Teaching Yoga to People with an Eating Disorder

Amy Woods — Wellbeing Program Coordinator at Eating Disorders Victoria

As an eating disorder therapist and yoga teacher, I am in a unique position to see how yoga can help the recovery process for people with an eating disorder, some types of yoga, such as those that focus on perfecting physical postures, weight loss or exercise, can exacerbate symptoms. Working in private practice as a counsellor, as well was coordinating the Wellbeing Program at Eating Disorders Victoria, I have been able to take this knowledge and create yoga classes specifically for people recovering from an eating disorder. At Eating Disorders Victoria, we strongly believe that taking time to learn more about eating disorders can help yoga teachers connect more deeply with their students, their own yoga practice and connects yoga to broader exploration of social justice issues. After all, eating disorders affect 9% of our population in Australia and have been on a steep incline during the COVID-10 pandemic.

There a many different types of eating disorders that can affect people of all ages, sizes, genders and heritage. Some experiences are brief, and others are long term battles, almost to the point of chronicity. For many, being able to understand eating disorders remains confusing, particularly when we live in a world that has the capacity to normalize body dissatisfaction, and a search for happiness through changing one’s appearance. Yoga is an incredible support for a diverse range of people, and helps in many ways. It begs the question; how can we safely bring yoga into the eating disorder community?

Eating disorders are dangerous diseases and are among the highest in mortality rate of all mental illness’ in Australia, not just because of malnourishment and the plethora of medical challenges that can arise, but also the risk of suicide. Living with an eating disorder is torturous, but it takes great courage and vulnerability to choose recovery and yoga can assist with that, if done safely. Eating disorder treatment usually focusses on the weight restoration or re-nourishment of people, along with psychological therapy. Combined, these treatments help to re-establish healthy brain functioning, restore physical health and to address underlying issues or factors that may be contributing to the eating disorder. This ranges from support to heal from trauma, address concerns around someone’s over-evaluation of weight and shape and explore one’s values. Eating disorders have significant psychological, physiological, and social impacts. Treatment approaches and environments range from admissions to medical wards, psychiatric hospital inpatient or outpatient programs, and treatment in a community setting, such as private therapy. These treatments are essential of course, but there is a place for yoga to support healing from the distress and trauma of the illness and help repair relationships with bodies that have become the enemies, the outlet for punishment, self-loathing, and self-hatred.

Living with an eating disorder can sometimes involve engaging in activities that look like self-care, but in fact are aligned with the eating disorder in some way. This can be true for yoga. A space that is designed to help people feel unified as their whole self, gets misinterpreted as a way to further the eating disorders endeavors of manipulating shape, weight and self-esteem. Activities like meditation, or self-reflection can become chores for the sake of feeling fulfilled when finishing a goal or an activity. All of this can directly play into toxic productivity, the need to achieve for the sake of achievement itself. When we, as yoga teachers, are not aware of the thought processes of students recovering from eating disorders, we may potentially have students putting themselves at risk in our classes. As teachers we bring yoga to people and hope that they find a helpful connection to it, but we can also do our best to ensure that students are safe in our classes. When it comes to eating disorders, society as a whole is able to play an important role in prevention, as well as early intervention.

If a student walked in to register for an advanced class and told you they were doing chemo, would you let them participate? Or suggest a gentler class? What about someone with a broken leg and on crutches? High blood pressure? Recovering from spinal surgery? We regularly moderate who attends our classes based on how safe we think they will be for someone. The same must go for students with eating disorders. If somebody is unwell and physically compromised in any way, the dialogue must be had to keep that person safe. This does not mean that people with eating disorders can’t do yoga, not by any means, but physical and emotional safety is crucial.

On one hand we can see how beneficial yoga could be for someone that needs to rebuild a relationship with their body and learn to tolerate sensations and movement in a way that is not punishing or distressing, but on the other hand we must acknowledge when the yoga practice, or more specifically the asana practice, is dangerous for someone. This could be from the perspective of physical health and putting the body under strain that it is not equipped to manage, or by assuming that all movements and sensations feel safe for everyone.

There are a few important considerations to providing yoga safely to students with eating disorders.

1. Encourage the openness and disclosure of the disorder. Have a question on your registration forms about eating disorders, followed by “how are you hoping yoga will help with your recovery?” (adhering with privacy laws and scope of practice, including referral).
2. Ask for people’s GP or psychologist details so that you can escalate any concerns you might have, just as you might ask for an emergency contact. This means that the issue doesn’t sit with the yoga teacher but is being managed by a health care professional.
3. Set boundaries on which classes people go to if they are struggling with physical health issues, regardless of whether it is an eating disorder or not and help them understand that this is part of how you ensure students are safe at your studio. This is not about excluding them from classes but helping them attend a session that is more suitable and potentially beneficial.
4. Get trained and then run a workshop for your teachers on trauma sensitive approaches to yoga so that they can modify for students when needed or are at least aware of what might be occurring for someone in their class.
5. Be mindful of your own unconscious weight bias or subscriptions to diet culture and ensure this is not transferred onto your students, regardless of how well meaning it might be. Even though dieting is normalized in today’s society, it remains the single biggest risk factor in developing an eating disorder. Spaces such as gyms and yoga studios are in a unique position to be able to actively promote and support their clients to explore body positivity and respect for body diversity.
6. Be wary of spiritual bypassing and shifting the responsibility of safety back onto the students. Be guided by ahimsa and care for the community you create within your class.
7. Empower your teachers to ask the tough questions if they feel like something is wrong. This does not mean the teacher takes on a counselling role, but it shows an interest in keeping your students safe and supported whilst at your studio. Keep flyers on hand that staff can provide students on where to seek further support on what they are experiencing (e.g Butterfly Foundation, Eating Disorders Victoria).
8. Be informed about eating disorders and consider how you might approach someone you are concerned about. Consider how might you start a conversation and connect someone to the help they need. It is not your role to diagnose or treat, but you can be a crucial point of connection to professionals.

Becoming eating disorder informed is an important step in building meaningful connections with ourselves and our yoga students. At Eating Disorders Victoria, we have many staff members who also work as yoga teachers and are passionate about creating safe yoga spaces for those who are currently struggling with an eating disorder. It is for this reason that we are offering our ED101 with Yoga Australia. The two-hour workshop is designed to provide participants with a basic overview of eating disorders, including:

• Types of eating disorders
• Risk factors and warning signs
• Myths and misconceptions
• Factors that can protect against the development of an eating disorder
• The importance of early intervention
• How to approach someone when concerned
• Options for referral and support

Eating Disorders Victoria are the primary source of support, information, community education and advocacy for people with eating disorders and their families in Victoria. Our range of services cover the breadth of the eating disorder journey, from early intervention and diagnosis to treatment, relapse, maintenance and recovery. Our advocacy work helps inform policy and state-wide services as we continually strive to help build a better system of care for Victorians impacted by these illnesses.

Keen to learn more? Get in touch with Eating Disorders Victoria

Website: www.eatingdisorders.org.au

Phone: 1300 550 236

E-mail: hub@eatingdisorders.org.au

Instagram: @eatingdisordersvictoria