"Overeating is not about the food": women describe their experience of a yoga treatment program for binge eating

Yoga as an adjunct treatment for eating disorders: a qualitative enquiry of client perspectives

BACKGROUND

This qualitative enquiry explores the experiences and perspectives of individuals with an eating disorder (ED) regarding their perceptions of yoga as an adjunct intervention to psychotherapy. It also explores the feasibility, acceptability, and safety of yoga from their perspectives.

METHODS

This study used a practice-based evidence framework and employed semi-structured interviews with 16 females with an ED. Participants were asked about their perspectives on the use of yoga as an adjunct intervention in ED recovery, perceived risks and what factors supported or hindered engagement. Thematic template analysis was used.

RESULTS

Three topic areas were elaborated. The first included participants' perceptions of how yoga enhanced their ED recovery. The second included how and when participants came to find yoga in their ED recovery. The final topic explored factors that supported participants with ED to engage in yoga. These resulted in the development of guiding principles to consider when designing a yoga intervention for EDs.

CONCLUSIONS

This study adds further to the emerging evidence that yoga can bring complementary benefits to ED recovery and provides a biopsychosocial-spiritual framework for understanding these. Findings provide an understanding of how yoga programs can be adapted to improve safety and engagement for people with an ED. Yoga programs for people with EDs should be co-designed to ensure that the physical, social, and cultural environment is accessible and acceptable.

One size may not fit all: A mapping review of yoga-based interventions for the treatment of eating disorders

BACKGROUND

While research investigating the potential benefits of yoga for eating disorders (EDs) has expanded, a systematic approach examining how yoga has been implemented for this cohort has not yet been conducted. This research therefore aimed to synthesize the current understanding of how yoga has been implemented for individuals with EDs, with regards to the feasibility, acceptability, and safety of yoga for this cohort.

METHODS

This study utilised mapping review technology. The following electronic databases were searched within the month of September 2021 and December 2022: PsycINFO, MEDLINE, CINAHL, and Embase. Articles that applied and documented the use of yoga for the EDs were selected.

RESULTS

The review identified ten unique studies. Details regarding the application, feasibility, acceptability, and safety of these yoga programs were extracted. This resulted in an evidence map or visual summary of how yoga has been applied for the EDs.

CONCLUSION

While limited, the current literature suggests that yoga is a safe, acceptable, and feasible transdiagnostic intervention for EDs. These findings provide pragmatic support for safely applying yoga for the EDs into clinical practice to support ED recovery.

A randomized trial examining the effect of yoga on dietary lapses and lapse triggers following behavioral weight loss treatment

Background

Dietary lapses can hinder weight loss and yoga can improve self-regulation, which may protect against lapses. This study examined the effect of yoga on dietary lapses, potential lapse triggers (e.g., affective states, cravings, dietary temptations), and reasons for initiating eating following weight loss treatment.

Methods

Sixty women with overweight/obesity (34.3 ± 3.9 kg/m2) were randomized to a 12 week yoga intervention (2x/week; YOGA) or contact-matched control (cooking/nutrition classes; CON) following a 12-week behavioral weight loss program. Participants responded to smartphone surveys (5x/day) over a 10-day period at baseline, 12, and 24 weeks to assess lapses and triggers.

Results

At 24 weeks, YOGA and CON differed on several types of lapses (i.e., less eating past full, eating more than usual, loss of control when eating, self-identified overeating, difficulty stopping eating in YOGA), and YOGA was less likely to eat to feel better or in response to stress (ps < 0.05). YOGA also reported less stress and anxiety and more positive affect (ps < 0.01); dietary temptations and cravings did not differ from CON.

Conclusion

Yoga resulted in fewer dietary lapses and improved affect among women with overweight/obesity following weight loss. While preliminary, findings suggest that yoga should be considered as a potential component of weight loss treatment to target dietary lapses.

