Mindfulness eating program cuts emotional eating in Hong Kong university students

A ten-week mindfulness program delivered over Zoom has helped Hong Kong university students rein in the impulse to eat in response to stress, anxiety, and other strong emotions, according to a randomized controlled trial published in the Journal of Behavioral Medicine. The study, led by Dalinda Isabel Sanchez Vidaña of The Hong Kong Polytechnic University and colleagues, tested Mindfulness-Based Eating Awareness Training, or MB-EAT, in a population facing relentless academic pressure, and found that participants who completed the program showed meaningful reductions in emotional eating alongside improvements in depressive symptoms and mindful eating skills.

Emotional eating—the tendency to overeat in response to negative emotions such as anxiety or irritability, positive emotions such as happiness, or plain stress—is far from a niche behavior. Prevalence estimates among university students range from 15 to 47.5 percent worldwide, with figures of 14.5 to 52.7 percent reported in China and more than 14 percent of female students in Hong Kong reporting eating in response to negative emotions. The behavior carries real consequences: it increases caloric intake, promotes overweight and obesity, and has been linked to poorer sleep quality, binge eating, depression, and heightened stress sensitivity. Over time, the weight gain it drives raises the risk of chronic conditions including diabetes, hypertension, and colorectal cancer.

University students are particularly vulnerable. High academic expectations, financial worries, sleep problems, and pressure from peers and family all conspire to elevate stress in this group. In Hong Kong, roughly 22 percent of students report medium or higher levels of stress, and the COVID-19 pandemic worsened the picture for young adults aged 18 to 25, with academic concerns cited as a major driver. Stress itself is one of the psychosocial factors most consistently associated with emotional eating, creating a self-reinforcing loop in which negative feelings trigger overeating, which in turn generates guilt and further negative affect. Breaking that cycle is the central ambition of mindfulness-based interventions.

MB-EAT was originally developed by Jean Kristeller and colleagues to treat binge eating disorder, and clinical studies have already shown it can improve emotional impulse regulation and mood. The program trains participants to tune into bodily signals of physical hunger, sensory experiences of satiety and taste satisfaction, and the emotional triggers that propel overeating. Unlike restrictive dieting approaches, MB-EAT emphasizes flexibility and sustainable change, deliberately including foods people tend to overeat—chocolate, cookies, corn chips, cheese and crackers—though in smaller, mindfully savored quantities. Recent meta-analyses suggest that pure mindfulness-based interventions outperform other approaches, or combinations of approaches, for reducing emotional eating.

To test whether the program could work for non-clinical students, the researchers ran a parallel group randomized controlled trial, registered with the Hong Kong University Clinical Trials Registry (HKUCTR-3035) and approved by The Hong Kong Polytechnic University’s ethics committee. They screened 291 volunteers and enrolled 46 students—42 women and 4 men—who scored at or above 2.8 on the emotional eating subscale of the Dutch Eating Behavior Questionnaire, a validated cutoff separating emotional eaters from the general population. Exclusion criteria ruled out participants with diagnosed anorexia or bulimia nervosa, metabolic conditions such as diabetes, substance abuse, weight-loss pharmacotherapy, or prior mindfulness meditation experience.

Participants were randomized using stratified allocation matched on age, gender, and body mass index, yielding 23 students in each arm with identical sex distributions. The intervention group completed ten weekly MB-EAT sessions of 1.5 to 2.5 hours over Zoom, scheduled twice on weekends across four time slots to accommodate student timetables. Each session combined an introduction to the self-regulation model with meditation, mindful eating practice, body scans, and instruction on topics such as binge eating triggers and taste satiety cues. The instructor was certified through an international MB-EAT training institute and employed a trauma-sensitive mindfulness approach, creating a safe and empowering environment for participants with trauma histories. To protect privacy, the sessions used Zoom’s “Focus mode,” hiding participants’ videos and personal information, and participants joined under anonymous numbers.

