Mindfulness-based eating awareness

1. Introduction

Version followed: the 12-session group protocol (10 weekly sessions plus 2 monthly boosters) tabulated by Kristeller & Jordan (2018) for adults with obesity with or without binge eating disorder (BED). Where the current Kristeller & Lieberstein professional curriculum (2019–2025) differs, it is noted as "current training version". Earlier BED-only versions are not drawn on here [uncertain]: the 1999 pilot by Kristeller & Hallett and the 2014 RCT by Kristeller, Wolever & Sheets.

Mindfulness-Based Eating Awareness Training (MB-EAT) is a manualised group programme developed by Jean Kristeller. It started with BED and was later extended to overeating, emotional eating and obesity. It combines mindfulness meditation, borrowed from Kabat-Zinn's MBSR, with guided eating meditations and research on how food intake is regulated. The authors frame BED as dysregulation that is emotional, behavioural and physiological, tied to both food intake and self-identity. MB-EAT targets four things: managing responses to shifting emotions, making conscious food choices, recognising hunger and satiety cues, and building self-acceptance [source: Kristeller & Wolever 2011 abstract].

Core idea of change: meditation practice loosens conditioned, reactive eating patterns. The person can then use "inner wisdom" (body signals of hunger, fullness and taste satisfaction, plus awareness of emotions and self-acceptance) alongside "outer wisdom" (nutrition and activity information, used flexibly). Rigid dieting rules give way to wiser, self-regulated choices. Focusing on enjoyment changes the reward value of food without banning it, so the person can eat less while enjoying it more [source: Kristeller & Jordan 2018; Kristeller & Lieberstein 2020 Session 1 handout]. The theory draws on self-regulation theory (Carver & Scheier; Shapiro & Schwartz) [source: Kristeller & Jordan 2018].

2. Framework

Format [source: Kristeller & Jordan 2018 unless noted]

Closed group with a fixed curriculum. Ten weekly sessions of 2.5 hours, then sessions 11 and 12 as monthly boosters of 2 hours each.
Group size was not reported in that trial. A bariatric adaptation ran groups of up to 10–12 with two co-facilitators: a psychologist or psychometrist plus a registered dietitian [source: UHN protocol 2016].
Other versions exist. A popular summary describes a 10-week plan [source: WFAE/NPR 2015], and Sharma (2011), summarising the 2011 paper, describes a 10-session BED programme. The bariatric adaptation used 8 weekly 2-hour sessions plus an information session [source: UHN protocol 2016]. The current training teaches a "12-week group program" [source: MB-EAT training page 2025].

Each session follows the same arc

A brief meditation or body-awareness practice. It is longer in sessions 1–4.
15–20 minutes of inquiry into the past week's practice, progress and difficulties.
A new meditation or awareness practice.
A guided eating exercise.
Brief teaching on inner wisdom and outer wisdom. Both appear in every session.
Home practice is assigned: meditation, mindful-eating exercises and that week's theme.

[source: Kristeller & Jordan 2018]

Meditation dose. Sitting practice starts at about 10 minutes, reaches about 20 minutes by session 3 and about 30 minutes from mid-programme. Participants start with audio guidance and are encouraged to move towards practising without the recording [source: Kristeller & Jordan 2018].

Phases. The sources give a session sequence, not named phases. The grouping below is synthesis [synthesis]. Session contents are from Kristeller & Jordan 2018.

Phase A, foundations (sessions 1–2). Goals: introduce the inner/outer wisdom model, start daily meditation, and introduce mini-meditations, self-tracking and the calorie-awareness challenge.
- S1: model; first group meditation; raisin exercise.
- S2: mini-meditations; outer-wisdom introduction; challenging food (cheese and crackers).
Phase B, inner signals (sessions 3–6). Goal: separate physical hunger from other triggers, and learn the satiety signals of taste, stomach fullness and the body as a whole.
- S3: hunger awareness; body scan.
- S4: taste satisfaction; healing self-touch; chocolate.
- S5: fullness with water; body satiety; the chain-reaction concept; forgiveness meditation; chips vs cookies choice; pedometer awareness.
- S6: mindful choice with fruit and vegetables; the integrated eating meditation; energy needs.
Phase C, integration (sessions 7–9). Goal: apply all the skills to full meals, triggers and values.
- S7: potluck meal; review of the calorie-awareness challenge.
- S8: body scan and chair yoga; triggers revisited; mindful walking.
- S9: interrupting the chain reaction; values exercise; favourite food.
Phase D, wisdom and maintenance (sessions 10–12). Goal: consolidate, link change to a sense of wisdom and meaning, and prepare for the buffet home practice and for maintenance.
- S10: wisdom meditation; healthy snacking.
- S11–12: self-acceptance meditation; progress review; maintaining and deepening change.

