1. Jeanne Dalen, Ph.D Associate Research Scientist Oregon Research Institute

2. Lifestyle interventions resulting in weight loss can reduce the incidence of Type 2 diabetes and its complications Though most standardized prescribed diets result in weight loss when followed, most individuals are unable to adhere to a diet for the long term Psychological distress plays a prominent role in self-management behaviors reduced adherence to regimens, overeating, weight gain, and poorer glycemic control Need to specifically address barriers theorized to be associated with long-term weight loss

3. Mindfulness-Based Stress Reduction (MBSR) is a well- established, systematic patient centered educational approach that uses training in mindfulness meditation to increase awareness and the ability to respond skillfully to experiences that contribute to emotional distress and maladaptive behavior Reductions in - psychological distress - blood pressure and cholesterol - improvement in glycemic control ‘Mindful Eating & Living’ (MEAL): brief 6-session program designed to bodily sensations influencing eating behavior, as well as the physical, cognitive, and emotional triggers to eat - developed by Brian Shelley, M.D.

4. Pilot Data In Obese Populations Proposed Study to Collect Pilot Data In Diabetic Populations Partnership with NMVAHCS 60 men and women with T2DM 35–65 years of age Randomly assigned to 1) usual diabetes care plus MEAL, or 2) usual diabetes care alone primary outcomes: dietary patterns, eating behaviors, and distress secondary health outcomes (e.g. BMI,HbA1c) Compared MEAL with an active comparison support group (SUPP) 36 post-menopausal obese women Age: M = 58 yrs; SD = 4.9, Weight at baseline (M = 210 pounds; SD = 17.22)

5. Conceptual Model

6. The challenge is not to convey more diet information to people, nor to rely on drugs and surgery with high costs and safety concerns Sensible and sustainable approach is to help people develop the lasting skills they need to optimize their relationship to food, eating, and their health Mindfulness represents a new avenue of exploration - targets the psychological and behavioral etiology of obesity Developing research programs to examine the efficacy of a mindfulness-based eating awareness intervention (MEAL) specifically with individuals with T2DM Combines behavioral and biomedical science to be used in real- world clinical health-care practice settings