii) psychoeducational content on eating behavior, internal cues, and emotional regulation, and (iv) group discussion ( Supplemental data 2 ). Participants received weekly home practice assignments, including guided audio recordings and a reflective journal. A ninth consolidation session was added one month post-intervention to support long-term integration of skills. In clinical practice, the program is known as “MangerConscient”, a French-language name chosen to enhance patient engagement and echo public health messaging such as “MangerBouger” from the French National Nutrition and Health Program (PNNS). For clarity, we refer to the program as “Mind-Eat” throughout this manuscript. TPE group. Participants in the control arm followed the department’s standard TPE pathway. This included access to a modular set of six thematic workshops (1.5 to 2 hours each) covering topics such as hunger and satiety, nutrition, physical activity, sleep, and emotional eating ( Supplemental data 3 ). The approach was grounded in non-restrictive, internal-cue–driven principles consistent with intuitive eating ( 14 , 15 ). One of the workshops, the “Weight Management Follow-up Group”, was held biweekly and could be attended multiple times to support individualized care. Beyond the minimum of three mandatory workshops, participants were free to attend additional sessions based on their interests and availability. All workshops were open to patients receiving routine care in the department, regardless of study participation, and were delivered by a trained multidisciplinary team including dietitians, nurses, physical activity instructors, and diabetologists. Sessions were conducted either in person or online, following standardized departmental protocols. A comparative overview of the structure, delivery, and theoretical foundations of the Mind-Eat and TPE programs is provided in Supplemental data 4. 2.5 Outcome measures Data were collected at three time points: baseline (Week 0), post-intervention (Week 8), and follow-up (Week 12), i.e., 4 weeks after the intervention concluded. The primary outcome was change in mindful eating, assessed with the validated 24-item Mind-Eat Scale, developed in a French population ( 13 ). This multidimensional scale includes six subdomains, consisting of four items per dimension.: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety Secondary outcomes included: Disordered eating behaviors: assessed using the Binge Eating Scale (BES) ( 16 ) and the Dutch Eating Behavior Questionnaire (DEBQ) ( 17 ), which includes subscales for emotional, external, and restrained eating. Adaptive eating behavior was assessed using the Intuitive Eating Scale-2 (IES-2) ( 14 ), Psychological well-being: measured using the Perceived Stress Scale (PSS) ( 18 ) and the Hospital Anxiety and Depression Scale (HAD) ( 19 ), Trait mindfulness: assessed by the Five Facet Mindfulness Questionnaire (FFMQ) ( 20 ), Physical activity: assessed via the Ricci-Gagnon scale ( 21 ), Anthropometric outcome: body weight measured at each visit with a calibrated electronic scale, and height assessed at baseline with a stadiometer. 2.6 Sample Size Calculation Based on previous studies, we expected a moderate effect size (Cohen’s d = .25) for change in mindful eating over time ( 22 ). With α = .05 and power = 80%, and assuming three repeated measures, the required sample size was estimated at 44 participants using G*Power ( 23 ). To account for potential dropout and to maintain statistical power for secondary outcomes, we increased the planned sample size by 25%, targeting 56 participants. 2.7 Statistical analysis Baseline sociodemographic and clinical characteristics were summarized using means and standard deviations (SD) for continuous variables, and absolute and relative frequencies for categorical variables. Longitudinal changes in primary and secondary outcomes were analyzed using linear mixed-effects models (LMM) with a random intercept for each participant to account for intra-individual variability. Fixed effects included time (categorical), group, and their interaction (time × group) to evaluate differential change over time between the Mind-Eat and the TPE groups. All models were first fitted unadjusted, and then adjusted for age, sex, and baseline BMI. For the primary outcome (Mind-Eat Scale score), additional sensitivity analyses were conducted after adjusting for baseline levels of anxious and depressive symptomatology (HAD-A and HAD-D, subscales of the Hospital Anxiety and Depression Scale) and trait mindfulness (FFMQ), based on previous evidence of their influence on mindful eating behavior ( 24 , 25 ). All analyses used a modified intention-to-treat approach, including participants with baseline and at least one post-baseline assessment (n = 46). Among the 56 initially randomized participants, 10 were excluded from analyses due to complete absence of post-baseline data, which precluded any assessment of treatment response. The remaining participants (n = 46) had varying degrees of missing data at post-intervention (Week 8) or follow-up (Week 12) timepoints. Missing data were handled using maximum likelihood within the LMM framework, assuming data were missing at random (MAR). This approach utilizes all available data from each participant without requiring imputation, thereby preserving the longitudinal structure of the data while accommodating different patterns of missingness. A sensitivity analysis was also conducted to examine whether changes in mindful eating scores from baseline to follow-up (Week 12) were associated with the number of sessions attended in each group. Spearman correlations were calculated separately for the Mind-Eat and TPE arms. Given that over 80% of participants attended more than half of the sessions or workshops, and protocol adherence was high, per-protocol analyses were not deemed necessary. Given the significant baseline difference in BMI between groups (39.7 ± 4.99 vs 36.9 ± 4.42 kg/m², p < .001), we conducted an additional sensitivity analysis to assess whether this imbalance affected our primary findings. Participants were stratified into BMI tertiles ( 40 kg/m²), and separate linear mixed-effects models were fitted for each tertile to examine Group × Time interactions for the primary outcome (Mind-Eat Scale score). All statistical tests were two-sided, with significance set at p ≤ .05. Analyses were performed using R software (version 4.2.1; R Core Team, 2022). 3. Results 3.1 Sample characteristics A total of 46 participants (22 Mind-Eat, 24 TPE) with at least one post-baseline assessment were included in the modified ITT analysis (Fig. 2 ). Groups were comparable at baseline for sex, age, anxiety/depression (HAD), trait mindfulness (FFMQ), and mindful eating levels (Mind-Eat Scale). Mean BMI was higher in the Mind-Eat group (39.7 ± 4.99 vs. 36.9 ± 4.42 kg/m², p < .001) (Table 1 ). Table 1 Baseline characteristics of participants in the Mind-Eat (ME) and TPE groups (N = 46) Characteristic TPE (n = 24) ME (n = 22) Male 7 (29.2) 8 (36.4) Female 17 (70.8) 14 (63.6) Age, years 47.5 ± 14.3 49.3 ± 11.3 Weight, kg 112.0 ± 17.9 102.0 ± 17.6 Height, m 1.68 ± 0.10 1.66 ± 0.10 BMI, kg/m² 36.9 ± 4.42 39.7 ± 4.99 Mindfulness (FFMQ total) 130.0 ± 22.6 129.0 ± 18.4 Mindful eating (Mind-Eat Scale), mean ± SD 2.93 ± 0.60 2.83 ± 0.56 Anxiety + Depression (HADS total), mean ± SD 14.3 ± 5.83 14.4 ± 6.01 Values are mean ± SD or n (%). No statistical tests were performed in line with current recommendations; apparent baseline differences (e.g., BMI) were considered in sensitivity analyses. Adherence was high: Mind-Eat participants attended on average 6.9 of 8 sessions (36% attended all), while TPE participants attended 3.9 of 7 workshops (8% attended all). Follow-up attendance was 91% in Mind-Eat and 100% in TPE, with final visit completion rates of 96% and 92%, respectively. 3.2 Effects on Mindful Eating (Primary Outcome) At baseline, mindful eating scores did not differ between groups (β = .10, p = .60). As shown in Table 2 and Fig. 3 , mixed-effects models revealed significant Group × Time interactions favoring the Mind-Eat group at post-intervention (β = –.40, p = .002, d = − 1.32) and follow-up (β = –.31, p = .02, d = − 1.02). Table 2 Mind-Eat Scale total and subdimension scores at baseline, post-intervention, and follow-up: between-group comparisons using mixed-effects models (N = 46) Outcome TPE (n = 24) Mean ± SD ME (n = 22) Mean ± SD Cohen's d β (95% CI) p-value Mind-Eat Scale total - Baseline 2.93 ± 0.60 2.83 ± 0.56 - - .004¹ - Post-intervention 3.20 ± 0.70 3.50 ± 0.60 -1.32 -0.40 (-0.65, -0.15) .002 - Follow-up 3.31 ± 0.66 3.50 ± 0.61 -1.02 -0.31 (-0.56, -0.05) .020 Non-reactivity - Baseline 2.73 ± 0.73 2.52 ± 0.97 - - .013¹ - Post-intervention 2.89 ± 0.83 3.22 ± 0.84 -1.18 -0.54 (-0.92, -0.16) .002 - Follow-up 3.14 ± 0.95 3.32 ± 0.82 -0.90 -0.41 (-0.80, -0.02) .040 Awareness - Baseline 3.15 ± 1.04 3.19 ± 0.88 - - .134¹ - Post-intervention 3.51 ± 0.94 3.99 ± 0.84 -0.84 -0.43 (-0.86, -0.00) .050 - Follow-up 3.61 ± 0.83 3.83 ± 0.86 -0.42 -0.22 (-0.65, 0.22) .330 Openness - Baseline 3.15 ± 0.81 3.73 ± 0.90 - - .625¹ - Post-intervention 3.38 ± 0.97 3.86 ± 0.85 0.23 0.09 (-0.24, 0.43) .588 - Follow-up 3.18 ± 0.76 3.85 ± 0.90 -0.19 -0.08 (-0.42, 0.27) .664 Gratitude - Baseline 2.95 ± 0.87 3.06 ± 0.90 - - .438¹ - Post-intervention 3.33 ± 0.97 3.55 ± 0.98 -0.19 -0.10 (-0.55, 0.34) .649 - Follow-up 3.18 ± 0.99 3.62 ± 0.96 -0.54 -0.29 (-0.75, 0.16) .207 Non-judgment - Baseline 2.88 ± 0.87 2.39 ± 1.12 - - .021¹ - Post-intervention 2.91 ± 1.02 3.03 ± 0.95 -1.09 -0.62 (-1.08, -0.16) .010 - Follow-up 3.44 ± 1.10 3.05 ± 1.09 -0.19 -0.11 (-0.58, 0.36) .653 Hunger/Satiety - Baseline 2.72 ± 1.09 2.09 ± 0.89 - - < .001¹ - Post-intervention 3.18 ± 1.09 3.35 ± 0.89 -1.44 -0.80 (-1.26, -0.35) < .001 - Follow-up 3.27 ± 1.18 3.31 ± 1.12 -1.31 -0.73 (-1.20, -0.26) .003 Values are mean ± SD. Effect sizes (Cohen’s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group × Time interaction. ¹ Global Group × Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons. Subscale analyses showed greater improvements in Non-reactivity, Non-judgment, and Hunger/Satiety (Week 8 and 12) and in Awareness (Week 8 only), with no effects for Openness or Gratitude. To assess the potential influence of intervention exposure, we conducted a sensitivity analysis examining whether the number of sessions or workshops attended was associated with changes in mindful eating scores (Mind-Eat Scale, Week 12 – Week 0) within each group. In the Mind-Eat group, session attendance correlated positively with improvements in mindful eating (Week 8: r = .55, p = .008; Week 12: r = .47, p = .031), indicating a dose–response relationship. No association was observed in the TPE group (Week 8: r = –.10, p = .63; Week 12: r = –.10, p = .65). Stratified analyses by BMI tertiles confirmed intervention effectiveness across BMI categories. Results were consistent in sensitivity analyses (see 3.4). 