G Bossis

Y Grasselli

A Meunier

O Volkova

Outstanding magnetorheological effect based on discontinuous shear thickening in the presence of a superplastifier molecule

We present experimental results showing an increase of stress of about 150kPa for a weak applied magnetic field (H<10kA/m) in an aqueous suspension of carbony iron particles coated with a superplasticizer molecule used in cement industry. These values, which are several orders of magnitude larger than those classically obtained with magnetorheological suspensions at such low field, can open the way to new applications. These high values result from the triggering of a discontinuous shear thickening induced by the magnetic field. A phase diagram is presented for a volume fraction of carbonyl iron particles of 62%, showing two domains in the plane, magnetic field versus shear rate.

The lower one is liquid of quite low viscosity and the upper one corresponds to a jammed phase where the particles are in frictionnal contacts and can only move under very high stresses. The transition between the two states is monitored by the ability of the superplasticizer molecule to resist to the compression forces both hydrodynamic and magnetic.

Magnetorheological(MR) fluids are made of micron sized ferromagnetic particles suspended in a carrier fluid, more often a silicone oil. Under the application of magnetic field , the particles acquire a magnetic moment and attract each other to form a solid gel characterized by a yield stress τ y . The rheological behavior follows approximately a Bingham law : y 0 τ = τ + η γ ɺ where η 0 is the viscosity of the suspension in the absence of the field and γ ɺ the shear rate. The higher the yield stress the better will be the control of the effective viscosity of the fluid. The maximum attainable depends on the magnetization saturation of the particles, on their volume fraction and, of course, on the intensity of the applied magnetic field. In practice commercial fluids are based on carbonyl iron particles, with typical yield stresses of 30-60kPa for a magnetic induction of 0.4-0.6T 1,2 . Many efforts have been done to improve these fluids firstly in view to increase the yield stress and secondly to improve the redispersion of particles after their sedimentation which occurs quickly due to their high density. One way is to use fibers instead of spherical particles since they are more easily magnetizable and, indeed, for the same volume fraction and the same external field the yield stress is higher 3,4 , but due to entanglement the maximum possible volume fraction is lower so finally the result is not better. Concerning the aggregation due to sedimentation it can be reduced by using shell like particles where only the outside part is made of a magnetic material 5,6 ; a simpler approach is the use of a surfactant molecule ,like for instance stearic acid and many others, which form a barrier preventing the surfaces of the particles to come in contact. On the other hand the use of a surfactant molecule can allow to increase the volume fraction of particles and then to increase the yield stress. In cement industry superplastifier molecules are currently used to increase the solid content of the cement. Nevertheless at high volume fraction we encounter the phenomenon of discontinuous shear thickening which is a jammed state where a network of percolated frictional contacts between particles is formed at a given critical shear stress 7,8 . In this work we use this phenomenon to induce the jamming sate at a critical shear rate which can be controlled by the magnetic field. Then, instead of a yield stress which depends only on the dipolar interactions between the particles, we add a ratcheting effect which can multiply the simple magnetic interaction. Actually this kind of effect has been observed by D.J. Klingenberg et al: they found that adding a part of non magnetizable particles to magnetizable ones could notably increase the field induced yield stress 9 . Although not explained at this time the authors recently prove that it was due to a jamming effect induced by the magnetic field in the presence of a higher total volume fraction of particles [START_REF] Klingenberg | communication at ERMR2016[END_REF] . The solid friction between particles, which can be induced by the attractive magnetic forces is also one of the cause of the enhancement of the MR effect in suspensions of magnetic fibers [START_REF] Lopez-Lopez | [END_REF] or of faceted particles 12 compared with spheres at the same volume fraction.

In our experiments we have used commercial carbonyl iron particles (CIP grade HQ from BASF 13 ) suspended in water and a commercial superplasticizer molecule (Optima 100 from Chryso) which has a head made of two phosphonate groups (PO 3 H -) and an hydrophilic tail made of a polyoxyethylene chain. The counter ions of the phosphonate group are sodium ions which react with the OH -group present on the surface of iron particles, contributing to form an ionic bond between the oxygen of the phosphonate and iron atoms. The use of this molecule allows to reach volume fraction of carbonyl iron in water as high as 62% with a small yield stress -about 20Pa-and still a low plastic viscosity -η 0 ≃ 1Pa.s.

The experiments were conducted firstly in the imposed shear stress mode on a MCR502 (Physica) rheometer in the plate plate geometry using a serrated plateau and a serrated plate to prevent the slipping of the suspension on the walls. A coil of inner diameter 75mm was surrounding the plate of diameter 40mm. The ramp of stress was chosen at a typical rate of 20 Pa/min which allows to obtain steady state results and is still fast enough to be able to do several successive experiments without drying. The resulting rheograms are presented in The jamming transition at zero field occurs at a critical shear rate of 35s -1 and is characterized by a discontinuity in the shear rate followed by oscillations around an average value which is lower than the critical one. When the field is increased the value of the critical shear rate decreases and reaches a zero value at a field of 18 kA/m. Inside the jamming domain, if we continue to increase the stress, either the average shear rate does not change and we end up by reaching the limiting torque of the apparatus ( 0.3N.m) or we have an expulsion of the suspension outside the gap. An other way to explore the effect of the magnetic field on the jamming transition is to impose a constant shear rate and then to increase progressively the field. The result is presented in Fig. 2 with a low imposed shear rate: 0.001 γ = ɺ , so that the stress is equivalent to a yield stress. We see that the yield stress increases progressively with the field, as it should when the only interactions between the particles are dipolar ones; then above a given value, here H=18kA/m, we have a jump in the yield stress which overcomes the limit torque of the rheometer and represents an increase of two orders of magnitude in the yield stress. Such transition was also recently observed 12 with a carbonyl iron suspension at Φ=30% without additive, but with an increase of stress only by a factor 2 and for much higher fields: H>500kA/m FIG 2. Evolution of the stress versus the applied field for a constant shear rate of 0.001s -1 ; volume fraction Φ=0.62

It then appears that the jamming transition can be monitored by the application of a magnetic field. For a volume fraction Φ=0.62 we have reported in Fig. 3 , for a given imposed shear rate, the value of the magnetic field which gives the jamming transition. In this way we obtain a division in two domains of the plane expressing the critical field corresponding to the jamming transition versus the imposed shear rate. The lower part corresponds to the liquid state and the upper one corresponds to the jammed state. The uncertainty is given by the standard deviation of the values corresponding to different experiments at the same shear rate. The boundary between the two domains can be approximated by a straight line. The jamming transition occurs when the stress acting on a given pair of particles is strong enough for pushing the adsorbed molecules away of the contact zone. Then we expect that this critical stress ,σ c , will only depend on the shape of the particles and on the characteristics of the adsorbed polymer. In this case we can write the condition of jamming like :

c 0 c m c c m 0 1 (H) or ( (H)) σ = η γ + τ γ = σ -τ η ɺ ɺ
where τ m (H) is the magnetic stress. If τ m (H) is linear in the field, then we recover the straight line of Fig. 3.

Actually the theory for the magnetic stress between carbonyl iron particles predicts rather, at low field, a H 3/2 dependence 14 . A possible explanation for this discrepancy stands in the fact that we have ignored the angular dependence of the forces: the compressive magnetic force between two particles is maximum when their line of centre is aligned with the field whereas the hydrodynamic compression force is maximum at θ=-45° relatively to the direction of the field. As σ c is the applied shear stress it does not reflect exactly the compressive one; a theoretical approach, which is beyond the scope of this paper, should take into account the angular dependence of the compressive stress. It is also worth noting that at usual volume fraction of MR fluids (e.g. Φ=45%), there is no impact of the coating by the superplastifier on the yield stress since the volume fraction is not high enough to produce the jamming transition.