Current training version order (lesson titles from the course outline; content was locked). Mindful eating and mindfulness meditation; mini-meditation; hunger awareness and emotional eating; taste satisfaction and self-compassion; fullness and hunger awareness; integrated eating meditation. A recurring theme called "Keep in Balance" also appears. Its content was not seen [uncertain] [source: MB-EAT training course outline]. The current version adds loving-kindness and self-compassion practices, guided visualisation and role-play, and calls itself weight-inclusive and non-diet [source: MB-EAT training page 2025].

Moving between sessions. Progression is calendar-based, not criterion-based. In the trial, completion meant attending at least 7 of the 10 weekly sessions. A missed session could be covered in a brief individual appointment on that session's core elements [source: Kristeller & Jordan 2018].

Suggested readiness checks before moving on [synthesis]:

Before Phase B: the client is doing some home meditation most days.
Before Phase C: the client can report a hunger and a fullness rating at most meals.
Before the buffet: the client has checked hunger, taste and fullness during the potluck without a binge.

If a client is not ready, keep the group's pace and use the inquiry period plus an individual check-in rather than holding the group back [synthesis].

Selection and screening. Trial exclusions [source: Kristeller & Jordan 2018]:

current regular meditation practice
concurrent weight-loss programme
purging bulimia
active need for psychiatric management
unstable medication affecting eating or weight

The bariatric adaptation also excluded [source: UHN protocol 2016]:

active suicidal ideation
psychosis or bipolar disorder
severe depression or anxiety, screened with the PHQ-9 and GAD-7
current PTSD

The developers' training lists "precautions" for mindful-eating exercises with some eating-disorder clients but gives no detail [source: Kripalu 2019] [uncertain]. Do not run MB-EAT as stand-alone treatment for anorexia nervosa or active purging [synthesis].

Who leads. Qualified instructor status (MB-EAT-QI) requires three things: at least six months of personal mindfulness practice, a relevant professional credential, and experience facilitating groups. Training takes three months online and includes the MB-EAT Teaching Manual. A separate practitioner certificate (MB-EAT-P) covers using the tools with individual clients [source: MB-EAT training page 2025]. The full treatment manual (Kristeller & Wolever, Guilford) was listed as "in press" in 2018 and is not drawn on here [uncertain].

3. Guiding principles

[source: Kristeller & Jordan 2018; Kristeller & Lieberstein 2020 handout; Kripalu 2019; training page 2025 — as tagged]

Mindfulness practice is the foundation. Daily sitting practice is not optional decoration. Protect time for it in every session and review it in every inquiry [handout; K&J 2018].
Inner wisdom and outer wisdom together. Pair every body-signal skill with usable information on nutrition and activity. Neither replaces the other [K&J 2018; Kripalu 2019].
Wisdom over rules. Help clients decide from experience "rather than strictly following external rules and guidelines" (K&J 2018). Do not hand out diet rules.
Quality over quantity. The session 1 handout's subtitle is "Choosing Quality Over Quantity". Coach savouring and enjoyment as the way to feel satisfied with less [handout].
No forbidden foods. Use foods people overeat (chocolate, chips, cookies, favourite foods) inside sessions. Indulgent foods stay in the diet, in amounts the person chooses mindfully [K&J 2018].
Flexibility. Make eating and food choices flexible from day to day. Treat a "bad" day as data, not failure [handout; K&J 2018].
Self-acceptance and letting go of self-judgment. Meet lapses, body size and shape with acceptance. Forgiveness and self-acceptance practices are core content, not extras [K&J 2018; K&W 2011 abstract].
Curiosity. Model "an attitude of mindful curiosity" (K&J 2018) in inquiry. Ask what was noticed, not whether the client succeeded.
Practice and patience. Set expectations for gradual, sustainable change [handout].
Experiential learning. Teach through guided eating in the room followed by inquiry, not through lectures. Keep teaching segments short [K&J 2018; Kripalu 2019].
Shift energy towards values. Over the course, move attention away from food and weight preoccupation and towards what the person values more [K&J 2018].
Spirituality is invited, not imposed. The word "spirituality" is held back until the session 10 wisdom meditation. Let clients connect practice to their own tradition, for example a prayer-like tone [K&J 2018].
Non-diet, weight-inclusive stance (current training version). Frame the work around relationship with food and wellbeing. Note that research versions also included calorie awareness. Choose deliberately and tell clients which emphasis you are using [training page 2025; K&J 2018].
The instructor practises. Your own regular meditation is a prerequisite for credible teaching and inquiry [training page 2025].

