Monday, May 2, 2011

Eating Disorders and Yoga

Rachael O'Mara

Professor Douglass

Yoga: culture theory and practice

Introduction

Eating disorders are taking over some women’s lives, which are causing much harm to them as it is slowly destroying both their bodies and minds. These disorders mislead them from finding a healthy atmosphere in which to grow and from discovering their own uniqueness and individuality. There are eight million American suffering from eating disorders today; 90-95% of these are women (Douglass, 2009). Eating disorders are a huge problem in the world that mostly women are suffering from. Eating disorders are one of the most difficult mental diseases to heal, as there is no cure for it. It is mainly due to a psychological problem that only the person who has the disease can change. This can be done by accepting oneself, accepting one’s body, and wanting to get better. This is why there has been an increased need for research on alternative therapies such as yoga, to help eliminate suffering from these diseases. This led me to want to focus on how different yoga interventions, workshops, and strategies can help impact the psychological and emotional functioning, and mood of women suffering from eating disorders.

Women and Eating Disorders

There are multiple eating disorders that women are experiencing in the world today. Women are starving themselves, binging, vomiting, exercising excessively, taking diuretics and even are taking up to five times the recommended dose of laxatives (Douglass, 2009). Some of these eating disorders are called: anorexia nervosa, bulimia nervosa, and binge-eating. For the past two decades, research has shown a dramatic increase in the occurrence of both anorexia nervosa and bulimia nervosa, in which are mostly affecting younger women (Scime, Cook-Cottone, Kane, & Watson, 2006). These eating disorders are now starting in children as early as the fourth grade, and are mostly affecting adolescents and middle-aged women. These eating disorder behaviors and the risks that associate with their development are known to emerge in early adolescents. Eating disorder prevalence estimates a range from 3% to 10% of at-risk females who fall between the ages of 15-29, and the occurrence of partial eating disorders is at least twice that of full syndrome eating disorders (Scime, ‘et al.’, 2006).

Eating disorders and body image disturbances are known to affect between five and eight million Americans, mainly being women and girls (Dittmann & Freedman, 2009). Women who experience body dissatisfaction are more likely to put a greater value on their physical appearance, which leads to diminishing feelings about their personal characteristics, strengths, and skills (Dittmann & Freedman, 2009). This dissatisfaction woman tend to feel is a form of self-consciousness that leads them to constantly feel judged by others around them, as if their physical body was constantly on display. These feelings that are created in the mind become an addictive disease, that creates distance between women and their internal bodily cues and sensations, which then leads to the lack of interceptive awareness (Dittmann & Freedman, 2009).

College Women and Eating Disorders

There have also been studies that shown disordered eating among college women, in which there were 13.3% of undergraduate women who were experiencing moderate or severe binge eating (Mitchell, Mazzeo, Rausch, & Cooke, 2007, p120). Researchers found that extreme dieting and purging have been occurring at higher rates. As many as 79% of undergraduate women reported symptoms of an eating disorder, and there were 61% who suffered from some form of eating disorder including subclinical bulimia nervosa, chronic dieting, binging, or purging (Mitchell, ‘et al.’, 2007, p 120) Due to all these findings on how eating disorders are affecting women of all ages, it shows that there is a tremendous need for effective interventions for young and middle aged women. This study examined new types of eating disorder interventions which included a yoga group and a cognitive dissonance based discussion group. The yoga intervention that was used to help with the treatment of eating disorders was meditation, since it is related to medical and mental health. Yoga that used meditation helped college women increase body awareness, responsiveness and satisfaction as well as less self-objectification (Mitchell, ‘et al.’, 2007, p 121). Research showed mindfulness meditation techniques improved the participants’ mental health, frequency of binging, depression, and anxiety (Mitchell, ‘et al.’, 2007, p 121). This type of yoga prevention can go either way with helping college women with eating disorders.