FIG. .3 Critical field corresponding to the jamming transition for different constant shear rates

An important question for the practical applications, is to know what happens above the transition. In the jammed domain the compressive force which is both due to the hydrodynamic stress and to the magnetic stress, is large enough to sweep the polymer out of the contact surface and to provoke the solid friction between the particles which is at the origin of the jamming phenomenon. When the total stress is reduced, either by decreasing the shear rate or the magnetic field , the polyelectrolyte molecule can come back between the surfaces of the particles and the suspension can flow again. At this stage it is difficult to know if the suspension can still flow in the jamming sate if a strong enough stress was applied because, on one hand, the torque range of the rheometer is too low and, on the other hand, the radial stress which is developped during the jamming is strong enough to expel the particles from the suspension as explained by Cates et al 15 . We have developped a home made viscosimeter based on a commercial one (CAD company) which can afford and measure torques as high as 10N.m which is about fifty times the maximum torque of commercial rheometers.

We have also designed an hermetic cell in which the suspension is confined by a teflon seal. The outer cylinder is in plexiglass so we can check the absence of bubbles inside the cell and it is serrated with stripes parallel to the axis of rotation to prevent wall slip. The tool is made of a double helix which is used to study the rheology of complex fluid 16 ; this tool behaves approximately like a cylinder of same radius but it has the advantage to induce a small flow along the axis of the helix which contributes to avoid sedimentation or segregation effects. Its diameter was 22mm and the gap between the outer cylinder and the helix was 2mm It is worth noting that, in this configuration, the field inside the cell is larger than between the plates for the same external field due to the difference in demagnetizing field. In these experiments we have a mechanical safeguard which disconnects the cell from the motor at a torque around 8N.m. A typical result obtained with the helicoidal tool is shown in Fig. 4 for a constant applied shear rate of 11s -1 . The field was increased progressively from zero with a step of 0.48kA/m every 5s We see that we have a first jump of stress up to 50kPa at a field H=6.7 kA/m , and then each time the field is increased we have an important increase of stress. Here we stopped the field at H=8.2 kA/m to avoid the triggering of the torque limiter and we end up with a steady value of 150kPa, then the field is turned off after 30s and the stress immediately comes back to its low initial value. This value of 150kPa is approximately three times more than the maximum yield stress in conventional MR fluids and ,above all, it is obtained at a very low field (H=8kA/m) compared to the one used with conventional MR fluids (typically 300-400kA/m for a stress of 40-50 kPa). It is important to note that we have a steady state in the jamming regime whose stress is controlable by the magnetic field.

The vane geometry also avoids slipping of the suspension on the walls. We have made one with six blades , an external diameter of 22mm and a length of 43mm. With a vane as well as with a cylinder the sedimentation of the particles can change locally the volume fraction and also produces irreversible aggregation. The fact to use an horizontal geometry is less problematic for the redispersion of the particles, nevertheless the effect of sedimentation is still an opened question not easy to solve experimentally. We have used the opportunity of parabolic flight offered by the CNES to check this effect. The duration of a parabola is 22 s. In the experiment presented in Fig. 5 the field was turned on before the parabola and a ramp of shear rate started 7s before the microgravity and reached its maximum of 20 s -1 after 15s. The same experiment was repeated just after in normal gravity. We see in fig. 5 that there is a difference at short time when the rotation of the tool has still not completely redispersed the suspension, but that after a few seconds there is no noticeable difference. This is a proof that the horizontal geometry is very efficient against sedimentation. We note also that, here too, we reach a stationary very high stress ,as with the helix tool, but for a field which is more than two times larger. We have no simple explanation for this difference. B / = τ η γ ɺ ,with τ y =150kPa and η 0 =1Pa.s, is always larger than 10 2 even for shear rates as high as 10 4 s -1 , meaning that we have a very large range of control of the effective viscosity. In the case of applications related to the locking of rotating parts, like for brakes or clutches, it is important that the jammed state remains stable for a long enough time which seems to be the case as observed in figs 4 and 5 but it needs to be confirmed more systematically. This opens the way to the synthesis of new MR fluids which will be more efficient than the usual ones at much lower fields, so allowing new applications. Furthermore, as the magnetic force induced by the field can be easily estimated, it gives a new approach for a better understanding of the DST phenomenon.

  FIG. 1. Ramp of stress for a volume fraction Φ=62% and different values of the magnetic field.

Fig. 4

 4 Fig.4 Stress versus time during a ramp of field with a step of 0.48 kA/m every 5s; the shear rate was constant and equal to 11 s -1

Fig. 5

 5 Fig.5 Stress versus time with vane geometry at a field H=19.2kA/m; comparison microgravity/gravity In summary, using a superplastifier molecule with carbonyl iron particles dispersed in water, we found a discontinuous shear thickening with a huge jump of stress which can be controled by a low magnetic field. For instance at H=10kA/m the Bingham number: i y 0

Acknowledgments

This work was supported by the Centre National d'Etudes Spatiales CNES and by European Spatial Agency ESA.


Alexis Ruffault
email: alexis.ruffault@parisdescartes.fr

Sébastien Czernichow

Martin S Hagger

Margot Ferrand

Nelly Erichot

Claire Carette

Emilie Boujut

Cécile Flahault

The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis

Keywords: mindfulness, body mass index, weight, binge eating, disordered eating, physical activity

de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction 1.Obesity and health-related behaviors

According to a recent systematic review, 36.9% of men and 38.0% of women are overweight or obese [START_REF] Ng | Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: A systematic analysis for the Global Burden of Disease Study 2013[END_REF]. According to the World Health World Health Organization [START_REF]Global recommendations on physical activity for health[END_REF], obesity results from an inappropriate energy balance between energy intake and energy expenditure. Negative affective states, such as acute stress and depressive mood, have been associated stronger drive to eat, which leads to excess weight gain and obesity [START_REF] Privitera | Differential food intake and food choice by depression and body mass index levels following a mood manipulation in a buffet-style setting[END_REF][START_REF] Wardle | Stress, dietary restraint and food intake[END_REF][START_REF] Torres | Relationship between stress, eating behavior, and obesity[END_REF][START_REF] Groesz | What is eating you? Stress and the drive to eat[END_REF]. Additionally, excessive food consumption is known to lead to excess weight and is also associated with sedentary behaviors [START_REF]Global recommendations on physical activity for health[END_REF][START_REF] Joseph | The neurocognitive connection between physical activity and eating behaviour[END_REF]. Binge eating disorder (BED) is the most prevalent eating disorder in individuals with overweight and obesity [START_REF] De Zwaan | Binge eating disorder and obesity[END_REF] and is characterized by recurrent and persistent episodes of uncontrolled and disinhibited eating sustained by psychological distress without any compensatory behavior [START_REF]Diagnostic and statistical manual of mental disorders[END_REF].

Research has outlined that impulsive actions occur without considered deliberation or reflection [START_REF] Strack | Reflective and impulsive determinants of social behavior[END_REF][START_REF] Hofmann | Capturing eating behavior where the action takes place: A comment on McKee et al[END_REF]. Such actions are the result of action patterns being initiated beyond an individual's awareness usually as a result of repeated exposure to cues and action pairings that are linked to reward (e.g., pleasure sensations, positive affect). The strength of these impulsive pathways are dependent on moderating factors such as context (e.g., the strength of the cue), and an individual's motivation (e.g., beliefs perceived benefits and costs of engaging in the action, beliefs about the behavior as a reward or stress management strategy) and capacity to override the impulsive pathway (e.g., levels of impulsivity, levels of self-control). The loss of control and disinhibited behaviors experienced during binge episodes therefore likely reflect a failure of the individual's capacity to regulate their impulses and may be dependent on a number of moderating factors [START_REF] Dawe | The role of impulsivity in the development of substance use and eating disorders[END_REF]. Thus, impulsive eating refers to eating behaviors that are controlled by impulsive pathways to action that are manifested in binge eating behavior. In individuals with obesity, binge eating may be perceived as a compensatory behavior to cope with psychological distress [START_REF] Hill | Obesity and eating disorders[END_REF], and has been shown to be stronger in patients with extreme levels of obesity [START_REF] Hsu | Binge eating disorder in extreme obesity[END_REF]. Moreover, individuals with overweight and obesity tend to be more impulsive [START_REF] Mobbs | Obesity and the four facets of impulsivity[END_REF][START_REF] Nederkoorn | Impulsivity in obese women[END_REF] and report greater difficulties managing hedonic impulses [START_REF] Hagger | Chronic inhibition, self-control and eating behavior: Test of a 'resource depletion' model[END_REF] compared to normal weight individuals. Furthermore, excess weight has been associated to the tendency to prefer smaller immediate rewards over larger delayed ones in studies using classical or food-related delayed discounting tasks [START_REF] Madden | Impulsivity: the behavioral and neurological science of discounting[END_REF][START_REF] Davis | Immediate pleasures and future consequences: A neuropsychological study of binge eating and obesity[END_REF][START_REF] Rasmussen | Percent body fat is related to delay and probability discounting for food in humans[END_REF].