Notably, all eating practices in the program were purpose-built for MB-EAT, apart from the classic raisin exercise borrowed from Mindfulness-Based Stress Reduction. Participants also received audio tracks for daily home practice—mini-meditations of six minutes and longer guided sessions of 10 to 20 minutes—and completed structured reflections after each session. The waitlist control group received weekly email infographics on nutrition and exercise and was offered the full MB-EAT program after the study ended. Both groups were assessed for emotional eating using the 20-item Salzburg Emotional Eating Scale at baseline, at five weeks, and after the intervention, while secondary measures covered stress eating, emotion regulation, depression, anxiety, stress, mindfulness, and mindful eating.

The results showed a clear pattern favoring the intervention. Mixed ANOVA revealed a significant change over time and, crucially, a significant time-by-group interaction for emotional eating: post-hoc tests confirmed that within the MB-EAT group, emotional eating scores declined from pre-test to post-test, while the waitlist group’s scores followed a downward trend that was smaller and less sustained. The authors interpret this interaction as evidence of a cumulative effect—the longer students practiced, the more they benefited. Although the between-group difference on the primary outcome alone did not reach statistical significance, the trajectory of improvement in the MB-EAT group was distinctly stronger.

Secondary outcomes sharpened the picture. Large and significant interaction effects emerged for stress eating and for mindful eating overall, as well as for the Disinhibition, Awareness, and Distraction subscales of the Mindful Eating Questionnaire. By the end of the program, MB-EAT participants scored significantly higher than controls on total mindful eating, better regulated their disinhibited eating, were less prone to distracted eating, and reported a reduced tendency to use food as a coping mechanism for emotional distress. They also showed significantly lower depression scores than the waitlist group at post-test. Stress eating scores fell within the intervention group, suggesting the program’s benefits extended beyond eating in response to discrete emotions to eating under the grind of daily pressure.

Correlation analyses offered clues to the mechanisms at work. In the MB-EAT group at post-test, emotional eating was strongly and positively correlated with cognitive reappraisal (r = 0.840, p < 0.001), and reappraisal was in turn strongly tied to stress eating (r = 0.790, p < 0.001)—a finding the authors describe as complex and in need of further study, since reappraisal is usually considered an adaptive strategy. Meanwhile, depression was strongly negatively correlated with the Awareness subscale of mindful eating (ρ = −0.80, p < 0.001), echoing earlier work linking eating awareness to mental well-being. In the waitlist group, mindfulness correlated strongly and negatively with stress (r = −0.730, p < 0.001), suggesting mindfulness acts as a protective buffer against stress in untreated students.

The trial was not without complications. Attendance declined across the ten weeks—from 96 percent in the first session to between 26 and 30 percent in later sessions—largely coinciding with examination periods, and only 56.5 percent of the MB-EAT group completed the full program. The authors attribute attrition to a lack of time for meditation practice and preoccupation with studies, and they recommend shorter or more flexible sessions, and possibly some in-person meetings, to improve adherence for time-pressed students. Self-reported meditation practice also proved unreliable—mean recorded practice was 307 minutes but varied wildly from 39 to 632 minutes, and many participants admitted forgetting to log sessions—so the team excluded this measure and suggests future studies use app-based tracking or physiological markers such as heart rate variability.

Despite these constraints, the researchers argue the findings carry practical weight. For clinicians, MB-EAT offers a promising tool for clients struggling with emotional eating, and because maladaptive emotional eating commonly feeds into overweight and obesity, the program could serve as a precursor or adjunct to weight-loss interventions, potentially amplifying their effectiveness. Incorporating mindfulness into everyday dietary practice, they suggest, could help people sustain healthier long-term relationships with food. The team also points to neuroimaging work showing that mindfulness practitioners, even novices, can regulate emotion through distinct neural mechanisms, raising the possibility that MB-EAT equips students with alternative regulatory pathways that stabilize eating behavior over time.

The authors conclude that MB-EAT is a genuinely helpful approach for students battling emotional eating, with benefits that may compound as practice continues. As students build mindfulness skills, they become better at handling their emotions and improve their overall mental health—the foundation, the study suggests, for overcoming the urge to eat their way through a stressful semester. With follow-up data at three and six months still needed to confirm durability, the trial stands as the first randomized controlled test of MB-EAT for emotional eating in Hong Kong university students, and a signal that ten weeks of attention to the present moment may be enough to change a deeply habitual relationship with food.