The power of yoga in eating disorder recovery

yoga and eating disorders

Yoga as an embodiment practice

 

There is a growing interest in the benefits of practicing yoga for those struggling with an eating disorder. You might be wondering how a form of exercise could help with eating disorder recovery – however yoga is about so much more than moving from pose to pose or sitting cross legged on the floor. By promoting slowing down and turning the awareness inwards, yoga encourages a harmony between the mind and body that is lost through the eating disorder.

In this article, we’ll do a deep dive into the benefits of yoga in eating disorder recovery and the evidence supporting it.

 

What does the research say?

There is plenty of evidence supporting the benefits of yoga in eating disorder recovery. To describe a few…

One study of a group of women with Bulimia Nervosa or EDNOS found a significant decrease in eating disorder psychopathology after six months of twice-weekly yoga classes.1 The most significant impact was seen in a reduction in eating concern, weight concern and restriction.

Similarly, a study of women between the ages of 18-30 found a reduction in body-image dissatisfaction and spent less time focused on their appearance when they practiced yoga twice a week for twelve weeks.2

Another small study of adolescents with an eating disorder being treated as outpatients found a significant decrease in anxiety, depression, and body image disturbance after completing a weekly yoga class for twelve weeks.3

 

What is it about yoga that supports recovery?

Yoga can be uncomfortable, both physically and emotionally. By offering a safe space that is free of distraction, there is the opportunity to process and release emotions that may have been pushed down for a long time or coped with through the eating disorder. You might also find you can prove to yourself that you can survive hard things and that discomfort will pass. Learning to sit with discomfort and respond to your feelings rather than react are key skills for eating disorder recovery, as they allow you to navigate the urge to engage in disordered behaviours.

Another idea that is emphasised in most yoga classes is meeting yourself where you’re at. This means not comparing yourself to others, or even to your own “best self”. Instead, yoga encourages you listen to your body in any given moment, and to give it what it needs. Some days your healthy self will want a little more movement; some days it will need rest. Both are okay!

We said earlier that yoga is not just about the poses, but they have their place too! Moving (or holding still) with mindful intention allows you to connect in with your body without any focus on appearance. Despite an often-obsessive focus on the body, eating disorders leave us feeling incredibly numb and disconnected from our physical selves. Too often, we treat the body like the problem, when reconnecting with it can actually be the solution.

 

What should I look for in a yoga class?

Not every yoga class is going to be helpful, especially in the early stages of recovery. Choose classes that are gentle and focused on relaxation and stretching rather than more intensive movement. These classes are sometimes called “Yin yoga” or “restorative yoga”. Yoga classes that are trauma-informed, or even specifically directed towards eating disorder recovery are also out there – we suggest Googling what is available in your area.

Like almost all good things, diet culture has unfortunately found its way into some parts of the yoga community. While many studios are “safe” spaces, not all will be. Have a look at their website and social media to see what kind of messaging they promote and avoid any that refer to using exercise or food to change your physical appearance.

It should also be noted explicitly that while we obviously believe in the power of yoga in supporting eating disorder recovery, it should be practiced in combination with other treatment modalities and should NOT replace traditional evidence-based treatments. Make sure you discuss with your team before you introduce any exercise!

To learn more about how our dietitians can support you in your eating disorder recovery, book a free discovery call.

 

Karli Battaglia, APD

EHL Team x

 

References

1. Karlsen K, Vrabel K, Bratland-Sanda S, Ulleberg P, Benum K. Effect of yoga in the treatment of eating disorders: A single-blinded randomized controlled trial with 6-months follow-up. International Journal of Yoga. 2018;11(2):166.

2. Ariel-Donges A, Gordon E, Bauman V, Perri M. Does Yoga Help College-Aged Women with Body-Image Dissatisfaction Feel Better About Their Bodies?. Sex Roles. 2018;80(1-2):41-51.

3. Hall A, Ofei-Tenkorang N, Machan J, Gordon C. Use of yoga in outpatient eating disorder treatment: a pilot study. Journal of Eating Disorders. 2016;4(1).

 

This happens when you stop weighing yourself

weighing yourself

As soon as you wake in the morning, you tense up… you place both feet on the ground, take a breath and sigh in apathy just hoping the number you see this time might just be enough… feel like enough… but to no avail, is it really ever?

Continue reading

How to build a body compassion practice

body compassion mindfulness positive body image

Practical tips to improve your relationship with your body and food

Body compassion plays a significant role within the intuitive eating framework, and working on embodiment can also be an essential step in your quest to improve your relationship with food.

