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Yoga as a treatment for binge eating disorder: A preliminary study
Abstract
To examine the efficacy of a 12-week yoga program aimed at reducing binge eating severity.
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.
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.
Primary outcomes included the Binge Eating Scale (BES) and International Physical Activity Questionnaire (IPAQ). Secondary outcomes comprised measures for BMI, hips and waist.
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.
In conjunction with formal weekly sessions, home-based yoga programs are potentially efficacious for the treatment of binge eating.
... Treatment-To our knowledge, this study is among the first to synthesize expert opinion and report on CIH use in the context of adult BED treatment. Previous studies have mainly focused on the efficacy and acceptability of specific CIH interventions [17], such as mindfulness [19,24], yoga [45,49,50,60], or acupuncture [18] for BED or related symptoms. However, little is known about how BED experts view CIH use in general, what specific CIH interventions they are familiar with or use in their practice, what benefits they associate with CIH use in BED treatment, what empirical support they perceive for CIH use, what challenges they face in implementing CIH interventions, and how they recognize CIH use in current conventional treatments. ...
... Disorder-Over half of BED experts (57%) demonstrated familiarity with primary literature supporting CIH use in the context of BED (section 3.5), with mindfulness, acupuncture, yoga, massage, and meditation most commonly recognized as having empirical support (section 3.5.1). These findings align with the literature base, which provides empirical support for the benefits of yoga [16,17,19,24,[28][29][30][31][32]36,42,[48][49][50], mindfulness and self-compassion practices [16,19,24,33,35,[37][38][39][40][41], acupuncture [16,17,25], one herbal supplement [16,43], and potential for pre/probiotics [44], as well as for hypnosis [16], meditation [51], and TCM [18] in the context of eating disorders broadly [16][17][18][19] and BED specifically [16][17][18][19][24][25][26]33,34,[36][37][38]40,42,46,47], as described in Bray et al. 2023 [77] and Table 10 and Table 11 below. ...
... -Empirically supported in the context of BED [45,49,50,111,112,114,150]. * -Virtual/remote delivery options available [155][156][157][158][159][160][161][162][163][164][165][166]. ...
... To evaluate the severity of the EDs, EDE-Q was used in six articles (Boerhout et al. 2016(Boerhout et al. , 2017Brennan, Whelton, and Sharpe 2020;Karlsen et al. 2018;Pacanowski et al. 2017;Ziv et al. 2023). Other tools were used, including EDI (Catalan-Matamoros et al. 2011;Karlsen et al. 2018;McIver, O'Halloran, and McGartland 2009;Wallin, Kronovall, and Majewski 2000) Self-Expression and Control Scale (Boerhout et al. 2016(Boerhout et al. , 2017, Difficulties in Emotion Regulation Scale, Ways of Self-Criticism/ Aggression and Self-Confidence Scale, the Short Form of the ...
... Improvement in body awareness from conscious movement therapies may explain positive outcomes, as ED patients often lack interoceptive awareness and suppress emotions, leading to body dissatisfaction (Boerhout et al. 2017). Yoga improved emotional regulation, reduced self-criticism, and decreased preoccupation with food, likely due to enhanced mindfulness and anatomical changes in the brain (Carei et al. 2010;McIver, O'Halloran, and McGartland 2009). Body awareness therapy positively impacted body satisfaction and attitudes toward eating, promoting both physical and mental health benefits (Catalan-Matamoros et al. 2011). ...
... Self-Compassion Scale, the Toronto Mindfulness Scale and the Short Form of Attitudes Toward Seeking Professional Psychological Help (Brennan, Whelton, and Sharpe 2020), Emotional Avoidance Questionnaire (EDE-Q), the Hamilton Anxiety Scale and the List of Positive and Negative Affect (Pacanowski et al. 2017), State-Trait Anxiety Inventory, the Beck Depression Inventory and measured body mass index(Carei et al. 2010;McIver, O'Halloran, and McGartland 2009;Ziv et al. 2023), and Multidimensional Body Self Relations Questionnaire, the Toronto Alexithymia Scale(Savidaki, Demirtoka, and Rodríguez-Jiménez 2020). ...
Given the rising prevalence and complexity of eating disorders, a comprehensive multidisciplinary holistic approach is necessary. This work aimed to assess the effectiveness of body and movement awareness therapies in patients with eating disorders. Search strategy was undertaken using several scientific health databases. Articles were eligible if they were randomized controlled trials analyzing the effects of movement and body awareness therapies in eating disorders. The Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) statement for systematic reviews was followed and the risk of bias was assessed using the “Cochrane Collaboration Tool to assess the risk of bias.” 11 articles met the inclusion criteria, including 437 patients. No high‐quality randomized controlled trials were found. Forest plot analysis of the Eating Disorder Examination scale showed a difference favors to body awareness therapies but not significantly neither homogeneous. The interventions analyzed included yoga, body awareness therapy, dance, and psychomotor therapy. Body awareness therapies provide some additional benefits for eating disorder symptoms, such as emotion regulation, self‐criticism, self‐confidence, self‐compassion, anxiety, body attitude, eating disorder symptoms, and quality of life.
