Wednesday, December 15, 2010

Yoga as a Therapeutic Model for Disordered Eating Patterns

Yoga as a Therapeutic Model for Disordered Eating Patterns

Sinéad McCarthy

Laura Douglass

CSOCS 3452

6 December 2010

Yoga as a Therapeutic Model for Disordered Eating Patterns


Eating disorders are one of the most prevalent diseases that adolescents suffer in our society, specifically young, white girls (American Academy of Pediatrics, 2003). In the United States, approximately 1% of children and adolescents suffer from anorexia, 90% of these teens are white middle or upper class females. As society puts more pressure on women to fulfill an impossibly perfect image, young girls across the country from various ethnic backgrounds are also developing eating disorders such as anorexia (American Academy of Pediatrics, 2003). Today, eating disorders are listed as the third most common chronic illness among adolescents. From a young age girls are learning poor dieting habits, whether it be from television, peers, or even family members (American Academy of Pediatrics, 2003; Bissell, 2007; Harrison, 2007).

Women across America are starving, binging, purging, exercising excessively, and abusing laxatives all to look like the models on billboards and in magazines (Harrison, 2007). For women who have suffered from trauma or feel as though they are inherently flawed, their internal thought processes focus on their flaws rather than their accomplishments. It is too easy for a person to ignore the achievements they have made in life when he or she has received negative responses throughout much of life. For many, eating disorders such as anorexia and bulimia become a crutch for the person to lean on when other areas of their lives are not as unfolding as initially planned. These negative comments, thought processes, and pressures to be perfect become overwhelming for many women leading to drastic measures (Cook-Cottone, Beck, & Kane 2008). Unfortunately, eating disorders often become the only source of feeling as though they have control in life. Many psychologists, physicians, and nutritionists specialize in this field in order to curb these statistics, and develop a treatment plan that actually works. One treatment that is currently becoming increasingly popular to help curb eating disorder patterns is yoga and meditation (Doulgass, 2009).

Alternative forms of treatment have always been fascinating to me. One day, I hope to become a psychologist who specializes in working with adolescents and young adults. In order to be most effective with all my future clients, I hope to be able to provide each with the best care possible, personalized specifically for each individual’s needs. Working with this age group, I know that I will come across many young women who suffer with body image issues. It is unfortunate, but in our society body image will constantly plague thousands of girls and women throughout their entire lives. Thus, I feel it is incredibly important for me to discover as many treatment methods as possible regarding eating disorders. Unlike many other psychiatric diagnoses, eating disorders are not easily managed simply through talk therapy, and patients can not receive a quick fix via a prescription (Comer, 2009). Instead, the emotions surrounding body image and incessant need for control must be evaluated and the counselor and client must work together to find an alternative manageable and healthy outlet.

Disordered Eating Thought Processes

While many people do not immediately think of yoga when discussing eating disorders, instead many people in a Western society such as America believe that yoga would only hinder a person’s self esteem. In recent studies (Cook-Cottone et al, 2008) the contrary has been proven, psychologists have found that regular practice of yoga may in fact help women become more comfortable in their bodies – when practiced under the appropriate conditions. If a person who suffers from an eating disorder practices yoga it is common for the patient to use the practice as another form of control (Cook-Cottone et al, 2008), which is why it is necessary for any person suffering from an eating disorder to first practice with an instructor who specializes in eating disorders. Practicing yoga does not only provide physical health benefits, but also mental health benefits. People who regularly practice have been found to be more aware of their bodies, mind, habits, and surroundings (Daubenmier, 2005). It is because of this new sense awareness that it is highly suggested as a form of treatment for women suffering from body image issues and eating disorders (Daubenmier, 2005).

Psychologists and nutritionists both agree that one of the contributing factors behind disordered eating patterns are because women have been sexually objectified in the media throughout history in Western societies (Bissell, 2007). Everywhere you look implicit sexual connotations can be found in advertisements, television, film, even Microsoft Clipart, it is no wonder that women feel pressured to obtain irrational bodies (Daubenmier 2005). Women begin to view themselves more as sex objects rather than human beings. By seeing themselves as objects, women are imposing social and psychological issues onto themselves including relationships (romantic and platonic) and how they view themselves in general, which can in turn lead to disordered eating habits.

