Eating Disorders, Mind-Body Interventions, and Body Positivity: On Healing the Self and Society

EATING DISORDER OVERVIEW

Eating disorders are on the rise in the majority of industrialized nations, having among the highest mortality rates of all psychiatric illnesses. There are three main types of eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder. These disorders share a common characteristics: an extreme fear of weight gain, intense disturbance with body self-perceptions, and negative relationships with food. The distinguishing factor between each disorder lies in how one copes with these neuroses; in anorexia nervosa, one engages in intense food restriction. Meanwhile, bulimia nervosa is characterized by episodes of binge eating followed by compensatory purging (i.e. self-induced vomiting, laxative abuse, fasting, and/ or excessive exercise). Binge eating disorder is characterized by recurring episodes of binging without compensatory behaviors. Binge episodes are typically used to alleviate feelings of emotional distress.

While statistics report that eating disorders affect approximately 1-3% of the population, this represents an underestimation as these studies do not account for those undiagnosed and untreated. Moreover, a large proportion of the population (the majority being women and trans folk), still suffer from eating disorder symptoms at a subclinical threshold, even if they do not fully express clinical behaviors. Full recovery rates of documented cases are dismal at approximately 50% with many patients experiencing relapse. Thus, there is certainly a pressing need for more research and rapid clinical application to better assist existing patients and subclinical persons at risk, through their recovery.

MIND-BODY INTERVENTIONS

Mind-body interventions such as Hatha yoga and mindfulness meditation have been of increasing interest to mental health professionals. Both of these interventions share a common thread of their ability to aid in distress tolerance and emotion-regulation while improving body awareness– features that are impaired in those with eating disorders. For instance, recent neuroimaging studies have found that patients with eating disorders tend to have dysfunction in a brain area called the insula, which allows one to feel internal body signals such as pain, temperature, itch, tickle, muscle tension, hunger, stomach pH, and intestinal tension. Furthermore, many eating disorder patients face co-morbid affect disorders and emotion-regulation deficits such as maladaptive anxiety, depression, and intense shame.

With promise, mind-body interventions may work to combat these neural dysfunctions. Hatha yoga and mindfulness meditation have been shown to improve insula functioning, through practice of listening to internal body signals and thus re-establishing clear communication between the body and mind. Furthermore, Hatha yoga and mindfulness meditation can help tolerate and alleviate negative emotional states which can contribute to binging episodes. While studies on Hatha yoga are in their infancy, a recent array of mindfulness studies have shown promising effects for decreasing eating disorder symptoms. Mindfulness interventions that involve mindful eating components have been revealed to be the most beneficial for healing relationships with food by method of de-conditioning negative emotional responses to food consumption. Taken together, mindfulness meditation is recognized as an efficacious conjunctive treatment to eating disorders. Please see the meditation tab for a mindful body scan and mindful eating guide.

CULTIVATING A BODY POSITIVE SOCIETY 

Healing our relationships with food and our bodes is an important step in fighting eating disorders. However, this fight must not be disconnected from the sociocultural systems which strategically create this suffering for monetary profit. The fashion, diet, weight loss, and some exercise industries all cooperate in creating intense fears of weight gain and toxic ideologies of how we relate to food and our bodies, just so they can sell us “cures,” that quite frankly, do not work. It’s time to take a stand against these systems of oppression. Join in the body-positivity movement, where we work to create societies free of body shame and objectification. How? Start with your own social sphere: be mindful of your speech to avoid triggering someone with an eating disorder and/ or negative past histories. Here’s a quick guide how:

  1. RESPECT EVERYONE’S GENDER. Use appropriate names and pronouns. Respect style and dress.
  2. DO NOT COMMENT ON BODIES. There is a lot more to a person beyond the body they live in. Never criticize or shame a person’s body. Do not attach positive or negative connotations to certain body features. Be aware of weight biases (the false belief that fat individuals are undisciplined and lazy). Reserve compliments to style choices rather than body features.
  3. AVOID DIET AND WEIGHT TALK. Do not add to the obsessive diet and weight culture. Seek other ways to bond!
  4. KEEP YOUR HEALTH CONCERNS TO YOURSELF. Contrary to popular belief, studies show that self- and other health concern shaming is not helpful for changing health behaviors. If you want to help someone, focus on supporting them emotionally. Lastly, acknowledge that content of food consumed primarily depends on social class and accessibility; check yourself before making any potentially classist comments.
  5. YOUR BODY. YOUR RULES. Respect people’s sexual orientation, relationship orientation, diet, gender, style, and dress.