Recent research has demonstrated that low physical activity levels were also associated with increased risk of being overweight or obese [START_REF] Van Dyck | International study of objectively measured physical activity and sedentary time with body mass index and obesity: IPEN adult study[END_REF], and evidence-based recommendations advocate physical activity programs may assist in reducing this risk [START_REF] Orrow | Effectiveness of physical activity promotion based in primary care: Systematic review and meta-analysis of randomised controlled trials[END_REF]. While it is known that disordered eating and low physical activity level lead to weight gain, recent results have suggested that disinhibited eating, binge eating, brain responses to food cues, and food intake regulation may be attenuated by increased physical activity level [START_REF] Cornier | The effects of exercise on the neuronal response to food cues[END_REF][START_REF] Myers | Associations among sedentary and active behaviours, body fat and appetite dysregulation: Investigating the myth of physical inactivity and obesity British Journal of Sports Medicine[END_REF]. This means that physical activity may be an appropriate intervention to manage weight gain and disordered eating patterns.

Mindfulness-based interventions

There is growing interest in mindfulness training interventions to promote behaviors related to maintaining a healthy body weight and minimizing overweight and obesity such as dietary behavior and physical activity consistent with national recommendations [START_REF] Roberts | Mindfulness and health behaviors: Is paying attention good for you?[END_REF].

Mindfulness training is commonly defined as an intervention that aims to foster nonjudgmental and moment-to-moment awareness of the present experience [START_REF] Kabat-Zinn | Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness[END_REF]. Forman, Butryn, Hoffman, and Herbert [START_REF] Forman | An open trial of an acceptance-based behavioral intervention for weight loss[END_REF] recommended the use of mindfulness-based cognitivebehavioral interventions to manage the physical and psychological health of obese patients in clinical contexts.

Mindfulness training is delivered in several treatment programs such as Mindfulness-Based Stress Reduction (MBSR) [START_REF] Kabat-Zinn | Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness[END_REF], Mindfulness-Based Cognitive Therapy (MBCT) [START_REF] Segal | Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse[END_REF],

Acceptance and Commitment Therapy (ACT) [START_REF] Hayes | Acceptance and commitment therapy: Model, processes and outcomes[END_REF], Dialectical Behavioral Therapy (DBT) [START_REF] Linehan | Cognitive behavioral treatment of borderline personality disorder[END_REF], and a large number of adapted interventions targeting specific outcomes or populations (e.g., Mindfulness-Based Eating Awareness Training) [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF]. MBSR, the most studied mindfulness-based program, is an 8-week intervention with weekly 2-hour group sessions (held to teach meditation and provide collective feedback while participants share experiences) and daily 45-minutes home practice. Mindfulness-based interventions, such as MBSR and MBCT, have first been developed as cognitive behavioral therapies for mood and anxiety disorders [START_REF] Kabat-Zinn | Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness[END_REF][START_REF] Teasdale | Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy[END_REF]. Acceptance-based (e.g., ACT) or other behavioral (e.g., DBT) interventions, which systematically include a mindfulness training, have been built to fit the needs of individuals seeking behavior change [START_REF] Hayes | Acceptance and commitment therapy: An experiential approach to behavior change[END_REF]. While mindfulness-based interventions focus on the awareness of thoughts, affects, and bodily sensations, acceptance-based and behavioral interventions focus on the acceptance of these cognitions, emotions, and sensations. Furthermore, Brown and Ryan [START_REF] Brown | The benefits of being present: Mindfulness and its role in psychological well-being[END_REF] placed a strong emphasis on the selfregulatory function of mindfulness, which is characterized as "being attentive to and aware of what is taking place in the present moment" (p. 882).

In addition, studies showed that mindfulness skills (i.e., the ability to be nonjudgmentally aware of the present experience) are linked to participation in health-related behaviors such as dietary behavior and physical activity consistent with national recommendations [START_REF] Roberts | Mindfulness and health behaviors: Is paying attention good for you?[END_REF]. With regard to weight loss, studies investigating the effects of mindfulness training aiming at increasing physical activity in obese patients -who previously failed to lose weight after several attempts -have shown a post-treatment decrease in body mass index (BMI) compared to control groups [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Tapper | Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women[END_REF]. Results of these studies also indicate that previous failed attempts to lose weight are an important contributing factor to psychological distress in obese patients. Mindfulness training focusing on acceptance, awareness, and values, may help participants attend to the thoughts and feelings associated with these failures, and to develop new skills to manage them.

Previous reviews

To date, five reviews have investigated the effects of mindfulness training on disordered eating patterns and weight loss in obese patients [START_REF] Godfrey | Mindfulness-based interventions for binge eating: A systematic review and meta-analysis[END_REF][START_REF] Godsey | The role of mindfulness based interventions in the treatment of obesity and eating disorders: An integrative review[END_REF][START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF][START_REF] Wanden-Berghe | The application of mindfulness to eating disorders Treatment: A systematic review[END_REF]. Only one of these reviews conducted a meta-analytic synthesis of findings of randomized controlled trials (RCTs) [START_REF] Godfrey | Mindfulness-based interventions for binge eating: A systematic review and meta-analysis[END_REF], two conducted effect size analyses from baseline to post-intervention [START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF], and two described the literature [START_REF] Godsey | The role of mindfulness based interventions in the treatment of obesity and eating disorders: An integrative review[END_REF][START_REF] Wanden-Berghe | The application of mindfulness to eating disorders Treatment: A systematic review[END_REF]. Previous within-group results showed small effects of mindfulness-based interventions on body weight outcomes (Cohen's d range: -.17 to .26) [START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF], small-to-large effects on binge eating (d range: .36 to 3.02) [START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF], small-to-large effects on emotional eating (d range: .01 to .94) [START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF], and moderate effects on external eating (d range: .53 to .70) [START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF]; previous between-group effects of mindfulness-based interventions on binge eating ranged from -1.20 to .27 (Hedge's g) [START_REF] Godfrey | Mindfulness-based interventions for binge eating: A systematic review and meta-analysis[END_REF]. Moreover, the number of included studies ranged from 12 to 21, depending on the selection criteria. Reviews investigating the effects of two standardized mindfulness-based interventions and excluding other techniques of mindfulness training resulted in smaller number of included studies [START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] Wanden-Berghe | The application of mindfulness to eating disorders Treatment: A systematic review[END_REF], while reviews investigating the effects of any mindfulness training on obesity-related disordered eating without targeting adults with overweight and/or obesity resulted in larger number of included studies [START_REF] Godfrey | Mindfulness-based interventions for binge eating: A systematic review and meta-analysis[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF]. While previous reviews have focused on eating behaviors and weight changes, none have examined the overall effects of mindfulness training on physical activity.

