The benefits of Yoga are many. For someone with an eating disorder, including individuals interested in exploring issues related to food, body image and emotions, these benefits can be a powerful adjunct to psychotherapy and nutrition counseling.
What are the benefits of Yoga for an individual with an eating disorder or disordered eating?
* Delaying of “impulse control,” – through regular Yoga practice, individuals may find themselves in postures that are difficult or awkward. Learning to stay within the poses and work through these postures can help an individual, who feels an urge binge or purge, delay acting on this urge. In our society, there is a natural tendency to want to escape anything that causes psychological or physical discomfort. People tend to escape by overeating, working too much, getting caught up in unhealthy relationships or by drug/alcohol use. In Yoga, individuals are encouraged to observe rather than react to their discomfort by breathing and listening carefully for what his/her body/mind is conveying.
* Individuals learn to tolerate uncomfortable emotional states without running toward food for comfort, for which they truly may not be hungry, or numbing out by turning away from food. When in various Yoga poses, postures are held for a certain length of time while maintaining the breath. Often, individuals tend to want to “run away” from uncomfortable situations. Practicing Yoga can help maintain discipline, help an individual to feel and accept uncomfortable emotions and avoid eating/purging on impulse.
* Individuals begin to enjoy their body for the first time. They start to define their body in terms of “what it can do” versus “what it is.” They learn that they are not mere extensions of their body, but possess beautiful internal qualities.
* For many people, part of maintaining weight maintenance is learning to tune in to the body’s signals of hunger and satiety. For individuals with eating disorders, particularly binge eaters, eating only when hungry and stopping when the body is satisfied will result in the body slowly returning to its natural set point weight. Unfortunately, most people who have attempted to control their weight through dieting are fearful of allowing themselves to decide when and how much to eat. Yoga can help those with eating disorders trust their body and understand the messages given to them by their own body.
* The physical discomfort of overeating and under eating becomes more obvious as greater awareness learned in the regular practice of Yoga makes all sensations more apparent. This can make it easier for eating disordered patients to choose to stop eating before the point of physical discomfort as well as honor hunger and nourish the body.
* Mindful awareness, which emphasizes “observing” vs. “reacting” to daily stresses in life. When one becomes stressed, they tend to hyperventilate causing stress hormones to elevate, insulin and blood sugar to rise throwing your body into fat storage mode. Dr. Herbert Benson, from Harvard Medical School, studied the relaxation response when one breathes deeply using the diaphragm vs. the chest. Dr. Benson showed that deep diaphragmatic breathing lowered blood pressure and heart rate in his subjects. In a relaxed state, insulin and blood glucose levels are stable allowing the body to burn calories for energy versus store them as fat around the abdomen.
* Yoga also emphasizes mindful eating. Individuals learn to experience the taste, texture, and other sensual qualities of food and to pay attention to what and how much they are eating. They also learn to rely on their higher wisdom and intuition to make decisions about food and daily life decisions.
* Staying present is another important concept learned in Yoga, where as the mind starts to wander, individuals are taught to draw their attention back to the breath. Poses are also meant to be enjoyable, thus teaching the individual with an eating disorder how to engage into life and “let go” of whatever they are holding on to that is hindering them from moving forward in life.
* Yoga students are taught to look inward and focus on inner qualities versus the body’s outward appearance. Students are encouraged to let go of competition with themselves and others. Yoga teaches self-acceptance in this way.
Regular attendance at a Yoga class is encouraged, which gives eating disordered individuals a chance to become part of a community and make sorely need connections. Yoga becomes part of daily maintenance during recovery and indefinitely. The regular practice of Yoga becomes part of self-care just like brushing one’s teeth.
What type of Yoga should an individual with an eating disorder or disordered eating practice?
Depending on the nature of their eating disorder, the type of Yoga that an individual should practice needs to be discussed with the treatment team, which includes the medical doctor, psychiatrist, psychotherapist and registered dietitian. An individual who is not yet weight restored or one who is purging (bulimic) needs to start with a gentle or “slow flow” and progress to a level that the team is comfortable with. Ashtanga, Vinyasa or more cardio-intensive Yoga may be more suited for someone trying to lose weight, but is not purging. However, in any class, students are taught to “find their edge” meaning working at a pace of intensity that is not too extreme where breathing is compromised, but also challenging themselves and taking balanced risks. This is an important concept in life as individuals begin to “take their Yoga off the mat” and find their edge in everyday life. Participation in any Yoga pose is voluntary, therefore a class of any intensity can be modified to suit the needs of an eating disordered patient on any given day.
Extremely high temperatures in the classroom may be contraindicated for the anorexic individual. Emphasis should be placed on breath and movement vs. how a student looks in the poses. It is important that a recovering individual does not use the Yoga as form of exercise “work-out” or purging mechanism as many Yoga studios have “westernized” Yoga making it a form of aerobics and compromising the integrity of this ancient teaching.
