Yoga's Influence on Treatment of Eating Disorders and Negative Body Image- Research Paper

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Yoga’s Influence on Treatment of Eating Disorders and Negative Body Image

Research Paper

Kristen Cartin

CSOCS 4352

Professor Laura Douglass

December 6, 2010

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Yoga’s Influence on Treatment of Eating Disorders and Negative Body Image

Research Paper

Introduction

When considering the impact of negative body image and eating disorders in people today, one would think that the calm, relaxing, body orientated practices of yoga would be a beneficial tool in overcoming and coping with these struggles. According to Dittman and Freedman (2009), over five million Americans are affected by negative body image disturbances and eating disorders (p. 273), whereas Douglass (2009) state that eight million Americans suffer from eating disorders in which ninety to ninety-five percent of them are women (p. 126). Studying the impact that yoga has as a healing tool is extremely interesting to me. I have done previous research on how dance/movement therapy (DMT) is an effective treatment with individuals who have eating disorders and its positive impact of healing by allowing one to get to know and build a relationship with their physical bodies through movement. The movement component of DMT made me think of the relaxing mind, body, spirit aspects of yoga and made me question what research was out their regarding the use of yoga for healing with this population, and how could it be used as a helpful tool to promote positive self-esteem and positive body image.

Yoga’s positive influence in possible treatment

The DSM-IV characterizes eating disorders as “severe disturbances in eating behavior (American Psychiatric Association, 2000, p. 583). Anorexia nervosa is characterized by the

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“refusal to maintain a minimally normal body weight” and bulimia nervosa is characterized as “repeated episodes of binge eating, followed by inappropriate compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, and other medications, fasting, or excessive exercise”(p. 583). According to many research articles, there are limited studies on the long-term effects that yoga has on treatment of these disorders. Douglass (2009) makes a point that yoga could have a positive influence. She argues that the practice of yoga has been effective with the intervention of obsessive compulsive disorder, depression, and anxiety; all of which have comorbid links to eating disorders (p. 127). She also makes points to research that has been done on the influence of yoga and it’s change in neurophysiology. Yoga increases melatonin (which helps regulate circadian rhythm, sleep, and mood), increasing GABA (which low levels are linked to depression and anxiety), increasing Dopamine (has important role in behavior, cognition, motivation, etc.), increasing Serotonin (has important role in regulation of anger, mood, metabolism, appetite, etc.), and decreases Cortisol (which is involved in the stress response and increases blood pressure, blood sugar, and is an immunosuppressant) all of which have a positive impact in the healing of individuals with eating disorders and depression (p. 128). This physiological impact is extremely relevant because all of these neurotransmitters connect to eating disorder disturbances in one way. Another physiological impact that yoga has on the body relates to bone density and muscle mass. Individuals who have anorexia nervosa often have low bone density. Strength exercises in patients with anorexia nervosa can help increase muscle mass and strength within the individual (“Strength Training or Yoga for AN Patients”, 2005, para. 1). The article reports a hypothesis that the strength practices of yoga can not only help with the production of muscle mass and strength, but can increase bone density as well (para. 2).

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Though this scientific explanation for positive influence is important, the simpler explanations of how yoga can be positive are important as well. Relaxation in yoga is beneficial. This sensation is often new to patients in the recovery process. The combination of yoga postures that is followed by relaxation helps create “a deep sense of peace and freedom” that patients may have never experienced before (Boudette, 2006, p. 167). Yoga also enables them to experience their bodies in ways that may be new to them. Eating disordered patients often relate to the body as “ornament” and suffer from the disconnect between their body, feelings, appetites, and inner experience (p. 168). Boudette (2006) also explains how in an authentic yoga class, you will not find mirrors, therefore the individual can solely focus inward on what their body feels like rather than what it looks like allowing for a new awareness of their physical selves (p. 167). I feel that this thought makes sense in the way that it allows for an inner focus of how the body is working and moving. Newmark (n.d.) also supports this idea by stating that yoga teachers invite people who focus solely on their bodies’ outer appearances to let go of competition with themselves and others and to notice the inner qualities throughout the practice (para. 5). The body is the main “battlefield” of eating disorders in which all negative attention is focused. The practice of yoga can help the individual focus on the body as part of the self that has the ability to accomplish something positive. The act of achieving certain postures that can have a relaxing and euphoric effect shows this positivity and connection with the physical self rather than seeing the body as a disliked attachment. I believe that this can be essential in the healing process.