Mechanisms of mindfulness implicated in obesity-related behaviors

Mindfulness-and acceptance-based interventions aim at training several skills such as awareness (i.e., noticing internal and external stimuli), disidentification (i.e., the ability to label thoughts as 'just thoughts' and to imagine having a distance from them), and acceptance (i.e., remain open to experiences without judgement). To understand the mechanisms of mindfulness training to manage food craving, Lacaille and colleagues [START_REF] Lacaille | The effects of three mindfulness skills on chocolate cravings[END_REF] conducted an experiment testing the effectiveness of each of the three core mindfulness skills. Results showed that disidentification may have the most important role in coping with food cravings when compared to awareness and acceptance. The ability to defuse from distractive foodrelated thoughts could be the most effective skill to reduce food cravings when compared to the ability to notice such thoughts or to accept them. Moreover, mindfulness includes a deautomation element (i.e., a skill to reduce automatic thoughts and behaviors) that can be effective in reducing of impulsive eating [START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF]. In addition, given that impulsive eating among individuals with obesity is related to difficulties to cope with psychological distress [START_REF] Hill | Obesity and eating disorders[END_REF], and that mindfulness is related to the reduction of stress and depressed mood [START_REF] Greeson | Decreased symptoms of depression after Mindfulness-Based Stress Reduction: Potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age[END_REF], mindfulness training may be beneficial in the reduction of disordered eating by helping individuals manage their psychological distress.

Mindfulness training (including acceptance-based interventions and behavioral interventions that include mindfulness training) has also been shown to increase physical activity level of sedentary individuals [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Tapper | Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women[END_REF][START_REF] Butryn | A pilot study of acceptance and commitment therapy for promotion of physical activity[END_REF]. According to cross-sectional studies investigating the role of mechanisms of mindfulness implicated in behavior change (in the context of physical activity), findings suggest that mindfulness skills have a moderating role between pre-behavioral variables (e.g., intentions to change, motivational regulation) and physical activity level [START_REF] Chatzisarantis | Mindfulness and the intention-behavior relationship within the theory of planned behavior[END_REF][START_REF] Ruffault | Mindfulness may moderate the relationship between intrinsic motivation and physical activity: A cross-sectional study[END_REF]. Hence, bringing an increased and non-judgmental awareness toward physical activity behaviors may empower the effect of pre-behavioral variables on the performance of such behaviors. Similarly, while satisfaction with health behaviors facilitates engagement in such behaviors [START_REF] Rothman | Toward a theory-based analysis of behavioral maintenance[END_REF], Tsafou and colleagues [START_REF] Tsafou | Mindfulness and satisfaction in physical activity: A cross-sectional study in the Dutch population[END_REF] showed that mindfulness may be related to increased satisfaction in so far as it presumably enhances the favorable processing of physical activity experiences (either positive, or negative) which conjointly lead to enhanced satisfaction with physical activity.

The present study

While there is growing research on the effectiveness of mindfulness training programs in promoting better health-related behaviors in individuals with overweight and obesity, a meta-analytic synthesis of the research examining its effectiveness on such behaviors across multiple studies has not been conducted. The purpose of the current review is to conduct a comprehensive quantitative synthesis of RCTs of the effects of mindfulness training on health behaviors of adults with overweight and obesity using meta-analytic techniques. The current study will advance understanding by providing quantitative estimates of the effect size of mindfulness techniques on eating patterns in individuals with excess weight as well as physical activity in addition to weight loss. Our systematic review and meta-analysis of the current literature test the effectiveness of interventions adopting any form of mindfulness training provided in cognitive and behavioral interventions on weight loss, impulsive eating, binge eating, and physical activity, among overweight and obese individuals. It will make a unique contribution as only one previous systematic review in this field focused exclusively on RCTs and meta-analyzed the effects of the interventions, and none focused on physical activity. However, our review will contribute to understand the role of mindfulness in weight management (i.e., energy balance) by statistically correcting for the methodological artifact of sampling error and testing the effects of mindfulness on eating and exercise behaviors across the research literature.

Furthermore, meta-regression analysis of covariates will bring information regarding methodological and design features that may affect the effectiveness of mindfulness training programs on weight loss. To this end, type of intervention (behavioral or non-behavioral), primary focus of intervention (weight loss or eating behavior), intervention duration (less or more than 3 months), participants' condition (binge or non-binge eaters), and follow-up distance from post-intervention (less or more than 3 months) have been selected as potential moderators of the effects of mindfulness training on weight loss and related health behaviors. It was hypothesized that behavioral interventions (e.g., ACT) aiming at reducing weight loss would be more effective for weight loss in so far as such programs primarily aim at changing weight-related behaviors with mindfulness-based techniques. Likewise, it was expected that interventions targeting eating behaviors of those who endorse recent binge eating behavior would be more effective in the reduction of binge and impulsive eating. Moreover, longer intervention durations and follow-up distances may attenuate the effects of mindfulness training programs.

Material and methods

Study selection

Studies were selected to inclusion in the current analysis if they satisfied the following criteria: (a) adopted an RCT design, (b) used any form of mindfulness training as intervention, (c) were conducted on adult participants (aged over 18 years) with a BMI of at least 25 kg/m 2 , and (d) included weight, impulsive eating, binge eating, or physical activity level as an outcome measure. Studies including patients with comorbid physical or psychological disorders were eligible for inclusion. No restriction was applied on the primary focus of the intervention (e.g., weight loss, reduction of caloric intake), administration modality, duration, frequency, and predominance of the mindfulness training in the interventions. Treatment as usual, wait-list, and information-only programs were eligible control groups. The primary outcome measure was the change in BMI from baseline to postintervention. Secondary outcomes were impulsive eating including disinhibited and uncontrolled eating (measured by self-reported questionnaires such as the Three-Factor Eating Questionnaire [START_REF] Stunkard | The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger[END_REF] or experimental tasks such as delay discounting tasks specific to food items), binge eating (measured by self-reported scales such as the Binge Eating Scale [START_REF] Marek | Replication and evaluation of a proposed two-factor Binge Eating Scale (BES) structure in a sample of bariatric surgery candidates[END_REF], or semi-structured diagnostic interviews aiming at checking relevant symptoms), and changes in physical activity level, from baseline to post-intervention.

We only included articles published in English-language journals. MEDLINE (PubMed), EMBASE (ScienceDirect), PsycINFO, and CENTRAL (The Cochrane Library) were searched up to February 2016, with no restriction applied on begin date range. The literature search was constructed around search terms for obesity (obesity, overweight, weight, metabolic syndrome, adiposity), mindfulness (mindfulness, acceptance, meditation, awareness), disordered eating (binge eating, impulsive eating, disinhibition, uncontrolled eating, disordered eating, calorie intake), and exercise (exercise, physical activity, sport, energy expenditure) in full texts words. The search strategy was adapted for each database as necessary. Potential additional studies were searched through the reference lists of included trials. The selection process for studies included in this review is shown in Fig 1.

Data extraction

First, titles and abstracts were screened to identify potentially eligible studies. Second, full texts of all potentially relevant articles were investigated. Two authors independently screened the articles to identify studies that met inclusion criteria, and conflicts of opinion were discussed with a third author until consensus was reached. Using a standardized data extraction form, two independent investigators extracted and tabulated all data with any disagreements resolved by discussion among the investigators, or, if required, by a third party. When necessary, the primary authors of the trials were contacted for additional information. Data extracted from the studies and study characteristics are available in Table 1. Risk of bias was independently assessed by two authors using the Cochrane risk of bias assessment tool [START_REF] Higgins | The Cochrane Collaboration's tool for assessing risk of bias in randomised trials[END_REF]. The risk of bias assessment tool assesses risk of bias in the included trials for the following domains: selection, performance, attrition, reporting, detection, and other. For each domain, risk of bias was judged as 'low', 'unclear', or 'high'. Conflicts of opinion were discussed with a third author until consensus was reached.

Statistical analysis

Data for the primary outcome variable, change in BMI, were expressed as a mean difference (MD) because BMI was measured using identical units (kg/m 2 ) across studies. Data for secondary outcomes, impulsive eating, binge eating, and physical activity levels, were expressed as Cohen's d, because different measurement tools were used to assess each variable. Data from original articles were transformed as MD and Cohen's d by using Cochrane guidelines in each case (e.g., transforming standard errors into standard deviation, calculating standard deviations of original MD if not provided) [START_REF] Higgins | Cochrane handbook for systematic reviews of interventions[END_REF]. MD and Cohen's d were analyzed using random effects because of small sample sizes in the included studies. We contacted the authors to obtain relevant missing data, if feasible.