It was found that the cognitive dissonance group in the study succeeded significantly more in the decrease in disordered eating symptomatology, drive for thinness, body dissatisfaction, and alexithymia compared to the yoga group (Mitchell, ‘et al.’, 2007, p 125). It seemed as if these women who choose to participate in yoga classes and remained committed to them for several years may have a better chance of help recovering from their eating disorder (Mitchell, ‘et al.’, 2007, p 126). I also feel that this type of yoga group may have not been that effective for college women because they used meditation. Due to meditation having a larger focus on body awareness, this could cause women to think even more about their self conscious issues and more about the problems they are experiencing with eating disorders instead of using it as a distraction. I truly believe that at college age women are going through a tremendous amount of stress, due to copious amount of school work and body image concerns. It is at this age there is more apprehension with the way one looks or thinks they have to look to fit in or be liked by others. If college women are experiencing continuous stress, meditation may not be the best way to manage their eating disorders. It may provide them with more time to think about the issues that they are struggling with or facing in their lives. It’s been a long time since I read the Mitchell article, but I thought they found no improvement in the yoga group?

Mood and Emotions of Women with Eating Disorders and How Yoga can Impact these Women

Eating disorders can lead to severe medical and psychological consequences. Women with eating disorders may exhibit heightened awareness of basic bodily signals, such as hunger and a state of overindulgence, different levels of energy and fatigue, and may perceive bodily signals but ignore or deny the experience of them (Dale, Mattison, Greening, Galen, Neace, & Matacin, 2009). Awareness of a woman’s emotional state and mood is also an important factor for those suffering from eating disorders. It was found that both positive and negative emotions such as anger, anxiety, depression, loneliness, and happiness may be an important precursor, trigger, and consequence of eating disturbances (Dale, ‘et al.’, 2009, p 423). Body awareness and mood both play an important role in people who have an eating disorder, and a particular modality such as yoga can help center on one’s physical and emotional awareness. Yoga is considered an adjunct to traditional treatment of eating disorders, since traditional interventions may neglect some of the crucial elements of eating disorders. Some of the factors that are neglected include mood and body awareness, which is important in the development and maintenance of eating disorders (Dale, ‘et al.’, 2009, p 423). Yoga could be beneficial for women with eating disorders, because it’s a process in which people can gain a better understanding of life, learn methods to manage the mind, realize ones potential, and transform personality (Dale, ‘et al.’, 2009, p 423). Yoga is also considered to be beneficial, since it has a therapeutic impact on people who practice it, leading to a decrease in symptoms of depression, anxiety, and an improvement in self efficacy and a sense of self control (Dale, ‘et al.’, 2009). Research shows an improvement in emotions women with eating disorders experience after doing yoga (Dale, ‘et al.’, 2009). These emotions consisted of tension-anxiety, depression, anger, fatigue, and confusion.

Using yoga in order to help control these moods and emotional states of women can also be problematic, since it focuses too much on body awareness. This can cause a reverse effect for women with eating disorders and make them feel even worse about themselves, by increasing their anxiety levels. Another negative aspect that came from Dale’s, Mattison’s, Greening’s, Galen’s, Neace’s, & Matacin’s study was that it only consisted of a six day workshop, which doesn’t prove that yoga can help cure the long term affect of eating disorders. The workshop also included other elements that went into treating women with eating disorders and not just using the practice of yoga. This workshop included information on healthy eating by offering interactive cooking class and education about the basics of whole foods theory and the increase of organic foods as well as the elimination of highly processed foods. The workshop also encouraged self-reflection and interpersonal skills (Dale, ‘et al.’, 2009, p 424). This shows that using just a yoga practice may not be as beneficial as using multiple factors to help cure eating disorders. Yoga can also cause a problem for women with eating disorders if the practice is done in a room with mirrors. This leads to a constant distraction for women, since they are only focusing on their physical appearance in the mirror, making it difficult for them to achieve the benefits of practicing yoga. By having mirrors, it could increase their negative emotions, anxiety and depression which will consequently cause them to give up.

The Impact of Culture, Society, and Yoga on Women with Eating Disorders

There are many reasons behind why mostly women are being affected by these eating disturbances. For over fifty years, feminist theorists have argued that women are sexually objectified in Western cultures, and it is still seen today in our society’s culture. It is even being exposed in yoga practices and magazines around the world say how yoga contributes specifically. Our society creates a world where women have to create an image in their mind of having the perfect body, the perfect hair, clothes, and etc… When they cannot reach that goal, it leads to a loss of confidence and the loss of their inner self, which most likely leads to eating disorders. According to Dittmann and Freedman, women in Western cultures experience a paradox: susceptibility to over-valuation of the female physical form attached with the desire to be respected for thought and abilities (2009, p 273). When femaleness is seen as a liability, women may rebel against their own bodies, seen as confining and preventing them from reaching their full potential (Dittmann & Freedman, 2009, p 273). These feelings then go on to create a continuum form of nagging the body of its dissatisfactions, which then lead to a life-threatening eating disorder.