4. Intervention inventory

The components and their session placement come from Kristeller & Jordan 2018 unless tagged otherwise. The step-by-step instructions are my own operational wording. The manual's scripts were not available, so the steps are marked [synthesis] where they go beyond what the sources describe. All therapist language is illustrative. No calorie, weight or exercise targets are given here.

4.1 Orientation to the Inner Wisdom / Outer Wisdom model (S1, revisited every session)

Purpose: Gives the group a shared map: mindfulness practice is the foundation, inner wisdom (hunger, fullness, triggers, emotions, thoughts, self-acceptance) and outer wisdom (nutrition, calorie and activity information) are the two pillars, and the aims are eating with more satisfaction and less struggle, flexibility, more physical activity, and practice and patience [source: Kristeller & Lieberstein 2020 handout].
Steps:
1. Ask members what years of diets have taught them about rules versus their own experience.
2. Draw the model with mindfulness at the base and the two pillars on top.
3. Explain that every session will train both pillars.
4. Name the goal of enjoying food more with less struggle.
5. Set expectations of daily practice and gradual change. [synthesis on sequence]
Example language (illustrative): "Inner wisdom is what your body and mind can tell you, once you can hear them again. Outer wisdom is what we know about food. We'll learn to use both, not obey either."
Watch for: Members hearing "outer wisdom" as a new diet. Reframe it as information to weigh, not rules [synthesis].

4.2 Sitting mindfulness meditation (S1 onward; daily home practice)

Purpose: The core training in attention and non-reactivity that every other skill depends on. It is adapted from MBSR and starts with the breath as anchor, then opens to awareness of thoughts, emotions and sensations [source: K&J 2018].
Steps:
1. Guide an upright, comfortable posture.
2. Rest attention on the breath. When the mind wanders, note it and gently return.
3. In later sessions, widen attention to sounds, sensations, thoughts and feelings as passing events.
4. Lengthen the practice across the programme: about 10 minutes at first, about 20 by S3, about 30 from mid-programme [source: K&J 2018].
5. Give recordings for home practice, then encourage practising without them.
6. Open each week's inquiry by reviewing the practice.
Example language (illustrative): "Each time you notice the mind has gone to food, or to planning, that noticing is the practice. Just come back."
Watch for: Members treating wandering as failure. Signs it is working: members report noticing urges or thoughts sooner, and can pause briefly before acting [synthesis].

4.3 Raisin eating meditation (S1)

Purpose: The first experience of eating with full attention. It shows how much is missed when eating automatically. The raisin exercise is adapted from MBSR, and the guided eating starts with several raisins (four in the version described) [source: K&J 2018].
Steps [synthesis on detail]:
1. Hand each person a few raisins.
2. Guide them to look at one as if for the first time, then to notice its texture, smell and any urge to eat it.
3. Have them place it in the mouth without chewing, then chew slowly and notice the taste changing, then the swallow.
4. Pause, then repeat with the next raisin. Invite members to compare the first and later raisins: do they taste as good?
5. Inquire into what they noticed.
Example language (illustrative): "Before you chew, just notice the impulse to chew. ... Now, as you chew, is the flavour getting stronger or fading?"
Watch for: Disgust, shame, or memories of food being policed. Normalise these and allow anyone to opt out of eating while still observing [synthesis]. If members notice that later raisins are less vivid, this prepares the ground for taste satiety.

4.4 Mini-meditations (introduced S2; S3 in the current training version)

Purpose: Short pauses, from a few moments to a few minutes, that bring mindful awareness into daily life. They are used before and during eating and at moments of stress or urges [source: K&J 2018; training course outline].
Steps [synthesis]:
1. Teach a brief stop.
2. Take a few conscious breaths.
3. Notice body, emotion and thought.
4. Then choose the next action.
5. Agree cue points with each member: before meals, at the fridge or cupboard, when stressed, in the car.
6. Have them log how many they did each day and review this in inquiry.
Example language (illustrative): "Before you open the cupboard, take three breaths and just check: what's actually going on in me right now?"
Watch for: The mini-meditation turning into a gate the person must pass before being allowed to eat. Keep it about noticing, not refusing. Working: members describe catching themselves mid-pattern [synthesis].