Yoga at Every Size: A Preliminary Evaluation of a Brief Online Size-Inclusive Yoga and Body Gratitude Journaling Intervention to Enhance Positive Embodiment in Higher Weight College Women

The present pilot randomized controlled trial (RCT) evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week online yoga and body gratitude journaling intervention for strengthening positive embodiment among racially-diverse higher weight college women. Seventy-five participants were initially randomized to either the yoga condition (n = 36) or to a wait-list control (n = 39). Participants completed measures of positive and negative body image, weight bias internalization, self-compassion, drive for leanness, and physical activity acceptance at both baseline and post. Preliminary results among the 42 analyzed completers (mean age = 20.9, SD = 2.4; 30% Black or African American) revealed acceptable feasibility given the low-intensity nature of the intervention reflected in a 36% attrition rate. Self-reported adherence was strong for the yoga component with 81% of participants indicating that they practiced with the videos ≥3–4 times per week as suggested. Although 71% reported completing the body gratitude journal ≥1–2 times per week, daily adherence was minimal. Acceptability was also high among participants randomized to the yoga condition as indicated by 86% expressing at least moderate levels of satisfaction with the overall program. Qualitative feedback from participants further supported the acceptability of the program and pointed to important areas in further refining the protocol in the future. Preliminary efficacy was supported by significant reductions in internal body shame and gains in body appreciation, functional body appreciation, functional body satisfaction, functional body awareness, and behavioral commitment to physical activity engagement among the yoga vs. wait-list control participants. These promising findings once replicated in larger, higher-powered trials may have important implications for extending the reach and accessibility of mind-body wellness practices like yoga to benefit racially-/ethnically-diverse college women of higher weight. This research is further responsive to the growing need for efficacious remotely-delivered, and scalable behavioral health interventions in the ongoing era of the COVID-19 pandemic. However, additional research is warranted to explore ways of enhancing engagement of participants with lower levels of positive embodiment and to further incentivize the journaling component of the intervention.

A preliminary investigation of yoga as an intervention approach for improving long-term weight loss: A randomized trial

OBJECTIVE

Yoga targets psychological processes which may be important for long-term weight loss (WL). This study is the first to examine the feasibility, acceptability, and preliminary efficacy of yoga within a weight management program following WL treatment.

METHODS

60 women with overweight or obesity (34.3±3.9 kg/m2, 48.1±10.1 years) were randomized to receive a 12-week yoga intervention (2x/week; YOGA) or a structurally equivalent control (cooking/nutrition classes; CON), following a 3-month behavioral WL program. Feasibility (attendance, adherence, retention) and acceptability (program satisfaction ratings) were assessed. Treatment groups were compared on weight change, mindfulness, distress tolerance, stress, affect, and self-compassion at 6 months. Initial WL (3-mo WL) was evaluated as a potential moderator.

RESULTS

Attendance, retention, and program satisfaction ratings of yoga were high. Treatment groups did not differ on WL or psychological constructs (with exception of one mindfulness subscale) at 6 months. However, among those with high initial WL (≥5%), YOGA lost significantly more weight (-9.0kg vs. -6.7kg) at 6 months and resulted in greater distress tolerance, mindfulness, and self-compassion and lower negative affect, compared to CON.

CONCLUSIONS

Study findings provide preliminary support for yoga as a potential strategy for improving long-term WL among those losing ≥5% in standard behavioral treatment.

Yoga as adjunctive therapy in the treatment of people with anorexia nervosa: a Delphi study

BACKGROUND

There is preliminary evidence to suggest that yoga can be beneficial in reducing anxiety, depression and general eating disorder symptoms in people with Anorexia Nervosa (AN). It is unclear whether the therapeutic benefits of yoga are supported or utilised in the treatment of AN amongst clinical experts. The present study aimed to explore and synthesise expert opinion on the use of yoga as an adjunctive therapy in the management of anxiety, depression and over-exercise in individuals with AN.

METHODS

A Delphi methodology was employed, with clinicians considered experts in the treatment of AN recruited internationally to form the panel (n = 18). The first iteration of questionnaires comprised of four open-ended questions concerning the experts' understanding of the term yoga and opinions on its' use in therapy generally and more specifically in the treatment of AN. Using content analysis, statements were derived from this data and included as Likert-based items in two subsequent rounds where panellists rated their level of agreement on each item. Seventeen out of 18 respondents completed all three iterations.

RESULTS

Consensus (level of agreement defined at ≥ 85%) was achieved for 36.47% of the items included in the second and third rounds. The panel reached consensus on items defining yoga and pertaining to its' general benefits. The panel agreed that yoga is a adjunct therapy for various problems, consensus was not achieved on the specific use of yoga as an adjunct therapy in the treatment of comorbid anxiety, depression or trauma in patients with AN. Although the expert panel acknowledged a number of benefits for use of yoga in AN, they strongly endorsed that future research should evaluate the potential risks of using yoga as an embodied practice.

