Efficacy of Mindful Tai Chi on Obese or Overweight Adults: A Randomized Controlled Clinical Trial

Objective: The objective of this protocol is to pilot test the efficacy of a Mindful Tai Chi (MTC) intervention as an integrative approach to facilitate durable weight loss and well-being among sedentary obese and overweight individuals. Numerous interventions for obesity are available but the results are temporary, with most individuals returning to or exceeding their baseline weights. Contrasting with conventional emphases on quantitative weight reduction with factual didactics, exercise and diet, this protocol will focus on enhancing individuals integrative resources utilizing mindfulness principles facilitating changes in self healthcare behaviors. MTC is a combined form of Tai Chi and mindfulness meditation. Tai Chi and mindfulness both have common philosophical underpinnings that address health promotion and well-being. Tai Chi is a gentle moving meditation that fosters individuals body-mind-spiritual integration through specific movements. MTC is a systemic intervention with multidimensional effects on health and well-being that facilitate healthy lifestyle by applying the skill of non-judgmental awareness on a moment-to-moment daily basis. We hypothesize improvements in health and well-being variables of the participants. Study population: Healthy ambulatory volunteers 18 years and older with BMI between 25 and \< 40 will be recruited from the greater Washington area. Exclusion criteria include mental or physical health limitations that impede participation in the treatments or assessment of outcome variables. Design: A randomized controlled clinical trial: comparing the MTC group to an active health education (HE) control group. These groups will participate in the assigned activities in a 90 minute session twice a week for 10 weeks. All groups will be assessed at baseline and upon completion of the treatments at week 10 and at a 2 month follow-up. Outcome measures: The primary outcomes are changes in weight and multiple domains of well-being. BMI and intra-abdominal fat by abdominal ultrasound will measure weight changes. Physical well-being variables include biomarkers (lipid profile, BP, CRP, Leptin, IL 6, and A1C), aerobic fitness from VO(2) max measurement with 6 to 10 minutes of a treadmill test, and telomerase activity in leukocytes. A battery of questionnaires will measure psychological, cognitive-affective, socio-spiritual and overall well-being. Secondary outcomes include mindfulness quality and lifestyle indices.