Let’s work together to heal ourselves and at the same time, create a more body-positive social environment.

References:

American Psychiatric Association (2000). Diagnostic and Statistical Manual for Mental Disorders: Fourth Edition Text Revision. Washington, DC: APA Press.

American Psychiatric Association (2006). Practice Guideline for the Treatment of Patients with Eating Disorders Third Edition. Washington, DC: APA Press.

Carei, T. R., Fyfe-Johnson, A. L., Breuner, C. C., & Brown, M. A. (2010). Randomized controlled clinical trial of yoga in the treatment of eating disorders. Journal of Adolescent Health, 46(4), 346-351.

Forbes, B. (2011). Yoga for Emotional Balance: Simple Practices to Help Relieve Anxiety and Depression. Boston, MA: Shambhala.

Kaye, W. (2008). Neurobiology of anorexia and bulimia nervosa. Physiology & Behavior, 94(1), 121-135.

Kaye, W. H., Fudge, J. L., & Paulus, M. (2009). New insights into symptoms and neurocircuit function of anorexia nervosa. Nature Reviews Neuroscience, 10(8), 573-584.

Kim, K. R., Ku, J., Lee, J. H., Lee, H., & Jung, Y. C. (2012). Functional and effective connectivity of anterior insula in anorexia nervosa and bulimia nervosa. Neuroscience Letters, 521(2), 152-157.

Kristeller, J. L., Baer, R. A., & Quillian-Wolever, R. (2006). Mindfulness-based approaches to eating disorders. Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications, 75-91.

O’Reilly, G. A., Cook, L., Spruijt‐Metz, D., & Black, D. S. (2014). Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review. Obesity Reviews, 15(6), 453-461.

…And THANK YOU to all the amazing community members who participated in a series of focus groups by which I was able to create a guideline for mindful, body positive speech.

Meditation Alters Brain Wave Activity

The brain is an extremely complex organ which communicates via electrical impulses between neurons. An electroencephalogram (EEG) is a device which measures the frequency and amplitude of these electrical impulses (i.e. “brain waves”). Studies have shown that meditation practices can induce different EEG states in practitioners.

For instance, one review found that relaxation-based meditations induces a larger proportion of alpha wave (8-12 hz) and theta wave (4-8 hz) activity in the brain, which are characterized by rest.

In addition, yoga nidra practitioners have been shown to induce slow wave delta wave activity (0.5-4 hz) — that is, EEG activity exhibited during deep sleep stages, while paradoxically remaining conscious. Delta waves contain a “down state,” where neurons in the neocortex are silent and able to rest.

Finally, studies have shown that some advanced Buddhist meditators are able to self-induce high frequency gamma waves (25-42 hz) during practice. Gamma wave activity has been associated with heightened perceptual clarity and superior cognitive control of thought and emotional expression.

Why is this important?

As workaholic North Americans, our brains spend a lot of the day producing beta waves, that is characterized by states of heavy information processing. Too much beta wave activity is associated with anxiety, insomnia, anger, and paranoia– it is not surprising that many of us suffer from illnesses related with these states of mind. Thus, meditation breaks can be highly beneficial for controlling differing levels of brain wave frequencies protective of mental illness.

References:

Buchsbaum, M. S., Hazlett, E., Sicotte, N., Stein, M., Wu, J., & Zetin, M. (1985). Topographic EEG changes with benzodiazepine administration in generalized anxiety disorder. Biological Psychiatry, 20(8), 832-842.