CONCLUSIONS

It is possible that yoga could be considered for inclusion in future guidelines if supported by empirical research. We conclude that there seems to be enough consensus that such further scientific investigation is warranted. This study aimed to explore expert opinion on the use of yoga as an adjunctive therapy in the management of anxiety, depression and over-exercise in individuals with Anorexia Nervosa (AN). Clinicians considered experts in the treatment of AN recruited internationally to form the panel (n = 18). Experts were asked about their understanding of the term yoga and their opinions on its' use in therapy. The panel reached consensus on items defining yoga and pertaining to its' general benefits. Although the panel agreed that yoga is a nice additional therapy for various problems, consensus was not achieved on the use of yoga as an additional therapy in the treatment of specific problems like anxiety, depression or trauma in people with AN. The expert panel acknowledged a number of benefits for use of yoga in AN. However the panel strongly considered that future research should evaluate the potential risks of using yoga as an embodied practice. The areas of collective agreement gained in the study can serve as preliminary guidelines for the use of yoga in AN whilst guiding future research directions.

Yoga in women with abdominal obesity - Do lifestyle factors mediate the effect? Secondary analysis of a RCT

INTRODUCTION

The reduction of obesity is an important challenge for health policy. Although dietary interventions are widely available, patient adherence is usually low. A promising alternative is yoga. We hypothesized that weight reduction through yoga is mediated by aspects related to eating habits as well as physical aspects.

METHODS

This is an exploratory secondary analysis of a randomized controlled trial comparing the effects of yoga to waiting list in women with abdominal obesity. Body mass index (BMI) and waist circumference were assessed as outcomes; physical exercise habits, physical activity habits at leisure time, physical activity habits at work time, daily fruit and vegetable intake, nutrition self-efficacy, and physical self-efficacy were captured as mediators. Measures were assessed at weeks 0 and 12. The original trial was conducted between April and August 2015. The secondary analysis was performed December 2019.

RESULTS

Forty patients were randomized to the 12 weekly yoga sessions (48.5 ± 7.9 years) and 20 patients to the waitlist group (46.4 ± 8.9 years). Physical exercise habits fully mediated the effect of yoga on BMI (B=-0.26;CI[-.56;-.07]). Daily fruit and vegetable intake partially mediated the effect of yoga on BMI (B=-0.13;CI[-.38;-.01]). No further mediation effects were found.

CONCLUSIONS

Yoga supports people with overweight in eating healthier and increasing their physical activity which in turn leads to a reduced BMI. Yoga's effects on waist circumference seem to be due to other mechanisms.

Women, Exercise, and Eating Disorder Recovery: The Normal and the Pathological

The appropriate form, regularity, and intensity of exercise for individuals recovering from eating disorders is not agreed upon among health care professionals or researchers. When exercise is permitted, it is that which is mindful, embodied, and non-competitive that is considered normative. Using Canguilhem's concepts of "the normal and the pathological" as a theoretical frame, we examine the gendered assumptions that shape medical understandings of "healthy" and "dysfunctional" exercise in the context of recovery. The data set for this article comes from longitudinal semi-structured interviews with 19 women in the United Kingdom who engaged in weightlifting during their eating disorder recovery. We argue that women in recovery navigate multiple and conflicting value systems regarding exercise. Faced with aspects of exercise that are pathologized within the eating disorder literature (such as structure/routine, body transformations, and affect regulation), women re-inscribe positive value to these experiences, thus establishing exercise practices that serve them.

Yoga practice among ethnically/racially diverse emerging adults: Associations with body image, mindful and disordered eating, and muscle-enhancing behaviors

BACKGROUND

This study explores cross-sectional associations between yoga and body image, mindful eating, disordered eating, and muscle-enhancing behaviors among a population-based sample of ethnically/racially diverse emerging adults.

METHOD

An ethnically/racially diverse population-based sample of 1,568 emerging adults (18-26 years) completed surveys as part of EAT 2010-2018 (Eating and Activity over Time). Models were adjusted for sociodemographic characteristics and body mass index (BMI).

