Enhancing Interoceptive Awareness Through a Digital Mindfulness Intervention: Evidence from a Real-World Population

(ERN) app is a digital MBI targeting craving-related eating through mindfulness training. While ERN has previously been shown to reduce craving-related eating, the mechanisms underlying its effects, particularly the role of interoceptive awareness-the conscious perception of internal bodily signals such as hunger, satiety, and muscular tension, and the capacity to use these signals to guide behavior-remain understudied. Interoceptive awareness is the ability to identify, understand, and respond to internal bodily signals. To examine whether engagement with the ERN app is associated with changes in interoceptive awareness in a real-world sample, a total of 3,469 users completed three subscales of the Multidimensional Assessment of Interoceptive Awareness (MAIA), a self-report measure of interoceptive awareness, every 7 days throughout app usage, including the capacity to attend to uncomfortable bodily sensations without avoidance (Not Distracting), to actively listen to bodily signals (Body Listening), and to trust the body as a source of reliable information (Trusting). App usage metrics were extracted, including core module completion, mindfulness exercises, tool use, community engagement, and latency between assessments. Tobit regression models and two-part models were utilized to assess the relationship between app engagement and follow-up MAIA scores. Engagement with ERN app was associated with greater interoceptive awareness across subscales. Increased latency between assessments was negatively associated with Not Distracting. App community engagement was not significantly associated with interoception. These findings suggest that interoceptive awareness may be a mechanism through which digital mindfulness interventions support healthier eating behaviors.