Development and Evaluation of a Mindfulness-Based on Emotional Eating Reduction Program
Phase: NA
Conditions: Emotional Eating
Sponsor: tuğba çolak

STUDY PROTOCOL AND STATISTICAL ANALYSIS PLAN 
Study Title: 
Development and Evaluation of a Mindfulness-Based Emotional Eating Reduction Program (MB-
EER) 
NCT Number: 
[To be filled after ClinicalTrials.gov registration] 
Document Date: 
May 21, 2023 
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궡 Table of Contents 
1.
Introduction
2.
Objectives
3.
Study Design
4.
Participants and Eligibility Criteria
5.
Intervention Description
6.
Outcome Measures
7.
Data Collection
8.
Statistical Analysis Plan
9.
Ethical Considerations
10. Data Storage and Confidentiality
11. Timeline
12. Appendices
1. Introduction
Emotional eating refers to the tendency to eat in response to emotional states rather than 
physiological hunger. Recent studies have indicated a strong link between emotional 
dysregulation and unhealthy eating behaviors. Mindfulness-based practices have shown 
promise in reducing emotional eating by enhancing awareness, emotion regulation, and 
interoceptive sensitivity. This study aims to develop and evaluate a Mindfulness-Based 
Emotional Eating Reduction (MB-EER) program tailored to adults with elevated emotional eating 
behavior. 
2. Objectives
Primary Objective: 
To evaluate the effectiveness of the MB-EER program in reducing emotional eating. 

Secondary Objectives: 
•
To increase mindful eating skills.
•
To reduce emotional appetite and emotional eating
•
To evaluate the sustainability of changes in eating behavior after 3 months.
3. Study Design
This is a true experimental study using a pretest–posttest control group design with follow-
up measures and mixed-method embedded elements (qualitative and quantitative). The 
experimental group received a 7-week online MB-EER program, while the control group received 
no intervention during the study period. Data were collected at three time points: pretest, 
posttest, and 3-month follow-up. 
4. Participants and Eligibility Criteria
Recruitment: 
135 applicants were screened. A total of 30 participants (15 per group) were randomly assigned. 
Inclusion Criteria: 
•
Adults aged 18–65
•
Moderate to high scores on the Emotional Eating Scale (Z scores between -2 and +2)
•
Ability to attend 7 online sessions
Exclusion Criteria: 
•
Diagnosed eating disorder (e.g., bulimia, binge eating)
•
Chronic conditions affecting appetite (e.g., Hashimoto's, diabetes)
•
Pregnancy
•
Refusal to consent
5. Intervention Description
Program Title: 
Mindfulness-Based Emotional Eating Reduction (MB-EER) 
Delivery Method: 
Online via Zoom, once per week for 2 hours, over 7 weeks. 
Components: 
•
Psychoeducation (emotional eating, mindfulness, body awareness)
•
Experiential practices (e.g., raisin exercise, body scan, mindful movement)
•
Homework and reﬂections

