Body of Life: Yoga as Treatment for Eating Disorders

By Kathleen McAuliffe

During her 15-year struggle with an eating disorder, Heather Jacoby’s body has been an object of self-hatred.

But when she began yoga therapy as a part of treatment, her body became a means of self-acceptance.

“The first time I walked into the yoga studio, I found peace for the first time,” Jacoby said. “Yoga teaches me that however I am in that moment, I’m OK.”

“I don’t have to like everything. I don’t have to be at peace and I can still be OK.” Though she still has bad body image days, Jacoby credits yoga with improving her perception of herself.

Yoga is emerging as a form of therapy for eating disorders, from anorexia to binge eating, both in treatment centers and standalone facilities in the Chicago area and nationwide. Before starting a yoga program, clients have typically reached advanced stages of recovery and have stabilized their weight.

Classes focus on mindfulness and breath work instead of nailing precise postures or burning calories. Unlike standard yoga classes, instructors do not manually adjust their students’ postures, nor do they critique students’ form. This enables clients to regain autonomy over their bodies, said yoga therapy instructor Jenny Kreatsoulas.

“I am very mindful of my language,” Kreatsoulas added, “I won’t use certain cues, I will never say the word belly or hips or ‘Shift your hips.’ I don’t teach in a way that is acting for more. Like, ‘Go higher, go deeper.’ It’s more like, ‘Let’s breathe. Let the rhythm of breath move your body.’”

“Whatever’s happening through the practitioner is coming from them, not because the teacher is dictating someone at them.”

Instructors, who are often licensed counselors or therapists, are specifically trained to teach clients with eating disorders. During individual debriefings, they stay aware of their students’ mental states and modify sequences accordingly.

“We do a check-in at the beginning of [class] and at the end,” said Ashley Podzius, an instructor at Rago & Associates, a counseling center in Naperville,” If they’re having a really awful day, I’ll never correct their postures, as long as they are safe.”

“[My instructor] really individualizes everything depending on what you’re feeling,” Jacoby added. “Recently, I’ve had more struggles being uncomfortable with yoga and she’s really responded to that.”

In this supportive environment, clients regain connection with their thoughts and emotions, said Ashley Sheil, site director and yoga specialist at Renfrew Center Charlotte.

“Eating disorders really numb and disconnect you,” she said. “But with yoga, they start to connect back to their bodies and they notice how their bodies physically feel. They notice when they’re feeling hungry or when they’re feeling sadness, happiness, anxiety and depression.”

Given its relative newness, little research has been conducted on its long-term ability to reduce the risk of relapses. But recent research, including a 2015 study by the University of Michigan, has shown promising preliminary results. After completing a yoga therapy program in conjunction with their regular course of treatment, women in partial-hospitalization treatment reported a better ability to maintain an appropriate calorie intake for their weight.

For some, yoga is medicine. But for those who used exercise to lose weight, it’s a risky reintroduction to their eating issues.

Although instructors deliberately de-emphasize strength building, clients may set and work toward physical goals, Sheil said. Taken to extremes, this competitive mindset can reinforce the perfectionistic and obsessive mindset thought to underlie eating disorders.

“There can be a real competitive aspect to it,” she added. “‘How long can I go in a pose? How much strength can I build?’ For someone in the outside world, it’s fine. But for someone with an eating disorder, it can become rigid and competitive. It can become self-defeating and if you keep doing that, you’ll never feel happy with yourself and ultimately, it can be harmful to recovery.”

And as clients transition from treatment to recovery, from yoga therapy to more physically strenuous classes, they may encounter harmful messaging from teachers and studios that encourage weight loss above all else.

Clients should not automatically avoid traditional yoga classes, but they should approach potential studios with a healthy skepticism, Sheil said.

“We certainly want people to reintegrate activity into their lives. But some studios do focus on weight loss and caloric burn,” Sheil said. “We hope [clients] would choose a studio that’s more focused on being present and practicing increasing function and movement of their bodies and less on how long you can hold a posture, or being thin and limber or weight loss.”

Jacoby acknowledges that for her, “workout-focused” classes can trigger negative thoughts about her body. But by staying vigilant of her emotions and body image, she proactively chooses studios that will enhance, not threaten, her recovery.

“I purposely do not go to studios like that,” Jacoby said. “I took a couple classes at a studio that’s very workout-focused and I’m very mindful about not going to those classes. It can be triggering, when they’re not telling you to listen to your body. Like hot yoga, I can’t do that.”

The long-term impact of trauma-focused yoga requires more research, and many experts maintain that no one can be fully “cured” from an eating disorder.

But through yoga, clients can cultivate the coping skills and self-acceptance necessary to combat the daily challenges of life after an eating disorder, Kreatsoulas said.

“We use yoga to create coping tools that they can apply to situations in their daily life,” she added, “So that when they’re confronted with a hard meal or urge to restrict, they can call on their own internal strengths to combat that pull to use the eating disorder.”

With yoga comes healing. (Kathleen McAuliffe/MEDILL)
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