What Is Yoga’s Place in Eating Disorder Recovery?

Yoga has long been recognized for its healing effects for a variety of health issues, but can it be applied in the recovery from eating disorders?

In recent decades, the popularity of yoga has grown to such an extent that it is a hugely recognizable part of our cultural wallpaper, from classes at the gym to #asanas on Instagram. But while many of us think of yoga as a useful method of relaxation and exercise, it’s reputation as a clinically viable therapeutic pathway for a variety of physical and mental health conditions has also been growing – and one such example is in the treatment of eating disorders.

Eating disorders are often complex and difficult to manage, from both a medical and an individual perspective. Any tool which can be utilized in a person’s recovery is a welcome development. Initial research suggests that yoga is proving a promising adjunct treatment for those living with an eating disorder, but one that nonetheless needs to be applied with care.

Eating Disorders in the USA

Although most common in women in their teens and early adulthood, eating disorders can occur in people of any gender, background, and age. They can be life-threatening, and tragically eating disorders have the highest mortality rates among psychiatric disorders.

The South Carolina Department of Mental Health estimates that 8 million Americans (seven million women and one million men) have an eating disorder.
Eating disorders include bulimia nervosa, binge eating disorder (BED), and anorexia nervosa.
Early intervention has an effect on the success of treatment – the earlier that eating disorder treatment is sought, the better the sufferer’s chance of recovery.

There are a variety of factors that appear to contribute to the development of eating disorders, including:

Genetics – people are more likely to develop an eating disorder if a member of their family also lived with the illness.
Experience – The development of eating disorders is linked to childhood trauma.
Poor body image – Body dissatisfaction and low self-esteem are important factors in many eating disorders.
Personality – People with eating disorders are often intelligent and perfectionists.
Culture – So-called “diet culture” can enable and encourage unhealthy behaviors around food and damage people’s sense of self-worth.

How Yoga Can Help People Recover

When guided by a highly trained yoga therapist (or within a clinical setting under medical supervision), the practice of yoga can be a highly effective method through which people with eating disorders can overcome some of the challenges of their illness.

People with eating disorders often struggle with feelings of depression and anxiety and the effects of trauma. A growing wealth of research indicates the efficacy of yoga in helping people manage and recover from these issues. A recent study from the Boston University School of Medicine has found that people diagnosed with clinical depression who attended a 90-minute yoga class exhibited increased levels of gamma-aminobutyric acid (aka, GABA).

GABA is an amino acid that acts as a neurotransmitter and is associated with improvements in our mental state and greater wellbeing – which explains why this is a common self-reported result for participants in many yoga studies. Levels remain elevated for up to four days following a yoga class before dissipating after eight days, suggesting that one class a week is enough to maintain the effects.

A yoga class can give people being treated for an eating disorder a safe and controlled environment in which they can be reintroduced to movement and get re-acquainted with their bodies in a safe, guided, and non-goal driven way.

When people use exercise compulsively (both to lose weight and to modulate the intensity of their feelings) and experience intense self-judgment regarding their bodies, it can be difficult for them to practice movement to explore the present moment without stress or strain.

As those suffering from illnesses such as anorexia are often perfectionists, they may also view yoga as something to be practiced faultlessly – for example, by enacting a pose even if it causes them pain.

Yoga professionals can help people overcome these barriers by working within their “window of tolerance” (where their nervous system is neither hyper nor hypo-aroused) to explore their feelings carefully. Guided self-inquiry allows students to take the position of expert of their bodies and use awareness to regulate their present moment experience, rather than using compulsive exercise to avoid feelings.

A yoga teacher can give students options to help them to start listening to their bodies and tune in to the present moment – for example, by asking “can you take an easeful breath” while they are practicing asanas, and if they find they can’t, loosening themselves out of the pose a little.

Over time, this helps students experience their body in a different way, encouraging feelings of self-acceptance and mental calm. People with eating disorders are often profoundly disconnected from their bodies. Yoga helps them become much more aware of how their bodies feel (and encourages a non-judgemental conduit to explore how they feel existing within it), giving them a new perspective of themselves once they step off the mat.

Considerations for using yoga for people with eating disorders

Yoga is a holistic system for wellbeing on every level – physical, emotional, mental, and spiritual. However, it is extremely important for people within the yoga community to understand that this purpose can be subverted and used self-destructively by those who are vulnerable.

People with eating disorders can be drawn to the compulsive practice of yoga postures to numb psychological pain, especially in intensive routines such as Hot Yoga (which can also have appeal in the short term loss of water weight).

A so-called “yoga lifestyle” can also become a cover for disordered behaviors, with retreats offering “clean eating” plans (often associated with cutting out entire food groups) or juice cleanses, and online influencers promoting nutritional advice they are unqualified to give. It’s incredibly important that the yoga community counteracts potentially damaging messages and promotes a philosophy of body positivity and inclusivity.

Yoga professionals can also make themselves aware of the warning signs of eating disorders and flag any students they are worried about to their doctor. Unless they are teaching within a hospital or clinical setting with medical supervision (such as an inpatient facility), yoga teachers shouldn’t work with anyone suffering from an eating disorder unless they are in a late stage of recovery and no longer exhibiting any active symptoms.

Yoga therapists who have gained additional training in working with this health population – including taking into account physical issues such as osteoporosis and postural hypotension – are better placed to engage with patients at more vulnerable points of their treatment.

Yoga professionals who wish to work with this health population can be most helpful within a hospital or inpatient facility. The advantage of working within a clinical setting (for both yoga teachers and therapists) is that they can work directly with their student’s medical team, ensuring that their plans are approved for each individual.

With awareness of these requirements, however, yoga can be a truly beneficial part of eating disorder treatment and a way in which individuals can take care of themselves as they move forward into a healthier future.

About the Author: This post was written by Heather Mason, founder of The Minded Institute – the UK’s leading yoga therapy institute which explores the use of yogic techniques in the treatment of a variety of physical and mental health issues, providing yoga therapy training for a variety of medical, therapeutic and wellbeing professionals.

Photo by Avrielle Suleiman on Unsplash

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