... Both studies focussed on AN only, and questions relating to yoga's perceived risk or safety were not explored. Two further studies used qualitative methods as part of a mixed methods evaluation of novel yoga programs for people with EDs [29][30][31]. Diers et al., [29] piloted a yoga program for 67 people diagnosed with an ED using mixed methods with quantitative data showing decreased body image concerns. The qualitative data suggested that the yoga program improved participants' self-acceptance, self-awareness, confidence, and emotional and physical strength, and that group discussion enhanced the experience of embodiment through verbal processing and peer-based support. ...
... The qualitative data suggested that the yoga program improved participants' self-acceptance, self-awareness, confidence, and emotional and physical strength, and that group discussion enhanced the experience of embodiment through verbal processing and peer-based support. However, along with these perceived benefits, participants reported that at times they had negative experiences with yoga due to self-judgement, vulnerability, and confrontation of uncomfortable feelings McIver et al., [30, 31*] piloted a yoga program for 25 people with Binge Eating Disorder (BED) which resulted in a decrease in BED symptomatology with qualitative data indicating that participants felt more positively connected to their bodies, and food, resulting in feelings of self-empowerment [30,31]. Qualitative data in this study was limited to self-report diary entries, and participants were not asked about the feasibility or safety of the yoga program. ...
... Accordingly, the reported benefits are consistent with previous yoga research, which found that yoga can provide biopsychosocial-spiritual benefits. Physical and psychological benefits such as managing weight gain and cravings [46], improving physical strength and capacity [47], body satisfaction, body appreciation and body image [21,22,24,29,48], mindfulness, self-compassion [20], self-efficacy [49], selfregulation [50], empowerment [30,31], motivation [49], connection [51], psychological flexibility [50], positive affect [52] where all reported by participants. Furthermore, participants reported that yoga provided an opportunity for developing social connections and a sense of belonging [13] and an opportunity for deeper spiritual reflection [32]. ...
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 study analyzed the efficacy of yoga: participants took part in a 12-week yoga program composed of 60-minute SA sessions performed at different intensities (Pranayama, Hatha yoga, yoga Nidra) and 30-minute homebased sessions. 39 One study proposed a 6-month SA program, including 4 weekly sessions of 60 minutes of aerobic activity, such as brisk walking, 20 minutes of resistance training, and 10 minutes of static stretching. 41 In another study, participants in the exercise intervention group were involved in a 4-month SA intervention (within the 16-month program), composed of two 45-minute supervised aerobic sessions and 1 homebased walking session. ...
... 40,41 Only 1 article in the control group was considered a waitlist and therefore not involved in any intervention. 39 Studies varied in their rates of and approach to the analysis of dropout. In Pendleton et al, 37 (78.9%) ...
... This was the only study in which analyses were conducted using the per-protocol and intention-to-treat approaches. 39 In the analysis of Mama et al, 40 310 women were randomized, and 180 (58.1%) were included, with a dropout rate of 41.7% and 47.2% for the intervention and control arm, respectively. Finally, Galasso et al 41 reported that 65 participants were eligible for the study, and 41 (63.1%) were excluded. ...
Objective:
This review aimed to collect evidence about the effectiveness of exercise programs for managing binge eating disorder (BED) (recurrent binge eating episodes).
Methods:
Meta-analysis was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Articles were searched in PubMed, Scopus, Web of Science, and Cochrane Library. Randomized controlled trials were eligible for inclusion if they reported the effect of an exercise-based program on BED symptoms in adults. Outcomes were changes in binge eating symptom severity, measured through validated assessment instruments, after an exercise-based intervention. Study results were pooled using the Bayesian model averaging for random and fixed effects meta-analysis.
Results:
Of 2,757 studies, 5 trials were included, with 264 participants. The mean age was 44.7 ± 8.1 years for the intervention group and 46.6 ± 8.5 years for the control group. All participants were female. A significant improvement was observed between groups (standardized mean difference, 0.94; 95% credibility interval, -1.46 to -0.31). Patients obtained significant improvements either following supervised exercise programs or home-based exercise prescriptions.
Implications for research and practice:
These findings suggest that physical exercise, within a multidisciplinary clinical and psychotherapeutic approach, may be an effective intervention for managing BED symptoms. Further comparative studies are needed to clarify which exercise modality is associated with greater clinical benefits.
... Uno de los posibles motivos es la práctica disfuncional o compensatoria de EF en BN, causada por la necesidad de controlar el peso corporal (32) que afecta al 20-40% de personas con BN (33). Los estudios existentes sobre el EF como tratamiento complementario para los TCA son escasos (27,34), donde se observa que se utiliza una combinación de entrenamientos aeróbicos y de fuerza para obtener beneficios sobre la condición física y la salud (35,37). Además, la AF no sólo reduce los episodios de atracón, sino que puede suponer una reducción de peso (26), y una mejora en los sentimientos de autopercepción (38). ...