The magnitude of between-study heterogeneity after correcting for statistical artifacts evaluated by the I 2 statistic with levels below 40%, between 30% and 60%, between 50% and 90%, and greater than 75% equating to low, moderate, substantial, and high levels of heterogeneity, respectively [START_REF] Higgins | Cochrane handbook for systematic reviews of interventions[END_REF]. The χ 2 test was used to assess whether the proportion of the total variability across studies was statistically significantly different to the proportion of variance attributable to the methodological artifact for which we corrected i.e. sampling error. A statistically significant finding indicates that a substantial proportion of the variance is attributable to factors other than sampling error and is indicative of potential extraneous moderators of the effect. Given the poor power of this test when only a few studies or studies with low sample sizes are included in a meta-analysis, a p-value below or equal to .10 was regarded to indicate statistically meaningful difference from zero [START_REF] Higgins | Cochrane handbook for systematic reviews of interventions[END_REF]. We used funnel plots to assess the potential existence of small study bias in cases where we could include 10 or more studies to investigate a particular effect. We statistically summarized data when the data were available, sufficiently similar, and of sufficient quality [START_REF] Higgins | Cochrane handbook for systematic reviews of interventions[END_REF]. We performed analyses according to the statistical guidelines contained in the latest version of the Cochrane Handbook for Systematic Reviews of Interventions [START_REF] Higgins | Cochrane handbook for systematic reviews of interventions[END_REF].

In addition, when substantial or high heterogeneity was present, we carried out metaregression analyses [START_REF] Berkey | A random-effects regression model for meta-analysis[END_REF] of the following moderator variables: type of intervention (i.e., behavioral vs. non-behavioral), main focus of the intervention (i.e., disordered eating vs. weight loss), duration of the intervention (i.e., less than 3 months vs. more than 3 months), participants' condition (i.e., binge eaters vs. non-binge eaters), distance of the outcome measure from baseline (i.e., less than 3 months vs. more than 3 months). Moderator variables were selected among study design characteristics as potential methodological factors that could impact effect sizes. All analyses were conducted using R [START_REF] Core | R: A language and environment for statistical computing[END_REF] and the 95% confidence intervals were used to establish whether effect size statistics were statistically significantly different from zero.

Results

Description of studies

The literature review resulted in 2867 records being identified that were subsequently screened for eligibility. Application of our exclusion criteria resulted in a total of 12 studies included in the meta-analysis [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF][START_REF] Hendrickson | Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals[END_REF][START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF][START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF]. In total, 20 studies were excluded from the review for the following reasons: lack of randomized controlled design or mindfulness intervention, participants had normal weight (BMI < 25kg/m 2 ) or lack of outcome eligible for inclusion.

Baseline characteristics for the studies included in the meta-analysis are presented in Table 1. Trial durations across the included studies ranged from 3 days to 6 months. There were a total of 626 participants across the 12 trials, out of which 315 were randomized to intervention group and 311 to control groups. The percentage of participants who completed the studies ranged from 55% to 100%. Trials were conducted with the participation of adults with overweight and obesity exclusively. Percentage of women in the included studies ranged from 64% to 100%, with three trials including only female participants [START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF]. Mean age of the participants ranged from 20.7 to 54 years old. Mean BMI at baseline ranged from 26.1 to 40.3 kg/m 2 . Out of the 12 selected trials, three included participants with diagnosed binge eating disorders [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF], two included students [START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Hendrickson | Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals[END_REF], one included participants with diagnosed type 2 diabetes mellitus [START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF], one included obese individuals after bariatric surgery [START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF], and five included individuals with overweight and obesity who wanted to lose weight [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF].

Descriptions of interventions for the included trials are shown in Table 1. Out of the 12 trials that tested an intervention including mindfulness training, three interventions were based on mindfulness-based eating awareness training (MB-EAT) [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF], three were based on acceptance and commitment therapy [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF], two were adapted for food craving or weight loss [START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF], one was mindfulness-based stress reduction (MBSR) [START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF], one was an initiation to MBSR [START_REF] Hendrickson | Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals[END_REF], one was dialectical behavioral therapy [START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF], and one was yoga and meditation [START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF]. Eight interventions aimed at improving eating behaviors [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Hendrickson | Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals[END_REF][START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF], two focused on weight loss and health [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF], one aimed at reducing caloric intake and increasing exercise behavior [START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF], and one focused on eating behaviors and diabetes management [START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF]. Two trials tested a self-help intervention [START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF]. Four trials tested mindfulness training as supplementary care, adding cognitive behavioral components and counseling (exercise, dietary, nutrition) [START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF]. Length of intervention in the trials ranged from 50 minutes to 24 weeks.

The primary outcome variable in the current view was change in BMI at postintervention. Out of the nine trials that measured BMI at post-intervention, two trials assessed BMI after two months [START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF], four trials assessed BMI after 3 months [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF][START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF], one trial assessed BMI after 4 months [START_REF] Daubenmier | Changes in stress, eating, and metabolic factors are related to changes in telomerase activity in a randomized mindfulness intervention pilot study[END_REF], and two trials assessed BMI after 6 months [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF]. The four trials that measured impulsive eating used four different tests: three used self-report surveys [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF][START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF], and one used a delayed-discounting task [START_REF] Hendrickson | Effects of mindful eating training on delay and probability discounting for food and money in obese and healthy-weight individuals[END_REF]. The five trials that measured binge eating used four different self-reported outcomes [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF]. The four trials that measured physical activity used three different self-reported questionnaires [START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF][START_REF] Miller | Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: A pilot study[END_REF]. Three trials measured self-reported mindfulness skills in participants: two trials measured acceptance [START_REF] Lillis | Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF], and one trial measured dispositional mindfulness [START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF]. Details on the outcomes are described in Table 1.

Risk of bias in included studies

Risk of bias of the included studies is described in Table 2. Nine trials (75%) had some methodological weaknesses according to the criteria applied. Only three (25%) trials reported adequate methods for sequence generation. Six trials (50%) reported adequate methods for allocation; the other six did not report any information regarding allocation and randomization. Only one study (8%) reported the methods of blinding of participants and personnel, and it was judged as a high risk of bias. Three studies (25%) reported adequate methods of blinding of outcome assessment. Four studies (33%) reported adequate methods for imputing missing data, two (17%) reported inadequate methods, and the six other (50%) did not report any information regarding the missing data. Selective reporting was at low risk of bias in all of the included studies. Four studies (33%) were at high risk of bias, because they offered compensation for participation.

Effects of interventions

Given the relatively small number of included studies in analyses of each outcome, meta-regression analyses of potential moderators were conducted when more than one study was part of a subgroup (e.g., analyses of the moderator 'type of intervention' were not conducted when only one study was testing a 'non-behavioral' intervention).

Primary outcome: change in BMI.

Overall, the change in BMI from baseline to post-intervention in RCTs did not show a statistically significant effect of mindfulness training in adults with overweight and obesity (MD = -.15 kg/m 2 ; 95% CI -.59 to .29; p = .50). Assessment of heterogeneity showed statistically significant substantial levels of heterogeneity among the trials assessing BMI at baseline and post-intervention (I 2 = 63%; p < .05). The forest plot of BMI change in the included studies is displayed in Fig 2 . Maximum likelihood meta-regression of covariates showed that the differences in study designs (i.e., following five criteria called moderators) were responsible for substantial statistical heterogeneity between studies. The model predicting weight loss with the five moderators explained 100% of initial heterogeneity (τ 2 = 0; SE = .04; QE(3) = 6.47; p = .09), and distance of the administration of the outcome measure from baseline was the only significant predictor, suggesting that longer term outcome measures were associated with larger weight loss (Table 4).

Impulsive eating.