There has also been empirical evidence which has documented that women are more likely to be portrayed as sexual objects than men in visual mass media (Daubenmier, 2005, p 207). For example on television there are always sexual comments being made about women’s bodies and body parts compared to men’s. Women are more frequently presented as sex objects all over the media, and are more likely to be gazed at and sexually objectified (Daubenmier, 2005, p 207). This is seen in yoga magazines as well. Yoga magazines are portraying women who practice yoga to have to look thin, be in shape, and wear tight revealing clothes. This may cause women to become more self conscious about themselves when attending yoga classes, and makes them think twice about practicing yoga. This proves how physical appearance is more strongly related to women compared to men. Research shows that some women become fixated on the way they look, and on the way others perceive them, because they feel physical attractiveness correlates more highly with dating experiences and spouse’s marital satisfaction for women compared to men (Daubenmier, 2005, p 207). If women ought to be less attractive or overweight, they experience lower educational and economic achievements, and more job discrimination compared to men (Daubenmier, 2005, p 207). Society creates a lot of pressure on women today to fit this perfect demeanor that only causes women to experience a lot of negative feelings within themselves, which then leads to a detachment of their body and mind. This loss of connection between their body and mind then causes women to view their bodies as objects of others’ attention. These emotions create a pessimistic impact on women, which pushes them towards eating disorders. It always makes me sad to be reminded of how many obstacles women still have!

There is also research that shows how yoga can benefit women with eating disorders as well. Yoga is seen as a popular form of mind body exercise in the West, which develops a direct experience of the body, which may be particularly effective in counteracting self-objectification and it negative consequences (Daubenmier, 2005, p 208). Yoga can help as part of the process in recovering from eating disorders in women because it has many physical health benefits (increasing strength, flexibility, and balance), and since its main goal is to unify the mind and body by immersing oneself in subtle sensations of the body (Daubenmier, 2005, p 208). Yoga can help these women suffering to start accepting their bodies and feel better about themselves. This practice can help change the way these women think and lead to a decrease in mind control over their bodies. To help these women, some yoga practices try to get rid of mirrors in their studios to help encourage movement based on internal awareness rather than outward appearance (Daubenmier, 2005, p 208). Daubenmier stated that other researchers found participants who partook in a three month yoga practice reported greater awareness of bodily processes compared to nonrandomized control group who did not have instructions (2005, p 208). This type of practice can be very helpful for women with eating disorders because while practicing they learn to value their body’s feedback and train in listening to the sensations of their bodies guidance (Daubenmier, 2005, p 208). This awareness yoga creates for practitioners may increase their value of their own 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).

In addition, society and culture are also placing women of all ages at risk for developing eating disorders. Some of the factors in today’s society and culture that affect young women are social transition, migration urbanization, peer pressure, social comparison and teasing, and exposure to Western media (Vandereycken, 2006, p 5). The mass media is a strong influence on how younger women or girls view themselves, especially between the ages of 14 and 17, since research has found a relationship between increased body consciousness and the worship of celebrities’ figures (Vandereycken, 2006, p 5). These idealizations women/girls have for these celebrity figures causes them to admire their own physical appearance and step toward slimming behaviors. Yoga can also be part of this negative influence on women, because of how society portrays it to be. In today’s society, yoga is viewed as more of a sexy way to exercise and keep in shape, due to how magazines, pamphlets, and commercials show the specific attire women should wear and the variety of poses women have to perform. The way our culture and society looks at yoga, is now more of a physical practice and a way to show off their bodies, rather than a lifestyle and deeper meaningful practice. Media portal of body image and how women should look causes great anxiety and body shame for many women, which increase their chances in experiencing eating disorders (Vandereycken, 2006, p 5). I feel our society and culture surrenders women from their connection with their inner-selves. This disconnection causes a great challenge for them to accept who they really are, and prevent them from being happy with what they have.