•
Tools: Mindfulness Booklet, WhatsApp group communication
Session Topics Include: 
1.
Awareness of how you eat
2.
Recognizing autopilot behavior
3.
Identifying stimuli (internal/external)
4.
Honoring hunger/satiety
5.
Self-compassion and body awareness
6.
Cultural beliefs around food
7.
Integration and future planning
Table 1. Experimental Research Sessions, Session Objectives, Materials Used, and Actions 
Performed. 
Sessions 
Session Objectives 
Materials Used 
Actions 
First Session: 
Focusing on How You Eat Rather 
Than What You Eat and Meet and 
Greet 
Objective 
1: 
Establishing 
a 
relationship of trust between group 
members 
Objective 2: To understand the 
basic concepts of the program 
(emotional eating, mindfulness and 
mindful eating, to be able to predict 
their relationships 
Objective 3: Understanding the 
concepts of physical and emotional 
hunger and their differences 
Objective 4: Mindful eating as 
shown 
 -Raisin
-Meeting Events
-Configuration of Group Process and Policies
-Introduction and explanation of concepts 
-Raisin exercise
-Breath awareness exercise 
-Evaluation
Second Session:  
Recognizing Autopilot 
Objective 1: Recalling the first 
session 
and 
talking 
about 
realizations 
Objective 
2: Understand 
and 
recognize the concept of autopilot 
Objective 3: Recognize emotional 
triggers that activate autopilot 
-Handwriting
Metaphor: 
Recognizing
Autopilot 
-Trigger 
food
exercise 
(participants
provided the food
themselves)
Reminders about session -1 were made. 
-A group discussion was held to share the experiences
of the 1st session practice assignments. 
-The concept of automatic pilot was explained.
Examples from daily life were given and a
'handwriting metaphor' study was done on recognizing 
the autopilot. Then, the group talked about awareness.
- Emotional triggers were discussed and examples
were given. Participants were sent to breakout rooms
(2-3 discussion groups) from time to time to gain
awareness of the emotions that often trigger them.
-They were shown how to eat the trigger food and then
given time to practice it themselves. Afterwards,
experiences of eating the trigger food were discussed. 
-Breath awareness exercise
-Evaluation
Third Session: 
Recognizing the Stimuli 
Objective 1: Recalling the second 
session 
and 
reflecting 
on 
realizations 
Objective 2: Recognize stimuli 
that accompany eating  
Objective 3: Distinguish stimuli 
accompanying eating as internal or 
external 
Objective 
4: Experiencing 
the 
effect of stimuli accompanying 
eating on eating awareness 
-Music
-Article 
on 
emotions
-Foods 
that 
participants
brought with them 
to eat during the 
session 
Reminders about session -2 were made. 
-A group discussion was held to share the experiences
of the 2nd session practice homework. 
- Information was given about stimuli and the effect of 
stimuli on eating behavior. The group talked about 
recognizing the stimuli that accompany eating. 
-Experiential practice 1: Eating the specified food
using eating awareness skills. 
-Experimental practice 2: Eating the food while
listening to music and reading an article.
-Awareness in practices 1 and 2 were discussed. 
-Breath awareness exercise
-Evaluation

Fourth Session: 
Honoring Hunger and Satiety 
Objective 1: Recalling the third 
session 
and 
reflecting 
on 
realizations 
Objective 2: Understand hunger 
and satiety signals and predict their 
relationship 
Objective 3: Assess and analyze 
hunger and satiety signals 
Objective 4: Finding the location 
of hunger and satiety in the body 
 
 
 
-Hunger 
and 
Satiety 
Assessment Scale 
 
-1 liter of water 
-Reminders about the 3rd session were made. 
-3rd session practice homework experiences were 
shared as a group. 
-Information was given on hunger and satiety signals.  
-The Hunger and Satiety assessment scale was 
presented. They were asked to examine it. Awareness 
was discussed as a group on making an assessment 
about themselves. 
-Body Scan was practiced. Awareness was discussed 
after the body scanning practice. 
-Participants were asked to drink 1 liter of water when 
they were hungry for at least 3 hours. They drank 
water until they felt full and then talked about their 
awareness. 
-Evaluation 
Fifth Session: 
Honoring the Body 
Objective 1: Recalling the fourth 
session 
and 
reflecting 
on 
realizations 
Objective 2: To understand the 
concept of self-compassion and to 
be able to predict its relationship 
with the body 
Objective 3: Assess and examine 
the components of self-compassion, 
Objective 
4: Recognizing 
the 
supportiveness and signals of the 
body, connecting with the body  
 
 
Self-compassion 
Scale 
 
-The metaphor of 
the weeping child 
 
-Mindful 
movements  
-Reminders about the 4th session were made. 
-4th session practice homework experiences were 
shared as a group. 
- The concept of self-compassion was explained and 
information was provided with research. 
- Awareness work on self-compassion was done with 
a metaphor over a crying child. 
- Self-compassion scale items were examined. The 
items that were most challenging for them were 
examined and their awareness was discussed. 
- Body awareness was practiced through mindful 
movements. After this study, awareness of the body 
was discussed. 
-Evaluation 
Sixth Session: 
Honoring the Past 
Objective 1: Recalling the fifth 
session 
and 
reflecting 
on 
realizations 
Objective 2: To evaluate and 
examine nutritional components 
and beliefs 
Objective 
3: Explore 
and 
recognize the cultural connections 
of eating 
Objective 
4: Recognize 
the 
influence of culture on food rules 
and habits 
 