4.5 Challenging-food exercise: cheese and crackers (S2)

Purpose: Early practice of mindful eating with a food that is easy to overeat. It shows that attention changes the experience even of "problem" foods [source: K&J 2018].
Steps [synthesis]:
1. Before eating, have each member rate their current hunger.
2. Guide slow eating of a single portion, noticing taste and the urge to reach for more.
3. Pause between pieces and check hunger and enjoyment again.
4. Invite a deliberate choice about whether to have more.
5. Inquire into urges, thoughts ("I shouldn't") and what was actually satisfying.
Example language (illustrative): "Before you reach for the next cracker, pause. How much are you still tasting the last one?"
Watch for: Anxiety in members with binge histories. Offer smaller amounts and the choice to observe. Ask about any after-session urge to binge at the next session [synthesis].

4.6 Self-tracking and mindful nutrition (S2 onward; outer wisdom)

Purpose: Building awareness of what, when and why one eats, used as information rather than for judgement [source: K&J 2018].
Steps [synthesis]:
1. Give a simple log with when, what, hunger before, fullness after, and the trigger or emotion.
2. Ask for a few days of logging rather than perfect records.
3. In inquiry, look for patterns with curiosity.
4. Introduce basic nutrition ideas briefly and tie them to members' own logs.
Example language (illustrative): "This log isn't a report card. It's a way of seeing your own patterns more clearly."
Watch for: Obsessive tracking or restriction. Scale tracking down if it feeds preoccupation [synthesis].

4.7 Calorie-awareness challenge (S2 introduced, S3 sustainable changes, S7 review; outer wisdom)

Purpose: A named outer-wisdom tool in the research and training versions. The sources name it with a specific calorie figure, which is omitted here. Members identify "mindless" extras they do not really enjoy and let them go, rather than following a diet. Kristeller does not prescribe a daily calorie target [source: K&J 2018; WFAE/NPR 2015; Kripalu 2019].
Steps [synthesis]:
1. Using their logs, members find eating they would not miss: second helpings without hunger, finishing a plate when already full, high-energy snacks that could be swapped for something equally satisfying.
2. Each person picks a few changes they could keep up long-term.
3. Review at S3 and S7 what has lasted and what hasn't.
Example language (illustrative): "Which bits of eating this week did you barely notice, or wouldn't really miss? Those are the easiest to let go."
Watch for: Clients turning this into restriction or counting. In weight-inclusive or eating-disorder settings, the current training emphasis lets you drop the numeric framing and keep the "mindless versus enjoyed" distinction [synthesis]. Do not set numeric targets.

4.8 Hunger awareness (S3; S4 in the current version, paired with emotional eating)

Purpose: Separating physical hunger from emotional, environmental and habitual triggers [source: K&J 2018; course outline].
Steps:
1. Guide a short meditation focused on body sensations linked to hunger: stomach, energy, mood, thoughts of food.
2. Have members rate hunger on a numeric scale from low to high. A 1–10 scale is commonly reported for MB-EAT, but the anchor wording was not verified [uncertain].
3. List the triggers that drive eating without physical hunger.
4. For home practice, members rate hunger before each eating episode and note the trigger when hunger is low. [synthesis on steps]
Example language (illustrative): "Where in your body do you notice hunger, if at all? Give it a number, and notice what else is here besides hunger."
Watch for: Members who cannot detect hunger, for example after long dieting, after bariatric surgery or on certain medications. Treat "I can't tell" as valid data and keep practising. Working: members can report a rating at most meals and name non-hunger triggers [synthesis].

4.9 Body scan (S3, S8)

Purpose: Body awareness and acceptance, and better detection of internal (interoceptive) signals [source: K&J 2018].
Steps [synthesis]:
1. Lying or seated.
2. Move attention slowly through the body region by region, noticing sensation without trying to change it.
3. Include the abdomen, noticing hunger or fullness.
4. Close with a sense of the whole body.
Example language (illustrative): "Let your attention rest on your belly, just as it is. If judgments come, notice them as thoughts and return to sensation."
Watch for: Body shame or trauma responses. Offer eyes open, seated practice, the option to skip regions, or an anchor point (see 5) [synthesis].

4.10 Taste satisfaction and taste-specific satiety, with chocolate (S4)

Purpose: Learning that the pleasure of a food fades within a few bites (sensory-specific satiety). Following that fading lets a person stop with satisfaction: quality over quantity [source: K&J 2018].
Steps [synthesis on detail]:
1. Give each member a few small pieces of chocolate.
2. Before eating, have them rate their desire for it.
3. Eat one piece very slowly, tracking how intense and pleasant the taste is from moment to moment.
4. Pause, then repeat with a second and third piece. Compare how satisfying each was.
5. Inquire: at what point did the taste stop getting better? What would be enough?
6. Combine this with outer wisdom: knowing that a small amount gives most of the pleasure helps with choices [source: K&J 2018, S4 outer wisdom].
Example language (illustrative): "Notice when the taste is at its peak, and notice whether it's still as good a minute later."
Watch for: Members who report no fading. Normalise this and repeat with slower pacing. Working: members spontaneously report leaving food when the taste fades, like the donut case in K&J 2018.