3.3 Secondary outcomes Results from mixed-effects models are shown in Table 3 . Intuitive eating (IES-2) improved more in the Mind-Eat group at both post-intervention (β = –.51, p = .002) and follow-up (β = –.38, p = .02). Among subscales, significant effects were found for “Eating for physical rather than emotional reasons” and “Reliance on hunger and satiety cues,”, with no effect for “Unconditional permission to eat.” Table 3 Between-group differences in secondary eating outcomes over time: results from mixed-effects models. Outcome / Time point TPE (n = 24) Mean ± SD ME (n = 22) Mean ± SD Cohen's d β (95% CI) p-value Intuitive eating (IES-2) .004¹ – Baseline 2.97 ± 0.66 2.61 ± 0.74 - - – Post-intervention 3.24 ± 0.68 3.39 ± 0.48 -1.35 -0.51 (-0.82, -0.20) .002 – Follow-up 3.41 ± 0.83 3.43 ± 0.55 -1.01 -0.38 (-0.70, -0.07) .019 Eating for physical rather than emotional reasons .066¹ – Baseline 3.05 ± 0.99 2.63 ± 1.17 - - – Post-intervention 3.30 ± 0.95 3.41 ± 0.81 -0.97 -0.52 (-0.95, -0.08) .002 – Follow-up 3.43 ± 0.99 3.34 ± 0.62 -0.59 -0.31 (-0.76, 0.13) .170 Reliance on hunger and satiety cues .006¹ – Baseline 2.76 ± 0.95 2.21 ± 1.09 - - – Post-intervention 3.21 ± 0.82 3.39 ± 0.95 -1.28 -0.73 (-1.20, -0.26) .003 – Follow-up 3.47 ± 1.17 3.43 ± 1.13 -0.99 -0.57 (-1.04, -0.09) .022 Unconditional permission to eat .517¹ – Baseline 3.12 ± 0.87 3.18 ± 0.93 - - – Post-intervention 3.16 ± 0.78 3.39 ± 0.85 -0.32 -0.17 (-0.61, 0.26) .440 – Follow-up 3.28 ± 0.86 3.63 ± 0.77 -0.47 -0.25 (-0.70, 0.19) .266 Binge eating (BES)² .030¹ – Baseline 13.42 ± 7.88 17.56 ± 8.26 - - – Post-intervention 10.92 ± 7.99 11.77 ± 5.06 0.85 3.27 (0.17, 6.38) .044 – Follow-up 9.00 ± 7.16 9.47 ± 6.40 1.06 4.06 (0.88, 7.24) .015 Restrictive eating (DEBQ) .322¹ – Baseline 2.61 ± 0.70 2.80 ± 0.80 - - – Post-intervention 2.70 ± 0.73 2.80 ± 0.88 0.20 0.08 (-0.25, 0.42) .631 – Follow-up 2.83 ± 0.84 2.73 ± 0.88 0.63 0.26 (-0.09, 0.61) .142 Emotional eating (DEBQ) .003¹ – Baseline 2.52 ± 1.18 3.03 ± 1.20 - - – Post-intervention 2.39 ± 1.17 2.24 ± 0.82 1.38 0.66 (0.27, 1.05) .001 – Follow-up 2.22 ± 1.12 2.24 ± 0.97 1.02 0.49 (0.09, 0.88) .020 External eating (DEBQ) < .001¹ – Baseline 2.82 ± 0.69 3.17 ± 0.68 - - – Post-intervention 2.76 ± 0.61 2.67 ± 0.62 1.48 0.44 (0.19, 0.68) < .001 – Follow-up 2.52 ± 0.66 2.59 ± 0.71 1.16 0.34 (0.09, 0.59) .008 Values are mean ± SD. Effect sizes (Cohen’s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group × Time interaction. ¹ Global Group × Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons. ² Multivariate models adjusted for sex, age, and baseline BMI. Binge eating symptoms decreased more in the Mind-Eat group, significant in adjusted models (p = .009) but borderline in unadjusted tests (p ≈ .06). Restrained eating (DEBQ) did not differ between groups, while emotional eating (β = .66, p = .001 at week 8; β = .49, p = .02 at week 12) and external eating (p < .001 and p = .008) decreased more in the Mind-Eat group. As shown in Table 4 , trait mindfulness (FFMQ) increased significantly more in the Mind-Eat group (β = − 13.81, p = .007 at week 8; β = − 12.16, p = .01 at week 12). No between-group differences were observed for physical activity (Ricci-Gagnon), anxiety or depression (HAD), perceived stress (PSS) or weight. Table 4 Mixed effects model results for between-group comparisons on secondary psychobehavioral outcomes. Outcome / Time point TPE (n = 24) Mean ± SD ME (n = 22) Mean ± SD Cohen's d β (95% CI) p-value Physical activity (Ricci-Gagnon) .921¹ – Baseline 20.46 ± 8.21 19.09 ± 8.77 - - – Post-intervention 20.46 ± 8.15 19.86 ± 9.20 -0.17 -0.77 (-1.90, 0.68) .690 – Follow-up 20.86 ± 8.08 19.71 ± 9.30 -0.06 -0.29 (-0.89, 0.59) .886 Anxiety and depression (HADS total) .480¹ – Baseline 14.40 ± 6.01 14.30 ± 5.83 - - – Post-intervention 11.50 ± 5.49 10.04 ± 5.45 0.32 1.03 (-1.62, 3.69) .447 – Follow-up 11.00 ± 5.78 9.62 ± 6.59 0.51 1.65 (-1.06, 4.37) .234 – Anxiety .370¹ – Baseline 8.46 ± 4.49 8.32 ± 3.24 - - – Post-intervention 6.83 ± 3.45 6.04 ± 2.70 0.34 0.65 (-0.94, 2.23) .418 – Follow-up 6.68 ± 3.14 5.62 ± 3.02 0.60 1.14 (-0.48, 2.76) .164 – Depression .795¹ – Baseline 5.92 ± 2.59 6.00 ± 3.53 - - – Post-intervention 4.67 ± 2.70 4.36 ± 3.54 0.21 0.39 (-1.13, 1.90) .618 – Follow-up 4.36 ± 3.35 4.00 ± 4.10 0.28 0.51 (-1.04, 2.06) .522 Stress (PSS) .510¹ – Baseline 16.46 ± 8.91 19.73 ± 5.98 - - – Post-intervention 15.20 ± 7.73 16.23 ± 8.86 0.41 2.25 (-2.28, 6.77) .326 – Follow-up 14.00 ± 9.58 15.62 ± 9.89 0.43 2.37 (-2.26, 6.99) .313 Mindfulness (FFMQ total)² .007¹ – Baseline 130.04 ± 22.55 129.46 ± 18.38 - - – Post-intervention 132.92 ± 23.24 146.14 ± 16.39 -1.14 -13.81 (-23.10, -4.52) .005 – Follow-up 138.82 ± 23.14 148.71 ± 19.83 -0.84 -12.16 (-21.67, -2.65) .014 Weight change (kg) .833¹ – Post-intervention vs Baseline -0.50 ± 2.18 -0.23 ± 3.38 - - – Follow-up vs Post-intervention -0.47 ± 1.94 -0.01 ± 0.95 -0.09 -0.17 (-1.75, 1.41) .832 – Follow-up vs Baseline -0.95 ± 3.23 -0.18 ± 3.48 -0.26 -0.48 (-2.08, 1.12) .552 Values are mean ± SD. Effect sizes (Cohen’s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group × Time interaction. ¹ Global Group × Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons. ² Models adjusted for sex, age, and baseline BMI. 3.4 Sensitivity analyses Sensitivity analyses confirmed the robustness of the findings. Including age, sex, and baseline BMI as covariates did not improve model fit or alter effect significance, supporting the unadjusted model as the most parsimonious. Baseline mindfulness predicted greater change (p = .008) ; however, additional adjustments for baseline mindfulness, anxiety, and depression did not alter the direction or significance of the results. 4. Discussion This study evaluated the effects of a structured mindful eating program, delivered in a real-world clinical setting and designed to target core mechanisms such as interoceptive awareness and non-reactivity. Compared to an active control group receiving therapeutic patient education grounded in intuitive eating principles, the Mind-Eat intervention led to significantly greater improvements in mindful eating behaviors. These effects were observed both immediately after the 8-week intervention and sustained at 12-week follow-up, with large effect sizes particularly in the domains of non-reactivity, non-judgment, and awareness of hunger and satiety cues. To our knowledge, this is one of the first trials to evaluate a mindful eating intervention using a validated, multidimensional scale specifically developed to capture change in this construct. The findings support the added value of experiential, mindfulness-based approaches, even when compared to active programs that already incorporate elements of internal cue awareness and non-restrictive eating. Using an active comparator grounded in intuitive eating represents both a strength and a challenge: this rigorous design sets a high bar for detecting incremental benefits, and the fact that Mind-Eat still outperformed TPE suggests that experiential mindfulness training provides additional therapeutic value. Beyond mindful eating, Mind-Eat participants showed greater improvements in intuitive eating, reductions in emotional and external eating, and increased trait mindfulness, confirming the psychological specificity of the intervention. In contrast, no differences were observed for weight, stress, or depressive symptoms, consistent with previous short-term mindfulness trials ( 5 – 7 ). These findings align with prior research suggesting that mindfulness-based eating interventions can reduce emotional dysregulation and maladaptive eating patterns while enhancing interoceptive awareness ( 9 , 26 – 28 ). Both interventions were grounded in non-restrictive, internal-cue–driven frameworks. While the TPE group followed a flexible, intuitive eating–oriented format, the Mind-Eat program implemented a highly structured experiential curriculum centered on mindfulness practice. This design allowed us to evaluate the specific contribution of formal mindfulness training beyond a contemporary, non-diet nutritional approach. A notable contribution of this study is the demonstration of a dose–response relationship within the Mind-Eat group, where higher session attendance was associated with greater improvements in mindful eating scores. This association was not observed in the control group. This suggests that intervention intensity may be particularly relevant in mindfulness-based programs and highlights the importance of accounting for actual participation when interpreting treatment effects. Although no significant weight change was observed in either group at 12 weeks, this aligns with prior mindfulness-based trials and reflects the program’s behavioral rather than weight-loss focus ( 6 , 7 ). Our results further revealed convergence between conceptually related outcomes. Improvements in emotional eating (DEBQ) mirrored those in the IES-2 subscale Eating for physical rather than emotional reasons . Likewise, improvements in the Mind-Eat subscale Awareness of hunger and satiety cues corresponded with increases in Reliance on hunger and satiety cues (IES-2), reinforcing the internal consistency and specificity of the intervention’s effects. In contrast, no significant changes were observed for the Openness or Gratitude subdomains of the Mind-Eat Scale, two novel dimensions introduced in the scale’s development. This may reflect the fact that these constructs were not explicitly targeted by the intervention and might require either more intensive practice or longer-term follow-up to show measurable effects. Finally, our findings add to the growing empirical support for the use of the Mind-Eat Scale. Although originally validated in an independent sample ( 13 ), this study provides additional evidence of the instrument’s sensitivity to change and convergent validity with established constructs. Nevertheless, the minimal clinically important difference (MCID) for the Mind-Eat Scale has not yet been established, which limits the ability to translate observed effect sizes into clinical significance. Future studies should aim to determine thresholds for clinically meaningful change. This study has several strengths, including its pragmatic RCT design, high retention and adherence rates, and use of an active comparator rooted in intuitive eating principles. Rather than comparing against inactive controls, this design tested whether experiential mindfulness training provides incremental benefits beyond cognitive-educational approaches, a stringent and clinically relevant comparison. Despite these similarities, the Mind-Eat intervention produced significantly greater benefits across multiple domains, highlighting the added clinical value of a structured mindfulness-based experiential program ( 29 , 30 ). Despite these encouraging findings, several limitations must be acknowledged. First, the modest sample size was adequate for the primary outcome but may have limited power for secondary outcomes. Second, as multiple secondary outcomes and subscales were tested, some significant findings may reflect chance associations. Third, although 10 participants were excluded for lack of post-intervention data, the overall low rate of missing data and balanced completion rates across groups support the validity of our approach; however, we did not perform multiple imputation or other sensitivity analyses beyond LMM, so the MAR assumption was not tested. Fourth, despite successful randomization, groups differed on baseline BMI (39.7 ± 4.99 vs 36.9 ± 4.42 kg/m²); stratified analyses by BMI tertiles indicated that effects persisted across BMI categories. Fifth, intervention intensity differed (~ 12h for Mind-Eat vs ~ 4-14h for TPE), which complicates causal attribution, although the dose–response observed only in Mind-Eat argues against a pure exposure-time effect. Sixth, the predominance of female participants, though reflective of typical obesity care populations, limits generalizability to men. Finally, while the absence of short-term weight reduction is consistent with the program’s behavioral focus and prior mindfulness-based trials, it may still be perceived as a limitation by patients and clinicians who prioritize weight outcomes. Future studies should therefore assess weight trajectories over extended follow-up durations, while continuing to evaluate mindful eating primarily as a behavioral mechanism rather than a weight-loss intervention. Collectively, these constraints motivate the following priorities for future research. Future studies should consider stratified randomization by key demographic and clinical variables, aim to replicate these findings in more diverse samples, and incorporate longer-term follow-up to assess durability of behavioral changes. Additionally, studies should examine objective behavioral and physiological markers and conduct mediation analyses exploring the role of interoceptive awareness, emotion regulation, and self-regulation capacities to clarify mechanisms of action. The qualitative data collected in this study also offer an opportunity to further refine intervention content and assess perceived barriers and facilitators to change. From a clinical implementation perspective, the Mind-Eat program's structured 8-week format aligns with established group therapy models and may facilitate standardized delivery across healthcare systems. While the higher intensity represents an investment of resources, the sustained behavioral improvements at follow-up suggest potential cost-effectiveness through reduced long-term healthcare utilization. However, healthcare systems will need to weigh the program's resource requirements against its demonstrated clinical benefits when considering implementation alongside existing patient education pathways. 