Yoga Therapy: yoga for eating disorders recovery
Ancient Ayurveda and yoga texts highlight the importance of a healthy and balanced diet; however, eating disorders are very common even in the yoga world.
There are tons of photos on social media portraying thin women performing yoga asanas.
Unfortunately, this wrong image of yoga doesn’t have nothing in common with the real teachings of yoga. It actually let people think that to practice yoga, they must be like those shown on social media.
This way yoga practitioners feel the pressure to be slim, but also strong, and flexible. They are critiquing their bodies with unattainable ideals.
As psychologist Bo Forbes said to Yoga Journal:
“Many yogini have drawn to yoga as a means of self-care; they instead may find reinforcement for dangerous weight-control behaviours in a studio culture that increasingly celebrates thinness, flexibility, and perfection of the form.”
“Mitahram vina yastu yogarambham tu karyet
Nanarogo bhavetasya kinchidhyogo na sidhyati”
He who begins the practice of yoga without controlling his diet suffers from many diseases and does not make progress
When food is an enemy
One of the most common psychological/psychosomatic disorders that cause many problems for physical health, mental functioning, and quality of life.
They affect the way a person sees themselves. A wrong attitude towards weight, unhealthy eating habits, obsession with body image, and wrong shape image perception result in fear of gaining weight.
The causes of eating disorders are still not completely identified, and treating them is difficult because many patients have no desire to use the available treatments.
The diagnostic system recognises six feeding disorders:
- bulimia nervosa
- anorexia nervosa
- rumination disorder
- avoidant-restrictive food intake disorder
- binge eating disorder
Here are some numbers to give you an idea of how serious these disorders are:
- Anorexia has the highest mortality rate of any other mental illness.
- Almost 60% of people with anorexia also suffer from depression and anxiety.
- 85-95% of anorexia patients are women; 15-20% are men
- Lifetime prevalence of anorexia nervosa for females ranges from 0.3%-1.5% and for males ranges from 0.1%-0.5%
- The mortality rate associated with eating disorders is 12 times higher than the rate of all causes of death, for women from 15 to 24 years old.
- 20% of male individuals have anorexia nervosa.
- Males are at a higher risk of dying because they are often diagnosed later, in part because of the assumption they haven’t the illness.
What is the most common eating disorder?
While for many of us, to have a meal is bliss, for some others is a nightmare.
Anorexia nervosa is the most common among eating disorders.
Anorexia is a psychiatric illness characterised by weight loss and difficulties maintaining an appropriate body weight for height, age, and stature.
People with anorexia generally restrict the number of calories and the types of food they eat and have a distorted body image.
In other words, anorexia is self-starvation and resistance against having a minimum weight.
Cause and symptoms
Anorexia, bulimia etc are under-researched, there is a lot of uncertainty regarding their physiology, cause, treatments, and management.
What causes anorexia is unknown. There are many factors that can increase the risk of developing anorexia. These factors can be genetic, biological, psychological and environmental.
For sure, a low body mass index, self-induced vomiting, and laxative abuse have been identified as predictors factors outcome in anorexia.
According to research and studies at the Center for Eating Disorders at Columbia University Medical Center, the number 1 risk factor for developing anorexia nervosa is the change in weight.
The presence of dieting is potentially contributing to the development of this disease.
If an individual is not vulnerable to this disease at its normal weight, for some reason, when she/he goes under a diet- perhaps, because related to cultural pressures- the individual is going to cross a threshold that brings out the vulnerability to the illness.
Symptoms of anorexia nervosa range from:
- physical symptoms – include fatigue, dizziness, rapid weight loss
- behaviour symptoms – from the severe restriction of food to extreme dieting, over-exercising, and secrecy around food, excessive chewing, denying feeling hungry
- psychological symptoms – include depression, anxiety, distorted body image, low self-esteem, irritability, poor concentration
Other anorexia physical symptoms can be:
- Cold intolerance
- Bloating and fullness after meals
- Thinning of the bones
- Muscle weakness
- Thinning of hair/nails
Social media as risk factor for body image concern
More studies hint at a link between social media and an increased risk of body image concerns.
Wrong dieting practices, cleansing detoxes, promotion of weight loss products and laxatives products can be dangerous for teens’ diet culture.
They create intolerable pressure on women, particularly young ones, on the idea of a perfect body, perfect lifestyle, and having everybody admiring them.
Another research shows the existence of Pro-anorexia websites whose contents have the potential to become a public health threat.
Their members share photos and videos of extremely thin models, which is pushing many teenagers towards unhealthy eating habits, and it reflects the dangerous media trend towards very thin beauty canons.