4.11 Healing self-touch (S4)

Purpose: Extending self-acceptance to body size and shape [source: K&J 2018; Kripalu 2019].
Steps: Guide gentle, kind touch to parts of the body, for example hands resting on the abdomen, arms or face, together with an attitude of care. Detailed script not seen [uncertain]; steps are [synthesis].
Example language (illustrative): "If it feels right, rest a hand somewhere that could use some kindness today. If not, simply imagine it."
Watch for: Trauma histories and touch aversion. Always make this optional and offer an imagined or self-chosen alternative [synthesis].

4.12 Fullness awareness with water; body satiety (S5; S6 in the current version)

Purpose: Recognising stomach fullness, which is distinct from taste satiety, and whole-body satiety as signals for ending a meal. Water makes stomach fullness easy to feel without food-related anxiety [source: K&J 2018].
Steps [synthesis on detail]:
1. Ask members to rate fullness before drinking.
2. Have them drink a glass of water slowly, pausing to notice stretch and pressure in the stomach.
3. Rate fullness again.
4. Discuss the difference between "pleasantly satisfied" and "stuffed", and between stomach fullness and the sense that the body has had enough.
5. For home practice, members rate fullness partway through and at the end of meals. A numeric fullness scale is commonly reported; the anchors were not verified [uncertain].
Example language (illustrative): "Notice the first sign the stomach is filling, not the last. What does 'enough' feel like, as opposed to 'full'?"
Watch for: Bariatric clients, whose fullness signals are altered. Coordinate with their dietitian, and note that the bariatric adaptation used sugar-free and fat-free foods in sweet exercises because of post-surgical discomfort [source: UHN protocol 2016].

4.13 Chain reaction (introduced S5; triggers revisited S8; interrupting the chain S9)

Purpose: Mapping the sequence that leads to mindless eating or a binge (trigger, then thoughts and feelings, then urge, then eating, then aftermath) and finding points to interrupt it [source: K&J 2018; Kripalu 2019 "chaining"].
Steps [synthesis]:
1. Choose a recent episode.
2. Write out each link in order: situation, body state and hunger rating, emotion, thoughts, urge, eating behaviour, then the aftermath (feelings, self-talk, what happened next).
3. Mark where a mini-meditation, a hunger check or a taste check could have fitted.
4. At S9, plan specific interruption points for high-risk situations, then review in later inquiries.
Example language (illustrative): "Let's slow the film down. Before the eating, what was the moment just before that? And before that?"
Watch for: Self-blame during the analysis. Keep the tone curious. Working: members catch the chain earlier and earlier.

4.14 Forgiveness meditation (S5)

Purpose: Addressing anger- and resentment-triggered eating, including anger at oneself [source: K&J 2018].
Steps: Guided meditation that brings to mind a source of hurt or anger (starting with something mild), notices the bodily feelings and the cost of holding on, and explores letting go, which may include forgiving oneself. The script was not seen [uncertain]; steps are [synthesis].
Example language (illustrative): "Start with something small. Notice how holding this feels in your body, and whether some of it could be set down, even just for now."
Watch for: Abuse histories. Make clear that forgiving is never required and that acknowledging harm comes first. Choose low-intensity targets in a group [synthesis].

4.15 Mindful choice: chips vs cookies (S5)

Purpose: Practising a deliberate choice between two tempting foods, based on what is actually wanted and satisfying [source: K&J 2018; Kripalu 2019 "mindful choice"].
Steps [synthesis]:
1. Place both foods in front of members.
2. Guide a pause: check hunger, then imagine the taste of each, then notice which one the body actually wants.
3. Choose one and eat it mindfully, tracking taste satisfaction.
4. Inquire into the experience of choosing, compared with grabbing.
Example language (illustrative): "You don't have to have both, and you don't have to have neither. Which one do you actually want right now?"
Watch for: Choices driven by "should" (picking the 'healthier' one out of guilt). Explore what was behind the choice.