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Yoga’s Eastern philosophy compared to Western medical model

The focus of a yogic practice centers on not only physical awareness, but also emotional awareness. This focus can not only help satisfy more emotional needs of patients suffering from eating disorders, but also their spiritual needs that may not be given attention to in traditional psychiatric interventions (Dale, Mattison, Greening, Galen, Neace, & Matacin, 2009, p. 423). Dale et al (2009) comment that “yoga is a process in which people can gain a better understanding of life, learn methods to manage the mind, realize one’s potential, and transform personality” (p. 423). They further explain that yoga instructors seek to create an environment in which practitioners can develop self-awareness and begin to facilitate and control their own healing whereas in the “allopathic” western medical model the physician is the main focus of healing facilitation (p. 423). This Eastern yogic perspective of providing an environment in which the individual can facilitate their own healing allows for them to take more ownership of themselves in many ways. Not only are they taking the ownership of their bodies, but also their healing process. Taking this ownership can be rewarding and empowering because it provides a sense of control and can positively influence one’s wellbeing. Individuals who have eating disorders struggle with control. Delaying “impulse control” is a benefit of a regular yoga practice. Price (n.d.) explains that “through a regular yoga practice, individuals may find themselves in postures that are difficult or awkward” and that “learning to stay within the poses and work through these postures can help an individual, who feels an urge to binge or purge, delay acting on this urge” (para. 2).

Yoga’s possible negative influence

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When thinking about using yoga as a tool in the treatment of individuals with eating disorders, the type of yoga practice needs to also be taking into consideration. The relaxation methods of yoga seem to be researched more on the benefits for treatment. When thinking about the individuals who are obsessed with thinness and exercise, yoga can have harmful side effects rather than helpful.. An example of this could be the practice of power yoga in which is a “vigorous, aerobic form of yoga that is performed in a room heated to a temperature of 99 degrees or higher” (Douglass, 2009, p. 132). Douglass (2009) explains the negative impact this can have on an with individual with the obsession of exercise and with the health issue of dehydration. When practicing power yoga, one sweats immensely and it is important to keep hydrated throughout the whole practice. Individuals with eating disorders are sometime accustomed to drinking only 8 to 16 oz. of water a day, which could propose serious health risk for this practice (p. 132). Many researchers and yoga instructors explain the importance of being aware of the risks of working with those who suffer from disordered eating and knowing which practice, if any, are suitable in each particular case. I feel that this need to be aware of each individual need is important in any therapeutic intervention. Each individual is different and has different needs, so many talk therapies, expressive therapies, or alternative therapies need to be evaluated as a whole to see if it suits their needs or not; yoga is not any different from considering cognitive behavioral therapy or pharmaceutical interventions.

Yoga as prevention

Yoga can not only be used as a treatment plan for those with eating disorders, but can also be used as a tool for prevention. There are multiple factors that can lead to eating disorders,

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such as trauma and issues of control, but there is a significant correlation between body dissatisfaction and the development of an eating disorder. There is a strong link between yoga and its influence of positive body image. Dittman & Freedman (2009) explain how women who have body dissatisfaction place a great importance on their physical appearance and devalue and objectify their physical selves (274). They explain how extreme body image disturbances can be conceptualizes as a “dualistic split between the mind and body or a spiritual crisis”. My understanding of this is that if someone struggles with dissatisfaction of their physical bodies, the negative thoughts cloud the connection of the body and the mind and can see them as not interrelated. Yoga offers a perspective that joins them and provides an approach for the unification of mind, body, and spirit. It helps the individual focus inward and experience the true self and uses the body as a “vehicle for self-discover through observation and attention” (p. 274). If this and the other previous research mentioned by Douglass, Dale, et al, and Boudette, are all true, then yoga can not only be used as a treatment method but as a prevention method as well. Negative body image starts at an early age when people are influenced by the media and cultural ideas of “perfection”. If one starts the practice of yoga and its body, mind, and spirit aspects and learn the values of seeing the body as an extension of one’s self with many abilities and capabilities, then there may be more positive self-esteem rates. Even though external factors, like the media and social/environmental factors, can still have a huge impact on how one views themselves, being introduced to practices that emphasize the bodies capabilities and what it can do and how it feels rather than what it can’t and what’s “wrong” with it can be huge educational practice that can benefit prevention. Yoga, a powerful practice for some individuals, can help

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influence a more positive outlook on one’s physical self-esteem as well as intellectual and spiritual esteem.