RESULTS

Practicing yoga at least 30 min/week was reported by 12.7% (n = 210) of the sample. Yoga practitioners had higher levels of mindful eating than those not practicing yoga. Although effect sizes were small, yoga practitioners were more likely than non-yoga practitioners to use steroids (3.8 vs. 0.7%, p < .001, h = 0.22) or protein powder/shakes (35.1 vs. 25.3%, p < .010, h = 0.21) to increase their muscle size/tone. Body satisfaction, unhealthy weight control behaviors, and binge eating tended to be similar among yoga practitioners and non-yoga practitioners. There was a significant interaction between BMI and yoga in predicting body satisfaction with a trend toward a positive impact among yoga practitioners at higher BMI values. Interactions between yoga practice and all body image attitudes and behaviors across gender and ethnicity/race were not statistically significant.

DISCUSSION

Young people from diverse ethnic/racial backgrounds who practice yoga are more likely to engage in mindful eating but have equal or elevated levels of unhealthy body image attitudes and behaviors as compared to non-yoga practitioners. Further research should explore how yoga is best taught and practiced to ensure that it is beneficial for body image and related behaviors.

The effects of yoga on functionality appreciation and additional facets of positive body image

This study investigated the effects of yoga on functionality appreciation, and the potential mechanisms that could explain the impact of yoga on additional facets of positive body image. Young adult women (N = 114; M_age = 22.19) were randomised to a 10-week Hatha yoga programme or waitlist control group. Participants completed measures of functionality appreciation, body appreciation, body compassion, appearance evaluation, self-objectification, and embodiment at Pretest, Midtest, Posttest, and 1-month Follow-Up. Follow-up data could not be analysed due to high levels of attrition. The remaining data showed that, compared to the control group, women in the yoga programme experienced lower self-objectification at Midtest and greater embodiment over time. Further, all participants experienced improvements in body appreciation, body compassion, and appearance evaluation over time, regardless of their assigned group. Lower self-objectification contributed to improvements in body appreciation and body compassion. In addition, greater embodiment contributed to improvements in body appreciation, body compassion, and appearance evaluation. Contrary to our expectations, yoga did not lead to increased functionality appreciation, nor was functionality appreciation a mediator of the impact of yoga on positive body image. Instead, lower self-objectification, and greater embodiment, drove improvements in positive body image.

Realizing Yoga's all-access pass: a social justice critique of westernized yoga and inclusive embodiment

In the 21^st century, the ancient mind-body practice of yoga has surged in popularity among western enthusiasts for its numerous health benefits. Particularly, a growing evidence base supports yoga for cultivating positive embodiment and reducing risk for disordered eating. Nevertheless, amidst its rise are concerns about yoga's departure from its spiritual foundations and increasing assimilation into the appearance- and commercial-driven exercise and fitness culture. Consequently, an exclusionary identity has been perpetuated in shaping norms surrounding who can and does practice yoga, which contradicts earlier egalitarian visions of a yoga for all. Therefore, we adopt a social justice lens in offering a focused analysis of the intersection of yoga, embodiment, and inclusion for select marginalized social identities typically underrepresented among yoga practitioners and in yoga scholarship. Data are synthesized from both qualitative and quantitative sources and integrate an understanding of how confined media representations of "the yoga body" and other practical constraints may undermine the perceived access to the practice for members of diverse groups. We conclude with inviting future considerations towards fostering more interdisciplinary community-based research partnerships among the variety of stakeholders invested in advancing the accessibility and inclusion of yoga and positive embodiment for all bodies.

Yoga and eating disorder prevention and treatment: A comprehensive review and meta-analysis

Yoga is frequently used in conjunction with standard treatment approaches for eating disorders. However, yoga's efficacy and effectiveness in preventing and treating eating disorders has remained unclear. The aim of this comprehensive review and meta-analysis is to review the extant literature and assess the effects of yoga in the prevention and intervention of eating disorder symptoms and correlates in both clinical and non-clinical populations. Studies assessing yoga and its effect on eating disorder symptoms and/or body image as related to disordered eating, were eligible for inclusion. The comprehensive review details correlational, non-controlled, non-randomized controlled, and yoga comparison studies. For the meta-analysis, only randomized controlled trials comparing a yoga-based intervention to a non-yoga control group were included. In total, 43 studies are included in this review, with 11 trials involving 754 participants included in the meta-analysis. Results of the comprehensive review and meta-analyses results indicated yoga interventions demonstrated a small, significant effect on global eating disorder psychopathology, a moderate-to-large effect on binge eating and bulimia, and a small effect on body image concerns, as compared to the control conditions. There was no statistically significant effect on dietary restraint in either direction. Additionally, results indicated a small-to-moderate effect on a composite measure of eating disorder-related constructs. These findings suggest that yoga-based interventions may be an effective approach supporting the prevention and treatment of eating disorders.

