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).

Anger as a Flame and Not a Forest Fire

Anger is a human emotion that involves physiological responses which can be adaptive for resolving conflict. However, when mishandled, this otherwise normal, healthy response can spiral out of control, causing pathological illness and enormous interpersonal relationship problems. A few ways that anger is mishandled are as follows: (1) Catharsis– research shows that contrary to popular belief, excessive expression of anger, e.g., venting, pillow punching, and being hostile and aggressive, is actually extremely destructive to the health of the individual and those involved. More importantly, this emotion tends to escalate rather than “release,” following cathartic methods. (2) Suppression– letting anger bottle up inside is also a recipe for illness. It can also lead to passive aggressive and antisocial behavior. Both unhealthy and expression and suppression of anger seems to promote hypertension, cardiovascular disease, and mood disorders. So what is to be done?

Research has shown that cognitive restructuring, problem solving, and relaxation techniques are much more adaptive strategies for channeling and coping with angry feelings. Cognitive restructuring involves thinking about the situation differently. This involves using logic, empathy, and wise reasoning to see all sides of the situation. This strategy tends to lead to more problem solving, rather than destructive, aggressive behaviors. Functional and healthy expression of anger comes in the form of self-respect and asserting boundaries in a clear, well-thought out, and confident manner. Lastly, relaxation techniques such as yoga, deep breathing and imagery meditation can be used to assist this process by cooling arousal and allowing the individual to act from a more rational and progressive vantage point. So let anger be the candle flame to spark your motivation and drive for social repair; not a forest fire that both suffocates you and destroys the environment around you.

References:

Beck, R., & Fernandez, E. (1998). Cognitive-behavioral therapy in the treatment of anger: A meta-analysis. Cognitive Therapy and Research, 22(1), 63-74.

Bushman, B. J. (2002). Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger, and aggressive responding. Personality and Social Psychology Bulletin, 28(6), 724-731.

DiGiuseppe, R., & Tafrate, R. C. (2003). Anger Treatment for Adults: A Meta‐Analytic Review. Clinical Psychology: Science and Practice, 10(1), 70-84.

Holt, R. R. (1970). On the interpersonal and intrapersonal consequences of expressing or not expressing anger.

Lewis, W. A., & Bucher, A. M. (1992). Anger, catharsis, the reformulated frustration-aggression hypothesis, and health consequences. Psychotherapy: Theory, Research, Practice, Training, 29(3), 385.

Warren, R., & Kurlychek, R. T. (1981). Treatment of maladaptive anger and aggression: Catharsis vs behavior therapy. Corrective & Social Psychiatry & Journal of Behavior Technology, Methods & Therapy.

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.

Acroyoga: Play, Communication, and the Power of Touch

“YOU CAN LEARN MORE ABOUT A PERSON IN AN HOUR OF PLAY THAN A LIFETIME OF CONVERSATION”
~ Plato

Acroyoga is a partner style of yoga which involves a base and a flyer whom help one another flow through yoga postures through communicative touch. In a society where personal bubbles are becoming larger and larger, it is no wonder why humans feel lonelier and touch starved despite infinite modes of technological communication. Human touch (IN SAFE AND CONSENSUAL contexts) have been shown to increase safety processing in the brain, release oxytocin (bonding hormone) and endogenous opiods (natural painkillers), lowering levels of stress and anxiety, improving mood, and thus boosting the immune system. “Rough and tumble” play has also been shown to increase cortical thickness in areas of the brain involved in social and cognitive function. Acroyoga is a perfect activity which exercise the tactile senses to not only bond with a partner but also improve health without necessarily being sexual.

References:

Pellis, S. M., Pellis, V. C., & Bell, H. C. (2010). The function of play in the development of the social brain. American Journal of Play, 2(3), 278-298.

Holt-Lunstad, J., Birmingham, W. A., & Light, K. C. (2008). Influence of a “warm touch” support enhancement intervention among married couples on ambulatory blood pressure, oxytocin, alpha amylase, and cortisol.Psychosomatic Medicine, 70(9), 976-985.

Tolerating Uncertainty and Transitions Between Asanas

Ambiguous life circumstances are common, and can be nerve racking. Therefore, tolerating uncertainty is an important life skill. However, it is not easy; studies have shown that when we make up endings to our stories, reward circuitry actually fires in our brains! Clearly, accepting uncertainty is not a built in skill within human neurobiology.

However, at the heart of vinyasa yoga practice, we learn to enjoy the transitions between poses; creating moment-to-moment body awareness in every movement rather than allowing the momentum of our bodies throw us into the different set postures. Similarly, living in transitory “limbo,” ex. the space between jobs, between partners, between homes, etc, can be extremely unnerving, which is why we wish to pop to the next stable place as ASAP.

However, by taking in this lesson from Vinyasa practice on the mat unto real life transitions, we are better prepared to appreciate these places for their limitless opportunities for growth and positive change. When we learn to become present for the transitions within our yoga practice, we learn to be present for life’s transitions off the mat as well.

References:

Brown, B. (2015). Rising strong: The reckoning. The rumble. The revolution. New York, NY: Penguin Random House.

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.