Judy Garland once said: “You have a right to be yourself, some people try to make us in to what they want us to be after a while, we surrender and make our self over to be accepted in love, we create disguises and hide behind them. Few see the real us, we wear masks at work, at home, and at recreation; we fear criticism rejection and intrusion” (St. Bernard’s Catholic Church, 2011, p 13). Women need to stop trying to impress or make others happy. They should be more concerned about themselves and what makes them happy and feel good. We need to let our mind relax and surrender to the peer pressure our society and culture throws upon us, and start opening up to our inner feeling and not hide or become disguised behind them. Women need to allow their body, mind, and spirit to stay as one in order to reach their own acceptance. This will allow them to lose that sense of urgency to always fit the “perfect object” our society and culture portrays on us. I feel if women can do that, it will decrease the amount of suffering they face from eating disorders. Researchers believe that yoga practices can help benefit women with eating disorders and start to accept themselves. By using yoga as a treatment or therapy, it can help enhance satisfaction with physical appearance, which may result in an increase in body awareness and responsiveness, since research found that body awareness training akin to yoga increased body acceptance in women after a two month program. Practicing yoga may also aid in healthier eating behaviors, since yoga helps gain sensitivity and responsiveness to bodily cues such as hunger or an over indulgence, which will help regulate food intake more based on bodily needs and less on emotional, situational, or other factors (Daubenmier, 2005, p 209).

Treatment and Yoga

There are many different types of treatments that were researched and found to be helpful for those women suffering from eating disorders in order to help them recover. The main problem is finding the best treatment that will work most efficiently for every woman. Traditional eating disorder prevention programs relied on instructive presentations that portrayed factual information targeting risk factors and defining eating disorders, which showed little effects on helping women with eating disorders (Scime & Cook-Cottone, 2008, 134). Some positive innovations included treatments that had educational sessions that offered information on healthy bodies, eating, and exercise (Scime & Cook-Cottone, 2008, p 134). Some of the newer treatment prevention programs are developed specifically to be interactive, which demonstrated an increase in knowledge, and some decreases in dysfunctional eating attitudes and behavior (Scime & Cook-Cottone, 2008, p 134). There has also been supporting evidence on the use of dissonance techniques to prevent the internalization of the thin-deal, and the use of enacting change in the social environments, which has also showed positive results for women with eating disorders (Scime & Cook-Cottone, 2008, p 135). Yoga is one of the newer treatments being looked at in many studies to see how effective it is with helping to cure women with eating disorders.

Yoga has been looked at as an alternative treatment for women with eating disorders. Yoga practices were found to increases the awareness of the indisputable link between a person’s overall physical and mental health, inner peace, and wellbeing (Boubette, 2006, p 167). Yoga is like other interventions for eating disorders, but has the potential to contribute to or detract women from treatment (Douglass, 2009, p 127). This type of treatment introduces many patients to a new sensation of relaxation. Patients often report the combination of yoga postures (asanas) followed by relaxation (savasana) creates a deep sense of peace and freedom they have never before experienced (Boubette, 2006, p 167). Yoga treatment has enabled patients to experience their bodies in a new way rather than just objects. Yoga helps develop body acceptance, by developing a series of poses that help women experience positive associations with their bodies as well as poses that present emotional and physical challenges (Boubette, 2006, p 168). Boubette describes yoga as a non verbal treatment that provides an opportunity for connection with the physical body and the inner experience (2006, p 170). The process of practicing stretching and strength-building positions with relaxation, meditation and breathing techniques provides opportunities for self-awareness, reflection and change while at the same time allows for the creation of inner peace (Boubette, 2006, p 170).

Another study mentioned how the use of yoga practices helped impact the physical and emotional signals of the body, which showed a psychological adjustment (Dale, ‘et al.’, 2009, p 430). Women were able to become more aware and identify their emotional and mood states as well as better tolerate their fluctuations. Yoga helped decrease eating disorder symptoms that women were experiencing and helped reduce eating and weight concerns (Dale, ‘et al.’, 2009, p 430). Participants demonstrated an increase in overall psychological functioning, decrease in eating disordered thoughts and behaviors, and a decrease in tension and anxiety at the end of the workshop study (Dale, ‘et al.’, 2009, p 430). Yoga seems to appear as an effective adjunctive treatment for women with eating disorders when specially targeting one’s attention on simple awareness of the body, both physically and emotionally (Dale, ‘et al.’, 2009, p 433). Other research found that yoga treatment can create change in the neurophysiology of the body, which shows that the body-based practices of yoga have a potential to positively shift one’s embodies experience allowing a better chance for healing (Douglass, 2009, p 127). Douglass also states how the incorporation of yoga in to treatment is to integrate some awareness of one’s body as living, breathing entities that they are connected to as opposed to the body as a separate thing that they hate and try to manipulate ( 2009, p 130). The rhythmic movements used in yoga practices helps make the connection between the mind, breath, and body by shifting one’s awareness and preventing the participant to become overwhelmed (Douglass, 2009, p 130). Yoga can be a very effective alternative treatment for those suffering from eating disorders, however there is a lack of evidence that shows yoga being an actual lifetime cure for eating disorders.

