The Effects of Background Music During Inpatient Meals

The idea of combining music and treatment isn’t new. For example, the Greek philosopher Pythagoras (c. 579-494 BC) prescribed a variety of musical scales and modes to cure a variety of physical and psychological ailments. The ability of music to ease negative moods is well established, and musical interventions are commonly used to soothe negative emotions in various settings, offering both psychological and physiological benefits. Furthermore, existing studies suggest that the particular style of music does not moderate mood during mealtimes, which reinforces the role of music as a potent way to detract patients from food-related concerns.

Dr. Paolo Meneguzzo and colleagues at the Padova Neuroscience Center of the University of Padova, Padua, Italy, recently found that adding background music to meals helped patients with anorexia nervosa, and restrictive or binge-eating disorders (J Eat Disord. 2024.12:7). Fifty-one women with eating disorders were recruited for a study while they were receiving inpatient care in a specialized ward for psycho-nutritional rehabilitation.

Three background music settings

From April to July 2022, general meal planning at the treatment center included six distinct mealtimes, breakfast, lunch, dinner, and three snack sessions, each customized to address specific nutritional rehabilitation needs related to the patient’s diagnosis. From Monday through Friday, three randomized background music conditions were used during lunch and dinner. For the first two weeks and the last two of the study, meal components were constant and identical for all study participants.

Three background music settings were used: (1) no background music; (2) continuous classical music featuring only a piano, termed ‘focus music,’ and (3) a preset pop music playlist. All other variables during mealtimes remained the same, including ward conditions, meal timing, meal planning, communal groups, and the presence of both a nurse and a dietitian. Participants were seated at tables in groups of three or four, and were encouraged to talk among themselves as usual. Dietitians managed individual differences in meal compositions, recording these for subsequent comparisons with participants.

Questionnaires

The participants also completed a series of questionnaires. Before each test meal, information on hunger, satiety, the desire to eat, and Positive and Negative Affect Schedule (PANAS) questionnaire scores were collected using a pencil-and-paper approach. [Note: see later description of the PANAS questionnaire.] Post-meal questionnaires were filled out 5 minutes after the end of the meal. The inpatients were assessed with The Eating Disorder Questionnaire (EDE-Q) and the Panas, a self-report questionnaire featuring two 10-item scales designed to measure positive and negative affect (Pers Soc Psychol. 1988. 54:1063).

Some unexpected aspects of background music

The absence of music led to an increase in uneaten food and in eating rituals during mealtimes. In the no-music, or silent, scenario, Dr. Meneguzzo and colleagues also noted a decrease in the Weight Bias Internalization Scale (WBIS), a self-report questionnaire that measures the degree to which overweight and obese persons internalize negative stereotypes and their own statements about their weight. The authors also reported decreased protein and lipid intake levels among the study participants. The authors pointed out that during nutritional rehabilitation, an appropriate amount of fat and protein is crucial for normal nutrient density, energy, muscle maintenance, hormonal balance, satiety, and brain function (Nutr Clin Prac. 2010. 122).

Indeed, this finding is intriguing, according to the authors, because protein is essential for the synthesis of serotonin and dopamine, neurotransmitters that play a pivotal role in fostering feelings of positivity, motivation, passion, tranquility, and presence. In the same way, lipids are crucial for neural development, nerve cell differentiation, and migration, making them vitally important for proper functioning of the nervous system and for activating reward-related areas in the brain. These findings affirm the role of music as a beneficial environmental distractor for people with eating disorders during mealtimes. The introduction of background music may enhance the overall inpatient treatment experience, creating a more supportive and accommodating atmosphere, particularly during stressful times like mealtimes.