Cahn, B. R., & Polich, J. (2006). Meditation states and traits: EEG, ERP, and neuroimaging studies. Psychological Bulletin, 132(2), 180.

Kjaer, T. W., Bertelsen, C., Piccini, P., Brooks, D., Alving, J., & Lou, H. C. (2002). Increased dopamine tone during meditation-induced change of consciousness. Cognitive Brain Research, 13(2), 255-259.

Lutz, A., Greischar, L. L., Rawlings, N. B., Ricard, M., & Davidson, R. J. (2004). Long-term meditators self-induce high-amplitude gamma synchrony during mental practice. Proceedings of the National academy of Sciences of the United States of America, 101(46), 16369-16373.

Moore, N. C. (2000). A review of EEG biofeedback treatment of anxiety disorders. Clinical EEG and Neuroscience, 31(1), 1-6.

Tang, Y., Li, Y., Wang, J., Tong, S., Li, H., & Yan, J. (2011, August). Induced gamma activity in EEG represents cognitive control during detecting emotional expressions. In Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE (pp. 1717-1720).

Change Over Blame: Fundamentals Behind a Determinist’s View of Problem Solving

Scientific determinism is a philosophy that posits that for every phenomenon in the Universe, there are preceding conditions which explain their occurrence. Many scientists adopt this view, since the nature of our work requires us to understand and disseminate the causes of simple and complex phenomenon at both the micro (e.g., molecular) and macro-environmental (e.g., sociocultural revolutions) levels.

When analyzing human behavior specifically, the deterministic neuroscientist believes that at the end of the day, it can be reduced into brain structures and functions at the biological level. These “inner biological workings” are influenced by themselves (e.g., genetics) as well as the natural and social environment. From this view, we understand that “we are our brain” (the underlying feature of neuroscientific monism).

A few points to note:

Determinism does not mean we do not make choices. We make choices every day, but there are natural systems in place that determines the expression of these choices.

Determinism does not mean that we cannot be in conflict with ourselves. In fact, our brains are made up of many structures that often compete with one another.

Determinism does not mean we cannot override biologically pre-potent behavioral responses. We actually have many evolved cognitive functions that enable us to resist impulse, habit, and temptation in favor of positive change.

Therefore, the determinist works on the basis of progression, whilst deliberately deciding to not waste energy and resources blaming an individual or a larger society for moral wrongdoings. The determinist asks: how can we rearrange a system to progress into a world where there is less suffering?

A common example is for the impulsive criminal. First, we understand that an infinite number of variables (e.g., early childhood abuse, neglect, lead exposure, poverty) led this person to act in a morally destructive manner. A note is then taken that these preceding variables need to be dealt with. Next, instead of blaming, raging, and locking this individual up in an extremely toxic environment, we ask: how do we make it easier for this individual to act in morally responsible ways from here on forward? Many scientists in the field of neurolaw are in fact working on the answer to this question right now.

This way of problem solving is not only rational and progressive, but it allows us to act out of compassion rather than destructive reactional patterns. It not only helps those who are completely dismantled by biological pathology, but it also helps us forgive and be at peace. It allows us to break out of cycles of massive destruction and conserve energy often wasted on playing blame games.

The determinist is often accused of being completely disempowering. But this is misunderstood. I see it as the acceptance and commitment therapy of life, that is, accepting what is, and committing to moving forward.

Dismantling the Default to Deal with a Wandering Mind

Research has shown that mind wandering, that is, ruminating on the past or worrying about the future, makes people unhappy. On the other hand, mindfulness, which is attuning to internal and external present moment stimuli with full acceptance and equanimity, is associated with greater subjective well-being and overall quality of life. The “default mode network,” which is comprised of several midline structures of the brain (medial prefrontal cortex, posterior cingulate cortex, and precuneus), is highly active during mind wandering, and studies suggest that its hyper-functionality may be implicated in psychiatric disorders associated with maladaptive anxiety, major depression, attention deficits, and mild cognitive impairment. However, studies show that mindfulness meditation decreases activity in the default mode network while strengthening connections of various attention circuits. These findings suggest that mindfulness may improve attentional abilities and help individuals disengage from irrelevant distractions in their daily life, and that this may have downstream implications for preventing and treating psychiatric disorders affiliated with mind wandering.