Overall, post-intervention impulsive eating was statistically significantly lower in the intervention groups than in the control groups (p < .01) (see Table 3). Moreover, mindfulness training significantly reduced impulsive eating from baseline to post-intervention in the intervention groups (d = -1.15; 95% CI -1.91; -.38; p < .01) 1 . These results show that the effects of mindfulness training on impulsive eating are statistically significant and large in the included studies (i.e., d > .80) [START_REF] Cohen | Statistical power analysis for the behavioral sciences[END_REF]. Assessment of heterogeneity showed statistically significant substantial-to-high heterogeneity among the trials (p < .001). Maximum likelihood meta-regression of covariates showed that the differences in study designs (i.e., following two criteria called moderators) were responsible for substantial-to-high statistical heterogeneity between studies. The model predicting impulsive eating with two moderators (focus of intervention and participants' condition) explained 18.34% of initial heterogeneity (τ 2 = 0.93; 1 We conducted an additional analysis to test the effects of mindfulness training on impulsive and binge eating as separate outcomes and as a single outcome aggregated across studies. Results indicated that the effects of intervention on measuring 'impulsive eating' (k = 4, d = -1.13 (-1.93; -.33), I 2 = 85%) and 'binge eating' (k = 5, d = -.90 (-1.52; -.28), I 2 = 79%) were comparable to results for studies measuring either outcome (k = 9, d = -1.05 (-1.73; -.32); I 2 = 90%). These results indicated that the effects were no different across these outcomes. We have, however, retained the distinction given that this distinction has been made in the literature. SE = .76; QE(1) = 18; p < .001); however none of the moderators was significantly associated to reductions in impulsive eating (Table 4).

Binge eating.

Overall, binge eating at post-intervention was statistically significantly lower in the intervention groups than in the control groups (p < .01) (see Table 3). Moreover, mindfulness training statistically significantly decreased binge eating from baseline to post-intervention in the intervention groups (d = -1.26; 95% CI -1.89 to -.63; p < .001). Subgroup analyses revealed that participants' condition and type of intervention were effective moderators (see Table 3): mindfulness training was significantly effective on the reduction of binge eating in binge eaters (and non-significant in non-binge eaters) and behavioral interventions (e.g., ACT) showed significant effects on the reduction of binge eating while other interventions (e.g., MB-EAT) showed non-significant results. These results show that the effects of mindfulness training on binge eating are statistically significant and large in the included studies (i.e., d > .80) [START_REF] Cohen | Statistical power analysis for the behavioral sciences[END_REF]. Assessment of heterogeneity showed statistically significant and substantial-to-high levels of heterogeneity among the trials (p < .001). Maximum likelihood meta-regression of covariates showed that the differences in study designs (i.e., following two criteria called moderators) were responsible for substantial-to-high statistical heterogeneity between studies. The model predicting binge eating with two moderators (type of intervention and participants' condition) explained 65.64% of initial heterogeneity (τ 2 = 0.12; SE = .14; QE(2) = 10.57; p < .01). Participants' condition was significantly associated with larger reductions in binge eating, which suggests that individuals suffering from BED benefit more from mindfulness training to reduce the tendency to binge eat (Table 4). -.97* (-1.86 to -.07) CI: confidence interval. Type of intervention: 0=non-behavioral, 1=behavioral. Focus of intervention: 0=eating behaviors, 1=weight loss. Intervention duration: 0=less than 3 months, 1=more than 3 months. Participants' condition: 0=non binge eaters, 1=binge eaters. Follow-up distance: 0=less than 3 months, 1=more than 3 months * p < .05.

Table 3. Effect sizes (d) of secondary outcomes in the included studies between intervention and control groups at post-intervention.

Change in physical activity.

Overall, there was a small-to-medium statistically significant between-group effect of mindfulness training on change in physical activity from baseline to post-intervention in RCTs in adults with overweight and obesity (p < .01) (see Table 3). Assessment of heterogeneity showed low and statistically non-significant levels of heterogeneity among the trials assessing physical activity at baseline and post-intervention (p = .38). No metaregression analysis has been conducted for physical activity as levels of heterogeneity were considered low.

Mindfulness skills.

Overall, mindfulness skills at post-intervention were statistically significantly lower in the intervention groups than controls (p < .01) (see Table 3). Comparing mindfulness skills at baseline and post-intervention in the intervention groups, the overall effect of mindfulness training on mindfulness skills was not statistically significant (d = -.05; 95% CI -.66 to .55; p = .86). Assessment of heterogeneity showed statistically significant and substantial-to-high levels of heterogeneity among the trials (p < .01).

Discussion

The purpose of the current review was to conduct a quantitative synthesis of the effects of mindfulness-based training on BMI, health-related behaviors (impulsive eating, binge eating, physical activity), and mindfulness skills in a total of 12 RCTs with adults with overweight and obesity. The findings of our meta-analysis do not support the hypothesis that mindfulness training will have an effect on BMI measured between three days and three months post-intervention. However, our findings support the hypothesis that mindfulness training reduces impulsive and binge eating, and increases physical activity levels, in adults with overweight and obesity. More precisely, example results from included studies suggest that mindfulness training resulted in a mean reduction in binge episode frequencies from 18 episodes at baseline to five episodes at post-intervention over a 28 day period [START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF]. Moreover, example findings from included studies suggest a mean increase in energy expenditure (i.e., physical activity levels) resulting from mindfulness training from 767 kcal/week at baseline to 1700 kcal/week at post-intervention [START_REF] Davis | Effect of mindfulness meditation and home-based resistance exercise on weight loss, weight loss behaviors, and psychosocial correlates in overweight adults[END_REF].

The results of the current analysis indicate that mindfulness training could be effective in reducing of impulsive and binge eating in individuals with overweight or obesity, as well as increasing levels of physical activity, which should lead to a better energy balance and contribute to better weight management [START_REF]Global recommendations on physical activity for health[END_REF]. These results for two key health-related behaviors are consistent with previous findings suggesting that higher mindfulness skills are associated with better self-perceptions of physical and mental health in clinical and nonclinical contexts [START_REF] Roberts | Mindfulness and health behaviors: Is paying attention good for you?[END_REF]. Mindfulness is known to reduce impulsivity by acting as a deautomation component of self-regulation [START_REF] Brown | The benefits of being present: Mindfulness and its role in psychological well-being[END_REF], and to reduce impulsive eating even when individuals are exposed to food cues by accepting the experience judged as frustrating [START_REF] Alberts | Coping with food cravings. Investigating the potential of a mindfulness-based intervention[END_REF]. In addition, mindfulness increases physical activity levels in adults with overweight and obesity, and previous findings suggest that bringing an open awareness to present experiences could foster the impact of intentions and motivations to adopt physical activity behaviors [START_REF] Chatzisarantis | Mindfulness and the intention-behavior relationship within the theory of planned behavior[END_REF][START_REF] Ruffault | Mindfulness may moderate the relationship between intrinsic motivation and physical activity: A cross-sectional study[END_REF], and could increase satisfaction to be physically active [START_REF] Tsafou | Mindfulness and satisfaction in physical activity: A cross-sectional study in the Dutch population[END_REF]. Thus, simply observing, nonjudging, and accepting an aversive experience appears to lead to a more rational decisionmaking in the context of health behaviors. In fact, automatic thoughts, emotions, and behaviors seem to change while being mindful, even if the situation is perceived as aversive (e.g., taking the stairs at work instead of the elevator). There is a need for investigations testing the effectiveness of mindfulness training on behavior change in adults with overweight and obesity to include measures that would enable tests of mechanism through mediation. For example, researchers should consider introducing measures of the psychological factors linked to behavior engagement (e.g., intentions and motivations to change) and cognitive processes (e.g., tendency to act impulsively when exposed to food cues) to better understand the role of mindfulness in weight management.