According to Franzoi (1995), “women learn to view their bodies as objects of others’ attention, or body-as-object” whereas men tend to view themselves in a “body-as-process” manner (Daubenmier, 2005, p. 207). By viewing themselves in such a way, women are socialized to conceive themselves as objects to be evaluated by others causing women to criticize themselves based on the ideals they believe others have set for them. Fixated on fulfilling others’ standards, women may often find themselves battling inner conflicts of “how do I look?” rather than sentiments such as “how do I feel?” (Daubenmier 2005, p. 208). Self-objectification increases one’s feelings of shame and guilt, resulting in restrained eating patterns.

It is because of such thought patterns that many women in Western societies suffer from eating disorders, depression, anxiety, and sexual dysfunction disorders. In hopes to help women with these issues, many psychologists suggest sports participation, physical activity, and other activities to help females “experience their bodies in more direct and positive ways” (Daubenmier, 2005, p. 208). Yoga has been found to be a great form to stop, or at least curve people’s self-objectifications. This is because through practicing yoga, a person is able to experience the body as whole rather than focus on individual functions or portions of the body. When practicing yoga, one has to feel the stretch throughout different sequences of poses. For many people who suffer from eating disorders, it is important to feel the stretch and be able to hold the stretch. To successfully hold the pose, one has to make sure that they are able to recognize the signals the body is releasing, to note that the stretch feels right, not too tight or loose. As Daubenmier (2005) states so eloquently, the “underlying goal is to unify mind and body, by immersing oneself in subtle sensations of the body” (Daubenmier, 2005, p. 208).

Yoga as a Form of Treatment

Several studies have been complied in recent years to determine if there is actually any correlation between practicing yoga and developing a new sense of self-awareness. Researchers have already compiled information regarding the correlations between anxiety and yoga (Godfrey, 2006; Netz & Lidor, 2003), which is a good stepping point for work with eating disorder clients. Many people diagnosed with eating disorders often have anxiety issue as well (Comer, 2009). According to Godfrey’s discussion with Eva Selhub (2006), “[y]oga reduces anxiety, promotes well-being, and improves quality of life among the women who practice it regularly” (Godfrey, 2006, p. 1113). Knowing that yoga is an accepted form of treatment for anxiety, it is interesting to learn how people have redeveloped the practice to treat eating disorders.

Indra Singh discusses her own battles with anorexia and how yoga helped her come to terms with her body image in her 2010 Natural Life article. Throughout the article she discusses how she was first introduced to yoga at the age of seventeen. Prior to taking any yoga classes she was only sixty-three pounds. She had no energy. She could barely make it through a day, she has “lost all control” of her life (Singh, 2010). Shortly after beginning yoga, Singh could see and feel the positive affects of the exercises, “[w]ith various pranayama techniques, meditations, and relaxation skills, I was steadily on the road to recovery” (Singh, 2010). She goes on to explain the importance of these relaxation techniques and how one is given “permission to live, to relax, to let go” (Singh, 2010). Letting go is not something that most people with eating disorders are able to do because of the constant pressures and anxieties they tend to put on themselves. According to Singh, both her personal experiences and work as yoga instructor, has taught her that when these practices are completed daily, “these skills help transform the mind and allow you to gain back your own personal power” (Singh, 2010).

Rani and Rao conducted a three-month study to see if participants had any change in feelings of self-objectification. As hypothesized, the women who participated regularly in yoga classes for the allotted time felt a greater sense of “awareness of bodily processes” (Daubenmier, 2005, p. 208). In similar studies, researchers found that these results are not limited to females (Daubenmier, 2005). In fact, in a two-month study of undergraduate students, both male and female students had increased levels of body satisfaction after practicing consistently. A third study conducted with children’s yoga groups found that only after four weeks children experienced greater body acceptance and awareness. With evidence such as this it is no wonder psychologists have contacted yoga centers to create specified classes to work with eating disorder clients.

Further research has even discussed additional health benefits yoga provides if practiced routinely and accurately. One form of yoga as a therapeutic tool to treat clients with disordered eating habits is Attunement of Mind, Body, and Relationship (AMBR). Attunement in this model “is defined as a reciprocal process of mutual influence and coregulation” (Cook-Cottone et al, 2008, p. 66). In order to successfully attain attunement, one must be able to define how his or her social interactions (i.e. environment, family members, peers, etcetera) affect them individually. According to Cook-Cottone et al (2008), “representational self is the constructed self that is presented to the external system” (Cook-Cottone et al, 2008, p. 68).