References:

Hasenkamp, W., & Barsalou, L. W. (2012). Effects of meditation experience on functional connectivity of distributed brain networks. Frontiers in Human Neuroscience, 6, 38.

Froeliger, B., Garland, E. L., Kozink, R. V., Modlin, L. A., Chen, N. K., McClernon, F. J., … & Sobin, P. (2012). Meditation-state functional connectivity (msFC): strengthening of the dorsal attention network and beyond. Evidence-Based Complementary and Alternative Medicine, 2012.

Killingsworth, M. A., & Gilbert, D. T. (2010). A wandering mind is an unhappy mind. Science, 330(6006), 932-932.

The Brains of Meditators

There appears to be distinct differences between the brain structures of expert meditators vs. non-meditators. A meta-analysis of neuroimaging studies found that when compared to with meditation naive individuals,  meditators showed greater grey matter volumes in areas associated with meta-cognition (Brodmann areas 9/10 of the frontopolar cortex), executive control (dorsolateral prefrontal and anterior cingulate cortex), body awareness (sensory cortices and the insula), memory consolidation (hippocampus), and emotion-regulation and empathy (ventromedial prefrontal and orbitofrontal cortex). These findings are interesting in providing a possibility of meditation effects on altering brain structures. However, it should be noted that most studies were cross-sectional and thus cannot infer causality; it may be possible that those with greater integrity in these brain areas were drawn to meditation practices in the first place. Nevertheless, hopefully more experimental studies will give us a greater idea of the directionality of these fascinating findings.

References:

Fox, K. C., Nijeboer, S., Dixon, M. L., Floman, J. L., Ellamil, M., Rumak, S. P., … & Christoff, K. (2014). Is meditation associated with altered brain structure? A systematic review and meta-analysis of morphometric neuroimaging in meditation practitioners. Neuroscience & Biobehavioral Reviews, 43, 48-73.

Hatha Yoga Enhances Self-Regulation

Recent research evidence suggests that Hatha yoga may enhance brain abilities called the executive functions. Executive functions enable self-control over behavior, emotion, and thought. These processes enable goal-directed (rather than automatic) behavior. Following Hatha yoga practice, studies have shown that both chronic and acute bouts of Hatha yoga significantly improves executive function in healthy adults, children, older adults, and special populations such as type-2 diabetics and impulsive prisoners. Researchers speculate that these improvements stem from Hatha yoga’s concentrative and emotional stabilizing properties. These findings are highly implicated for improving quality of life in terms of enabling health behavior maintenance, improving emotion-regulation, and sustaining long-term goal achievement.

References:

Luu, K., Hall, P. (2015). Hatha yoga and executive function: A systematic review. The Journal of Alternative and Complementary Medicine, 22(2), 125-133.

Exercise Instead: Brain Training Games Don’t Work!

Don’t bother with the brain training computer games– they don’t work! Studies have shown that although brain training programs such as Luminosity improve cognitive abilities (attention, memory, shifting, updating, planning, inhibition, verbal reasoning, problem solving, etc.) that are very specific to the particular game, these effects don’t transfer over to other tasks which require the same cognitive abilities. This implies that these improvements were due to mere learning effects from repeated practice.

It is however well established that aerobic exercise, resistance exercise, yoga, meditation, and learning novel tasks improve cognitive functioning. Preliminary studies on breathing exercises are revealing mostly positive results as well. So save your dollars! Get out, get active, and learn something new– no computer screen needed.

References:

Owen, A. M., Hampshire, A., Grahn, J. A., Stenton, R., Dajani, S., Burns, A. S., … & Ballard, C. G. (2010). Putting brain training to the test. Nature465(7299), 775-778.