... Además, la AF no sólo reduce los episodios de atracón, sino que puede suponer una reducción de peso (26), y una mejora en los sentimientos de autopercepción (38). Por tanto, actividades como el yoga o el pilates, que conectan el cuerpo, la respiración y la mente, pueden mejorar la salud general (35). Siendo, fundamentales para tratar los TCA. ...
... Resulta relevante que tan solo en el estudio de Mathisen et al., (46), se valoró el deterioro clínico (CIA 3.0), los síntomas de depresión (Inventario de depresión de Beck "BDI-Ia), y la calidad de vida (Escala de la Satisfacción de vida "SWLS"). En la literatura científica, existen diferentes documentos relacionados con ejercicios para combatir la depresión y la ansiedad (35,52), siendo dos de las comorbilidades más habituales entre las personas con TCA. Para ello, es fundamental las actitudes positivas hacia la práctica físico-deportiva en personas con TCA (53). ...
Eating Disorders (ED) are a severe mental illness that causes physical and psychosocial problems. This illness has a higher prevalence among young women, and between athletes. cognitive behavioural therapy (CBT) is the current treatment for this type of disorder. However, more and more programs are including physical exercise (PE) and nutritional therapy (TN) for eating disorders treatment. Objective. To carry out an exploratory systematic review of the literature that allows us to know the current state of intervention programs through physical exercise and nutritional therapy for the treatment of eating disorders. Materials and methods. For the reference search thesame search phrase was used. The terms were entered in English in the following computerized databases: SCOPUS, Web of Science, and PubMed. To limit the search, four inclusion criteria were introduced. Results. The review included five scientific articles related to the study topic, which met the inclusion criteria. Conclusion. Intervention programs for the treatment of eating disorders that include physical exercise and nutritional therapy are shown as an alternative or complementary tool to conventional therapy. These programs involve a reduction in the severity of ED symptoms and an improvement in anthropometric parameters and physical condition. More studies that combine PE and TN programs for people with ED are required.
... The QEWP has been shown to work best when used for the screening of BED, with interviews used to confirm the disorder (Yanovski, Marcus, Wadden, & Walsh, 2015). Binge eating severity can also be assessed using the Binge Eating Scale (BES), a valid and reliable self-reported measure of assessment (Mclver, Halloran, & McGartland, 2009) . Total BES scores above 27 indicate a serious binge eating problem, while scores between 18-26 indicate a moderate binge eating problem, and scores below 17 indicate the absence of a binge eating problem (Mclver et al., 2009). ...
... Binge eating severity can also be assessed using the Binge Eating Scale (BES), a valid and reliable self-reported measure of assessment (Mclver, Halloran, & McGartland, 2009) . Total BES scores above 27 indicate a serious binge eating problem, while scores between 18-26 indicate a moderate binge eating problem, and scores below 17 indicate the absence of a binge eating problem (Mclver et al., 2009). There are also clinical ways to assess and diagnose BED including physical exams and interviews with questions related to BED characteristics described in the DSM-5 (Gluck et al., 2004). ...
... With stress being the most commonly reported trigger of binge eating, and evidence correlating high cortisol levels with abdominal fat and food intake after laboratory stress, researchers are spending valuable time and resources analyzing how mindfulness interventions can effect behaviors associated with binge eating disorder (Gluck et al., 2004). Mclver, Halloran, and McGartland (2009) completed a randomized trial with ninety women measuring the effects of a 12-week yoga program on reducing binge eating severity (Mclver et al., 2009). For this study, yoga was defined in a broad definition that included all major approaches and paths reflecting the pedagogical framework of yoga provided by Gowans (Mclver et al., 2009). ...
This literature review examines the impact of various mindfulness-based interventions (MBIs) on the obesity-related eating behaviors of stress eating, emotional eating, and binge eating. With the inconsistency of the weight loss industry to provide long-term weight loss results, the United States is in need of alternative methods of weight loss and weight maintenance to combat the current overweight and obesity epidemic. MBIs are thought to be beneficial when targeted at behaviors of weight gain because mindfulness promotes an individual’s awareness of present physical and emotional sensations within the body, including hunger and satiety cues. Self-acceptance and stress reduction are also targeted outcomes of mindfulness and are linked to the benefits of MBIs on obesity-related eating behaviors. Results show that MBIs may be beneficial to improving the targeted eating behaviors which have been linked to weight gain. However, when weight change is the goal, MBIs have been shown to be most effective when used in conjunction with other weight loss methods such as dietary and physical activity and education modifications. To date, studies are few and contain a variety of definitions for both eating behaviors and MBIs. Future research with a narrowed scope of view and greater variation within the study populations will be beneficial. Although more research is needed, current evidence exists to support the use of MBIs to reduce the frequency and severity of stress eating, emotional eating, and binge eating.
... Characteristics of the sample, interventions, and outcome assessment are shown in Table 1 and 2. Eight of the included studies were randomized controlled trials, [65][66][67] and four were uncontrolled trials. 68,69 Of the twelve studies that were included, eight originated from the USA, 65,67-72 one from Norway, 73 one from India, 74 one from Tunisia, 75 and one from Australia. ...