5. Conclusions This randomized controlled trial provides preliminary but robust evidence that the Mind-Eat program, a structured, mindfulness-based intervention, can significantly enhance mindful and intuitive eating in individuals with overweight or obesity. Compared to an active, intuitive eating–oriented control group, Mind-Eat offered additional clinical benefits, with high acceptability and feasibility in a real-world outpatient setting. Although no short-term effects were observed on weight, the sustained improvements in eating behaviors highlight its potential as a complementary approach in multidisciplinary obesity care. Baseline BMI differences between groups represent a limitation, but stratified analyses confirmed intervention effectiveness across BMI categories. Future research should replicate these findings with longer follow-up, establish clinically meaningful thresholds for mindful eating, and evaluate implementation across diverse healthcare settings. Abbreviations WHO World Health Organisation REML Restricted Maximum Likelihood PSS Perceived Stress Scale MECL Mindful Eating Conscious Living ME Mind-Eat MEAL Mindful Eating and Living MB-EAT Mindfulness-Based Eating Awareness Training MBSR Mindfulness-Based Stress Reduction LMM Linear Mixed Models IES-2 Intuitive Eating Scale-2 HAD Hospital Anxiety and Depression Scale FFMQ Five Facet Mindfulness Questionnaire DEBQ Dutch Eating Behavior Questionnaire BMI Body Mass Index BES Binge Eating Scale. Declarations Ethics approval and consent to participate The study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411. All subjects provided informed consent. Consent for publication Not applicable. Availability of data and materials Data will be made available on request. Declaration of competing interest None. Funding This research was part of the MIND-EAT project, which was supported by the Institute for Public Health Research (IReSP) (2021–2024). Authors’ contributions Marion Van Beekum : Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Writing – original draft, Writing – review & editing. Angélique Rodhain : Conceptualization, Funding acquisition, Methodology, Writing – original draft. Rebecca Shankland : Conceptualization, Methodology, Writing – original draft. Soumeya Chetouane : Conceptualization, Investigation, Methodology, Writing – original draft. Dominique Jullien-Durmont, Camille Le Rouzic, Justine Myzia, Marie Guiraudou, Youadigue Kemba, Catherine Boegner, Jean-Baptiste Bonnet, Vincent Attalin, Ariane Sultan, and Abdulkader Jalek : Conceptualization, Data curation, Investigation, Methodology. Christophe Leys: Conceptualization, Methodology, Writing – original draft. Sandrine Péneau: Conceptualization, Funding acquisition, Project administration, Resources, Supervision, Visualization, Writing – original draft. Antoine Avignon: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. Acknowledgments The authors thank: Joy Fabre (healthcare manager); Anne-Lise Pouget, Delphine Deguirard-Demontarnal, Nadège Amphoux, Sandrine Olivas-Carrion, Laëtitia Ricci, Chrystel Pellissier-Dieraert, and Stéphanie Bicand (nurses); Jean-Marc Vicedo (nursing assistant); Carine Durand and Audrey Ruiz (secretaries); Leslie Bouisset (clinical research associate); Lilian Rouch and Clément Picavet (adapted physical activity specialists); Morgane Montagne (psychologist); as well as all the interns who contributed to this research. References Lapadat L, Gao A, Bicaker E, Racine SE. 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Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J Behav Med avr. 2016;39(2):201–13. Additional Declarations No competing interests reported. Supplementary Files SupplementalData.docx Appendix A. 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05:09:53","extension":"html","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":160526,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/4557633eab7c6f1c4926cfb2.html"},{"id":92048106,"identity":"90962131-e790-428a-8576-d135fa981acf","added_by":"auto","created_at":"2025-09-24 05:09:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":86530,"visible":true,"origin":"","legend":"\u003cp\u003eOverview of study design\u003c/p\u003e\n\u003cp\u003eOverview of the study design and baseline assessment procedures. All participants underwent a one-day hospital assessment including four individual consultations (physician, dietitian, therapeutic education nurse, and, depending on individual needs, either a physical activity specialist or a psychologist). *\u003cem\u003eConsultations were tailored according to the patient’s profile.\u003c/em\u003eAPA: Adapted Physical Activity Professional; G: Group\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/96b8c0dbb5a14918d4d8dd2a.png"},{"id":92063112,"identity":"2ca8a1f5-abf0-4d96-a153-d6d14e3b93b5","added_by":"auto","created_at":"2025-09-24 08:37:02","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":56965,"visible":true,"origin":"","legend":"\u003cp\u003eCONSORT flow of participants\u003c/p\u003e\n\u003cp\u003eCONSORT flow diagram of participants randomized to the Mind-Eat (ME) program or therapeutic patient education (TPE). \u003cem\u003eNumbers reflect participants included in the modified intention-to-treat analysis (22 ME; 24 TPE).\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/76a356f0df44a4401df55bce.png"},{"id":92048107,"identity":"19761e5d-06e5-435e-9955-c2e33d384254","added_by":"auto","created_at":"2025-09-24 05:09:53","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":39197,"visible":true,"origin":"","legend":"\u003cp\u003eChanges in mindful eating scores over time\u003c/p\u003e\n\u003cp\u003eMean (±SD) changes in total Mind-Eat Scale scores from baseline to post-intervention (Week 8) and follow-up (Week 12). *p \u0026lt; 0.05 (baseline to follow-up); *\u003cem\u003ep \u0026lt; 0.01 (baseline to post-intervention). Group × Time interaction: p = 0.004 (linear mixed-effects model).\u003c/em\u003e\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/ea577a3c2962c91170de5608.png"},{"id":92063555,"identity":"db5097b5-19e0-40f8-97e5-210a5c710112","added_by":"auto","created_at":"2025-09-24 08:38:39","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2008022,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/035f6cc5-2be7-477a-a930-5c5acdd951fe.pdf"},{"id":92048108,"identity":"c292c093-5d41-4dd0-baa2-b69efd9e0c32","added_by":"auto","created_at":"2025-09-24 05:09:53","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":89365,"visible":true,"origin":"","legend":"\u003cp\u003eAppendix A. Supplementary data\u003c/p\u003e","description":"","filename":"SupplementalData.docx","url":"https://assets-eu.researchsquare.com/files/rs-7456763/v1/ff62a5ce8e5a09013136b6bd.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Mind-Eat Program Improves Mindful Eating and Related Behaviors in Adults with Overweight or Obesity: A Randomized Controlled Trial","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eTraditional weight management interventions, which focus on caloric restriction and physical activity, often yield only short-term benefits, partly due to a lack of sustained behavioral change and emotional regulation (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Recent studies have highlighted the role of psychological and behavioral factors in eating habits. Disordered patterns such as emotional, external, and non-hunger-related eating are prevalent among individuals with overweight or obesity. They are linked to impaired interoceptive awareness and reduced sensitivity to internal cues (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eMindfulness-based interventions (MBIs) promote non-judgmental awareness of internal experiences, including hunger, satiety, and emotions. They have shown promise in reducing binge eating and improving self-regulation in people with overweight or obesity (\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Mindful eating (ME), a specific application of MBIs to eating behavior, focuses on restoring an attuned relationship with food through interoceptive and emotional awareness (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). However, previous ME studies often relied on passive comparators and lacked standardized, validated tools to measure change (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTo address these limitations, we developed the Mind-Eat program, a structured, group-based ME intervention tailored to individuals with overweight or obesity. It was adapted from a validated protocol (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and refined through qualitative feedback from patients in our clinical setting. The program was designed for implementation in real-life care pathways and evaluated using the Mind-Eat Scale, a validated, multidimensional instrument measuring key components of mindful eating (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eImportantly, we compared the Mind-Eat program to an active control group receiving structured therapeutic patient education (TPE) aligned with intuitive eating principles (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This approach allowed us to isolate the added value of mindfulness-based experiential training beyond standard non-diet, cue-focused education.\u003c/p\u003e\u003cp\u003eThis randomized controlled trial aimed to evaluate the effectiveness of the Mind-Eat program in improving mindful eating and related behaviors. The primary outcome was the change in mindful eating score, measured using the Mind-Eat Scale. Secondary outcomes included intuitive and disordered eating behaviors, psychological well-being, physical activity, and weight.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study design, data collection and ethical considerations\u003c/h2\u003e\u003cp\u003eThis study was a single-center, two-arm randomized controlled trial (RCT) conducted at the Nutrition-Diabetes Department of Montpellier University Hospital (France). It forms part of the MIND-EAT research project, supported by the French Institute for Public Health Research (IReSP), which aims to develop and evaluate mindful eating tools and interventions.\u003c/p\u003e\u003cp\u003e The study adhered to the principles of the Declaration of Helsinki and received ethical approval from the Institutional Ethics Committee of Bic\u0026ecirc;tre University Hospital (ID CAAE: 23.03237.000242) on November 14, 2023. It was registered on ClinicalTrials.gov (NCT06157411). Initial oral consent was obtained from all participants, followed by written informed consent during the first study visit. Study data were collected and managed using Aviitam\u0026reg;, a GDPR-compliant and HDS-certified health data platform.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Participants\u003c/h2\u003e\u003cp\u003eEligible participants were adults aged 18 years or older with a body mass index (BMI) between 25 and 50 kg/m\u0026sup2; who were consulting the nutrition department for the first time for the management of overweight or obesity.\u003c/p\u003e\u003cp\u003eExclusion criteria included genetic/syndromic obesity, weight-affecting medications, bariatric surgery, severe psychiatric disorders, pregnancy/breastfeeding, insufficient French fluency, and concurrent study participation.\u003c/p\u003e\u003cp\u003eParticipants were excluded from the analysis if they became pregnant during the study, initiated any medication affecting weight, or did not attend a minimum number of intervention sessions. To ensure sufficient exposure to the interventions while respecting their structural differences, minimum attendance thresholds were defined (\u0026ge;\u0026thinsp;3 core workshops for TPE and \u0026ge;\u0026thinsp;5 sessions for Mind-Eat). Sensitivity analyses were conducted to assess the robustness of findings with respect to these thresholds.