Through this process, clinicians use a combination of cognitive and dialectic behavioral therapy processes in order to have clients gain an acceptance for her body. This model has shown great results because “the model posits that the etiology of eating disordered behavior is a developmental trajectory influenced by a complex interaction of individual, relational, and cultural variables” (Cook-Cottone et al, 2008, p. 66). Unlike other psychotherapies mentioned previously, AMBR tries to bring in all the variables known to attribute to eating disorders in hopes to reframe the client’s worldview and view of self. From the data collected thus far, it has been found that this treatment works best in group settings where clients are able to discuss personal opinions with others’ to gain a greater understanding of the world.

These group sessions are extremely structured, and each week follows the same general model as the previous week. Typically a session “followed the same predictable sequence of activities designed to provide practice in mind–body integration (i.e., a body, mind, and mind–body sequence)” (Cook-Cottone et al, 2008, p. 70). Sessions consist of a ten-minute review of the previous weeks work before about a one-hour yoga practice (Cook-Cottone et al, p. 70). This process enables clients to work towards inner attunement. Over the course of treatment, a successful candidate will begin to realize the negative cognitive defenses they have created internally and externally are at fault for their eating disorder. As previously stated, it is common for many people to develop eating disorders because they can only see imperfections in themselves. Feeling as though they lack control, people who are susceptible to disordered eating spend much of their time comparing their own appearance to that of others and images projected in society because “the body present a more accessible, measurable object of conflict” than what the initial issue may be in some cases (Cook-Cottone et al 2008, p. 67).

Many professionals believe that through the use of the body and mind, yoga allows people to maintain healthier eating patterns in general (Daubenmier, 2005). It is believed that these habits are enforced by “gaining sensitivity and responsiveness to bodily cues, including those of hunger and satiety” in turn allowing people to realize that they do not have to eat whenever they are faced with an emotional or situational circumstance, but instead because they are truly hungry (Daubenmier, 2005, p. 209). Many studies surrounding this realization have been conducted with clients who suffer from binge eating disorders, and the results are overall successful among all clients while in the program. Kristeller and Hallett conducted a six-week intervention program for women suffering from binge eating in 1999, concluding that women who participated in the program had a dramatic decrease in amount and severity of their binges during and after. This can be credited to the fact that through yoga practice, one is able to understand their bodily sensations more freely. In many eating disordered patients, the physical feelings of hunger are not easily recognizable because people develop the ability to ignore the cues the body associates with hunger.


After conducting the research for this paper, the benefits of yoga on a person’s overall well-being are too obvious to ignore. It is through this enhanced awareness that people are able to reassess their feelings of self, enacting an awareness of and responsiveness to the body’s functions that was previous ignored or non-existent. These new thoughts toward the body often cause people to gain a greater appreciation for “autonomic processes and physical abilities, thereby diminishing the importance of physical appearance to one’s physical self-concept and overall sense of self” (Daubenmier, 2005, p. 208). These new abilities often allow people to improve their entire view toward their physical appearance, lower the need to control or change their appearances in harmful ways.

Still, it is important to remember that this method may not work for every person who has disordered eating habits. Some studies have shown that yoga can also be harmful to clients struggling with eating disorders because of the Western perception of yoga (Daubenmier, 2005). Unfortunately, like most modern fads in Western culture, yoga has also strayed from its roots. When first introduced in the United States, yoga was seen as a practice only for the elite (Douglass, 2007). I was first introduced to yoga through tabloid magazines discussing how skinny certain actresses are because they regularly practice yoga. Even yoga magazines published in the United States are filled with unattainable body images. Encouraging people (especially young girls) who are already struggling with body image issues to practice a form of exercise that is strongly associated with thin celebrities can be damaging if not monitored. All the psychologists and yoga instructors must be specifically trained in this area to ensure the best results. If not, there is a strong possibility that the client will not be able to ever recover fully from an eating disorder, but instead develop a form of exercise bulimia.

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