... 68,69 Of the twelve studies that were included, eight originated from the USA, 65,67-72 one from Norway, 73 one from India, 74 one from Tunisia, 75 and one from Australia. 66 The studies included a total of 495 participants; sample sizes ranged from 8 to 113 with a median sample size of 31. Participants in eight studies were diagnosed with eating disorders including binge eating disorder, 66 anorexia nervosa, 65,69 bulimia nervosa 65,69 , eating disorders not otherwise specified, 65 or any eating disorder. ...
... 66 The studies included a total of 495 participants; sample sizes ranged from 8 to 113 with a median sample size of 31. Participants in eight studies were diagnosed with eating disorders including binge eating disorder, 66 anorexia nervosa, 65,69 bulimia nervosa 65,69 , eating disorders not otherwise specified, 65 or any eating disorder. 68 The remaining study involved participants with disordered eating and/or body dissatisfaction but without a formal diagnosis of an eating disorder. ...
Background:
The question of whether yoga practice ameliorates or even aggravates eating disorders is currently under debate. The aim of this review was to systematically assess and the effectiveness and safety of yoga in patients with eating disorders.
Methods:
Medline/PubMed, PsycINFO, and the Psychological and Behavioral Science Collection were screened through July 2018 for randomized controlled trials, non-randomized controlled trials and longitudinal observational studies on yoga for patients with eating disorders and other individuals with disordered eating and/or body dissatisfaction. Risk of bias was assessed using the Cochrane risk of bias tool and the Newcastle-Ottawa Quality Assessment Scale.
Results:
Eight randomized trials and four uncontrolled trials involving a total of 495 participants were included. Risk of bias was mixed. Comparing yoga to untreated control groups, effect sizes ranged from negligible effects of d = 0.02 to very large effects of d = 2.15. However, most effects were small to moderately sized and in most cases not significant. No safety-related data were reported.
Conclusions:
There is limited evidence on the effectiveness and safety of yoga in patients with eating disorders. Yoga can be preliminarily considered as an additional treatment option in multimodal psychiatric treatment programs.
... Per Borden and Cook-Cottone's metaanalysis general findings across studies include increased embodiment and connection, increased authenticity and selfempowerment, and increased present moment awareness. McIver et al. (2009) analyzed personal journals written by women who participated in a yoga treatment program for EDs and found evidence of an overall reduction in ED pathology and behaviors including more appropriate food intake quantity and decreased feeding pace, along with improved relationship with food. Another qualitative study focused on interviews with participants revealing increased positive body image as a result of yoga-fostered body-based gratitude (Neumark-Sztainer et al., 2018). ...
... Other qualitative research on the efficacy of yoga-based interventions for EDs reveals similar outcomes to the present research. Individuals report decreased ED symptoms, such as eating meals more slowly, and an improved relationship with food and attribute these changes to their mindfulness and yoga-based practices (McIver et al., 2009). Another interviewbased study on yoga interventions reported an increased positive relationship with the body due to increased exposure to positive state experiences such as gratitude, acceptance, and self-confidence. ...
A growing body of evidence suggests that yoga-based interventions might aid in the prevention and treatment of eating disorders. The current qualitative study used Interpretative Phenomenological Analysis (IPA) to analyze the nature and degree of impact of a yoga and mindfulness-based eating disorder prevention intervention Eat Breath Thrive (EBT). Data was collected via semi-structured interviews with 16 participants over the age of 18 who took part in the EBT program between 2018 and 2022. Using IPA methodology, and after several rounds of coding, emergent themes were interpreted and organized to develop a theoretical model explaining the mechanism of change experienced and described by EBT participants. The resulting model outlines an experiential progression from psychoeducation and skill development/practice to increased mindful awareness, and empowered state experiences which led to the following outcomes: independent positive action, self-initiated positive state experiences, and increased embodied well-being. Participants reported increased self-compassion and self-acceptance, with decreased emphasis on disordered eating behaviors. Qualitative data is necessary for understanding why yoga works, from an experi-ential perspective. This study adds to the new, and rapidly expanding body of research supporting the positive effects of yoga and mind-fulness on the prevention and treatment of eating disorders.
... In supporting this integration, clinicians put forward several considerations for the safe and suitable application of yoga for people with EDs. Many of these considerations have been utilised in previous studies investigating the use of yoga for EDs, such as the practice being centred in it's traditional roots [63]; employing slow and gentle styles in a non-heated environment [64]; only offering simple postures that bring a sense of comfort rather than exertion [26], small group sizes [28], and the instructor being ED-trained (Hall et al., 2016; [26]. This study uniquely highlighted clinicians' support for exact dosages of yoga for EDs, the importance of offering few sitting to standing sequences, comfortable clothing, dimmed lighting, debriefing at the end of each session, and having no-mirrors in the room. ...