- Table of rules and 
false beliefs  
 
-Table 
of 
clean 
plate values  
 
 
-Last 
bite 
experiment  
(participants 
provided their own 
food) 
-Reminders about the 5th session were made. 
-5th session practice homework experiences were 
shared as a group. 
-The table of rules and false beliefs about eating was 
examined and discussed. 
-The impact of culture on eating was discussed and 
awareness was evaluated. 
-Items related to nutrition rules were introduced. The 
most challenging items were examined, and their 
awareness was discussed. 
-The clean plate values table was questioned.  
- Last Bite Experiment was conducted. Mindful eating 
skills were reminded while eating the food. The ability 
to leave 1 or 2 pieces behind while eating the food was 
discussed. 
-Evaluation 
Seventh Session:  
Looking into the Past and 
Moving On 
Objective 
1: Recognize 
improvements since the past weeks 
Objective 
2: Make 
eating 
awareness skills sustainable 
Objective 
3: To 
ensure 
the 
continuity of the positive skills 
acquired in the future. 
Objective 4: To evaluate the group 
process 
 
-Story of the Battle 
of the Wolves 
-Reminders about the 6th session were made. 
-6th session practice homework experiences were 
shared as a group. 
-The story of the War of the Wolves was read and 
discussed. 
- What can be done to make eating awareness 
sustainable from now on was discussed. Personal 
evaluations were taken in terms of where they came 
from. 
- The intentions file for each week was examined and 
self-evaluation and awareness talks were made about 
where they came from. 
-General evaluation of the program was made. 
 
 
 
 
 
 
 

6. Outcome Measures 
1. Emotional Eating Scale (EES-30) 
• 
Likert-type; 30 items 
• 
Higher scores = higher emotional eating 
• 
Cronbach’s α = .92 
2. Mindful Eating Questionnaire (MES-30) 
• 
30 items; 7 subscales 
• 
Higher scores = more mindful eating 
• 
Cronbach’s α = .72 
3. Emotional Appetite Questionnaire (EAQ-22) 
• 
22 items; emotional appetite under various emotional states 
• 
Cronbach’s α = .71 
 
7. Data Collection 
Time Points: 
• 
Pretest: Week 0 
• 
Posttest: Week 7 
• 
Follow-up: 3 months after posttest 
Tools: 
Google Forms, Zoom (recorded with consent), WhatsApp (coordination) 
 
8. Statistical Analysis Plan 
Software Used: 
SPSS version 26.0 
Assumptions Tested: 
• 
Normality: Shapiro–Wilk 
• 
Variance Homogeneity: Levene’s Test 
• 
Z-score range for inclusion 
Tests Employed: 
• 
Mixed-design ANOVA (Repeated Measures) 
• 
Bonferroni correction for post hoc pairwise comparisons 
• 
Eta squared (η²) for effect sizes 

• 
Wilks' Lambda for multivariate time x group interaction 
Interpretation Thresholds for η²: 
• 
Small: 0.01 
• 
Medium: 0.06 
• 
Large: 0.14 and above 
 
9. Ethical Considerations 
• 
Ethical approval was obtained from the Düzce University Scientific Research Ethics 
Committee (Date: 29.12.2022, Decision No: 493). 
• 
Informed consent obtained from all participants prior to data collection. 
• 
No participant data (names, identifiers) are disclosed. 
• 
Participants were free to withdraw at any point. 
 
10. Data Storage and Confidentiality 
• 
Data stored securely on a password-protected institutional drive. 
• 
Only the principal investigator and authorized team have access. 
• 
All data are anonymized using participant IDs. 
• 
Data will be stored for 5 years in compliance with institutional policy. 
 
11. Timeline 
Activity 
Date Range 
Recruitment 
May 2023 – Nov 2023 
Pilot Study 
May – July 2023 
Experimental Implementation Sept – Nov 2023 
Follow-up Assessments 
Feb 2024 
Data Analysis & Report Writing Mar – May 2024