\u003c/p\u003e\u003cp\u003eBoth arms included interventions aimed at improving eating regulation through interoceptive awareness, making this study a comparison between two contemporary non-diet approaches.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Randomization and blinding\u003c/h2\u003e\u003cp\u003eAll outcomes were self-reported through online questionnaires, except for body weight, which was measured by staff blinded to group allocation. Participants were randomized (1:1) to either the mindful eating intervention (Mind-Eat group) or a control group receiving standard nutritional education and TPE. Randomization was conducted centrally using the ENNOV Clinical platform (CSRandomization module), programmed and overseen by the hospital\u0026rsquo;s Clinical Research Unit. Allocation occurred at the end of the baseline visit after eligibility confirmation and consent. A schematic overview of the study design and participant flow is provided in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Interventions\u003c/h2\u003e\u003cp\u003eAll participants, irrespective of group assignment, underwent a comprehensive baseline assessment conducted during a single day of outpatient hospitalization. This included four individual consultations (approximately 45 minutes each) with a physician, a dietitian, a therapeutic education nurse, and, depending on individual needs, either a physical activity specialist or a psychologist. All professionals, particularly the dietitian, adopted an approach grounded in intuitive eating, fostering interoceptive awareness and promoting the recognition of internal hunger and satiety cues.\u003c/p\u003e\u003cp\u003eThe two interventions differed in format and degree of standardization. The Mind-Eat program followed a fixed 8-week structure with a ninth follow-up session 4 weeks later. Participants were expected to attend at least five of the eight core sessions (Mind-Eat) or a minimum of three core workshops (TPE) to be considered adherent to the protocol, in line with French national guidelines and funding criteria.\u003c/p\u003e\u003cp\u003e\u003cem\u003eMind-Eat group.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eThe Mind-Eat program is a structured, experiential group intervention developed as part of the MIND-EAT research project. It was adapted from the protocol by Alberts et al. (2010) to meet the needs of individuals with overweight or obesity and further refined through qualitative feedback from former participants (\u003cb\u003eSupplemental data 1\u003c/b\u003e). The intervention consisted of eight weekly 90-minute group sessions delivered by a facilitator with dual expertise in mindfulness and clinical nutrition. Each session included (i) formal mindfulness practice (e.g., body scan, mindful breathing), (ii) experiential eating exercises (e.g., mindful eating of a raisin or biscuit), (iii) psychoeducational content on eating behavior, internal cues, and emotional regulation, and (iv) group discussion (\u003cb\u003eSupplemental data 2\u003c/b\u003e). Participants received weekly home practice assignments, including guided audio recordings and a reflective journal. A ninth consolidation session was added one month post-intervention to support long-term integration of skills.\u003c/p\u003e\u003cp\u003eIn clinical practice, the program is known as \u0026ldquo;MangerConscient\u0026rdquo;, a French-language name chosen to enhance patient engagement and echo public health messaging such as \u0026ldquo;MangerBouger\u0026rdquo; from the French National Nutrition and Health Program (PNNS). For clarity, we refer to the program as \u0026ldquo;Mind-Eat\u0026rdquo; throughout this manuscript.\u003c/p\u003e\u003cp\u003e\u003cem\u003eTPE group.\u003c/em\u003e\u003c/p\u003e\u003cp\u003eParticipants in the control arm followed the department\u0026rsquo;s standard TPE pathway. This included access to a modular set of six thematic workshops (1.5 to 2 hours each) covering topics such as hunger and satiety, nutrition, physical activity, sleep, and emotional eating (\u003cb\u003eSupplemental data 3\u003c/b\u003e). The approach was grounded in non-restrictive, internal-cue\u0026ndash;driven principles consistent with intuitive eating (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). One of the workshops, the \u0026ldquo;Weight Management Follow-up Group\u0026rdquo;, was held biweekly and could be attended multiple times to support individualized care.\u003c/p\u003e\u003cp\u003eBeyond the minimum of three mandatory workshops, participants were free to attend additional sessions based on their interests and availability. All workshops were open to patients receiving routine care in the department, regardless of study participation, and were delivered by a trained multidisciplinary team including dietitians, nurses, physical activity instructors, and diabetologists. Sessions were conducted either in person or online, following standardized departmental protocols.\u003c/p\u003e\u003cp\u003eA comparative overview of the structure, delivery, and theoretical foundations of the Mind-Eat and TPE programs is provided in Supplemental data 4.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Outcome measures\u003c/h2\u003e\u003cp\u003eData were collected at three time points: baseline (Week 0), post-intervention (Week 8), and follow-up (Week 12), i.e., 4 weeks after the intervention concluded.\u003c/p\u003e\u003cp\u003eThe primary outcome was change in mindful eating, assessed with the validated 24-item Mind-Eat Scale, developed in a French population (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This multidimensional scale includes six subdomains, consisting of four items per dimension.: Awareness, Non-reactivity, Openness, Gratitude, Non-judgement, and Hunger/Satiety\u003c/p\u003e\u003cp\u003eSecondary outcomes included:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eDisordered eating behaviors: assessed using the Binge Eating Scale (BES) (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) and the Dutch Eating Behavior Questionnaire (DEBQ) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), which includes subscales for emotional, external, and restrained eating. Adaptive eating behavior was assessed using the Intuitive Eating Scale-2 (IES-2) (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e),\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003ePsychological well-being: measured using the Perceived Stress Scale (PSS) (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) and the Hospital Anxiety and Depression Scale (HAD) (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e),\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eTrait mindfulness: assessed by the Five Facet Mindfulness Questionnaire (FFMQ) (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e),\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003ePhysical activity: assessed via the Ricci-Gagnon scale (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e),\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eAnthropometric outcome: body weight measured at each visit with a calibrated electronic scale, and height assessed at baseline with a stadiometer.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.6 Sample Size Calculation\u003c/h2\u003e\u003cp\u003eBased on previous studies, we expected a moderate effect size (Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;.25) for change in mindful eating over time (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). With α\u0026thinsp;=\u0026thinsp;.05 and power\u0026thinsp;=\u0026thinsp;80%, and assuming three repeated measures, the required sample size was estimated at 44 participants using G*Power (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). To account for potential dropout and to maintain statistical power for secondary outcomes, we increased the planned sample size by 25%, targeting 56 participants.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.7 Statistical analysis\u003c/h2\u003e\u003cp\u003eBaseline sociodemographic and clinical characteristics were summarized using means and standard deviations (SD) for continuous variables, and absolute and relative frequencies for categorical variables.\u003c/p\u003e\u003cp\u003eLongitudinal changes in primary and secondary outcomes were analyzed using linear mixed-effects models (LMM) with a random intercept for each participant to account for intra-individual variability. Fixed effects included time (categorical), group, and their interaction (time \u0026times; group) to evaluate differential change over time between the Mind-Eat and the TPE groups.\u003c/p\u003e\u003cp\u003eAll models were first fitted unadjusted, and then adjusted for age, sex, and baseline BMI. For the primary outcome (Mind-Eat Scale score), additional sensitivity analyses were conducted after adjusting for baseline levels of anxious and depressive symptomatology (HAD-A and HAD-D, subscales of the Hospital Anxiety and Depression Scale) and trait mindfulness (FFMQ), based on previous evidence of their influence on mindful eating behavior (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAll analyses used a modified intention-to-treat approach, including participants with baseline and at least one post-baseline assessment (n\u0026thinsp;=\u0026thinsp;46). Among the 56 initially randomized participants, 10 were excluded from analyses due to complete absence of post-baseline data, which precluded any assessment of treatment response. The remaining participants (n\u0026thinsp;=\u0026thinsp;46) had varying degrees of missing data at post-intervention (Week 8) or follow-up (Week 12) timepoints.\u003c/p\u003e\u003cp\u003eMissing data were handled using maximum likelihood within the LMM framework, assuming data were missing at random (MAR). This approach utilizes all available data from each participant without requiring imputation, thereby preserving the longitudinal structure of the data while accommodating different patterns of missingness.\u003c/p\u003e\u003cp\u003eA sensitivity analysis was also conducted to examine whether changes in mindful eating scores from baseline to follow-up (Week 12) were associated with the number of sessions attended in each group. Spearman correlations were calculated separately for the Mind-Eat and TPE arms.\u003c/p\u003e\u003cp\u003eGiven that over 80% of participants attended more than half of the sessions or workshops, and protocol adherence was high, per-protocol analyses were not deemed necessary.\u003c/p\u003e\u003cp\u003eGiven the significant baseline difference in BMI between groups (39.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.99 vs 36.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.42 kg/m\u0026sup2;, p\u0026thinsp;\u0026lt;\u0026thinsp;.001), we conducted an additional sensitivity analysis to assess whether this imbalance affected our primary findings. Participants were stratified into BMI tertiles (\u0026lt;\u0026thinsp;35, 35\u0026ndash;40, \u0026gt;\u0026thinsp;40 kg/m\u0026sup2;), and separate linear mixed-effects models were fitted for each tertile to examine Group \u0026times; Time interactions for the primary outcome (Mind-Eat Scale score).\u003c/p\u003e\u003cp\u003eAll statistical tests were two-sided, with significance set at p\u0026thinsp;\u0026le;\u0026thinsp;.05. Analyses were performed using R software (version 4.2.1; R Core Team, 2022).\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Sample characteristics\u003c/h2\u003e\u003cp\u003eA total of 46 participants (22 Mind-Eat, 24 TPE) with at least one post-baseline assessment were included in the modified ITT analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Groups were comparable at baseline for sex, age, anxiety/depression (HAD), trait mindfulness (FFMQ), and mindful eating levels (Mind-Eat Scale). Mean BMI was higher in the Mind-Eat group (39.