... Clinicians expressed concern that, if yoga did not have a focus on inclusivity, that programs may unintentionally reinforce unhelpful messaging such as thin body ideals and diet culture. These findings align with previous studies using yoga for EDs, where poses have been adapted for people in larger bodies [28,63] and the language has been reported as non-judgemental, inclusive, and non-competitive based [26]. These findings are critical given the diversity in demographics and bodies among clients with EDs, with atypical AN and BED presentations increasing [67] and the recognition that people in marginalised bodies are often underrepresented among yoga communities [68]. ...
... In supporting this integration, clinicians put forward several considerations for the safe and suitable application of yoga for people with EDs. Many of these considerations have been utilised in previous studies investigating the use of yoga for EDs, such as the practice being centred in it's traditional roots [63]; employing slow and gentle styles in a non-heated environment [64]; only offering simple postures that bring a sense of comfort rather than exertion [26], small group sizes [28], and the instructor being ED-trained (Hall et al., 2016; [26]. This study uniquely highlighted clinicians' support for exact dosages of yoga for EDs, the importance of offering few sitting to standing sequences, comfortable clothing, dimmed lighting, debriefing at the end of each session, and having no-mirrors in the room. ...
... Clinicians expressed concern that, if yoga did not have a focus on inclusivity, that programs may unintentionally reinforce unhelpful messaging such as thin body ideals and diet culture. These findings align with previous studies using yoga for EDs, where poses have been adapted for people in larger bodies [28,63] and the language has been reported as non-judgemental, inclusive, and non-competitive based [26]. These findings are critical given the diversity in demographics and bodies among clients with EDs, with atypical AN and BED presentations increasing [67] and the recognition that people in marginalised bodies are often underrepresented among yoga communities [68]. ...
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.
... Other studies focused on at-risk adult populations in the community. Ninety overweight or obese participants from a community sample with a binge eating problem were randomly assigned to a weekly 60 min hatha yoga session for 12 weeks or a waitlist control [88]. The yoga group's binge eating scores and physical activity significantly decreased, while the waitlist controls showed no changes. ...
... Yoga appears to be a promising adjunct for treating people with eating disorders and may be an efficacious prevention strategy in reducing risk factors and symptoms when used in the community (e.g., [83,86,88]). Although the studies reviewed generally drew positive conclusions about yoga's efficacy with these populations and make sense from a theoretical standpoint, the research evidence is weak, as many studies lacked a control group and studies that did employ a control group often used waitlist controls rather than active control groups. ...
Background: Because the prevalence of mental health concerns is high and access or full responsiveness to pharmacological or psychotherapeutic treatment for many individuals is low, there has been increased interest in yoga as a potential therapy for many mental health concerns. Approach: We synthesize and critique current research on the efficacy of yoga relative to pharmacological approaches for anxiety disorders, mood disorders, posttraumatic stress disorder, obsessive-compulsive disorder, and eating disorders. Results: Yoga has been tested mostly as a complementary treatment to standard psychiatric and psychotherapeutic approaches. Findings from efficacy trials largely support the notion that yoga can help reduce symptoms of many psychiatric conditions, including anxiety, depression, and PTSD symptoms, above and beyond the effects achieved by standard pharmacological treatments alone; however, most evidence is of poor to moderate quality. Plausible transdiagnostic bottom-up and top-down mechanisms of yoga’s therapeutic effects have been advanced but remain untested. Conclusions: While results should be considered preliminary until more rigorous evidence is available, yoga appears to have the potential to provide many people suffering with psychiatric symptoms additional relief at relatively little cost. Yoga may be a viable complementary therapy to psychiatric and psychotherapeutic approaches for people with mental health challenges.
... More recently, adolescent females from an eating disorder clinic participated in six to 12 weekly Yoga classes, and experienced decreases in anxiety, depression, and body image disturbance (Hall, Ofei-Tenkorang, Machan, & Gordon, 2016). McIver, O'Halloran, and McGartland (2009) conducted one of the first RCTs in which they compared the effects of a 12-week Yoga program to a waitlist control amongst 50 women self-identifying with a binge eating problem. Compared to waitlist controls, Yoga participants experienced decreased binge eating frequency that was maintained at a three-month follow-up. ...
... This finding is consistent with the conclusions of two meta-analyses investigating the use of mindfulnessbased interventions in the treatment of binge eating (Godfrey, Gallo, & Afari, 2015;Katterman, Kleinman, Hood, Nackers, & Corsica, 2014). The decrease in binge eating episodes experienced by the Yoga participants is also consistent with existing research exploring the use of Yoga in the treatment of BED (Clarke, 2008) and women reporting problematic binge eating behavior (McIver et al., 2009). It is important to note that similar to the present study, the Clarke (2008) and McIver et al. (2009) studies did not involve an active control condition. ...
... Ряд авторів відзначають, що діюча в теперішній час організація фізичного виховання в вузах недостатньо ефективна для підвищення рівня фізичного стану студентів. У практичній діяльності акцент надається виконанню нормативно-базової частини навчальної програми без врахування мотивів і потреб студентів у різних видах рухової активності 2,3,4 . ...
... Молодий вчений, 2015. № 2. С. 497-500.4 Футурий С. М. Шляхи удосконалення організації фізичного виховання студентів ВНЗ. ...