4.16 Physical activity awareness and mindful walking (S5 pedometers; S8 mindful walking; walking meditation)

Purpose: Outer wisdom about activity, and mindful movement as a practice in its own right [source: K&J 2018; Kripalu 2019].
Steps [synthesis]:
1. Offer a pedometer or phone counter so members can notice their usual daily activity, with no targets.
2. Invite small, enjoyable increases that each person chooses.
3. Teach walking meditation: slow steps, attention on the feet and the shifting of weight, returning when the mind wanders.
4. Encourage mindful walking in everyday life.
Example language (illustrative): "Feel the heel, the roll, the push-off. Just walking, nowhere to get to."
Watch for: Mobility limits or compulsive exercise. Adapt or omit as needed. No exercise targets are set here.

4.17 Fruit-and-vegetable exercise and integrated eating meditation (S6; S8 in the current version)

Purpose: Bringing all the signals (hunger, taste, fullness, choice) together in one guided eating practice, using healthier foods [source: K&J 2018; course outline].
Steps [synthesis]:
1. Set out a variety of fruit and vegetables.
2. Guide members through hunger check, choice, slow tasting with attention to taste satiety, a mid-way fullness check, and a decision to stop or continue.
3. Close with a body check and a moment of appreciation.
4. At home, members use the same sequence at one meal a day.
Example language (illustrative): "Check in: hunger, taste, fullness. What would be a wise next choice?"
Watch for: Members experiencing healthier food as "diet food". Highlight genuine taste discoveries.

4.18 Energy needs, nutrition choices and healthy snacking (S6, S10; outer wisdom)

Purpose: Understanding the body's general energy needs and making nutritious choices while keeping favourite foods [source: K&J 2018; Kripalu 2019].
Steps [synthesis]:
1. Give short teaching on how needs vary from person to person and on balanced choices. A dietitian co-leader is ideal [source: UHN protocol 2016 for the co-leader model].
2. Members compare what they learn with their own hunger and fullness data.
3. Plan satisfying snacks that fit hunger and taste. Give no numeric intake targets.
Example language (illustrative): "Use this as outer wisdom, alongside what your body's been telling you, not instead of it."
Watch for: Rule-making creeping back in.

4.19 Potluck meal (S7)

Purpose: The first full-meal application in a social setting. Each member brings two dishes: one "healthier" and one they want to keep eating in moderation [source: K&J 2018].
Steps [synthesis]:
1. Before the meal, have members survey the whole table mindfully without serving.
2. Check hunger, then choose what and how much to take.
3. Eat with periodic pauses to check taste and fullness. Some silent eating at the start can help.
4. Decide whether to go back for more.
5. Debrief on social pressure, abundance and choosing.
Example language (illustrative): "Look at everything before you take anything. What looks really worth it today?"
Watch for: Overwhelm at abundance in members with binge histories. Offer a smaller plate or a planned first serving, and a check-in afterwards.

4.20 Chair yoga (S8)

Purpose: Gentle, accessible body awareness and acceptance [source: K&J 2018; Kripalu 2019].
Steps: Lead slow seated stretches synchronised with the breath, with attention on sensation and limits. Steps are [synthesis].
Example language (illustrative): "Move only as far as is comfortable today. Notice the edge without pushing."
Watch for: Pain or injury. Offer alternatives and remind members to work within their limits.

4.21 Values exercise (S9)

Purpose: Connecting eating to broader life priorities and shifting energy away from preoccupation with food and weight [source: K&J 2018; Kripalu 2019].
Steps [synthesis]:
1. Members list what matters most to them (relationships, health, work, faith, creativity).
2. Reflect on how food and weight preoccupation has taken time or energy from these.
3. Choose one valued action for the coming week.
Example language (illustrative): "If food took up less room in your head, what would you want to fill that space?"
Watch for: Values written as weight goals. Gently redirect to what weight was meant to bring.

4.22 Favourite food exercise (S9)

Purpose: Applying taste satiety and mindful choice to the food each person finds most compelling [source: K&J 2018].
Steps [synthesis]:
1. Members bring or name a favourite food.
2. Eat a small amount with full attention.
3. Track peak enjoyment and when it fades.
4. Decide what amount gives real satisfaction.
Example language (illustrative): "This is the food you most deserve to really taste. Let's see how much of it you actually need to enjoy it."
Watch for: The trigger food setting off a later binge. Plan a mini-meditation for the hours after the session.

4.23 Wisdom meditation (S10)

Purpose: The culminating practice. Members connect with an inner sense of wisdom (a "wise self") to guide choices. This is the first point where the word spirituality is introduced [source: K&J 2018; Kripalu 2019].
Steps: A guided meditation in which members settle, then contact a sense of their own deeper or wiser self, in whatever form fits their beliefs. They consult it about eating and life choices, then note what arises. The script was not seen [uncertain]; steps are [synthesis].
Example language (illustrative): "Let yourself sense the part of you that already knows what you need, and listen without arguing."
Watch for: Religious or secular discomfort. Offer neutral wording such as "wise mind" or "your best judgement".