So what is body compassion, and how can we develop a practice to improve our self-esteem and cultivate positive embodiment? Read on to learn more!

 

What is body compassion, and why might we need a body compassion practice?

There are several ways in which we can explain or understand what we mean by body compassion. Put simply, it can be defined as how an individual relates and experiences being in their body. 

For years, people of all shapes and sizes have been shamed by diet culture, promoting the ‘thin ideal,’ which places smaller bodies above larger ones. 

We live in a society where bodies, like foods, are labelled as ‘good and bad’ or ‘healthy and unhealthy,’ leading to weight stigma and food restriction. Where we are never perfect and constantly need to be improving our bodies, appearance and health. 

Being brave enough to unpack our internalised beliefs can be the critical step to finding freedom and being more body compassionate.

However, it’s important to remember that body compassion is prolonged, difficult work. There is a lot of ‘unlearning’ involved, and it is impossible to reverse beliefs overnight.

However, there may be amazing benefits to working on our body compassion. A recent literature review found that having a stronger body compassion practice was protective against poor body image and eating pathology. Body compassion has therefore been linked to decreasing eating disorder outcomes and disrupting the risk factors that may trigger them. (1)

Other research has shown that major life events are less likely to trigger binge eating episodes when body compassion is present (2) and reduce feelings of shame and guilt. (3) 

A body compassion study on young women was also shown to reduce social appearance anxiety, upward appearance comparison, body dissatisfaction, drive for thinness, and increase body appreciation and compassion even when tested one month post-intervention. (4)

 

How can we create develop our body compassion practice?

Body compassion practice is deliberate – it will help to set aside some time each day or week to commit to this form of healing. It can be great to familiarise yourself with these tools and techniques so they feel more natural when you might need them most. Below is some inspiration for what your body compassion practice may look like.

 

ONE: Making rituals 

Making rituals and committing to them can be a fantastic stepping stone in your journey to body empowerment. Some examples you could include in a ritual might consist of:

  • Journalling your thoughts, emotions and feelings
  • Listening to a body positivity/neutrality podcast or meditation
  • Reading a chapter or section of a body liberation book
  • Creating and saying a positive mantra 
  • Yoga, stretching and other movements you enjoy
  • Committing to a regular mindfulness practice
  • Offering yourself a massage
  • Scrolling through the feeds of positive body activists
  • Checking in with your values and reminding yourself of them
  • Seeking and looking at images of diverse bodies and not just what we see on media

You could write these as a list or in a diagram format to remind you of simple techniques and even add your own ideas too. Hanging this up on a wall or somewhere you will see it daily may act as a gentle reminder to embrace body compassion throughout your day. 

 

TWO: Write a letter to your body

Another step you could try is writing a letter to your body. There are plenty of ways in which you could address this, and examples may include:

  1. Writing a letter of love to your body, appreciating and noticing its intricacies and nuances, thanking it for all of the amazing purposes it serves in this very moment, and not when or if you look a certain way. Your body allows you to breathe, run, dance eat, sleep, and even read this article!
  2. Writing a letter of apology to your body for what may have been a lifetime of negativity, low self-esteem, criticism and punishment, engaging in disorderly behaviours and not appreciating it for being a particular shape. 

Both of these letters may feel quite difficult to do but can be liberating and help you to reground with your values and what truly matters. 

 

THREE: Explore your intentions.

Ask yourself some questions to further understand your feelings around embodiment and to identify and even alter thought patterns. You could delve into some of the following questions:

  • What does embodiment look like and mean to you?
  • What are the barriers between you and encompassing your body?
  • Are you able to recall a time, perhaps in early childhood, when you felt at peace within your body and carefree of how you would be perceived? How does that differ from how you feel now?
  • In what ways do you feel proud of your body and what it can do?
  • How has fatphobia shaped your view of your body and yourself?
  • When did you first feel as though your body was a problem? What may have influenced this?
  • Do you have a particular role model who you feel best represents positive embodiment for you? What about them can you appreciate, and how can you apply this to your own body?
  • Have you been able to feel gratitude or appreciation for your body that you didn’t feel previously?

Exploring these questions (and others that may come to mind) can be an excellent way of breaking down internalised beliefs, shifting the blame from ourselves to external sources that feed these beliefs.

Remember, practices can be dynamic and change over time as you learn and progress further and develop more skills and tools to better empower yourself. Stay tuned with future articles and learn how to beat diet culture and boost your body image.

This is extremely brave work, and you are doing amazing in beginning the journey of understanding body compassion.