Yoga and the experience of embodiment: a discussion of possible links

The impact of yoga on body image and embodiment has been a recent area of focus in the field of body image and eating disorders. This paper comprises a theoretical discussion of how the practice of yoga can lead to positive ways of inhabiting the body, specifically through the lens of the Developmental Theory of Embodiment. Yoga may enhance the overall experience of embodiment, by having a positive impact on each of its five dimensions: body connection and comfort, agency and functionality, attuned self-care, subjective immersion (resisting objectification), and experience and expression of desires. The article therefore describes examples of teacher-related practices during yoga that can enhance each of these dimensions. Further, yoga teachers can consider the varied protective physical and social factors delineated by the Developmental Theory of Embodiment to facilitate positive embodiment. Future research should explicitly integrate embodiment theory with yoga interventions, as well as measures that assess both possible mechanisms of change and positive ways of living in the body.

(Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance

Binge-eating disorder (BED) is a severe eating disorder strongly associated with obesity. Treatments struggle to provide safe and effective ways of addressing weight in a BED context. This study explored a two-phased treatment for BED developed at a major out-patient eating disorder service in Denmark. The study used interviews and participant observations to gain insight into experiences and processes related to weight and body issues in three treatment contexts that addressed weight stability, weight acceptance, and weight loss. Using systems theory, the study proposed a relational weight problem that embeds feelings of non-acceptance due to weight, a merge of weight and identity, and an internalized body- and weight-critical gaze of others. Contrary to critical claims that weight acceptance discourages people with obesity from engaging in weight loss efforts, this study suggests that acceptance and a disentanglement of weight and identity are prerequisites for weight loss for this group.

Yoga and body image: How do young adults practicing yoga describe its impact on their body image?

This study explored the perceived impact of yoga on body image. Young adults (n= 34 female, 12 male; M_age = 30.6 [SD = 1.6]) practicing yoga were interviewed and data were analyzed for emerging themes across weight status. In general, participants discussed the positive impact of yoga on their body image, but some described both a positive and negative impact. Yoga was perceived as having a positive impact on body image via perceived physical changes, gratitude for one's body, a sense of accomplishment within one's yoga practice, self-confidence, and witnessing different types of bodies practicing yoga. Yoga was perceived to have a negative impact on body image via comparative critique (e.g., upward comparisons with others) and inner critique (e.g., negative self-talk). Themes were generally similar across weight status; exceptions were that participants at higher weight status were more likely than those at lower weight status to discuss accomplishment within one's yoga practice as a positive impact on body image and comparative critique as a negative impact on body image. Yoga studios and instructors can take steps to further enhance the positive impact of yoga and to provide environments that are inclusive of participants with diverse body shapes and sizes.

Feasibility of yoga as a complementary therapy for patients with type 2 diabetes: The Healthy Active and in Control (HA1C) study

OBJECTIVES

This study:Healthy Active and in Control (HA1C), examined the feasibility and acceptability of yoga as a complementary therapy for adults with Type-2 Diabetes (T2DM).

DESIGN

A 2-arm randomized clinical trial comparing Iyengar yoga with a supervised walking program.

SETTING

Hospital based gym-type facility and conference rooms.

INTERVENTIONS

Participants were randomized to a 12-week program of either; (1) a twice weekly Iyengar yoga, or (2) a twice-weekly program of standard exercise (SE).

MAIN OUTCOME MEASURES

Primary outcomes assessed feasibility and acceptability, including enrollment rates, attendance, study completion, and participant satisfaction. Secondary outcomes included HbA1c, physical activity, and measures of diabetes-related emotional distress, self-care and quality of life (QOL). Assessments were conducted at baseline, end of treatment, 6-months and 9-months post-enrollment.

RESULTS

Of 175 adults screened for eligibility, 48 (30 women, 18 men) were eligible and enrolled. The most common reasons for ineligibility were orthopedic restrictions, HbA1c levels <6.5 and BMI > 42. Session attendance was high (82% of sessions attended), as was follow-up completion rates (92%). Program satisfaction rated on a 5-point scale, was high among both Yoga (M = 4.63, SD = 0.57) and SE (M = 4.77, SD = 0.52) participants. Overall 44 adverse events (26 Yoga, 18 SE) were reported. Of these, six were deemed "possibly related" (e.g., neck strain, back pain), and 1 "probably related" (ankle pain after treadmill) to the study. Yoga produced significant reductions in HbA1c. Median HbA1c at 6 months was 1.25 units lower for Yoga compared to SE (95% CI: -2.54 -0.04). Greater improvements in diabetes self-care, quality of life, and emotional distress were seen among Yoga participants than among SE participants. Increases in mindfulness were seen in Yoga but not in SE.