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.99 vs. 36.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.42 kg/m\u0026sup2;, p\u0026thinsp;\u0026lt;\u0026thinsp;.001) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBaseline characteristics of participants in the Mind-Eat (ME) and TPE groups (N\u0026thinsp;=\u0026thinsp;46)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTPE (n\u0026thinsp;=\u0026thinsp;24)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eME (n\u0026thinsp;=\u0026thinsp;22)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7 (29.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e8 (36.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17 (70.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14 (63.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge, years\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e47.5\u0026thinsp;\u0026plusmn;\u0026thinsp;14.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49.3\u0026thinsp;\u0026plusmn;\u0026thinsp;11.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeight, kg\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e112.0\u0026thinsp;\u0026plusmn;\u0026thinsp;17.9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e102.0\u0026thinsp;\u0026plusmn;\u0026thinsp;17.6\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHeight, m\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.68\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.10\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBMI, kg/m\u0026sup2;\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e39.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.99\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMindfulness (FFMQ total)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e130.0\u0026thinsp;\u0026plusmn;\u0026thinsp;22.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e129.0\u0026thinsp;\u0026plusmn;\u0026thinsp;18.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMindful eating (Mind-Eat Scale), mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnxiety\u0026thinsp;+\u0026thinsp;Depression (HADS total), mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e14.4\u0026thinsp;\u0026plusmn;\u0026thinsp;6.01\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003cem\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%). No statistical tests were performed in line with current recommendations; apparent baseline differences (e.g., BMI) were considered in sensitivity analyses.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAdherence was high: Mind-Eat participants attended on average 6.9 of 8 sessions (36% attended all), while TPE participants attended 3.9 of 7 workshops (8% attended all). Follow-up attendance was 91% in Mind-Eat and 100% in TPE, with final visit completion rates of 96% and 92%, respectively.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Effects on Mindful Eating (Primary Outcome)\u003c/h2\u003e\u003cp\u003eAt baseline, mindful eating scores did not differ between groups (β\u0026thinsp;=\u0026thinsp;.10, p\u0026thinsp;=\u0026thinsp;.60). As shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, mixed-effects models revealed significant Group \u0026times; Time interactions favoring the Mind-Eat group at post-intervention (β = \u0026ndash;.40, p\u0026thinsp;=\u0026thinsp;.002, d = \u0026minus;\u0026thinsp;1.32) and follow-up (β = \u0026ndash;.31, p\u0026thinsp;=\u0026thinsp;.02, d = \u0026minus;\u0026thinsp;1.02).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMind-Eat Scale total and subdimension scores at baseline, post-intervention, and follow-up: between-group comparisons using mixed-effects models (N\u0026thinsp;=\u0026thinsp;46)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOutcome\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTPE (n\u0026thinsp;=\u0026thinsp;24) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eME (n\u0026thinsp;=\u0026thinsp;22) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCohen's d\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eβ (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMind-Eat Scale total\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.93\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.004\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.40 (-0.65, -0.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.31 (-0.56, -0.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.020\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNon-reactivity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.013\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.89\u0026thinsp;\u0026plusmn;\u0026thinsp;0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.54 (-0.92, -0.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.14\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.32\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.41 (-0.80, -0.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.040\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAwareness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.15\u0026thinsp;\u0026plusmn;\u0026thinsp;1.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.19\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.134\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.99\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.43 (-0.86, -0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.050\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.22 (-0.65, 0.22)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.330\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOpenness\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.15\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.625\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.38\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.86\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.09 (-0.24, 0.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.588\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.85\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.08 (-0.42, 0.27)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.664\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGratitude\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.95\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.06\u0026thinsp;\u0026plusmn;\u0026thinsp;0.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.438\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.33\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.55\u0026thinsp;\u0026plusmn;\u0026thinsp;0.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.10 (-0.55, 0.34)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.649\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.29 (-0.75, 0.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.207\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNon-judgment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.88\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.021\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.91\u0026thinsp;\u0026plusmn;\u0026thinsp;1.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.62 (-1.08, -0.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.010\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.44\u0026thinsp;\u0026plusmn;\u0026thinsp;1.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.05\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.11 (-0.58, 0.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.653\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHunger/Satiety\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.72\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.09\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.80 (-1.26, -0.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e- Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.27\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.31\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.73 (-1.20, -0.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD. Effect sizes (Cohen\u0026rsquo;s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group \u0026times; Time interaction. \u0026sup1; Global Group \u0026times; Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSubscale analyses showed greater improvements in Non-reactivity, Non-judgment, and Hunger/Satiety (Week 8 and 12) and in Awareness (Week 8 only), with no effects for Openness or Gratitude.\u003c/p\u003e\u003cp\u003eTo assess the potential influence of intervention exposure, we conducted a sensitivity analysis examining whether the number of sessions or workshops attended was associated with changes in mindful eating scores (Mind-Eat Scale, Week 12 \u0026ndash; Week 0) within each group. In the Mind-Eat group, session attendance correlated positively with improvements in mindful eating (Week 8: r\u0026thinsp;=\u0026thinsp;.55, p\u0026thinsp;=\u0026thinsp;.008; Week 12: r\u0026thinsp;=\u0026thinsp;.47, p\u0026thinsp;=\u0026thinsp;.031), indicating a dose\u0026ndash;response relationship. No association was observed in the TPE group (Week 8: r = \u0026ndash;.10, p\u0026thinsp;=\u0026thinsp;.63; Week 12: r = \u0026ndash;.10, p\u0026thinsp;=\u0026thinsp;.65). Stratified analyses by BMI tertiles confirmed intervention effectiveness across BMI categories. Results were consistent in sensitivity analyses (see 3.4).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Secondary outcomes\u003c/h2\u003e\u003cp\u003eResults from mixed-effects models are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Intuitive eating (IES-2) improved more in the Mind-Eat group at both post-intervention (β = \u0026ndash;.51, p\u0026thinsp;=\u0026thinsp;.002) and follow-up (β = \u0026ndash;.38, p\u0026thinsp;=\u0026thinsp;.02). Among subscales, significant effects were found for \u0026ldquo;Eating for physical rather than emotional reasons\u0026rdquo; and \u0026ldquo;Reliance on hunger and satiety cues,\u0026rdquo;, with no effect for \u0026ldquo;Unconditional permission to eat.\u0026rdquo;\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBetween-group differences in secondary eating outcomes over time: results from mixed-effects models.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOutcome / Time point\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTPE (n\u0026thinsp;=\u0026thinsp;24) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eME (n\u0026thinsp;=\u0026thinsp;22) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCohen's d\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eβ (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIntuitive eating (IES-2)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.004\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.97\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.51 (-0.82, -0.20)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.38 (-0.70, -0.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.019\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEating for physical rather than emotional reasons\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.066\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.63\u0026thinsp;\u0026plusmn;\u0026thinsp;1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.30\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.52 (-0.95, -0.08)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.31 (-0.76, 0.13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.170\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eReliance on hunger and satiety cues\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.006\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.21\u0026thinsp;\u0026plusmn;\u0026thinsp;1.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.21\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.73 (-1.20, -0.