How does an individual with an eating disorder choose a teacher/studio?
Choosing a teacher is somewhat like choosing a psychotherapist or registered dietitian. Individuals need to consider whether or not they like the teacher and feel comfortable in their presence. The teacher should do minimal modeling or demonstrating during class while giving clear and simple directions so that the student can follow. The teacher should be skilled in listening to their students’ breath, which gives them an understanding of what the student is experiencing during that particular Yoga practice.
Students must be able to tell the teacher if they don’t want to be touched/adjusted in Yoga class, especially if they have a history of sexual abuse, which often goes hand in hand with eating disorders. This requires a good rapport and a degree of trust with the teacher, who must have a certain capacity for understanding and compassion. A teacher with a soothing voice but is also enthusiastic and positive is a plus. Also, the teacher should offer support and encouragement to people who are learning unfamiliar ways, while avoiding criticism or judgment.
Individuals with eating disorders need to talk to others who take classes at certain studios, try different teachers or even interview potential teachers. Yoga teachers and studios who tend to get caught up in their own issues and unload them on their students, or try to profess to have training in an area that they do not understand from a treatment standpoint should be avoided by someone with an eating disorder. This can be very dangerous to an individual in recovery, leaving this teacher or studio with serious liability. Yoga teachers who find individuals with eating disorders in their classes, should make appropriate referrals to psychotherapists or registered dietitians who are credentialed and trained at accredited institutions, but also have specialized training in eating disorders. Students should not be afraid to ask the teacher their education and training beyond just Yoga.
In our Reconnect with Food ® weekly series program, a total of 51 eating disordered individual enrolled in a seven week series, that incorporated one hour of Hatha Yoga plus one hour of mindfulness based training and discussion. After seven weeks, subjects reported that they began to tap into and feel their emotions on a deeper level, relate their Yoga practice to food behaviors, work through uncomfortable asanas to let go of fears and move outside their comfort zone, experience their body and allow change to take place, experience self-love and self-acceptance, while sharing their experiences with others. It was concluded that Yoga can help the individual, with an eating disorder, delay impulse control, enjoy their body, learn to eat mindfully while recognizing sensations of hunger and fullness, heal negative body image and fostering self-acceptance, along with avoiding the use of food or starvation to numb painful emotions. In a four-week program, 49 eating disordered individuals experienced similar benefits, but not as great as those enrolled in the longer program.
After just one week in our Reconnect with Food Intensive Support Program, participants improved coping skills and began to practice mindful eating and awareness, while beginning to think about food and their bodies in a healthy way. Participants also experienced a positive synergy with Yoga, meditation, art and music therapy, craniosacral therapy, recreational challenges and psychodrama in opening doors to their recovery. Participants valued the significant connections that they made with others.
Further studies are warranted to understand the mechanics of Yoga and how Yoga can help the patient release emotions locked in the brain in order to help the psychotherapist, registered dietitian and physician to break through barriers.
About the Author:
Beverly Price is a registered dietitian, exercise physiologist and registered Yoga teacher who specializes in the treatment of anorexia and bulimia nervosa, binge and compulsive eating along with adult, adolescent and childhood weight management. She holds a Bachelor’s Degree in Dietetics from Michigan State University, emphasizing the Science of Human Nutrition and Medical Nutrition Therapy. She holds a Master’s Degree in the Science of Human Movement from Wayne State University. Beverly has a private practice located in Bingham Farms and Royal Oak, Michigan, or by telephone, where she offers conscious eating for body, mind and spirit along with Yoga therapy. She offers a weekly series along with a weeklong intensive program for eating disorder recovery for those near and far. For more information: prazamana.org and reconnectwithfood.com.
1. Finger W, Arnold ME. Mind-body interventions: Applications for social work practice. Social work in health care 35(4) 57-77, 2002.
2. Gimbel, AM. Yoga, meditation and imagery; clinical applications. Nurse practitioner forum, 9 (4) 243-55, 1989.
3. Long L, Huntley A, Ernst E. Complementary therapies in medicine 9:178-185, 2001.
4. National Institute of Health (NIH), National Center for Complementary and Alternative Medicine (NCCAM). Clinical Trial: Meditation-based treatment for binge eating disorder. Clinical Trials.gov., 2003.
5. Self-Care, Gretchen Rose Newmark, RD, Yoga Journal, March/April 1997 and Hatha Yoga as an Adjunct to Eating Disorders Treatment, Gretchen Rose Newmark, RD, Today’s Dietitian, January 2004.
6. Yoga and Eating Disorders, Marcie Berman, PhD, Yoga World, No. 15, Oct/Dec 2000.