CONCLUSIONS

The yoga intervention was highly feasible and acceptable, and produced improvements in blood glucose and psychosocial measures of diabetes management.

Yoga as a Complementary Therapy for Adults with Type 2 Diabetes: Design and Rationale of the Healthy, Active, and in Control (HA1C) Study

Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management.

Yoga and body image: Findings from a large population-based study of young adults

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1-2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.

How Is the Practice of Yoga Related to Weight Status? Population-Based Findings From Project EAT-IV

BACKGROUND

Yoga may provide a strategy for healthy weight management in young adults. This study examined prevalence and characteristics of young adults' yoga practice and associations with changes in body mass index.

METHODS

Surveys were completed by 1830 young adults (31.1 ± 1.6 y) participating in Project EAT-IV. Cross-sectional and 5-year longitudinal analyses were conducted stratified by initial weight status.

RESULTS

Two-thirds (66.5%) of nonoverweight women and 48.9% of overweight women reported ever doing yoga, while 27.2% of nonoverweight women and 16.4% of overweight women practiced regularly (≥30 min/wk). Fewer men practiced yoga. Among young adults practicing regularly (n = 294), differences were identified in intensity, type, and location of yoga practice across weight status. Young adults who were overweight and practiced yoga regularly showed a nonsignificant 5-year decrease in their body mass index (-0.60 kg/m²; P = .49), whereas those not practicing regularly had significant increases in their body mass index (+1.37 kg/m²; P < .01). Frequency of yoga was inversely associated with weight gain among both overweight and nonoverweight young adults practicing yoga regularly.

CONCLUSIONS

Young adults of different body sizes practice yoga. Yoga was associated with less weight gain over time, particularly in overweight young adults. Practicing yoga on a regular basis may help with weight gain prevention.

Group Qigong for Adolescent Inpatients with Anorexia Nervosa: Incentives and Barriers

Background

Qigong is a mind-body intervention focusing on interoceptive awareness that appears to be a promising approach in anorexia nervosa (AN). In 2008, as part of our multidimensional treatment program for adolescent inpatients with AN, we began a weekly qigong workshop that turned out to be popular among our adolescent patients. Moreover psychiatrists perceived clinical benefits that deserved further exploration.

Methods and findings

A qualitative study therefore sought to obtain a deeper understanding of how young patients with severe AN experience qigong and to determine the incentives and barriers to adherence to qigong, to understanding its meaning, and to applying it in other contexts. Data were collected through 16 individual semi-structured face-to-face interviews and analyzed with the interpretative phenomenological analysis method. Eleven themes emerged from the analysis, categorized in 3 superordinate themes describing the incentives and barriers related to the patients themselves (individual dimension), to others (relational dimension), and to the setting (organizational dimension). Individual dimensions associated with AN (such as excessive exercise and mind-body cleavage) may curb adherence, whereas relational and organizational dimensions appear to provide incentives to join the activity in the first place but may also limit its post-discharge continuation. Once barriers are overcome, patients reported positive effects: satisfaction associated with relaxation and with the experience of mind-body integration.

Conclusions

Qigong appears to be an interesting therapeutic tool that may potentiate psychotherapy and contribute to the recovery process of patients with AN. Further analysis of the best time window for initiating qigong and of its place in overall management might help to overcome some of the barriers, limit the risks, and maximize its benefits.

Associations between yoga/meditation use, body satisfaction, and weight management methods: Results of a national cross-sectional survey of 8009 Australian women

OBJECTIVES

To analyze whether yoga or meditation use is associated with body (dis)satisfaction and weight control methods in Australian women.

METHODS

Women ages 34 to 39 y from the Australian Longitudinal Study on Women's Health were surveyed regarding body satisfaction, weight control behaviors, and yoga and meditation practice. Associations of body satisfaction and weight control methods with yoga/meditation practice were analyzed using chi-squared tests and multiple logistic regression modelling.

