JHSM
Journal of Health Sciences and Medicine

Journal of Health Sciences and Medicine (JHSM) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

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Original Article
Evaluation of the relationship between health literacy and mindful eating in obesity patients
Abstract
Aims: Obesity is a multifactorial chronic disease and is a significant cause of morbidity and mortality when left untreated. Preventive health services play a substantial role in the fight against diseases that can cause a global crisis such as obesity. The primary goal of preventive health services in obesity is to ensure that people acquire healthy eating habits. It has been shown that factors such as maladaptive social attitudes, emotional eating have a significant effect on mindful eating. Health literacy and mindful eating are essential concepts in developing healthy eating habits. In this study, we aim to measure the health literacy levels of obese individuals, evaluate their mindful eating, and reveal whether there is any relationship between them.
Methods: The study consists of obese patients who were eligible and applied to Ankara Etlik City Hospital Obesity Center between August-December 2024. The individuals who gave their consent were given a form that evaluated their socio-demographic information, the Turkish Health Literacy Survey-32 (THLS-32) and the Mindful Eating Questionnaire (MEQ) and mental status examinations were conducted through face-to-face interviews by two psychiatrists in accordance with DSM-5 diagnostic criteria. Individuals under the age of 18 and those with conditions that could impair judgment were excluded from the study. With regard to eating disorders, participants were likewise evaluated by the interviewers based on DSM-5 diagnostic criteria.
Results: A total of 232 obese individuals were included in the study (191 female, 41 male). When the health literacy scores were examined, 3.0% (n=7) were inadequate (0-25), 23.7% (n=55) were problematic-limited (26-33), 47.8% (n=111) were sufficient (34-42), 24.6% (n=57) were excellent (43-50), and the general mindful eating scores were 2.90±0.541. When the relationship between health literacy and mindful eating is examined, it is seen that there is a positive (r=0.157) significant relationship at general score (r=0.146), treatment and service score (r=0.137), disease prevention and health promotion - access to health related-information (r=0.167), disease prevention and health promotion - understanding health related information (r=0.141), access to health-related information (r=0.154) and understanding health related-information (r=0.157).
Conclusion: Obesity treatment requires a multidimensional approach. For this process to be practical, many factors, such as healthy diet, physical activity, psychological support, and increasing health literacy, should be considered together. Healthy diet is an integral part of this multidimensional approach. Determining the psychological and individual factors associated with obesity, determining these factors, and increasing health literacy with dietary education and awareness-based practices can contribute to a more efficient, permanent, and sustainable weight loss process for obese patients.