... According to previous studies, individuals with higher Body Mass Index (BMI) present less mindfulness than those who practice yoga and meditation. Besides, mindful eating is strongly associated with yoga and exercise [38][39][40]. ...
... The results highlighted that practicing yoga and meditation, which include components of mindfulness, constructively impact reducing fatigue, increasing body awareness, and managing patients' stress [8]. It can also be associated with lower BMI [38][39][40]. ...
Background: Wrong eating behaviors increase the risk of numerous chronic diseases.
Objectives: This study aims to determine the validity and reliability of the Mindful Eating
Questionnaire (MEQ) in the Iranian population.
Materials & Methods: In a validation study at the University of Guilan City, Iran, in 2019-2020.
First, the MEQ was translated based on the forward-backward method. After applying the changes
to the Persian version of MEQ (P-MEQ), 50 participants responded to the P-MEQ twice with an
interval of 3 weeks. Then, 384 Iranian students selected by the two-stage cluster sampling method
completed the P-MEQ to determine its construct validity. Sixty participants simultaneously filled
the P-MEQ and the Freiburg Mindfulness Inventory (FMI-SF) to determine concurrent validity. To
determine known-group validity, 23 very obese participants and a Body Mass Index (BMI) of over
35 kg/m2 were compared to individuals with a healthy weight (BMI: 18.5-24.9 kg/m2).
Results: The test-retest reliability of the P-MEQ was obtained as 0.59 for the total score, and it
ranged from 0.58 to 0.79 for the subscales. The first-order Confirmatory Factor Analysis (CFA)
results indicated that after removing four items with weak factor loading, the five-factor P-MEQ
model had appropriate goodness of fit (χ2/df=2.516, RMSEA=0.067, AGFI=0.835, IFI=0.924,
& CFI=0.916). The second-order CFA revealed that the latent components of awareness,
distraction, disinhibition, emotional response, and external cues reflected the concept of higher
levels of mindful eating acceptably (χ2/df=2.545, RMSEA=0.067, AGFI=0.825, IFI=0.912, &
CFI=0.905). However, there was a poor relationship between the total score of P-MEQ and
FMI-SF (r=0.24, P=0.07).
Conclusion: Regardless of concurrent validity, the Persian version of MEQ has proper construct
validity, test-retest reliability, and internal consistency.
... Scalable, effective evidencebased body image interventions that are remotely delivered are particularly needed during the era of the COVID-19 pandemic and beyond. Extending previous lines of theory and research [e.g., (28,35,(42)(43)(44), the present study aimed to evaluate the feasibility, acceptability and preliminary efficacy among completers (i.e., per-protocol analysis) of this integrative online mind-body program in a sample of ethnically-diverse college women of higher weight. We prioritized a per-protocol analysis for this early phase evaluation of efficacy given the anticipated moderately high attrition (71), that the project was not specifically powered to detect specific effects apriori, and given the more real-world considerations of self-selection for remaining engaged in a low-intensity, web-based self-help intervention (77). ...
... First, limited yoga intervention research has specifically targeted the inclusion of higher weight college women who may feel stigmatized and alienated in practicing yoga in conventional mainstream wellness spaces (44,60). Our study expands upon the work of McIver and colleagues from a more weight-neutral perspective that does not center eating pathology and weight management as a major emphasis (42). Notably, in support of their earlier efforts, we found that our brief online intervention yielded benefits for strengthening participants' orientation towards physical activity more broadly and in particular a more positive and empowered connection to one's experience of the physical body (43). ...
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 versus 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.
... According to previous studies, individuals with higher Body Mass Index (BMI) present less mindfulness than those who practice yoga and meditation. Besides, mindful eating is strongly associated with yoga and exercise [38][39][40]. ...
... The results highlighted that practicing yoga and meditation, which include components of mindfulness, constructively impact reducing fatigue, increasing body awareness, and managing patients' stress [8]. It can also be associated with lower BMI [38][39][40]. ...
Background: Wrong eating behaviors increase the risk of numerous chronic diseases. This study aims to determine the validity and reliability of the Mindful Eating Questionnaire (MEQ) in the Iranian population. Methods: In a validation study at the University of Guilan City, Iran, in 2019-2020. First, the MEQ was translated based on the forward-backward method. After applying the changes to the Persian version of MEQ (P-MEQ), 50 participants responded to the P-MEQ twice with an interval of 3 weeks. Then, 384 Iranian students selected by the two-stage cluster sampling method completed the P-MEQ to determine its construct validity. Sixty participants simultaneously filled the P-MEQ and the Freiburg Mindfulness Inventory (FMI-SF) to determine concurrent validity. To determine known-group validity, 23 very obese participants and a Body Mass Index (BMI) [W1] of over 35 kg/m2 were compared to individuals with a healthy weight (BMI: 18.5-24.9 kg/m2. Results: The test-retest reliability of the P-MEQ was obtained as 0.59 for the total score, and it ranged from 0.58 to 0.79 for the subscales. The first-order confirmatory factor analysis (CFA) results indicated that after removing four items with weak factor loading, the five-factor P-MEQ model had appropriate goodness of fit (χ2/df=2.516, RMSEA=0.067, AGFI=0.835, IFI=0.924, & CFI=0.916). The second-order CFA revealed that the latent components of awareness, distraction, disinhibition, emotional response, and external cues reflected the concept of higher levels of mindful eating acceptably (χ2/df=2.545, RMSEA=0.067, AGFI=0.825, IFI=0.912, & CFI=0.905). However, there was a poor relationship between the total score of P-MEQ and FMI-SF (r=0.24, P=0.07). Conclusion: Regardless of concurrent validity, the Persian version of MEQ has proper construct validity, test-retest reliability, and internal consistency.