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.47\u0026thinsp;\u0026plusmn;\u0026thinsp;1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.43\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.57 (-1.04, -0.09)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.022\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eUnconditional permission to eat\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.517\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.18\u0026thinsp;\u0026plusmn;\u0026thinsp;0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.39\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.17 (-0.61, 0.26)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.440\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e3.28\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.63\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.25 (-0.70, 0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.266\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBinge eating (BES)\u0026sup2;\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.030\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e13.42\u0026thinsp;\u0026plusmn;\u0026thinsp;7.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e17.56\u0026thinsp;\u0026plusmn;\u0026thinsp;8.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e10.92\u0026thinsp;\u0026plusmn;\u0026thinsp;7.99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e11.77\u0026thinsp;\u0026plusmn;\u0026thinsp;5.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.27 (0.17, 6.38)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.044\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e9.00\u0026thinsp;\u0026plusmn;\u0026thinsp;7.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e9.47\u0026thinsp;\u0026plusmn;\u0026thinsp;6.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.06 (0.88, 7.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.015\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRestrictive eating (DEBQ)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.322\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.61\u0026thinsp;\u0026plusmn;\u0026thinsp;0.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.80\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.08 (-0.25, 0.42)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.631\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.26 (-0.09, 0.61)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.142\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmotional eating (DEBQ)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.003\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.52\u0026thinsp;\u0026plusmn;\u0026thinsp;1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.39\u0026thinsp;\u0026plusmn;\u0026thinsp;1.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.66 (0.27, 1.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.22\u0026thinsp;\u0026plusmn;\u0026thinsp;1.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.24\u0026thinsp;\u0026plusmn;\u0026thinsp;0.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.49 (0.09, 0.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.020\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eExternal eating (DEBQ)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.82\u0026thinsp;\u0026plusmn;\u0026thinsp;0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.76\u0026thinsp;\u0026plusmn;\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.44 (0.19, 0.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e2.52\u0026thinsp;\u0026plusmn;\u0026thinsp;0.66\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e2.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.34 (0.09, 0.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD. Effect sizes (Cohen\u0026rsquo;s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group \u0026times; Time interaction. \u0026sup1; Global Group \u0026times; Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons. \u0026sup2; Multivariate models adjusted for sex, age, and baseline BMI.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eBinge eating symptoms decreased more in the Mind-Eat group, significant in adjusted models (p\u0026thinsp;=\u0026thinsp;.009) but borderline in unadjusted tests (p\u0026thinsp;\u0026asymp;\u0026thinsp;.06).\u003c/p\u003e\u003cp\u003eRestrained eating (DEBQ) did not differ between groups, while emotional eating (β\u0026thinsp;=\u0026thinsp;.66, p\u0026thinsp;=\u0026thinsp;.001 at week 8; β\u0026thinsp;=\u0026thinsp;.49, p\u0026thinsp;=\u0026thinsp;.02 at week 12) and external eating (p\u0026thinsp;\u0026lt;\u0026thinsp;.001 and p\u0026thinsp;=\u0026thinsp;.008) decreased more in the Mind-Eat group.\u003c/p\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, trait mindfulness (FFMQ) increased significantly more in the Mind-Eat group (β = \u0026minus;\u0026thinsp;13.81, p\u0026thinsp;=\u0026thinsp;.007 at week 8; β = \u0026minus;\u0026thinsp;12.16, p\u0026thinsp;=\u0026thinsp;.01 at week 12). No between-group differences were observed for physical activity (Ricci-Gagnon), anxiety or depression (HAD), perceived stress (PSS) or weight.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eMixed effects model results for between-group comparisons on secondary psychobehavioral outcomes.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOutcome / Time point\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTPE (n\u0026thinsp;=\u0026thinsp;24) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eME (n\u0026thinsp;=\u0026thinsp;22) Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCohen's d\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eβ (95% CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePhysical activity (Ricci-Gagnon)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.921\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e20.46\u0026thinsp;\u0026plusmn;\u0026thinsp;8.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e19.09\u0026thinsp;\u0026plusmn;\u0026thinsp;8.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e20.46\u0026thinsp;\u0026plusmn;\u0026thinsp;8.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e19.86\u0026thinsp;\u0026plusmn;\u0026thinsp;9.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.77 (-1.90, 0.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.690\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e20.86\u0026thinsp;\u0026plusmn;\u0026thinsp;8.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e19.71\u0026thinsp;\u0026plusmn;\u0026thinsp;9.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.29 (-0.89, 0.59)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.886\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAnxiety and depression (HADS total)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.480\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e14.40\u0026thinsp;\u0026plusmn;\u0026thinsp;6.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e14.30\u0026thinsp;\u0026plusmn;\u0026thinsp;5.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e11.50\u0026thinsp;\u0026plusmn;\u0026thinsp;5.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e10.04\u0026thinsp;\u0026plusmn;\u0026thinsp;5.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.03 (-1.62, 3.69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.447\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e11.00\u0026thinsp;\u0026plusmn;\u0026thinsp;5.78\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e9.62\u0026thinsp;\u0026plusmn;\u0026thinsp;6.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.65 (-1.06, 4.37)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.234\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e\u0026ndash; Anxiety\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.370\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8.46\u0026thinsp;\u0026plusmn;\u0026thinsp;4.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e8.32\u0026thinsp;\u0026plusmn;\u0026thinsp;3.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.83\u0026thinsp;\u0026plusmn;\u0026thinsp;3.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e6.04\u0026thinsp;\u0026plusmn;\u0026thinsp;2.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.65 (-0.94, 2.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.418\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e6.68\u0026thinsp;\u0026plusmn;\u0026thinsp;3.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e5.62\u0026thinsp;\u0026plusmn;\u0026thinsp;3.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.14 (-0.48, 2.76)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.164\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003e\u0026ndash; Depression\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.795\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5.92\u0026thinsp;\u0026plusmn;\u0026thinsp;2.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e6.00\u0026thinsp;\u0026plusmn;\u0026thinsp;3.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.67\u0026thinsp;\u0026plusmn;\u0026thinsp;2.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.39 (-1.13, 1.90)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.618\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e4.36\u0026thinsp;\u0026plusmn;\u0026thinsp;3.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.51 (-1.04, 2.06)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.522\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eStress (PSS)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.510\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e16.46\u0026thinsp;\u0026plusmn;\u0026thinsp;8.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e19.73\u0026thinsp;\u0026plusmn;\u0026thinsp;5.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e15.20\u0026thinsp;\u0026plusmn;\u0026thinsp;7.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e16.23\u0026thinsp;\u0026plusmn;\u0026thinsp;8.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.25 (-2.28, 6.77)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.326\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e14.00\u0026thinsp;\u0026plusmn;\u0026thinsp;9.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e15.62\u0026thinsp;\u0026plusmn;\u0026thinsp;9.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.37 (-2.26, 6.99)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.313\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMindfulness (FFMQ total)\u0026sup2;\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.007\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e130.04\u0026thinsp;\u0026plusmn;\u0026thinsp;22.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e129.46\u0026thinsp;\u0026plusmn;\u0026thinsp;18.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e132.92\u0026thinsp;\u0026plusmn;\u0026thinsp;23.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e146.14\u0026thinsp;\u0026plusmn;\u0026thinsp;16.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-1.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-13.81 (-23.10, -4.52)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.005\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e138.82\u0026thinsp;\u0026plusmn;\u0026thinsp;23.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e148.71\u0026thinsp;\u0026plusmn;\u0026thinsp;19.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.84\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-12.16 (-21.67, -2.65)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.014\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eWeight change (kg)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.833\u0026sup1;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Post-intervention vs Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-0.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e-0.23\u0026thinsp;\u0026plusmn;\u0026thinsp;3.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up vs Post-intervention\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-0.47\u0026thinsp;\u0026plusmn;\u0026thinsp;1.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.17 (-1.75, 1.41)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.832\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ndash; Follow-up vs Baseline\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e-0.95\u0026thinsp;\u0026plusmn;\u0026thinsp;3.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e-0.