4.24 Buffet home practice (culminating)

Purpose: Using every skill at an "all-you-can-eat buffet", with the potluck as preparation [source: K&J 2018; Kripalu 2019 buffet lunch planning].
Steps [synthesis]:
1. In session, plan the visit: when to go (moderately hungry), surveying first, choosing what is really wanted, taste and fullness checks, and deciding when to stop.
2. Afterwards, debrief at the next session.
Example language (illustrative): "The buffet is a test of choice, not willpower. Go in with a plan to notice."
Watch for: Members who are not ready. Make it optional and offer a smaller step instead, such as a family meal or a party.

4.25 Self-acceptance meditation and maintenance review (S11–12)

Purpose: Consolidating acceptance and reviewing progress at monthly boosters. Maintaining and deepening change [source: K&J 2018; Kripalu 2019].
Steps [synthesis]:
1. Guide a meditation offering acceptance towards body, history and present effort.
2. Each member reviews what has changed (eating, practice, self-talk), what helps, and early warning signs.
3. Make a personal maintenance plan: daily practice, mini-meditations, check-ins.
Example language (illustrative): "Notice what has shifted, however small, and what you want to keep tending."
Watch for: Lapses since the weekly sessions ended. Treat them as expected and re-anchor practice.

4.26 Loving-kindness and self-compassion practices (current training version)

Purpose: Added in the current curriculum to support self-acceptance. The course outline pairs self-compassion with taste satisfaction [source: training page 2025; course outline].
Steps: Standard guided wishes of well-being directed to oneself and then others, or a brief self-compassion pause after a lapse. The MB-EAT-specific scripts were not seen [uncertain]; steps are [synthesis].
Example language (illustrative): "May I be kind to myself in this moment of struggle."
Watch for: Members who find warmth towards themselves aversive. Start with others or a pet.

4.27 Inquiry, teach-backs and role-play (every session; training)

Purpose: Inquiry is the 15–20 minute review of experience at the start of each session [source: K&J 2018]. Role-play is used in the programme [source: training page 2025]. Teach-backs are a training method for leaders [source: Kripalu 2019].
Steps [synthesis]:
1. Ask what each member noticed.
2. Reflect the experience back without praising or correcting.
3. Link it to the week's principle.
4. Use role-play to rehearse social eating situations, such as declining food or eating out.
Example language (illustrative): "What did you notice? ... And what was that like?"
Watch for: Inquiry drifting into advice-giving.

4.28 Process measurement and individual make-up sessions

Purpose: The training teaches assessment, including a process measure called KEEP IT OFF. Its content was not seen [uncertain] [source: Kripalu 2019]. Missed sessions are covered in a brief individual appointment on that session's core content [source: K&J 2018]. MB-EAT tools can also be used in individual work by MB-EAT-P certified practitioners [source: training page 2025].
Steps [synthesis]: Track home practice (days and minutes per week, as in the UHN protocol) and session attendance. For a make-up, deliver the session's core practice and eating exercise in a shortened form.

5. Handling problems

The sources say little about problems. They mention attrition, missed sessions handled through individual make-up appointments, unspecified precautions for some eating-disorder clients, religious framing, and psychiatric referral if serious issues arise [source: K&J 2018; Kripalu 2019; UHN protocol 2016]. Everything else below is [synthesis] unless tagged.