Studies on Yoga as Prevention Method

Throughout my research, I have come across two contradicting studies regarding yoga as a prevention method. Scime & Cook-Cottone (2008) present a study of a school-based eating disorder prevention program that involved 75 fifth grade students. This program included yoga as a major component along with a positive psychology framework and a focus on mind-body integration. The yoga sessions were conducted afterschool weekly for a period of 90min and ran for ten consecutive weeks (p. 136). At the end of the study, the results that the group that involved the practice of yoga was effective in reducing body dissatisfaction compared to the individuals in the comparison group. They also reported significantly decreased tendencies in their thought process in regards to engaging in uncontrollable eating (p. 140). Another study included female undergraduate participants suggest different results. In this study, those who participated in the programs that included a yoga practice for prevention showed no significant changes in the variables that were being measured, such as disordered eating symptomatology, drive for thinness, body dissatisfaction, and reduction of attitudes and behaviors related to disordered eating (Mitchell, Mazzeo, Rausch, & Cooke, 2007, pp. 125-126). They do argue that these results manifested because the yoga program used was not intense enough to have a significant impact on attitudes and behaviors and that members of the study have had no previous yoga experience. They cite that women who are committed to the practice of yoga for several years may have a predisposition to be more self-aware and perhaps a longer commitment

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and practice is needed in the study to show significant results (p. 126). Because these results differed, this suggests to me that more research needs to be done to get a better understanding of why, how, and if yoga can be used as a positive prevention method.

Conclusion

In conclusion, the research I have conducted in this paper seems to show a balance of benefits and concerns in a yoga practice for treatment/prevention methods for those who suffer with eating disorders. Even said, there does seem to be a strong correlation between the practice and negative body image. Newmark (n.d.) cites that “yoga teaches self-acceptance-in the poses and in life. People come to yoga for a variety of reasons. Without expecting it, through the practice of yoga, they gain a deep sense of well-being” (para. 5). If yoga is to be viewed as a treatment method, it should be explored and addressed just like any other form of treatment. It should be assessed on whether it will be beneficial to the individual based on their recover process and their specific needs. Throughout this paper, Douglass (2009), Boudette (2006), Dale et al (2009) are exploring whether yoga is a helpful tool or not in the treatment and prevention of eating disorders. I am interested in seeing how it can be used and learning more about the process yoga as treatment in the future. I strongly believe that movement can help an individual identify themselves within their own “skin” and can help improve their way of thinking about their bodies and its potential. Even if future research negates the impact of yoga as a treatment tool, I feel it still has a strong argument on how it can help improve body image perspective and help in the ways of prevention.

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References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

Boudette, R. (2006). Question & answer: yoga in the treatment of disordered eating and body image disturbance: how can the practice of yoga be helpful in recovery from an eating disorder? Eating Disorders, 14(2), 167-170.

Dale, L., Mattison, A.M., Greening, K., Galen , G., Matacin M.L., & Neace, W.P. (2009). Yoga workshop impacts psychological functioning and mood of women with self-reported history of eating disorders. Eating Disorders, 17(5), 422-434.

Dittman, K.A., & Freedman, M.R. (2009). Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga. Eating Disorders, 17(4), 273-292.

Douglass, L. (2009). Yoga as an intervention in the treatment of eating disorders: does it help. Eating Disoders, 17(2), 126-139.

Mitchell, K.S., Mazzeo, S.E., Rausch, S.M., & Cooke, K.L. (2007). Innovative interventions for disordered eating: evaluating dissonance-based and yoga interventions. International Journal of Eating Disorders, 40(2), 120-128.

Newmark, G. (n.d.). Hathat yoga and eating disorders. 6(1), Retrieved from http://www.yogapsychology.org/art_hathayogaanded.html

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Price, B. (n.d.). Reconnect with food: yoga in the treatment of eating disorders. Retrieved from http://www.yogapsychology.org/art_reconnectwithfood.html

Scime, M., & Cooke-Cottone, C. (2008). Primary prevention of eating disorders: a constructivist integration of mind and body strategies. International Jouranl of Eating Disorders, 41(2), 134-142.

Strenth training or yoga for an patients. (2005, March/April). Eating Disorders Review, 16(2), 8.