RESULTS

Of the 8009 women, 49% were overweight or obese. Sixty-five percent of women with normal body mass index (BMI) and approximately 95% of women with overweight/obesity wanted to lose weight. At least one in four women with normal BMI was dissatisfied with body weight and shape, as were more than two in three women with overweight/obesity. The most common weight control methods included exercising (82.7%), cutting down meal sizes (76.8%), and cutting down sugars or fats (71.9%). Yoga/meditation was practiced frequently by 688 women (8.6%) and occasionally by 1176 women (14.7%). Yoga/meditation users with normal BMI were less likely dissatisfied with body weight and shape. All yoga/meditation users more likely exercised and followed a low glycemic diet or diet books; and women with obesity occasionally using yoga/meditation also more likely used fasting or smoking to lose weight.

CONCLUSION

Yoga/meditation users with normal BMI appear to be more satisfied with their body weight and shape than non-yoga/meditation users. While women with normal BMI or overweight tend to rely on healthy weight control methods, women with obesity occasional using yoga/meditation may more likely utilize unhealthy weight control methods.

A Different Weight Loss Experience: A Qualitative Study Exploring the Behavioral, Physical, and Psychosocial Changes Associated with Yoga That Promote Weight Loss

Yoga interventions improve obesity-related outcomes including body mass index (BMI), body weight, body fat, and waist circumference, yet it is unclear whether these improvements are due to increased physical activity, increased lean muscle mass, and/or changes in eating behaviors. The purpose of this study is to expand our understanding of the experience of losing weight through yoga. Methods. Semistructured interviews were qualitatively analyzed using a descriptive phenomenological approach. Results. Two distinct groups who had lost weight through yoga responded: those who were overweight and had repeatedly struggled in their attempts to lose weight (55%, n = 11) and those who were of normal weight and had lost weight unintentionally (45%, n = 9). Five themes emerged that differed slightly by group: shift toward healthy eating, impact of the yoga community/yoga culture, physical changes, psychological changes, and the belief that the yoga weight loss experience was different than past weight loss experiences. Conclusions. These findings imply that yoga could offer diverse behavioral, physical, and psychosocial effects that may make it a useful tool for weight loss. Role modeling and social support provided by the yoga community may contribute to weight loss, particularly for individuals struggling to lose weight.

Yoga, bioenergetics and eating behaviors: A conceptual review

Yoga is an ancient oriental discipline that emerged from mystical and philosophical concepts. Today it is practiced in the west, partly due to the promotion of its benefits to improve the lifestyle and overall health. As compared to non-Hatha Yoga (HY) practitioners, healthier and better-eating patterns have been observed in those who practice it. Agreement with the brought benefits, HY can be used as a therapeutic method to correct abnormal eating behaviors (AEB), obesity, and some metabolic diseases. However, the energy expenditure during traditional protocols of HY is not high; hence, it is not very effective for reducing or maintaining body weight or to improve cardiovascular conditioning. Even so, several observational studies suggest significant changes in eating behaviors, like a reduction in dietary fat intake and increments in that of fresh vegetables, whole grains and soy-based products, which in turn may reduce the risk for cardiovascular diseases. Given the inconsistency of the results derived from cross-sectional studies, more case–control studies are needed to demonstrate the efficacy of HY as an alternative method in the clinical treatment of disordered eating and metabolic diseases.

Yoga and eating disorders: is there a place for yoga in the prevention and treatment of eating disorders and disordered eating behaviours?

This paper addresses the question: what can the practice of yoga offer the field of eating disorders in terms of prevention and treatment? Regarding prevention, preliminary research suggests that yoga may be effective in decreasing risk factors, and increasing protective factors, for eating disorders. Yoga was also found to be helpful in a small number of treatment studies. However, findings are not consistent across studies, which are limited in number, and due to the preliminary nature of this body of research, most studies have weaknesses in their designs (e.g. observational design, no control groups, or small sample sizes). The basic tenets of yoga, anecdotal reports of its effectiveness, its high accessibility and low cost, and initial research findings suggest that yoga may offer promise for the field of eating disorders. Two options are suggested for prevention: (1) eating disorder prevention can be integrated into ongoing yoga classes and (2) yoga can be integrated into eating disorder prevention programmes. Regarding treatment, it is important to examine the effectiveness of different teaching styles and practices for different eating disorders. Potential harms of yoga should also be explored. Further research, using stronger study designs, such as randomised, controlled trials, is needed.

