Yoga therapy for a client with Binge Eating Disorder

In the third article of this four-part series, we looked at a comprehensive Yoga therapy treatment plan, from assessment to a multidisciplinary professional team approach. This last article discusses Yoga therapy approaches for a client with binge eating disorder.

Individual struggling with binge eating disorder can be within their appropriate body mass for height or can be larger bodied. As professionals, we tend to assume that all individuals with binge eating disorder struggle with their weight. From a Yoga therapy perspective, the Yoga treatment plan will vary from client to client.

In my experience in working with individuals diagnosed with binge eating disorder, they like to move their bodies strongly on various days, with slower gentle postures on other days. For clients with risk factors, based on a thorough assessment, hypertension and type II diabetes may be a significant issue. If not monitored and managed, this can be a concern in an intense Yoga plan. For the Yoga therapist who practices in a private setting, client self-monitoring of blood pressure and/or blood glucose is crucial with available results guiding the respective day’s Yoga postures.

For clients needing a slower pace Yoga on a given day, or for clients with gastric implications – including gastric balloons, Yin Yoga can be a great option as discussed in the last article. Another option is chair Yoga where clients move into postures as they would on the floor, but the chair is actually the floor raised to meet the client. Clients also perform various postures standing but with the support of the chair.

Clients needing a faster pace Yoga can be guided through a series of poses, followed by the freedom to “flow on their own.” Clients can then add or delete poses of their choosing. They move at their own pace, tap into their breath and feel the movement of their bodies on a much deeper level. This type of free flow can also be very empowering. This style of Yoga can help clients with binge eating disorders begin to break free from the rigidity that often mirrors the history of the “diet” mentality.

Clients with binge eating disorder can take their Yoga off of their mat when it comes to practice mindful and intuitive eating. With mindful eating, clients begin to experience the taste, smell, and textures of food with greater sensation and presence. This population also is more appropriate for practicing the concept of intuitive eating, where Yoga can help clients trust their bodies and tune into the body’s signals of hunger and satiety. Yoga can also teach clients to understand their messages given by their bodies and trust them. The physical discomfort of overeating becomes more obvious, because awareness makes all sensations more apparent. This can make it easier for clients to choose to stop eating before the point of physical discomfort.

Physiologically, Yoga can aid in decreased activity of sympathetic nervous system, thus decreasing heart rate and blood pressure, while normalizing insulin and glucagon levels through decreased cortisol levels. By decreasing cortisol through Yoga, clients can also experience increased bone formation and calcium absorption.

In summary, you can see that Yoga therapy goes beyond just a “Yoga class.” However, a Yoga class at a gym or studio can be a progression for the client who is higher functioning, weight and risk factor normalized/managed and who is empowered to understand that not all of the postures and word choices directed by the Yoga teacher are appropriate—these clients are confident enough to take what they need from their Yoga, and not react to inappropriate word choices. It is important for a private practitioner and/or comprehensive eating disorder treatment center that offers Yoga to understand the Yoga culture of the community. Practicing your own Yoga at various studios in order to understand the lay of the land is necessary in order to safely advise clients where to practice Yoga in the community.

The Yoga therapist can even accompany the client to a Yoga studio to guide them. In the treatment center that I once owned and operated, we often had field trips to Yoga studios for clients who had medical clearance. This was a great way to monitor, supervise and debrief following the Yoga class. An experienced Yoga therapist and eating disorder practitioner would of course have the proper discernment to not send a client on their own, unsupervised to a Yoga studio where the client might gravitate to a hot and intense Yoga class.

This series has not explored trauma Yoga. Trauma informed Yoga is a specialty on its own where adjustments, placement of legs in postures along with open vs closed eyes, along with the integration with the multidisciplinary treatment team are highly significant concerns.

Your client’s relationship with food parallels all relationships in their lives as well as their relationship with their Yoga mat. Namaste and hope this article series was “food for thought.”

BEVERLY S PRICE is a certified eating disorder registered dietitian and iaedp supervisor, experienced registered yoga teacher and IAYT certified yoga therapist. Beverly is recognized for bringing mindfulness-based yoga to the eating disorder treatment community along with yoga therapy training programs in eating disorders for professionals.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders and not intended as endorsement by iaedp Foundation or its Board of Directors.

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