Conclusion

Eating disorders are incredibly difficult to cure. It is very difficult to cure because there are so many different aspects that go into this type of disease. It affects one’s psychological, emotional, and physical state of mind, which is extremely complex to cure since you’re dealing with mind power and control, which can only be helped by the person who is suffering from this sickness. There are many studies being performed on discovering the right cure for these disorders and yoga was seen as a new alternative treatment people were attempting to try.. Yoga treatment showed many effective and positive outcomes, but for only a short amount of time. The problem with yoga treatment is that it cannot be the only component of treatment used when it comes to curing eating disorders. One needs the social and educational components as well to help contribute to the improvement of those individuals’ moods, emotional and body awareness, and psychological well being (Dale, ‘et al.’, 2009, p 432). Yoga can offer a somatic approach that balances the other treatments necessary to work with those suffering from eating disorders (Douglass, 2009, p 135). Other treatments such as cognitive dissonance interventions, healthy eating workshops, and self-reflection workshops are needed along with yoga to get the most effective results from patients. Yoga can be a slow pace practice which may either be enjoyable to people with eating disorders or may be disturbing to others. Research shows that difficulties may occur with using yoga as a treatment for people with eating disorders, because having to choose a yoga class can be discriminating between which impulses to follow (Douglass 2009, p 132). The rush of endorphins in an athletic class may temporarily calm one’s anxiety, and the slow meditative class may have long term benefits, but put these individuals too closely in contact with their suffering to be an attractive option (Douglass 2009, p 132). The healing process for those going through eating disorders becomes very difficult and problematic to deal with. There needs to be more research performed on the different effective treatments being offered that will have a long term affect. Yoga could potentially be one component that could help lead to the cure of eating disorders with the help of other components that help one’s frame of mind, emotional and body awareness, and psychological well being restore to health.

References

Boudette, R. (2006, April). Questions & 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. doi:10.1080/10640260500536334.

Dale, L. P., Mattison, A., Greening, K., Galen, G., Neace, W., & Matacin, M. (2009). Yoga workshop impacts psychological functioning and mood of women with self-reported history of eating disorders. Eating Disorders,17(5), 422-234. Doi: 10.1080/10640260903210222

Daubenmier, J. J. (2005, June). The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychology of Women Quarterly, 29(2), 207-219. doi: 10.1111/j.1471-6402.2005.00183.x

Dittmann, K. A., & Freedman, M. R. (2009, September). Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga. Eating Disorders, 17(4), 273-292. doi:10.1080/10640260902991111

Douglass, L. (2009, March). Yoga as an intervention in the treatment of eating disorders: Does it help? Eating Disorders, 17(2), 126-136. doi: 10.1080/10640260802714555

Mitchell, K. S., Mazzeo, S. E., Rausch, S., & Cooke, K. (2007, March). Innovation intervention for disordered eating: evaluating dissonance-based and yoga interventions. International Journal of Eating Disorders, 40(2), 120-128. doi: 10.1002/eat.20282

Scime, M., & Cook-Cottone, C. (2008, March). Primary prevention of eating disorders: a constructivist integration of mind and body strategies. International Journal of Eating Disorders, 41(2), 134-142. doi:10.1002/eat.20480.

Scime, M., Cook-Cottone, C., Kane, L., & Watson, T. (2006, March). Group prevention of eating disorders with fifth-grade females: impact on body dissatisfaction, drive for thinness, and media influence. Eating Disorders, 14(2), 143-155. doi:10.1080/10640260500403881

St. Bernards Catholic Church. (2011, April). Untieing Life's Knots (p. 13).[Pamphlet]. Levittown, NY: Sica, J.

Vandereycken, W. (2006, March). Media influences and body dissatisfaction in young women. Eating Disorders Review, 17(2), 5. Retrieved March 16, 2011, from Academic Search Premier.

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