Why Practice Yoga as Part of Eating Disorder Treatment?by Lisa Diers, R.D., L.D., E-R.Y.T.
By Lisa Diers, RD, LD, E-RYT
Words aren't the only way to connect to memories and feelings stored in the body. This is why we incorporate integrative therapies, including yoga, into treatment at The Emily Program.
Yoga is a practice of specific postures (asanas) linked with breath while incorporating a focused intention of moving inward for self-exploration or reflection, and decreased anxiety and depression. In yoga, the mind is not separate from the body nor is the body separate from the mind. The Breath is the mechanism that bridges the gap between the two. When we discuss yoga here, we are referring to mind, body, and breath. When yoga is practiced with traditional methods, it is a practice of wholeness.
Yoga at The Emily Program
At The Emily Program (TEP), yoga is one of our integrative therapies and we incorporate it into all levels of care – from outpatient to 24/7 residential treatment. Clients have said, "there's a TEP way to yoga" and although our approach is not a "style" of yoga, our yoga team takes great care in offering clients postures, yoga sequences, and variations that are accessible to each emotional and physical body of the day. At TEP, yoga is for every person, regardless of diagnosis, body shape, or experience level. We believe in fitting the pose to meet our clients and NOT the clients to meet the pose. We feel this is very important in the recovery process and each of our 18 yoga teachers incorporate this into their practices. In fact, due to the uniqueness of this approach, we have offered Yoga and Body Image and Eating Disorder Sensitive Yoga training to community professionals including yoga instructors, registered dietitians, psychologists, and anyone wanting to learn more.
Sometimes in life we push our bodies too much. Yoga invites reconnection with his or her body. It's an opportunity to listen to the body's needs, and to ultimately make a decision on how or whether to respond based off the information gathered. Yoga creates a space of connection and gathering information in the body and also the mind. Once gathered, you may use mindfulness skills learned in yoga to be a curious observer around what you found. Thus practicing responding or not responding in a non-judgmental way. "Curious. Not Furious." I like to say!
Additionally, through the practice of yoga, clients are able to begin to explore new ways of thinking about what the body can 'do' vs. how it 'looks.' When the mind and body are quiet, clients are better able to listen, and hear, the negative talk in their heads – in the eating disorder field we sometimes call this negative voice "ED." Once they can identify the negative thoughts, they can begin to learn to challenge them. And as clients gain experience in yoga poses, they start to develop more positive and healing thoughts allowing for a decreased preoccupation with certain body parts and greater self-acceptance.
Decreasing Anxiety, Depression, and Stress
Yoga (breath centric asana) may also be beneficial for regulation of the nervous system. The prevalence of anxiety and depression in those with an eating disorder is significant, and the seemingly positive effect yoga may have on stress, anxiety, and depression may help those who struggle with eating disorders to manage these symptoms.
Yoga is each person's personal practice. A time to focus on their body and what it can do for them. The practice of yoga through mindful movement, meditation, and breathing can serve as a "pause" button, creating space to choose how to respond to stress, anxiety, or unhelpful coping mechanisms. Regularly practicing yoga gives an individual the opportunity to experience muscular re-patterning by way of helpful repetition of postures and breathing techniques, and space to release or let go of emotions – slowing down and letting go of all the worries and to-do lists – the anxiety and stress in life. This release creates room for quiet, calm, and gratitude, which in turn can produce more positive feelings. The positive feelings from a yoga practice transcend into other facets of an individual's life, providing those who struggle with an eating disorder a connection to parts of themselves they may not otherwise access.
A Few Real Life Stories of Yoga Benefits in Eating Disorder Treatment
A client who was a competitive dancer came to yoga with much apprehension. She was used to forcing her body to achieve perfection in poses regardless of pain or discomfort. To experience movement in yoga that set rules, judgments, and criticism aside to focus more on being kind and compassionate to one's body and self was a challenge for her. I remember her telling me "I can't do this! You're asking me to be kind to myself and do what feels good in my body? To let go of judgement? Yeah, right!" After practice and time experiencing yoga at TEP she was able to move into poses with a different perspective -- one of treating her body well and with kindness. Dance was still very much a part of her life, but now she had something to balance out that experience! She was able to see her body as amazing for what it could do with dance and things in daily life and developed a greater appreciation for this!
One client observed that for the first time in a long time, she was able to be gentle with her body, to stay in a restorative posture and listen to her body without judgment from ED. She mentioned that for the first time since she could remember she felt safe and supported enough to relax and was surprised that yoga could be accessible to her.
Another client expressed that by focusing on yoga postures and his breath, he was able, for the first time to truly hear all the self-criticism and judgmental thoughts that were running through his mind. This awareness allowed him to practice compassion and a non-reactive stance. He said he was able to hear the thoughts, breath, and watch them pass. The yoga postures gave him something else to focus on, and with practice, the thoughts were not as strong and at times had disappeared.
Once a client decided to move into a yoga pose in spite of her fears of her current body size "getting in the way" of performing the pose. We discussed fitting the pose to "meet her body where it was at," not where she thought it "should be." For the first time in 25 years, she was able to experience activity and she did it in a way that was filled with acceptance, receiving the full benefit of the pose, and challenging old thought patterns.
Yoga and Eating Disorders Research
Currently, there is more and more research being compiled about the benefits of yoga in the treatment of eating disorders. Some of these studies are being conducted within The Emily Program clinics and in partnership with the University of Minnesota.
Although the studies are not conclusive yet, the findings on the effectiveness of yoga for those in eating disorder treatment and with negative body image are promising. Overall, even anecdotally, The Emily Program clients who have participated in yoga along with other therapeutic interventions report higher self-esteem, less anxiety, decreased depression, and better body image.
At The Emily Program, our staff can see the positive effects that yoga has had on their clients' lives. Remaining on the forefront of this break-through research will continue to be a priority. With the right funding we can perform more rigorous studies in this area. We want our clients to live healthier, happier lives, and yoga is one integrative therapy we'll continue to use to help them reach these goals.
About the Author
Lisa is The Emily Program's Director of Nutrition and Yoga Services. Lisa oversees the national operations of both nutrition and yoga departments, which includes the direction and oversite of the clinical practices for 65+ nutrition staff and 20+ yoga instructors. She has over 10 years of eating disorder specific experience in yoga instruction, clinical nutrition counseling and program development. Lisa draws from her deep knowledge base of nutrition, yoga, body image and eating disorder treatment to meet clients' physical and emotional needs. She develops and conducts national eating disorder and body image sensitive yoga trainings and is also a regular blogger on nutrition, yoga and body image; a published author (articles, book chapters and published research); and continues to conduct research to better understand the role of yoga and nutrition in eating disorder recovery.