 

Priya Chotai, BSc ANutr 

EHL Team x

 

References:

1. Braun TD, Park CL, Gorin A. Self-compassion, body image, and disordered eating: A review of the literature. Body Image. 2016 Jun;17:117-31. doi: 10.1016/j.bodyim.2016.03.003. Epub 2016 Mar 31. PMID: 27038782.

2. Barata-Santos M, Marta-Simões J, Ferreira C. Body compassion safeguards against the impact of major life events on binge eating. Appetite. 2019 Mar 1;134:34-39. doi: 10.1016/j.appet.2018.12.016. Epub 2018 Dec 14. PMID: 30557589.

3. Oliveira S, Trindade IA, Ferreira C. The buffer effect of body compassion on the association between shame and body and eating difficulties. Appetite. 2018 Jun 1;125:118-123. Doi: 10.1016/j.appet.2018.01.031. Epub 2018 Feb 7. PMID: 29427690.

4. Seekis V, Bradley GL, Duffy AL. Does a Facebook-enhanced Mindful Self-Compassion intervention improve body image? An evaluation study. Body Image. 2020 Sep;34:259-269. doi: 10.1016/j.bodyim.2020.07.006. Epub 2020 Jul 24. PMID: 32717627.

 

Can I practice body neutrality and still care about my appearance?

body image positive neutral

Still care about what you look like?

You will probably not be surprised to hear that “body neutrality” is a huge buzzword in anti-diet spaces at the moment.

Body neutrality first gained popularity in 2015 as an alternative to the often-toxic “body positivity” movement.  It pushes back against beauty ideals and the promotion of appearance as the ultimate success or failure; instead, the key ideology of body neutrality is that how you look is not what makes you an amazing human being.

However, this begs the question – can you practice body neutrality and also put time and effort into how you look?

In short: absolutely!

Adopting a neutral perspective of your body doesn’t mean that you are suddenly blinded to your own appearance and aren’t allowed to put any thought towards it – instead, it means that your goals shift from aiming to conform to beauty standards to aiming to achieve contentment within yourself.

To learn more about the fundamentals of body neutrality, you can check out our blog “Four Ways to Practice Body Neutrality” here. As noted in that article, this concept is relatively new and as such, scientific research in this area is limited. However, you can learn more about body neutrality from people such as Anuschka Rees (find her on Instagram @anuschkarees and check out her book, Beyond Beautiful) and Jameela Jamil (follow @iweigh on Instagram and take her free course on FutureLearn, Exploring Body Neutrality and Body Image).

In this article, we’ll unpack three ways you can care about your appearance AND live a life of body neutrality.

 

ONE: Remember that self-worth is not reliant on appearance

Although your self-esteem may change from day to day, your self-worth is unalterable. Just like the value of a £5 note can’t be changed by the perceptions of others, neither can yours!

To practice body neutrality, you must disconnect your identity and worth from the way you perceive your appearance. The way you look does not define who you are.

Remove the pressure to feel positively about your body! There will always be aspects of your appearance that you like less than others – that’s okay! Body neutrality isn’t about feeling neutral about your appearance; instead, it’s about neutralising the impact of how you feel about your appearance on your mood, self-worth, identity and actions. In other words, focus on not allowing negative thoughts about your body stop you from living your life to its fullest.

 

TWO: Take care of your body

Another component of body neutrality is the idea that regardless of how you feel about your body on any given day, it’s important to show it care and respect.

Some days, this might take the form of brushing your hair, applying skincare or putting on clean clothes in the morning. On other days, taking it easy and staying in your PJs all day might be how you take care of yourself. Your appearance doesn’t need to change in order to care for your body!

This moves the focus from how you look at your body to how you feel within your body.

 

THREE: Utilise your appearance as a source of self-expression

The way we choose to show ourselves to the world is an incredible opportunity for self-expression. Through our clothes, makeup, hair and jewellery, we get to experiment and experience joy.

When you get ready in the morning, choose to present yourself in a way that makes you feel powerful, without an emphasis on how you look or how other people might perceive you.

In her book, The Curate Closet, Anuschka Rees writes ‘If something is your style and you love it, I believe you should wear it, regardless of whether it supposedly “flatters” your body or doesn’t. Plus, if we are being honest, to flatter almost always means “make you look thinner”, and that definitely shouldn’t be your prime objective when it comes to getting dressed’.

When you practice body neutrality, you can still feel a sense of peace in your body on days when you don’t get dressed up.

There is such a stark difference between using our appearance to conform to societal pressures and using it to show our uniqueness! This shifts the balance from your body having the power over you to you having the power over your body.

