Is There a Place for Yoga and Meditation in the Treatment of Eating Disorders?

There is no one single modality that most effectively addresses the complexities of treating patients with eating disorders. In fact, typically, it is the combination of treatments that are most likely to help patients on the road to their unique recovery. The use of interpersonal psychotherapy, group, experiential and nutrition therapies, psychiatric medication, and medical supervision are most likely to address the intricacies of treating patients with eating disorders. Additional treatment may also include the use of cognitive behavioral therapy (CBT) and Dialectical Behavior Therapy (DBT) to address symptom management and a more mindful approach to the treatment eating disorders. If you ask a handful of eating disorder specialists, each will report that they most probably combine some or many of the above treatment approaches in putting together a most effective treatment plan for their patients.What all of these approaches have in common are long term studies that show the effectiveness of these varied treatment modalities as well as respected outpatient, residential, day treatment and partial day treatment facilities implementing some combination of the above therapies to help their patients move towards recovery.

Less frequently do we read about integrative approaches to treating eating disorders such as yoga and meditation as they fall outside of the mainstream.
As a practitioner of yoga and meditation I began to wonder what role these two practices may play in the treatment of eating disorders. Translated from the Sanskrit word, yuki, yoga means “union” with the goal being to unify body and mind. The practice of yoga and meditation emphasizes focusing on the breath and moving through a series of asanas (poses) while increasing a greater mind body connection, gaining a sense of calm and the insight to correct distorted cognitions and painful emotions.

Patients with eating disorders struggle with dangerous and potentially life-threatening patterns of eating, difficulty with affect regulation, distorted body image, and atypical body sensations. Yoga provides the opportunity for patients to integrate mental, physical and spiritual aspects of themselves into a regular practice, which supports increasing self-esteem, confidence and a deeper connection to their authentic feelings and body sensations.  While focusing on breath and simple yoga poses, patients are offered a respite from the rigorous mental and emotional torment they live with daily. By paying attention to one’s breath and inner cues from body and soul, patients learn to reconnect with an ease and stillness that eating disorders aggressively disrupt.

Yoga offers a range of poses, which flow from one to the next routinely encouraging one to hold a pose to better develop the ability to tolerate stillness of mind and body. Bulimics have difficulty containing their feelings; holding poses while focusing on breath rather than the need to purge uncomfortable impulses and feelings can be a useful method for working with these patients. Typically anorexic patients are perfectionist and rigid in their beliefs and behaviors. Yoga allows these patients to learn to be more accepting of imperfections and less judgmental of themselves while moving in their own unique way through their yoga practice, focusing on breath rather than the negative thought patterns.

Moreover, lacking self esteem and confidence, patients have a tendency to internalize society’s relentless pursuit of thinness and latch on to this as a means of falsely making themselves feel better while simultaneously developing an intense scrutiny of their bodies and self objectification. In a study conducted at the University of California in 2005, yoga led to “less self-objectification, greater satisfaction with physical appearance and fewer disordered eating attitudes compared to nonyoga practitioners” among adult female subjects (Psychology of Women Quarterly, 29 (2005).

Furthermore, yoga and meditation have shown to lower blood pressure, reduce levels of cortisol and encourage relaxation, all which may aid in the reduction of anxiety and depression. Yogic breathing known as pranayama, emphasizes slow and deep abdominal breathing, which facilitates a sense of relaxation and decreases anxiety.

Currently, research published in the Journal of Adolescent Health (in press) found that out of 50 girls and 4 boys, “Individualized yoga treatment decreased Eating Disorder Examination (EDE) scores at 12 weeks, and significantly reduced food preoccupation immediately after yoga sessions. Yoga treatment did not have a negative effect on Body Mass Index (BMI). Results suggest that individualized yoga therapy holds promise as adjunctive therapy to standard care.”
As with any form of treatment, caution needs to be addressed when practicing yoga and meditation. Patients diagnosed with a dissociative disorder should refrain from intense forms of yogic breathing as it may trigger symptoms of depersonalization.
Through the practice of yoga and meditation we learn the art of not comparing, but accepting this moment and ourselves just as we are. It is a time to come to one’s mat to learn to reconnect with our healthy selves. Yoga offers patients with eating disorders the opportunity to consistently practice loving kindness, restore a sense of calm and balance and encourage the development of increased confidence and self esteem as one moves at her pace through yoga poses and gentle restorative breathing. Yoga can be incorporated into a full team approach to treating eating disorders supporting and enhancing more traditional forms of therapy.