Use of yoga in outpatient eating disorder treatment: a pilot study

Abstract

BackgroundIndividuals with restrictive eating disorders present with co-morbid psychiatric disorders and many attempt to control symptoms using strenuous exercises that increase caloric expenditure. Yoga offers a safe avenue for the engagement in physical activity while providing an outlet for disease-associated symptoms. This study sought to examine use of yoga practice in an outpatient setting and its impact on anxiety, depression and body image disturbance in adolescents with eating disorders.MethodsTwenty adolescent girls were recruited from an urban eating disorders clinic who participated in weekly yoga classes at a local studio, in addition to standard multidisciplinary care. Yoga instructors underwent training regarding this patient population. Participants completed questionnaires focused on anxiety, depression and body image disturbance prior to the first class, and following completion of 6 and 12 classes.ResultsIn participants who completed the study, a statistically significant decrease in anxiety, depression, and body image disturbance was seen, including: Spielberger State anxiety mean scores decreased after the completion of 7–12 yoga classes [47 (95%CI 42–52) to 42 (95%CI 37–47), adj. p = 0.0316]; as did the anorexia nervosa scale [10 (95% CI 7–12) vs. 6 (95%CI 4–8), adj. p = .0004], scores on Beck depression scales [18 (95%CI 15–22) to 10 (95%CI 6–14), adj. p = .0001], and weight and shape concern scores [16 (95%CI 12–20) to 12 (95%CI 8–16), adj. p =0.0120] and [31 (95%CI 25–37) to 20 (95%CI 13–27), adj. p = 0.0034], respectively. No significant changes in body mass index were seen throughout the trial.ConclusionsYoga practice combined with outpatient eating disorder treatment were shown to decrease anxiety, depression, and body image disturbance without negatively impacting weight. These preliminary results suggest yoga to be a promising adjunct treatment strategy, along with standard multidisciplinary care. However, whether yoga should be endorsed as a standard component of outpatient eating disorder treatment merits further study.

Disordered eating behaviours and correlates in yoga practitioners: a systematic review

“…For instance, a study where yoga was practiced at a small dosage (45 minutes per week for 6 weeks) had no significant effects on eating disorder symptomatology [40]. Interventions that offered higher yoga dosages (60 minutes per week for 12 weeks: [41]; 2 hours per week for 8 weeks: [42]; 60-90 minutes per week for 12 weeks: [43]) yielded positive results in decreasing disordered eating symptomatology or increasing positive body image.…”

Physical activity behaviors and attitudes among women with an eating disorder: a qualitative study

“…Furthermore, experimental studies report decreased compulsive PA, reduced drive for thinness and bulimic symptoms, improved body satisfaction, facilitated weight gain, enhanced muscular strength, and reversed cardiac abnormalities among women with an ED who engage in PA [21][22][23]. Additionally, PA can enhance mood, quality of life, and well-being among women with an ED [24,25].…”

“…Furthermore, experimental studies report decreased compulsive PA, reduced drive for thinness and bulimic symptoms, improved body satisfaction, facilitated weight gain, enhanced muscular strength, and reversed cardiac abnormalities among women with an ED who engage in PA [ 21 – 23 ]. Additionally, PA can enhance mood, quality of life, and well-being among women with an ED [ 24 , 25 ]. Last, PA can promote bone health [ 26 ], which is beneficial to women with anorexia nervosa because they often have decreased bone mass, impaired bone structure, and reduced bone strength [ 27 ].…”

Reclaiming the Lost Self in the Treatment of Bulimia Nervosa: A Neurobiological Approach to Recovery That Integrates Mind, Brain, and Body

“…It is not unusual for ED individuals with restrictive eating disorders to attempt to control symptoms by using strenuous exercise to increase caloric expenditure. Trauma-informed yoga offers these individuals a safe avenue for the engagement in physical activity while providing an outlet for disease-associated symptoms [38]. Trauma-informed yoga reprograms the brain through activating novel movement, breathing, and action patterns and their psychological correlates.…”

“…Trauma-informed yoga reprograms the brain through activating novel movement, breathing, and action patterns and their psychological correlates. Facilitating sensorimotor processing and mitigating stress responses through combined topdown and bottom-up influences, yoga practice provides "a non-threatening means by which to unearth previously disavowed emotions stored in the 'emotional' limbic system, then cortically mediates traumatic pathways and thoughts through psychological appraisal methods" [38]. Teaching the use of breath facilitates close attention to present-moment awareness of self, bringing the nervous system from a dysregulated state to a unified, centered state by shifting the sympathetic nervous system to a balanced parasympathetic sense of calm and relaxation, while offering patients a sustainable relationship with the internal body.…”