In contrast, our results suggested that RCTs investigating the effects of mindfulness training are not effective in reducing BMI in adults with overweight and obesity. This apparent discord in the findings relative to the findings for the behavioral outcomes may be due to a number of reasons. Weight loss outcomes require sustained behavior change both in terms of energy expenditure through physical activity and calorie restriction through dietary change. More studies with long-term follow-ups for weight loss and seeking change in both physical activity and eating behavior simultaneously may provide a better indication of the efficacy of these interventions on weight loss. Another possible influence is the measures used to tap physical activity. Participants could have overestimated their self-reported levels of physical activity, and, thus, adoption of objective measures of energy expenditure in future research would provide estimates of physical activity that were free of response bias [START_REF] Jakicic | Accuracy of self-reported exercise and the relationship with weight loss in overweight women[END_REF]. A further explanation may lie in the primary focus of the interventions: nine trials focused exclusively on eating behavior and only three focused on weight loss as the primary outcome. Findings for BMI should be treated as preliminary given the considerable heterogeneity in the effect sizes and few trials measured weight-loss at follow-up more than 6 months postintervention, and further investigations are needed. Our meta-regression analyses showed that (1) follow-up distance from post-intervention was the most predictive design characteristic for weight loss and (2) that differences in intervention type was fully responsible for high heterogeneity in the results. These results suggest that longer follow-up distances are associated with greater weight loss following mindfulness training. This tallies with our previous point that it takes time for behavioral changes to be manifested in changes in weight. It also indicates the need for researchers to adopt appropriate intervention type (i.e., behavioral instead of non-behavioral) to test the effects of mindfulness-based interventions.

Furthermore, only three trials assessed mindfulness skills at baseline and postintervention, and, contrary to expectations, our findings suggest a decrease in mindfulness skills as a result of mindfulness training. Baseline scores of mindfulness skills in participants could explain the reverse effect of mindfulness training on mindfulness skills in the included trials. In fact, participants in both intervention and control groups appeared to report high levels of mindfulness skills prior to the beginning of the intervention. Meta-analytic evidence of the effectiveness of mindfulness training on mindfulness skills in clinical and non-clinical samples of participants revealed that training should increase skills [START_REF] Quaglia | Meta-analytic evidence for effects of mindfulness training on dimensions of self-reported dispositional mindfulness[END_REF]; making the results of the present meta-analysis suggest that individuals with excess weight may benefit most from mindfulness training. Moreover, the use of self-report measures of mindfulness skills has been questioned and strongly criticized in the literature [START_REF] Grossman | Defining mindfulness by how poorly I think I pay attention during everyday awareness and other intractable problems for psychology's (re)invention of mindfulness: Comment on Brown et al[END_REF] in so far as these measures do not report on actual skills developed in mindfulness training programs. Recent efforts from research teams showed that breath counting during meditation sessions was associated with higher mindfulness skills and could be considered in future investigations as a behavioral measure of mindfulness skills [START_REF] Levinson | A mind you can count on: Validating breath counting as a behavioral measure of mindfulness[END_REF]. Furthermore, measures of effortless attention could also be included as a biomarker of mindfulness practice for experienced meditators [START_REF] Tanaka | Effortless attention as a biomarker for experienced mindfulness practitioners[END_REF].

In addition, selection bias was assessed as 'high' in the majority of the included studies. Methods for recruiting participants in psychological interventions need to be reviewed in studies on patients with overweight and obesity to limit the effects of prior motivation to participate in such interventions. Selection bias has been observed in many studies (e.g., [START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Fletcher | A mindfulness and acceptance-based intervention for increasing physical activity and reducing obesity[END_REF]) and presents a considerable challenge to research in healthrelated behavioral interventions that consistently relies on self-nomination of eligible individuals when it comes to recruitment to RCTs. Previous investigations of patients' motivation to attend weight loss interventions showed that (1) even if referred by their general practitioner, the majority of individuals with obesity are unlikely to schedule an appointment in a weight management clinic [START_REF] Brook | Predictors of attendance at an obesity clinic and subsequent weight change[END_REF], and (2) patients' motivation to attend a treatment is the best predictor of weight loss and weight-loss maintenance following weight-loss interventions [START_REF] Willams | Motivational predictors of weight loss and weight-loss maintenance[END_REF]. Systematic baseline assessment of prior intentions or motivation to participate in psychological interventions could be a strategy to control selection bias, as well as a potential moderator or mediator of the observed effect. Moreover, avoiding compensation for participation could also limit the effects of extrinsic motivation to enter psychological interventions. These two main biases could have affected adherence to interventions, which raises questions regarding the efficacy of mindfulness-based training in patients who did not self-select to participate in the trials. However, such biases exist in interventions that are administered to the community, outside the scope of a research study, so the potential confounding effect of selection bias in included studies may not affect the translation to clinical effectiveness of mindfulness training. Moreover, the majority of participants in studies included in this review were women. This finding is consistent with previous investigations showing that women tend to be more interested and motivated to engage in mindfulness-based interventions, and, as a consequence, they are more likely to respond to such treatment programs than men [START_REF] Greeson | Decreased symptoms of depression after Mindfulness-Based Stress Reduction: Potential moderating effects of religiosity, spirituality, trait mindfulness, sex, and age[END_REF][START_REF] Katz | A systematic review of gender differences in the effectiveness of mindfulness-based treatments for substance use disorders[END_REF].

The current analysis has several strengths. First, the adoption of meta-analytic techniques provides precise estimates of the effects of mindfulness training than systematic reviews that rely on 'vote-counts' of statistical significance of individual findings and do not statistically correct for methodological artifacts like sampling error. Second, the systematic literature search and strict selection criteria aimed to retrieve all relevant studies testing the effects of mindfulness training in individuals with overweight and obesity on weight loss, impulsive eating, binge eating, and physical activity levels. Moreover, the results of our metaanalysis are in accordance with previous reviews that aimed at investigating the effects of mindfulness-and acceptance-based interventions on obesity-related disordered eating and weight changes in individuals with overweight and obesity [START_REF] Godfrey | Mindfulness-based interventions for binge eating: A systematic review and meta-analysis[END_REF][START_REF] Godsey | The role of mindfulness based interventions in the treatment of obesity and eating disorders: An integrative review[END_REF][START_REF] Katterman | Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: A systematic review[END_REF][START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF]. The choice to include measures of energy intake as well as energy expenditure was made to better understand the role of mindfulness in weight loss, arguing that mindfulness training could impact healthrelated behaviors leading to a reduction in BMI. Furthermore, we chose to include studies in that included all forms of mindfulness training, while previous reviews (except [START_REF] O'reilly | Mindfulness-based interventions for obesity-related eating behaviours: A literature review[END_REF]) focused on separate conceptualizations of mindfulness-and acceptance-based interventions. In addition, meta-regression allowed us to identify the characteristics of included studies that might influence the size of intervention effect or its statistical heterogeneity. While nonbehavioral mindfulness-based interventions (e.g., MB-EAT) showed no effect on binge eating [START_REF] Kristeller | Mindfulness-Based Eating Awareness Training (MB-EAT) for binge eating: A randomized clinical trial[END_REF][START_REF] Blevins | Mindfulness meditation as an intervention for body image and weight management in college women: A pilot study[END_REF][START_REF] Mciver | Yoga as a treatment for binge eating disorder: A preliminary study[END_REF], our analysis showed that behavioral interventions (e.g., ACT) seem to reduce binge eating [START_REF] Masson | A randomized wait-list controlled pilot study of dialectical behaviour therapy guided self-help for binge eating disorder[END_REF][START_REF] Weineland | Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT[END_REF] (see Table 3).

A number of limitations of our analysis should be noted. First, we identified substantive between-study heterogeneity for many of the effects in the current analysis. The heterogeneity points to the likely presence of extraneous moderating variables likely influencing effect sizes. We specified numerous candidate moderating variables of mindfulness training effects including differences between mindfulness techniques and methodology, baseline characteristics of the participants, and intervention duration. We attempted to resolve heterogeneity across studies by conducting meta-regression analyses of the candidate moderators. Future meta-analyses in this field should conduct subgroup analyses based on these candidate moderators when sufficient effect sizes are available. Second, the likely presence of publication bias should be considered a limitation in the current review as we only considered published trials in our inclusion criteria. It must, however, be stressed that examination of the asymmetry in funnel plots did not indicate small-study bias, often interpreted as publication bias i.e. the tendency for studies with effect sizes disproportionate to their sample size to get published. However, the high heterogeneity precluded a formal test of small-study bias using Egger's regression analyses, so we cannot unequivocally rule out the potential for the current effect size to be affected by publication bias. Finally, most of the studies included in the present analysis did not provide sufficient information on allocation concealment, blinding of participants and personnel, blinding of outcome assessment, and imputation of missing data. Future studies testing mindfulness training in individuals with overweight and obesity should report these important design and analytic procedures.