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e-0.48 (-2.08, 1.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.552\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD. Effect sizes (Cohen\u0026rsquo;s d), β coefficients (95% CI), and p-values are derived from linear mixed-effects models including Group \u0026times; Time interaction. \u0026sup1; Global Group \u0026times; Time interaction p-values are shown in header rows; contrast p-values are presented for post-intervention and follow-up comparisons. \u0026sup2; Models adjusted for sex, age, and baseline BMI.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e3.4 Sensitivity analyses\u003c/h2\u003e\u003cp\u003eSensitivity analyses confirmed the robustness of the findings. Including age, sex, and baseline BMI as covariates did not improve model fit or alter effect significance, supporting the unadjusted model as the most parsimonious. Baseline mindfulness predicted greater change (p\u0026thinsp;=\u0026thinsp;.008) ; however, additional adjustments for baseline mindfulness, anxiety, and depression did not alter the direction or significance of the results.\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study evaluated the effects of a structured mindful eating program, delivered in a real-world clinical setting and designed to target core mechanisms such as interoceptive awareness and non-reactivity. Compared to an active control group receiving therapeutic patient education grounded in intuitive eating principles, the Mind-Eat intervention led to significantly greater improvements in mindful eating behaviors. These effects were observed both immediately after the 8-week intervention and sustained at 12-week follow-up, with large effect sizes particularly in the domains of non-reactivity, non-judgment, and awareness of hunger and satiety cues. To our knowledge, this is one of the first trials to evaluate a mindful eating intervention using a validated, multidimensional scale specifically developed to capture change in this construct. The findings support the added value of experiential, mindfulness-based approaches, even when compared to active programs that already incorporate elements of internal cue awareness and non-restrictive eating.\u003c/p\u003e\u003cp\u003eUsing an active comparator grounded in intuitive eating represents both a strength and a challenge: this rigorous design sets a high bar for detecting incremental benefits, and the fact that Mind-Eat still outperformed TPE suggests that experiential mindfulness training provides additional therapeutic value.\u003c/p\u003e\u003cp\u003e Beyond mindful eating, Mind-Eat participants showed greater improvements in intuitive eating, reductions in emotional and external eating, and increased trait mindfulness, confirming the psychological specificity of the intervention. In contrast, no differences were observed for weight, stress, or depressive symptoms, consistent with previous short-term mindfulness trials (\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). These findings align with prior research suggesting that mindfulness-based eating interventions can reduce emotional dysregulation and maladaptive eating patterns while enhancing interoceptive awareness (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBoth interventions were grounded in non-restrictive, internal-cue\u0026ndash;driven frameworks. While the TPE group followed a flexible, intuitive eating\u0026ndash;oriented format, the Mind-Eat program implemented a highly structured experiential curriculum centered on mindfulness practice. This design allowed us to evaluate the specific contribution of formal mindfulness training beyond a contemporary, non-diet nutritional approach.\u003c/p\u003e\u003cp\u003eA notable contribution of this study is the demonstration of a dose\u0026ndash;response relationship within the Mind-Eat group, where higher session attendance was associated with greater improvements in mindful eating scores. This association was not observed in the control group. This suggests that intervention intensity may be particularly relevant in mindfulness-based programs and highlights the importance of accounting for actual participation when interpreting treatment effects.\u003c/p\u003e\u003cp\u003eAlthough no significant weight change was observed in either group at 12 weeks, this aligns with prior mindfulness-based trials and reflects the program\u0026rsquo;s behavioral rather than weight-loss focus (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eOur results further revealed convergence between conceptually related outcomes. Improvements in emotional eating (DEBQ) mirrored those in the IES-2 subscale \u003cem\u003eEating for physical rather than emotional reasons\u003c/em\u003e. Likewise, improvements in the Mind-Eat subscale \u003cem\u003eAwareness of hunger and satiety cues\u003c/em\u003e corresponded with increases in \u003cem\u003eReliance on hunger and satiety cues\u003c/em\u003e (IES-2), reinforcing the internal consistency and specificity of the intervention\u0026rsquo;s effects. In contrast, no significant changes were observed for the \u003cem\u003eOpenness\u003c/em\u003e or \u003cem\u003eGratitude\u003c/em\u003e subdomains of the Mind-Eat Scale, two novel dimensions introduced in the scale\u0026rsquo;s development. This may reflect the fact that these constructs were not explicitly targeted by the intervention and might require either more intensive practice or longer-term follow-up to show measurable effects.\u003c/p\u003e\u003cp\u003eFinally, our findings add to the growing empirical support for the use of the Mind-Eat Scale. Although originally validated in an independent sample (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), this study provides additional evidence of the instrument\u0026rsquo;s sensitivity to change and convergent validity with established constructs. Nevertheless, the minimal clinically important difference (MCID) for the Mind-Eat Scale has not yet been established, which limits the ability to translate observed effect sizes into clinical significance. Future studies should aim to determine thresholds for clinically meaningful change.\u003c/p\u003e\u003cp\u003eThis study has several strengths, including its pragmatic RCT design, high retention and adherence rates, and use of an active comparator rooted in intuitive eating principles. Rather than comparing against inactive controls, this design tested whether experiential mindfulness training provides incremental benefits beyond cognitive-educational approaches, a stringent and clinically relevant comparison. Despite these similarities, the Mind-Eat intervention produced significantly greater benefits across multiple domains, highlighting the added clinical value of a structured mindfulness-based experiential program (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite these encouraging findings, several limitations must be acknowledged. First, the modest sample size was adequate for the primary outcome but may have limited power for secondary outcomes. Second, as multiple secondary outcomes and subscales were tested, some significant findings may reflect chance associations. Third, although 10 participants were excluded for lack of post-intervention data, the overall low rate of missing data and balanced completion rates across groups support the validity of our approach; however, we did not perform multiple imputation or other sensitivity analyses beyond LMM, so the MAR assumption was not tested. Fourth, despite successful randomization, groups differed on baseline BMI (39.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.99 vs 36.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.42 kg/m\u0026sup2;); stratified analyses by BMI tertiles indicated that effects persisted across BMI categories. Fifth, intervention intensity differed (~\u0026thinsp;12h for Mind-Eat vs\u0026thinsp;~\u0026thinsp;4-14h for TPE), which complicates causal attribution, although the dose\u0026ndash;response observed only in Mind-Eat argues against a pure exposure-time effect. Sixth, the predominance of female participants, though reflective of typical obesity care populations, limits generalizability to men. Finally, while the absence of short-term weight reduction is consistent with the program\u0026rsquo;s behavioral focus and prior mindfulness-based trials, it may still be perceived as a limitation by patients and clinicians who prioritize weight outcomes. Future studies should therefore assess weight trajectories over extended follow-up durations, while continuing to evaluate mindful eating primarily as a behavioral mechanism rather than a weight-loss intervention.\u003c/p\u003e\u003cp\u003eCollectively, these constraints motivate the following priorities for future research. Future studies should consider stratified randomization by key demographic and clinical variables, aim to replicate these findings in more diverse samples, and incorporate longer-term follow-up to assess durability of behavioral changes. Additionally, studies should examine objective behavioral and physiological markers and conduct mediation analyses exploring the role of interoceptive awareness, emotion regulation, and self-regulation capacities to clarify mechanisms of action. The qualitative data collected in this study also offer an opportunity to further refine intervention content and assess perceived barriers and facilitators to change.\u003c/p\u003e\u003cp\u003eFrom a clinical implementation perspective, the Mind-Eat program's structured 8-week format aligns with established group therapy models and may facilitate standardized delivery across healthcare systems. While the higher intensity represents an investment of resources, the sustained behavioral improvements at follow-up suggest potential cost-effectiveness through reduced long-term healthcare utilization. However, healthcare systems will need to weigh the program's resource requirements against its demonstrated clinical benefits when considering implementation alongside existing patient education pathways.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eThis randomized controlled trial provides preliminary but robust evidence that the Mind-Eat program, a structured, mindfulness-based intervention, can significantly enhance mindful and intuitive eating in individuals with overweight or obesity. Compared to an active, intuitive eating\u0026ndash;oriented control group, Mind-Eat offered additional clinical benefits, with high acceptability and feasibility in a real-world outpatient setting. Although no short-term effects were observed on weight, the sustained improvements in eating behaviors highlight its potential as a complementary approach in multidisciplinary obesity care. Baseline BMI differences between groups represent a limitation, but stratified analyses confirmed intervention effectiveness across BMI categories. Future research should replicate these findings with longer follow-up, establish clinically meaningful thresholds for mindful eating, and evaluate implementation across diverse healthcare settings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eWorld Health Organisation\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eREML\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eRestricted Maximum Likelihood\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003ePSS\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003ePerceived Stress Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMECL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMindful Eating Conscious Living\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eME\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMind-Eat\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMEAL\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMindful Eating and Living\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMB-EAT\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMindfulness-Based Eating Awareness Training\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eMBSR\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eMindfulness-Based Stress Reduction\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eLMM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eLinear Mixed Models\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIES-2\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eIntuitive Eating Scale-2\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eHAD\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eHospital Anxiety and Depression Scale\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eFFMQ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eFive Facet Mindfulness Questionnaire\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDEBQ\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDutch Eating Behavior Questionnaire\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBody Mass Index\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eBES\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eBinge Eating Scale.