... It is promising to see that young adults who have body image concerns and engage in disordered eating behaviors are choosing to practice yoga, given the underlying tenets of yoga, in addition to research findings suggesting that yoga may be helpful in terms of promoting a stronger sense of self and positive embodiment (22,39,64). Furthermore, some longitudinal and intervention studies have suggested that yoga may be effective in improving body image and disordered eating behaviors (37,38,60,61,65,66). Although findings do not consistently show the benefits of yoga (30, 31), we are not aware of research findings showing that yoga can be harmful in terms of worsening these outcomes. ...
... In prior qualitative research, young adults practicing yoga discussed how yoga helped with increased awareness of their bodies' needs, the selection of more nourishing foods, attentiveness to internal signs of hunger or fullness, and greater presence while eating (46). A randomized, controlled trial examining the impact of yoga among adults engaging in binge eating (65) found that yoga was associated with decreased binge eating. Likewise, qualitative interviews with study participants indicated perceived improvements in eating behaviors, including greater presence and mindfulness while eating (67). ...
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.
... It is promising to see that young adults engaging in disordered eating behaviors are choosing to practice yoga, given the underlying tenets of yoga, in addition to research ndings suggesting that yoga may be helpful in terms of promoting a stronger sense of self and positive embodiment (17,39,60). Furthermore, some longitudinal and intervention studies have suggested that yoga may be effective in improving body image and disordered eating behaviors (37,38,57,58,61,62). Although ndings do not consistently show the bene ts of yoga (30, 31), we are not aware of research ndings showing that yoga can be harmful in terms of worsening these health outcomes. ...
... In prior qualitative research, young adults practicing yoga discussed how yoga helped with increased awareness of their bodies' needs, the selection of more nourishing foods, attentiveness to internal signs of hunger or fullness, and greater presence while eating (63). A randomized, controlled trial examining the impact of yoga among adults engaging in binge eating (61), found that yoga was associated with decreased binge eating. Likewise, qualitative interviews with study participants indicated perceived improvements in eating behaviors, including greater presence and mindfulness while eating (64). ...
Background: Yoga may be beneficial for young people at risk for body dissatisfaction and unhealthy behaviors aimed at changing one’s body shape and size. This study explores associations between yoga practice and body image, mindful eating, disordered eating, and muscle-enhancing behaviors among a population-based sample of emerging adults from diverse socio-economic and ethnic/racial backgrounds.
Methods: Survey data were collected from 1,568 ethnically/racially diverse emerging adults (18-26 years) as part of the EAT 2010-2018 study (Eating and Activity over Time).
Results: Practicing yoga at least 30 minutes/week was reported by 12.7% (n=210) of the sample. In models adjusted for sociodemographic characteristics, yoga practitioners had higher levels of mindful eating and body satisfaction than non-practitioners. Of concern, yoga practitioners were more likely to use steroids to enhance the size or tone of their muscles than those not practicing yoga (4.2% vs. 0.8%, p<.001). Furthermore, 35.4% of yoga practitioners used protein powder or shakes in the past year as compared to 25.0% of those not practicing yoga (p=.005). Yoga practitioners had similar levels of unhealthy weight control behaviors and binge eating to those not practicing yoga. Associations between yoga practice and body satisfaction, mindful eating, disordered eating, and muscle-enhancing behaviors were similar across ethnic/racial groups.
Conclusions: In order to promote yoga among diverse populations, and enhance its safety and benefits for weight-related health, it is crucial for settings in which yoga is offered, and yoga teachers, to have awareness of the high prevalence of concerning disordered eating and muscle-enhancing behaviors among students and to address accordingly.
... More recently, adolescent females from an eating disorder clinic participated in six to 12 weekly Yoga classes, and experienced decreases in anxiety, depression, and body image disturbance (Hall, Ofei-Tenkorang, Machan, & Gordon, 2016). McIver, O'Halloran, and McGartland (2009) conducted one of the first RCTs in which they compared the effects of a 12-week Yoga program to a waitlist control amongst 50 women self-identifying with a binge eating problem. Compared to waitlist controls, Yoga participants experienced decreased binge eating frequency that was maintained at a three-month follow-up. ...