“Yuktaahaarviharasya yuktachestasya karmasu
Yuktaswapnavbodhasya yogo bhavatidukhah”
(Srimad Bhagvad Gita- 6/17)
He whose food and enjoyment are balanced, whose movements in actions are balanced, whose sleeping and waking is balanced, his yoga becomes eliminator of sorrows.
Yoga therapy for eating disorders and anorexia
Although anorexia nervosa is one of the most severe psychiatric illnesses, with a high mortality rate, advances in treatments have been slow.
Available treatments and their limitations
Treatment plans for this mental illness include psychotherapy, medical care, nutritional monitoring, and counselling.
Currently, there is little evidence on which to base treatment regarding the psychological treatments for this unbalance. There is a desperate need for further research in this area, especially in prevention and motivational enhancement strategies.
Treatment plans include psychotherapy, medical care, nutritional monitoring and counselling.
Typical treatments aim to help those affected to restore their body weight to a healthy level.
To normalise their eating behaviours, by focusing on counter anxiety about consuming a balanced range of foods, of different calorie densities, across regular meals during the day.
Yoga for eating disorders: a holistic treatment
The results of a 2005 study indicated that, in individuals with eating disorders, there’s low focus and awareness of their body and its internal sensations.
Body unawareness can lead to the development of body dissatisfaction, the highest risk factor linked to eating disorders.
Therefore, the promotion of body awareness has particular importance in therapy for individuals with anorexia nervosa, who have a distorted image of their body and low self-esteem.
Yoga creates awareness and teaches to appreciate and honour the body; it cultivates a direct experience of the body, which may be particularly effective in increasing body awareness to counteract body dissatisfaction.
It also reduces anxiety, depression, and the need for over-exercising, very common symptoms found in individuals with anorexia.
To date, there is little empirical evidence regarding the question: how yoga can help these patients and how yogic practices should be applied?
However, recent pilot studies on young women have shown that postures, movements, breathing techniques, meditation, and relaxation were perceived to be highly beneficial.
A significant decrease in depression, anxiety, and body image disturbance was seen as well.
There’s no evidence to show that yoga is an effective primary treatment for such disorders, even though its results are extraordinarily promising as complementary medicine in conjunction with psychological and psychiatric techniques.
Yoga therapy: yoga for eating disorders recovery
Different yoga practices can be used in the treatment and recovery of eating disorders; it should be a gentle approach, though.
Often, people with anorexia practice strenuous exercise because of their fear of gaining weight, and they are not aware of their inner body, sensations, or their “self”.
The practice of yoga must be appropriate and it must be done along with psychotherapy treatment.
The yoga practice for people suffering/recovering from anorexia should only include gentle asanas with a strong focus on body awareness and keeping ahimsa in mind.
Fast-paced yoga asana practice or more vigorous yoga flows should absolutely be avoided (unless the outpatient has already recovered for a long time and has a stable and comfortable exercising routine) because they can trigger the over-exercising mindset.
Because anorexia can affect the lungs and respiratory system, the use of pranayama is very beneficial because it helps to deliver oxygen to the body, facilitating blood circulation and regulating the nervous system and body functions. Especially Nadi shuddhi and bhramari.
Meditation and mantra chanting are helpful in the treatment to recover from anorexia because it helps to recognise and control mental processes, such as thoughts, emotions, perceptions, motivations, giving a sense of peace, relief, and liberation.
General program yoga therapy for anorexia
- OM chanting and Mantra Chanting
- Breath awareness
- Warm-up: Preparatory movements for arms, legs, hips and neck
- Asana: targeted asanas to relieve constipation and bloating, improve digestion, opening the chest, relieve anxiety and depression
Yoga Nidra is a powerful practice to include in the treatment of anorexia and eating disorders because relaxes the mind at the deepest level and has healing effects at a neurological level.
Click here to listen to Yoga Nidra for eating disorders
Are you a yoga teacher or holistic counsellor? Download yoga nidra script for teacher
This article suggests that anorexia and eating disorders are still to be researched.
Nevertheless, yoga is very effective as side treatment for people with eating disorders. Yoga creates self-confidence and positive feelings towards body and mind, providing simple techniques that aim to the development, heal, and balance human health.
(1) Arcelus, Mitchel, Wales & Nelson. (2011) Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.
(2) Carei TR, Fyfe-Johnson AL, Breuner CC, Brown MA. Randomized controlled clinical trial of yoga in the treatment of eating disorders. J Adolesc Health. 2010;46:346–51.
(3) Daubenmier JJ. The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychol Women Q. 2005;29:207–19