With twenty years of research we have provided scientific evidence that different eating styles are important factors in the development of long-term disordered eating. In addition, we have shown that modifying eating behavior in terms of food intake, regular meal structure, snacking, eating speed and eating rate are effective modalities for preventing overweight. With this understanding we have also developed tools to help achieve weight control goals.
Despite all the technical progress that humans have made, human biology remains the same. We have evolved to work hard for a modest amount of food but today we don´t need to engage in very much physical activity to eat high-energy meals because food is too easily available. When most humans are confronted with good tasting food, they lack the capacity to resist eating to excess; therefore, it is not surprising that two-thirds of Americans are overweight. Our research shows that individuals who become obese cannot sense their body’s normal cues that indicate they are full.
To help us deal with today´s un-biological situation, we need external support to control our bodyweight; the Mandometer device provides that support. The good news is that the Mandometer device can train people to recognize those cues. With this skill set, people can gain total control over their food intake and can thereby control their body weight.
Our research is carried out in close cooperation with the section for Applied Neuroendocrinology at the Karolinska Institutet.
Professor Per Södersten of the Karolinska Institutet is director of the Mando Group research department and is also one of Mando Group’s founders. He and his group have studied how people eat and what happens to their physiology and emotions when eating patterns change. Since restrictive eating behavior may cause psychological disorders, a patient can change their emotional behavior by learning how to eat normally.
His research has led to the development of the Mandometer, the device that facilitates the treatment of patients with disordered eating at the Mando Clinics.
You are How you eat
Today a number of exciting projects are being carried out at the Mando Group research department:
Eight treatment resistent adults (6 females, 2 males) in Primary Care with BMI=36 (28-41) kg/m², were trained during 3 months to eat less, slow down their eating and become more satiated. Four were treated individually and four in a group.
All lost weight, BMI = 34.5 (25.7-40.2) and showed significant clinical improvements. They felt stronger yet did not feel they were dieting.
30 obese adults in 5 Stockholm Primary Care districts are currently treated. They receive 11 visits by an RD, a Mandometer and an Activity Meter.
The Mandolean Weight Loss Treatmen has been tried out in a pilot study of eight children and youths with severe obesity (BMI > 40 kg/m²) at the institution of pediatric endocrinology, Children´s Hospital, University of Bristol, England.
The patients claimed that “they don’t experience that they are dieting or are hungry” and that they have “stopped eating snacks” between meals. The patients eating rate diminishes and they experience satiety at an earlier stage of the meal than before the treatment started. They also feel more self-confidence, meet friends, watch TV less and have increased their physical activity.
Ford et al (BMJ 2010) obtained the following results in a randomized controlled trial with Mandometer of obese children and adolescents (11-17 years) over 12 months:
- Significantly reduced their body weight and to a lower level than that obtained with a standard treatment which had previously been demonstrated to have a significant effect.
- Improved metabolic parameters and significantly more so than the standard of care.
- Reduced food intake and the speed of eating.
The effect on body weight was maintained six months after treatment.
The results are compelling firstly because an increased speed of eating is the likely cause of obesity and secondly, no one has previously reported an effect on body weight in obese patients persists after non-invasive treatment.
Galhardo et al (JCEM 2012) reported that hormones thought to be engaged in hunger, e.g., ghrelin, and satiety, e.g., peptide tyrosine tyrosine, PYY, can be controlled by eating behavior. Thus the obese children and adolescents reported by Ford et al (2010) were examined at admission and at discharge, 12 months later.
- At admission, the children assigned to standard treatment or Mandometer had similar levels of ghrelin.
- Those treated with standard care had elevated levels of ghrelin at discharge.
- Those treated with Mandometer had reduced levels of ghrelin at discharge.
- Changes in the levels of PYY were the opposite to those in ghrelin.
These results show firstly that it is possible to control the hormones associated with eating behavior, reducing the speed of eating brings the hormones under control. Secondly, the results brings into question commonly held assumptions about the cause-effect relationship between hormones and eating behavior. The assumption is that an increase in ghrelin causes eating and that an increase in PYY has the opposite effect. The results reported by Galhardo et al (2012) suggest that it’s the other way around.