Integrated Mindfulness-Oriented Recovery Enhancement (MORE) and physical health intervention for cancer survivors with obesity: Preliminary results from a pilot randomized controlled trial.

Abstract

237 Background: Hypothetically, interventions that reduce excessive weight and promote nutrition and physical activity may protect against cancer recurrence. Yet, obesity is often fueled by compulsive eating behaviors. Integrative therapies that combine exercise and nutrition training with techniques to enhance interoceptive awareness and cognitive control over automatic, compulsive eating may be especially efficacious. This pilot study tested the preliminary efficacy of an integrated exercise, nutrition, and Mindfulness-Oriented Recovery Enhancement (MORE) intervention in a sample of obese cancer patient. Methods: Obese (Mean BMI = 35.8) female patients (Mean age 58.41) with breast (n = 15), colon (n = 1), and endometrial cancers (n = 1) were recruited and randomly assigned to receive exercise and nutrition intervention without (POWER, n = 10) or with an additional mindfulness component (MORE POWER, n = 7). Participants met twice weekly for 10 weeks for group exercise and nutrition sessions. MORE POWER participants also participated in 10 weekly group mindfulness sessions. Pre- and post-intervention, assessments included self-report measures, weight and BMI measurement, and a cue-elicited heart rate variability (HRV) assessment. Results: The MORE POWER group evidenced significantly greater reductions in BMI (p = .015) and weight (p = .034; 6.57 lbs. vs. 1.35 lbs.) than the POWER group. The MORE POWER group also reported significantly greater increases in interoceptive awareness (p = .019) and mindful observation than the POWER group (p = .040). Increases in mindful observation predicted residualized change in BMI, Beta = -.13, SE = .05, p = .03. Lastly, MORE POWER group exhibited significantly greater post-intervention HRV than the POWER group (p = .011). Conclusions: Integrating MORE with an exercise and nutrition training program appeared to enhance weight loss outcomes in this pilot sample of obese cancer patients. Findings suggest that mindfulness training may strengthen cognitive regulation of appetitive and motivational reactions crucial to weight loss, and thereby promote health in cancer survivors.