"More than I expected": perceived benefits of yoga practice among older adults at risk for cardiovascular disease

OBJECTIVE

This study was conducted with participants from trials examining the effects of an Iyengar yoga program on cardiovascular disease risk. The objective of the current study was to evaluate the perceived benefits of yoga in a population of older, predominantly overweight adults participating in a gentle 8-week yoga program.

DESIGN

This study used a constructivist-interpretive approach to naturalistic inquiry.

SETTING

A total of 42 participants completed the intervention and met the inclusion criteria for the current qualitative study.

INTERVENTION

The 8-week Iyengar yoga program included two 90-min yoga classes and five 30-min home sessions per week. Participants completed weekly logs and an exit questionnaire at the end of the study.

MAIN OUTCOME MEASURES

Qualitative data from weekly logs and exit questionnaires were compiled and conventional content analysis performed with the use of ATLAS.ti to facilitate the process.

RESULTS

Four broad themes emerged from content analysis: practicing yoga improved overall physical function and capacity (for 83% of participants); practicing yoga reduced stress/anxiety and enhanced calmness (83% of participants); practicing yoga enriched the quality of sleep (21% of participants); and practicing yoga supported efforts toward dietary improvements (14% of participants).

CONCLUSIONS

These results suggest that yoga may have ancillary benefits in terms of improved physical function, enhanced mental/emotional state, enriched sleep quality, and improved lifestyle choices, and may be useful as a health promotion strategy in the prevention and management of chronic disease.

Participation in mindfulness-based stress reduction is not associated with reductions in emotional eating or uncontrolled eating

The adverse health effects and increasing prevalence of obesity in the United States make interventions for obesity a priority in health research. Diet-focused interventions generally do not result in lasting reductions in weight. Behavioral interventions that increase awareness of eating cues and satiety have been postulated to result in healthier eating habits. We hypothesized that participation in a program called mindfulness-based stress reduction (MBSR) would positively influence the eating behaviors and nutritional intake of participants through changes in emotional eating (EE), uncontrolled eating (UE), and type and quantity of food consumed. Forty-eight veterans at a large urban Veterans Administration medical center were assessed before MBSR, after MBSR, and 4 months later. For all participants (N = 48), MBSR participation was not associated with significant changes in EE or UE. In addition, there were no significant differences in the intake of energy, fat, sugar, fruit, or vegetables at either follow-up time point as compared with baseline. Enhanced mindfulness skills and reduced depressive symptoms were seen over time with medium to large effect sizes. Changes in mindfulness skills were significantly and negatively correlated with changes in EE and UE over time. Overall, there was no evidence that participation in MBSR was associated with beneficial changes in eating through reductions in disinhibited eating or significant changes in dietary intake. Randomized studies are needed to further define the relationship between mindfulness program participation and eating behaviors.

Yoga clinical research review

In this paper recent research is reviewed on the effects of yoga poses on psychological conditions including anxiety and depression, on pain syndromes, cardiovascular, autoimmune and immune conditions and on pregnancy. Further, the physiological effects of yoga including decreased heartrate and blood pressure and the physical effects including weight loss and increased muscle strength are reviewed. Finally, potential underlying mechanisms are proposed including the stimulation of pressure receptors leading to enhanced vagal activity and reduced cortisol. The reduction in cortisol, in turn, may contribute to positive effects such as enhanced immune function and a lower prematurity rate.

Yoga as a treatment for binge eating disorder: a preliminary study

OBJECTIVE

To examine the efficacy of a 12-week yoga program aimed at reducing binge eating severity.

DESIGN

A randomised trial was undertaken assigning participants to yoga (n=45) or wait-list control (n=45) groups. Of these, 25 in each group were analysed.

PARTICIPANTS

A community-based sample of women between 25 and 63 years of age who identified with diagnostic criteria for binge eating disorder (BED) and a BMI>25 were recruited for the study.

MAIN OUTCOME MEASURES

Primary outcomes included the Binge Eating Scale (BES) and International Physical Activity Questionnaire (IPAQ). Secondary outcomes comprised measures for BMI, hips and waist.

RESULTS

For the yoga group, self-reported reductions in binge eating and increases in physical activity were statistically significant. Small yet statistically significant reductions for BMI, hips and waist measurement were obtained. The wait-list control group did not improve significantly on any measures.

CONCLUSION

In conjunction with formal weekly sessions, home-based yoga programs are potentially efficacious for the treatment of binge eating.