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411. All subjects provided informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData will be made available on request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was part of the MIND-EAT project, which was supported by the Institute for Public Health Research (IReSP) (2021\u0026ndash;2024).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMarion Van Beekum\u003c/strong\u003e: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Software, Writing \u0026ndash; original draft, Writing \u0026ndash; review \u0026amp; editing. \u003cstrong\u003eAng\u0026eacute;lique Rodhain\u003c/strong\u003e: Conceptualization, Funding acquisition, Methodology, Writing \u0026ndash; original draft. \u003cstrong\u003eRebecca Shankland\u003c/strong\u003e: Conceptualization, Methodology, Writing \u0026ndash; original draft. \u003cstrong\u003eSoumeya Chetouane\u003c/strong\u003e: Conceptualization, Investigation, Methodology, Writing \u0026ndash; original draft. \u003cstrong\u003eDominique Jullien-Durmont, Camille Le Rouzic, Justine Myzia, Marie Guiraudou, Youadigue Kemba, Catherine Boegner, Jean-Baptiste Bonnet, Vincent Attalin, Ariane Sultan, and Abdulkader Jalek\u003c/strong\u003e: Conceptualization, Data curation, Investigation, Methodology. \u003cstrong\u003eChristophe Leys:\u003c/strong\u003e Conceptualization, Methodology, Writing \u0026ndash; original draft. \u003cstrong\u003eSandrine P\u0026eacute;neau:\u003c/strong\u003e Conceptualization, Funding acquisition, Project administration, Resources, Supervision, Visualization, Writing \u0026ndash; original draft. \u003cstrong\u003eAntoine Avignon:\u003c/strong\u003e Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing \u0026ndash; original draft, Writing \u0026ndash; review \u0026amp; editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors thank: \u003cstrong\u003eJoy Fabre\u003c/strong\u003e (healthcare manager); \u003cstrong\u003eAnne-Lise Pouget, Delphine Deguirard-Demontarnal, Nad\u0026egrave;ge Amphoux, Sandrine Olivas-Carrion, La\u0026euml;titia Ricci, Chrystel Pellissier-Dieraert,\u003c/strong\u003e and\u003cstrong\u003e\u0026nbsp;St\u0026eacute;phanie Bicand\u003c/strong\u003e (nurses); \u003cstrong\u003eJean-Marc Vicedo\u003c/strong\u003e (nursing assistant); \u003cstrong\u003eCarine Durand\u003c/strong\u003e and \u003cstrong\u003eAudrey Ruiz\u003c/strong\u003e (secretaries); \u003cstrong\u003eLeslie Bouisset\u003c/strong\u003e (clinical research associate); \u003cstrong\u003eLilian Rouch\u003c/strong\u003e and \u003cstrong\u003eCl\u0026eacute;ment Picavet\u003c/strong\u003e (adapted physical activity specialists); \u003cstrong\u003eMorgane Montagne\u003c/strong\u003e (psychologist); as well as all the interns who contributed to this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLapadat L, Gao A, Bicaker E, Racine SE. 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New York: St. Martin\u0026rsquo;s Griffin; 2012. p. 344.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBrunault P, Gaillard P, Ballon N, Couet C, Isnard P, Cook S, et al. de sa consistance interne et de sa validit\u0026eacute; de construit en population clinique et non clinique. L\u0026rsquo;Enc\u0026eacute;phale oct. 2016;42(5):426\u0026ndash;33. Validation de la version fran\u0026ccedil;aise de la Binge Eating Scale: \u0026eacute;tude de sa structure factorielle.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLluch A, Kahn J, Stricker-Krongrad A, Ziegler O, Drouin P, M\u0026eacute;jean L. Internal validation of a French version of the Dutch eating behaviour questionnaire. Eur Psychiatry. 1996;11(4):198\u0026ndash;203.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZemni I, Zemni K, Gara A, Maatouk A, Fredj MB, Abroug H et al. French version of the Perceived Stress Scale (PSS-10). mars 2023; Disponible sur: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://plos.figshare.com/articles/journal_contribution/French_version_of_the_Perceived_Stress_Scale_PSS-10_/22271782\u003c/span\u003e\u003cspan address=\"https://plos.figshare.com/articles/journal_contribution/French_version_of_the_Perceived_Stress_Scale_PSS-10_/22271782\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand juin. 1983;67(6):361\u0026ndash;70.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHeeren A, Douilliez C, Peschard V, Debrauwere L, Philippot P. Cross-cultural validity of the Five Facets Mindfulness Questionnaire: Adaptation and validation in a French-speaking sample. Eur Rev Appl Psychol juill. 2011;61(3):147\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRicci J, Gagnon L, TEST D\u0026rsquo;AUTO, EVALUATION [Internet]. Institut Curie. ; 2011 janv. (Document Clinicprosport). Disponible sur: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://curie.fr/sites/default/files/medias/documents/2020-01/Test%20d%27auto%C3%A9valuation.pdf\u003c/span\u003e\u003cspan address=\"https://curie.fr/sites/default/files/medias/documents/2020-01/Test%20d%27auto%C3%A9valuation.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTurgon R, Ruffault A, Juneau C, Blatier C, Shankland R. Eating Disorder Treatment: a Systematic Review and Meta-analysis of the Efficacy of Mindfulness-Based Programs. 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Obes Rev f\u0026eacute;vr. 2018;19(2):164\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKao TSA, Ling J, Alanazi M, Atwa A, Liu S. Effects of mindfulness-based interventions on obesogenic eating behaviors: A systematic review and meta-analysis. Obes Rev Off J Int Assoc Study Obes mars. 2025;26(3):e13860.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRogers JM, Ferrari M, Mosely K, Lang CP, Brennan L. Mindfulness-based interventions for adults who are overweight or obese: a meta‐analysis of physical and psychological health outcomes. Obes Rev janv. 2017;18(1):51\u0026ndash;67.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDaubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, et al. Effects of a mindfulness-based weight loss intervention in adults with obesity: A randomized clinical trial. Obes avr. 2016;24(4):794\u0026ndash;804.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMason AE, Epel ES, Kristeller J, Moran PJ, Dallman M, Lustig RH, et al. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. J Behav Med avr. 2016;39(2):201\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-behavioral-nutrition-and-physical-activity","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijbn","sideBox":"Learn more about [International Journal of Behavioral Nutrition and Physical Activity](http://ijbnpa.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ijbn/default.aspx","title":"International Journal of Behavioral Nutrition and Physical Activity","twitterHandle":"@IJBNPA","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Mindful Eating, Eating Behavior, Emotional Eating, Intuitive Eating, Overweight, Obesity, Randomized Controlled Trial","lastPublishedDoi":"10.21203/rs.3.rs-7456763/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7456763/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMindful eating interventions can reduce maladaptive eating behaviors, yet most structured programs have been tested in English-speaking countries, often using passive control groups. This randomized controlled trial assessed the effectiveness of the Mind-Eat program, a structured, mindfulness-based group intervention, compared to an active, intuitive eating–oriented education program in a clinical population with overweight or obesity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this single-center trial, 46 adults (BMI 25–50 kg/m²) consulting for the first time in a hospital nutrition unit were randomly assigned (1:1) to either the Mind-Eat program or an active control group receiving therapeutic patient education (TPE). The Mind-Eat group completed eight weekly experiential sessions and one follow-up session one month later. Assessments occurred at baseline (week 0), post-intervention (week 8), and follow-up (week 12). The primary outcome was change in mindful eating, measured using the validated Mind-Eat Scale. Secondary outcomes included intuitive and disordered eating behaviors, trait mindfulness, psychological well-being, physical activity, and weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMixed-effects models showed a significant Group × Time interaction for mindful eating scores at post-intervention (β = –.40, p = .002, d = − 1.32) and follow-up (β = –.31, p = .02, d = − 1.02), favoring the Mind-Eat group. Greater improvements were also found for intuitive eating, emotional and external eating, and trait mindfulness. No significant between-group differences were observed for cognitive restraint, psychological well-being, physical activity, or weight.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Mind-Eat program improved mindful and intuitive eating beyond intuitive eating–oriented education. Weight stability is consistent with the program's behavioral rather than weight-loss focus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol is recorded at Clinicaltrials.gov under the number: NCT06157411.\u003c/p\u003e","manuscriptTitle":"The Mind-Eat Program Improves Mindful Eating and Related Behaviors in Adults with Overweight or Obesity: A Randomized Controlled Trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-24 05:09:48","doi":"10.21203/rs.3.rs-7456763/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-24T23:22:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-20T20:27:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"325592530632635696493479219353552664366","date":"2026-02-11T15:46:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"10319180086750924413683341244759099783","date":"2026-02-09T15:05:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-10T21:22:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50577347100425725938232357346884061013","date":"2025-09-29T12:53:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-15T13:46:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-26T08:19:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-26T08:17:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Behavioral Nutrition and Physical Activity","date":"2025-08-25T20:05:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-behavioral-nutrition-and-physical-activity","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijbn","sideBox":"Learn more about [International Journal of Behavioral Nutrition and Physical Activity](http://ijbnpa.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ijbn/default.aspx","title":"International Journal of Behavioral Nutrition and Physical Activity","twitterHandle":"@IJBNPA","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"64172972-8e84-47f8-b7e4-525786634489","owner":[],"postedDate":"September 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-27T16:54:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-24 05:09:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7456763","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7456763","identity":"rs-7456763","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}