In conclusion, the present study suggests that mindfulness training shows promise in reducing impulsive eating and binge eating, and increasing physical activity levels among adults with overweight and obesity. Including individuals with poor mindfulness skills and impulsive and binge eaters in the trials would provide better evidence as to the effectiveness of mindfulness training among individuals with overweight and obesity who have these factors that may particularly predispose to having extreme difficulties when managing their weight. Future investigations in this field should focus on the role of mindfulness skills on eating outcomes as well as physical activity levels. A priority for future research is to provide better data on the long-term impact of mindfulness training on weight loss. Furthermore, adherence to the mindfulness training should be measured and clearly stated in future investigations.

Fig 1 .

 1 Fig 1. Flow diagram for the selection of studies. 2.2. Data extractionFirst, titles and abstracts were screened to identify potentially eligible studies. Second, full texts of all potentially relevant articles were investigated. Two authors independently screened the articles to identify studies that met inclusion criteria, and conflicts of opinion were discussed with a third author until consensus was reached. Using a standardized data extraction form, two independent investigators extracted and tabulated all data with any disagreements resolved by discussion among the investigators, or, if required, by a third party. When necessary, the primary authors of the trials were contacted for additional information. Data extracted from the studies and study characteristics are available in Table1.

Fig 2 . 3 . 3 . 2 .

 2332 Fig 2. Forest plot of comparison: BMI change from baseline to post-intervention. 3.3.2. Secondary outcomes.3.3.2.1. Impulsive eating.Overall, post-intervention impulsive eating was statistically significantly lower in the intervention groups than in the control groups (p < .01) (see Table3). Moreover, mindfulness training significantly reduced impulsive eating from baseline to post-intervention in the intervention groups (d = -1.15; 95% CI -1.91; -.38; p < .01)1 . These results show that the effects of mindfulness training on impulsive eating are statistically significant and large in the included studies (i.e., d > .80)[START_REF] Cohen | Statistical power analysis for the behavioral sciences[END_REF]. Assessment of heterogeneity showed statistically significant substantial-to-high heterogeneity among the trials (p < .001). Maximum likelihood meta-regression of covariates showed that the differences in study designs (i.e., following two criteria called moderators) were responsible for substantial-to-high statistical heterogeneity between studies. The model predicting impulsive eating with two moderators (focus of intervention and participants' condition) explained 18.34% of initial heterogeneity (τ 2 = 0.93;

Table 1 . Characteristics of the included studies.

 1

			Participants						Assessment
	Study ID	N (%women)	Mean (SD) BMI	Mean (SD) age	Condition	Intervention	Focus of the intervention	Control group	Assessments	times (from baseline)	Main findings
	Alberts 2010	19	31.3	51.9	Patients with	Manual based mindfulness	Eating behaviors	Exercise and dietary	Weight: BMI	Baseline	Participants in the
		(90%)	(4.1)	(12.8)	overweight	intervention for food		counselling (10	IE: G-FCQ-T	7 weeks	mindfulness-based
					and obesity	craving (7 weeks): weekly		weeks)	BE: none		intervention for food
					recruited in a	group sessions, daily 1.5h			PA: none		craving reported lower food
					community	homework, exercise and			Mindfulness: none		cravings compared to
					centre	dietary counselling (10					participants in the control
						weeks)					group.
	Blevins 2009	41	29.6	20.7	Students with	MBSR (8 weeks): weekly	Eating behaviors	Standard behavioral	Weight: BMI	Baseline	Standard behavioral
		(100%)	(1.9)	(1.4)	overweight	group sessions (2h), daily		treatment (8 weeks):	IE: none	8 weeks	treatment plus mindfulness
					and obesity	45min homework, eating		weekly group	BE: QEWP-R	5 months	training did not produce
						components, physical		sessions (2h),	PA: none		greater improvements than
						activity recommendation,		homework	Mindfulness: none		standard behavioral
						standard behavioral					treatment alone.
						treatment
	Daubenmier	47	31.4	40.8	Individuals	Adapted MBSR (MB-	Eating behaviors	Wait-list, nutrition	Weight: BMI	Baseline	Decreased levels of
	2012	(100%)	(4.8)	(NA)	with	EAT, 4 months): weekly		and exercise	IE: none	4 months	restriction, and fat and
					overweight	group sessions (2.5h), daily		information (2h)	BE: none		glucose intake were
					and obesity	30min homework, nutrition			PA: none		associated with increased
						and exercise information			Mindfulness: none		telomerase activity in the
						(2h)					mindfulness training group.

Body mass index (BMI) is expressed in kg/m 2 . SD: standard deviation. NA: not available. BED: binge eating disorder. ACT: acceptance and commitment therapy. DBT: dialectical behavioural therapy. MBSR: mindfulness-based stress reduction. MB-EAT: mindfulness-based eating awareness training. TAU: treatment as usual. IE: impulsive eating. BE: binge eating. PA: physical activity. G-FCQ-T: general food craving questionnaire-trait. TFEQ: three-factor eating questionnaire. QEWP-R: questionnaire of eating and weight patterns-revised. BES: binge eating scale. SBEQ: subjective binge eating questionnaire. PPAQ: Paffenbarger physical activity questionnaire. IPAQ: international physical activity questionnaire. MPAQ: modifiable physical activity questionnaire. MAAS: mindful attention awareness scale. AAQ-II: acceptance and action questionnaire-II.

Table 4 . Meta-regression analyses predicting outcomes with candidate moderators.

 4

	Outcome	Moderator	Groups	d	95% CI	Number of studies	Number of participants (in intervention group)	Inter-study heterogeneity (I 2 statistic)
	Impulsive eating			-1.13*	(-1.93 to -.33)	4	227 (120)	85%
		Type of intervention	Non-behavioral	NA	NA	4	NA	NA
			Behavioral	NA	NA	0	NA	NA
		Focus of the intervention	Eating behaviors	-1.49*	(-2.66 to -.31)	3	179 (96)	89%
			Weight loss	-.49	(-1.07 to .08)	1	48 (24)	NA
		Intervention duration	< 3 months	-1.49*	(-2.66 to -.31)	3	179 (96)	89%
			> 3 months	-.49	(-1.07 to .08)	1	48 (24)	NA
		Participants' condition	Non-binge eaters	-1.20*	(-2.31 to -.08)	3	162 (81)	87%
			Binge eaters	-1.20*	(-1.74 to -.66)	1	65 (39)	NA
		Follow-up distance	< 3 months	-2.00	(-5.30 to 1.29)	2	114 (57)	94%
			> 3 months	-.85*	(-1.55 to -.16)	2	113 (63)	68%
	Binge eating			-.90*	(-1.52 to -.28)	5	231 (121)	79%
		Type of intervention	Non-behavioral	-.95	(-2.09 to .20)	3	138 (76)	88%
			Behavioral	-.79*	(-1.22 to -.37)	2	93 (45)	0%
		Focus of the intervention	Eating behaviors	NA	NA	5	NA	NA
			Weight loss	NA	NA	0	NA	NA
		Intervention duration	< 3 months	-.93*	(-1.76 to -.10)	4	171 (91)	83%
			> 3 months	-.77*	(-1.30 to-.25)	1	60 (30)	NA
		Participants' condition	Non-binge eaters	-.24	(-1.43 to .96)	2	56 (27)	79%
			Binge eaters	-1.28*	(-1.84 to -.71)	3	175 (94)	65%
		Follow-up distance	< 3 months	-1.33*	(-2.24 to -.38)	2	83 (40)	72%
			> 3 months	-.63	(-1.51 to .25)	3	148 (81)	83%
	Change in PA level			.42*	(.15 to .69)	4	222 (112)	2%
	Mindfulness skills			-.40*	(-.12 to -.67)	3	204 (100)	0%
	CI: confidence interval. PA: physical activity. NA: not applicable.
	* p < .05.