The take home message from all of this is that you can absolutely still take pride in your appearance while practicing body neutrality! Your body is simply a tool for you to use as you desire.

If you’re experiencing body image concerns, we’re here to help! Reach out to us at hello@embodyhealthlondon.com to find out how we can support you towards introducing body neutrality in your own life.

 

Karli Battaglia MDiet, APD

EHL Team x   

Can you be in a larger body and also have an eating disorder?

The truth about body diversity in eating disorders

 

When you imagine someone with an eating disorder, you might visualise an emaciated young white woman. This is a common stereotype but it’s completely inaccurate! Eating disorders affect people of all ages, genders, ethnicities, and body sizes. For the purposes of this article, we’ll be focussing our myth-busting on the latter.

A disclaimer to start with: In this article, we’ll be describing different body shapes and sizes, and have endeavoured to do this as inclusively as possible. However, there are times when we use the terms “obese” and “overweight” in a biomedical context. We have kept these in quotations to acknowledge how stigmatising these labels are and to indicate that BMI categories are arbitrary. To learn more about this, check out our recent article about the reliability (or lack thereof) of BMI: We also use the term “fat” as a neutral descriptor, as many people with lived experience have expressed their preference for this terminology.

 

Do you need to be underweight to be diagnosed with an eating disorder?

“Obesity” is NOT an eating disorder and it is NOT the opposite of anorexia nervosa.

Eating disorders occur across the weight spectrum. In fact, less than 6% of people with an eating disorder are underweight.1

Unfortunately, the diagnostic criteria for anorexia nervosa (AN) has not yet caught up to 2021, with the DSM-5 (the current diagnostic manual for mental illnesses) still requiring a BMI of less than 18.5 in order to diagnose it. People who meet all of the criteria for AN but are at a higher body weight are instead diagnosed with “atypical anorexia nervosa”.

Not only is this separation of diagnoses unnecessary (and we’ll get into why later on!) but it’s a huge problem in terms of treatment. For example, in order to access NHS-funded treatment for anorexia in the UK, individuals require an “underweight” BMI.2

We’re as frustrated by this as you are, and we are advocating for the diagnostic criteria of eating disorders to be inclusive of all body sizes!

 

Do all people in larger bodies have binge eating disorder?

One of the major myths we need to dispel is the idea that the only eating disorder that a fat individual can have is binge eating disorder (BED). Branching off from that, there is even the myth that all people in larger bodies have BED. These are both simply untrue!

BED can occur at any body size. Additionally, there are many reasons why a person might be in a bigger body, which may or may not be related to their eating behaviours. Body diversity is a natural phenomenon – just as some people are naturally thin, others are naturally fat. Both are okay!

 

Why do eating disorder diagnoses need to be weight inclusive?

Eating disorder diagnoses are often missed or dismissed in larger-bodied people.

As a society, we encourage fat people to engage in the same behaviours that result in an eating disorder diagnosis in thin people. This is thanks to diet culture, which promotes that it is better to be thin and have a toxic relationship with food than it is to be fat and have a positive relationship with food.

Many people in larger bodies with eating disorders report traumatic experiences when they attempt to seek treatment. This is a result of not only the untrue stereotypes around eating disorders, but also anti-fat bias. As part of this, many struggle with feeling like they’re not “sick enough” to deserve help. This is compounded by their experiences in treatment, such as being provided low-calorie meals, being encouraged to skip dessert or even receiving praise from health professionals for their disordered behaviours.

This is despite their eating disorders being just as severe in terms of medical complications as those who present at a lower BMI.3 These complications can include amenorrhea (loss of menstruation), decreased bone density, loss of lean tissue, gastroparesis (delayed stomach emptying) and irregular heart rhythm.

All people with eating disorders, despite their body size, are in a state of starvation.

If you have an eating disorder and are in a larger body, please know that your experience is valid. There is nothing wrong with your body. You are sick enough to get help. You are worthy of treatment.

Our expert dietitians can support you on your journey to recovery. Get in touch with us at hello@embodyhealthlondon.com to chat with us about how we can help you.

 

Karli Battaglia MDiet, APD

EHL Team x

 

References

  1. Arcelus J, Mitchell A, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders. Archives of General Psychiatry. 2011;68(7):724.
  2. National Health Service. First Step: Information Pack for GP Referrers. Bristol: Mental Health Partnership NHS Trust; 2017.
  3. Neumark-Sztainer D. Higher Weight Status and Restrictive Eating Disorders: An Overlooked Concern. Journal of Adolescent Health. 2015;56(1):1-2.