Attrition and missed sessions. Dropout was relatively high in the trial, and completion was defined as attending at least 7 of the 10 weekly sessions [source: K&J 2018].
- Offer a brief individual make-up session covering the missed core practice [source: K&J 2018].
- Phone members who miss two sessions in a row [synthesis].
- Ask early about practical barriers such as childcare, shift work or session length [synthesis].
Not doing home meditation. Track days and minutes of practice weekly, as in the UHN protocol [source: UHN protocol 2016].
- In inquiry, explore the obstacle with curiosity rather than pressure.
- Shrink the commitment, for example a 5-minute sit plus mini-meditations, and link practice to an existing routine.
- Keep reinforcing mini-meditations as an entry point. [synthesis]
"It's just another diet" or dietary rigidity. Return to the wisdom-over-rules principle.
- Ask what rules from past diets are showing up.
- Present outer wisdom as information to weigh, not instructions.
- In weight-inclusive settings, play down numeric framing [synthesis; principle from K&J 2018 and training page 2025].
Weight-focused expectations. Validate the hope behind them, then redirect to the processes the programme trains: awareness, satisfaction, flexibility and values.
- Do not set or promise weight outcomes.
- Keep weighing out of sessions unless a medical team requires it [synthesis].
Binge or loss of control after a session's eating exercise. Anticipate this with trigger foods (S2, S4, S5, S9).
- Offer smaller portions, the option to observe only, and a plan for a post-session mini-meditation.
- Review the episode with chain analysis at the next session without blame (4.13) [synthesis].
Cannot sense hunger or fullness. Common after chronic dieting or bariatric surgery, and with some medications.
- Treat "don't know" as a valid rating.
- Use water fullness (4.12) and timing cues as scaffolds.
- Coordinate with the client's dietitian or medical team [synthesis; bariatric context from UHN protocol 2016].
Overwhelm, body shame or trauma responses during body scan, self-touch or forgiveness practices.
- Practise with eyes open, seated, and shorter.
- Offer an external anchor such as the sound of the room or feet on the floor.
- Let members skip body regions or touch.
- Make forgiveness explicitly optional.
- Check in privately afterwards and refer to individual therapy if needed [synthesis].
- If serious mental health issues arise, consult psychiatry [source: UHN protocol 2016].
Emerging eating-disorder risk. Watch for restriction, compensatory behaviours, purging or rapid weight change.
- Assess this individually and coordinate with eating-disorder services.
- MB-EAT trials excluded purging bulimia [source: K&J 2018], and the developers flag precautions [source: Kripalu 2019] [synthesis on response].
Depression and suicidality. Screen at intake. The UHN adaptation used the PHQ-9 and excluded active suicidal ideation [source: UHN protocol 2016].
- If risk emerges mid-group, do a standard individual risk assessment and safety plan, and refer to the appropriate level of care [synthesis].
Religious or secular discomfort with meditation or "wisdom". Participants may experience practice as prayer-like [source: K&J 2018].
- Welcome that framing.
- Use secular wording such as "wise mind" or "best judgement" for others [synthesis].
- Keep the word "spirituality" back until S10, as in the research version [source: K&J 2018].
Group dynamics. Some members dominate, compare body sizes, or talk about diets.
- Set group norms in S1: no body comments and no diet advice.
- Keep inquiry focused on direct experience.
- Redirect gently: "What did you notice?" (illustrative) [synthesis].
Rupture with the leader. For example, a member feels judged about food choices or body.
- Name it.
- Own your part.
- Restate that there are no forbidden foods and no judgement.
- Invite feedback privately or in the group [synthesis].
Meal settings feel unsafe or excluding. Allergies, cultural foods and budget can all be barriers at the potluck or buffet.
- Check allergies before every eating exercise.
- Invite culturally relevant foods.
- Offer low-cost alternatives [synthesis].
Bariatric clients. Use sugar-free or fat-free sweet foods to avoid post-surgical discomfort [source: UHN protocol 2016].
- Use very small portions.
- Follow surgical-team guidance on texture and volume [synthesis].
Late-programme relapse. Use the monthly boosters (S11–12) to re-anchor practice [source: K&J 2018].
- Normalise lapses as part of a flexible, long-term process.
- Revisit the chain analysis and values [synthesis].

Sources

Sources:

Further reading (not drawn on) [uncertain where relied on]:

Kristeller, J. L., & Wolever, R. Q. (2011). Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Eating Disorders, 19, 49–61. Only the abstract is drawn on.
Kristeller, J., Wolever, R. Q., & Sheets, V. (2014). Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: a randomized clinical trial. Mindfulness, 5, 282–297. Blocked.
Kristeller, J. L., & Hallett, C. B. (1999). An exploratory study of a meditation-based intervention for binge eating disorder. Journal of Health Psychology, 4, 357–363.
Kristeller, J. L., & Wolever, R. (2014). Mindfulness-Based Eating Awareness Training: treatment of overeating and obesity. In R. A. Baer (Ed.), Mindfulness-Based Treatment Approaches (2nd ed.). Elsevier.
Kristeller, J. L., & Wolever, R. Q. Mindfulness-Based Eating Awareness Training (MB-EAT): A Treatment Manual. Guilford Press (listed as in press in 2018).
Kristeller, J. (2015). The Joy of Half a Cookie: Using Mindfulness to Lose Weight and End the Struggle with Food. Perigee/Penguin.
Kabat-Zinn, J. (1990). Full Catastrophe Living. Delacorte.

The mb-eat.com source is not drawn on.

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