Keywords : Obesity, health literacy, mindfulness, disordered eating behavior

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1. GBD 2021 Obesity Collaborators. Global, regional, and national burden of disease attributable to high body-mass index in 204 countries and territories, 1990-2021: a systematic analysis. Lancet. 2024;403(10428): 1015-1034. doi:10.1016/S0140-6736(24)00411-2
2. Wolever RQ, Best JL. Mindfulness-based approaches to eating disorders. In: Didonna F, editor. Clinical handbook of mindfulness. New York: Springer; 2009. p. 259-287.
3. Zavala GA, Ainscough TS, Jimenez-Moreno AC. Barriers to a healthy diet and physical activity in Mexican adults: results from the Mexican Health and Nutrition Survey. Nutr Bull. 2022;47(3):298-306. doi:10.1111/nbu.12568
4. Soylar P, Kadıoğlu BU. Yetişkin bireylerin sağlık okuryazarlığı ve obeziteyle ilişkili bazı davranışlarının incelenmesi. Sak Tıp Derg. 2020; 10(2):270-276. doi:10.31832/smj.700979
5. Çın A, Akkan T, Dağdeviren M, et al. Valuation of the relationship of health literacy and healthy eating attitude in obesity. Turk J Fam Pract. 2022;26(4):154-163. doi:10.54308/tahd.2022.42104
6. Vidgen HA, Gallegos D. Defining food literacy and its components. Appetite. 2014;76:50-59. doi:10.1016/j.appet.2014.01.010
7. Yilmazel G, Çetinkaya F. Relation between health literacy levels, hypertension awareness and control among primary-secondary school teachers in Turkiye. AIMS Public Health. 2017;4(4):314-325. doi:10.3934/publichealth.2017.4.314
8. Speirs KE, Messina LA, Munger AL, Grutzmacher SK. Health literacy and nutrition behaviors among low-income adults. J Health Care Poor Underserved. 2012;23(3):1082-1091. doi:10.1353/hpu.2012.0113
9. Bandura A. Self-efficacy: The exercise of control. New York: W H Freeman/Times Books/Henry Holt & Co; 1997.
10. von Wagner C, Knight K, Steptoe A, Wardle J. Functional health literacy and health-promoting behaviour in a national sample of British adults. J Epidemiol Community Health. 2007;61(12):1086-1090. doi:10.1136/jech. 2006.053967
11. Nakamura T, Akamatsu R, Yoshiike N. Mindful eating proficiency and healthy eating literacy among Japanese mothers: associations with their own and their children’s eating behavior. Nutrients. 2021;13(12):4439. doi:10.3390/nu13124439
12. Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant of health. Annu Rev Public Health. 2021;42:159-173.
13. Sørensen K, Pelikan JM, Röthlin F, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015;25(6):1053-1058. doi:10.1093/eurpub/ckv043
14. Okyay P, Abacıgil T. Türkiye sağlık okuryazarlığı ölçekleri güvenilirlik ve geçerlilik çalışması. T.C. Sağlık Bakanlığı; 2016. Accessed October 2, 2024. Available from: https://ekutuphane.saglik.gov.tr/Yayin/530
15. Framson C, Kristal AR, Schenk JM, et al. Development and validation of the mindful eating questionnaire. J Am Diet Assoc. 2009;109(8):1439-1444. doi:10.1016/j.jada.2009.05.006
16. Köse G, Tayfur M, Birincioğlu I, et al. Adaptation study of the mindful eating questionnaire (MEQ) into Turkish. J Cogn-Behav Psychother Res. 2016;1. doi:10.5455/JCBPR.250644
17. Stroebele-Benschop N, Damms-Machado A, Milan F, et al. Gender differences in the outcome of obesity treatments and weight loss maintenance: a systematic review. J Obes Weight Loss Ther. 2013;3:1-11. doi:10.4172/2165-7904.1000176
18. Tiwari A, Balasundaram P. Public health considerations regarding obesity. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025.
19. van Strien T. Causes of emotional eating and matched treatment of obesity. Curr Diab Rep. 2018;18(6):35. doi:10.1007/s11892-018-1000-x
20. Zervos K, Koletsi M, Mantzios M, et al. An eight-week mindful eating program applied in a Mediterranean population with overweight or obesity: the EATT intervention study. Psychol Rep. 2022;125(2):1011-1040. doi:10.1177/0033294120988104
21. Karaca V, Rakıcıoğlu N. Yetişkinlerde yeme farkındalığı, beslenme bilgi düzeyi ve antropometrik ölçümlerin değerlendirilmesi. HÜ Sağlık Bil Fak Derg. 2024;11(3):671-689. doi:10.21020/husbfd.1443850
22. Barışkan H, Karakoç Kumsar A. Sağlık bilimleri fakültesi öğrencilerinde abdominal obezite sıklığı ve yeme farkındalık düzeyleri. Koç Üniv Hemş Eği Araş Derg. 2020;17(2):162-169. doi:10.5222/HEAD.2020.44452
23. Köse G. Üniversite öğrencilerinin yeme farkındalığının üzerine bir araştırma [doktora tezi]. Ankara: Başkent Üniversitesi Sağlık Bilimleri Enstitüsü; 2017.
24. Mason AE, Jhaveri K, Cohn M, et al. A pilot randomized trial of a mindful eating intervention targeting consumption of sugar-sweetened beverages. Obesity. 2020;28(6):1100-1106.
25. Hamurcu P, Taş D. Sağlık çalışanlarında yeme farkındalığı düzeyinin belirlenmesi: Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim Araştırma Hastanesi örneği. Batı Karadeniz Tıp Derg. 2022;6(1):96-105. doi:10.29058/mjwbs.1030982
26. Kristeller JL, Wolever RQ. Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Eat Disord. 2011;19(1):49-61.
27. Tapper K, Shaw C, Ilsley J, et al. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite. 2009;52(2):396-404. doi:10.1016/j.appet.2008.11.012
28. Kao TSA, Wei CN, Chen ML, et al. Effects of mindfulness-based interventions on obesogenic eating behaviors: a systematic review and meta-analysis. Obes Rev. 2025;26(3):e13860. doi:10.1111/obr.13860
29. Kausman R, Polivy J. If not dieting, then what? Psychol Today. 2018;51(1): 42-48.
30. Kim H, Xie B. Health literacy in the eHealth era: a systematic review of the literature. Patient Educ Couns. 2022;105(6):1076-1087.
31. Özkan S, Dikmen AT, Hakan K, et al. Prevalence and determiners of health literacy in Turkiye. Turk Sağl Okuryazar Derg. 2020;1:27-39. doi: 10.54247/SOYD.2020.3
32. Kaya M, Yılmaz Ö. Bireysel özellikler, sağlık okuryazarlığı ve genel sağlık durumu arasındaki ilişki. MAKÜ SOBED. 2020;33:113-122. doi: 10.20875/makusobed.820452
33. Sala M, Shankar Ram S, Vanzhula IA, Levinson CA. Mindfulness and eating disorder psychopathology: a meta-analysis. Int J Eat Disord. 2020;53(6):834-851. doi:10.1002/eat.23247
34. Treasure J, Schmidt U, Macdonald P. The clinician&rsquo;s guide to collaborative caring in eating disorders: the new Maudsley method. 2<sup>nd</sup> ed. London: Routledge; 2020.
35. Kickbusch I, Pelikan JM, Apfel F, Tsouros AD. Health literacy: the solid facts. Copenhagen: WHO Regional Office for Europe; 2013.
36. Chen X, Hay JL, Waters EA, et al. Health literacy and use and trust in health information. J Health Commun. 2021;26(12):911-920. doi:10.1080/ 10810730.2018.1511658
37. Carbone ET, Zoellner JM. Nutrition and health literacy: a systematic review to inform nutrition research and practice. J Acad Nutr Diet. 2012; 112(2):254-265. doi:10.1016/j.jada.2011.08.042 </ol> </div> <p>
Article available in :
Volume 8, Issue 3, 2025
Page : 514-523
https://doi.org/10.32322/jhsm.1660252
Article Information
Received : 18 Mar 2025
Accepted : 27 May 2025
Published : 30 May 2025
Corresponding Author :

Şule Bıçakcı Ay: Department of Psychiatry, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Koçyiğit Y, Bıçakcı Ay Ş, Demirel GK, Eriş Davut Ö. Evaluation of the relationship between health literacy and mindful eating in obesity patients. J Health Sci Med. 2025;8(3):514-523.

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