... This finding is consistent with the conclusions of two meta-analyses investigating the use of mindfulnessbased interventions in the treatment of binge eating (Godfrey, Gallo, & Afari, 2015;Katterman, Kleinman, Hood, Nackers, & Corsica, 2014). The decrease in binge eating episodes experienced by the Yoga participants is also consistent with existing research exploring the use of Yoga in the treatment of BED (Clarke, 2008) and women reporting problematic binge eating behavior (McIver et al., 2009). It is important to note that similar to the present study, the Clarke (2008) and McIver et al. (2009) studies did not involve an active control condition. ...
Yoga has begun to be incorporated into the treatment of eating disorders despite limited empirical support for this practice. The purpose of this study was to investigate the efficacy of incorporating Yoga into the treatment of eating disorders. This preliminary randomized controlled trial investigated the benefits of participating in an eight-week Kripalu Yoga program for 53 women with symptoms of bulimia nervosa and binge eating disorder. Compared to waitlist controls, Yoga participants experienced decreases in binge eating frequency, emotional regulation difficulties and self-criticism, and increases in self-compassion. Yoga participants also experienced increases in state mindfulness skills across the eight weeks of the Yoga program. While these results are encouraging and suggest Yoga may have a valuable role to play in the treatment of eating disorders, it is important to stress their tentative nature. Further research, adopting a more rigorous design, is needed to address the limitations of the present study and expand on these findings.
... Nevertheless, the time is ripe for partnering with body-positive yoga professionals making inroads in inspiring individuals of diverse body sizes and shapes to come to the practice (Pickett & Cunningham, 2017). Further, it is critical to expand the limited corpus of yoga scholarship focused on strengthening the experiences of positive embodiment and adaptive eating behavior among higher-weight individuals (McIver et al., 2009a(McIver et al., , 2009bNeumark-Sztainer et al., 2018;Webb et al., 2018a). ...
... tional quality of food choices(McIver, McGartland, & O'Halloran, 2009a;McIver, O'Halloran, & McGartland, 2009b;Neumark-Sztainer et al., 2018; Webb, Padro, Rogers, Vinoski, Etzel, & Putz, 2018a).In this context, those trailblazers at the forefront of the grassroots sizeinclusive yoga movement have strategically infiltrated alternative spaces such as books (e.g., Mega Yoga;Garcia, 2006; Yes! Yoga Has Curves: Volumes 1 and 2:;Smith, 2014Smith, , 2016 Curvy Yoga: Guest-Jelley, 2017; Every Body Yoga: Stanley, 2017; Fat Yoga: Harry, 2017), popular social media platforms (e.g., Instagram:Stanley, 2018;Webb et al., 2018b;Webb, Vinoski, Bonar, Davies, & Etzel, 2017c) ...
In the 21st 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.
... Improvements on these measures were also maintained at 3-month followup for the yoga group. Small reductions in BMI were also reported [136]. ...
Background:
The current review broadly summarises the evidence base for pharmacotherapies and adjunctive and alternative therapies in the treatment of eating disorders and disordered eating.
Methods:
This paper forms part of a Rapid Review series examining the evidence base in the field of eating disorders. This was conducted to inform the Australian National Eating Disorder Research and Translation Strategy 2021-2030. ScienceDirect, PubMed and Ovid/Medline were searched for included studies published between 2009 and 2021 in English. High-level evidence such as meta-analyses, large population studies and randomised control trials were prioritised, and grey literature excluded. Data from included studies relating to pharmacotherapy, and to adjunctive and alternative therapies in eating disorders, were synthesised and disseminated in the current review.
Results:
A total of 121 studies were identified, relating to pharmacotherapy (n = 90), adjunctive therapies (n = 21) and alternative therapies (n = 22). Some of the identified studies involved combinations of the above (e.g. adjunctive pharmacotherapy). Evidence of efficacy of interventions across all three categories was very limited with few relevant high quality clinical trials. There was a particular scarcity of evidence around effective treatments for anorexia nervosa (AN). With treatment of bulimia nervosa (BN), fluoxetine has exhibited some efficacy leading to regulatory approval in some countries. With binge eating disorder (BED), recent evidence supports the use of lisdexamfetamine. Neurostimulation interventions show some emerging efficacy in the treatment of AN, BN and BED but some, such as deep brain stimulation can be highly invasive.
Conclusion:
Despite widespread use of medications, this Rapid Review has identified a lack of effective medications and adjunctive and alternative therapies in the treatment of EDs. An intensification of high-quality clinical trial activity and drug discovery innovation are required to better assist patients suffering from EDs.
... In one study, a cognitive behavioral therapy (CBT) plus physical activity condition saw a reduction in Binge Eating and Health Behaviors During Times of High and Low Stress Among First-year University Students Collabra: Psychology weekly binge eating days from 4.4 days/week to less than 1 day/week at 4-, 10-, and 16-month follow-ups while a CBTonly condition saw a reduction in weekly binge eating days from 4.7 days/week to 2 days/week at follow-ups (Pendleton et al., 2002). Stronger effects of physical activity on binge eating in clinical samples are likely due to demanding interventions that require participants who are largely inactive to engage in exercise at least three times per week (Levine et al., 1996;McIver et al., 2009;Pendleton et al., 2002). Given that a high percentage of people with BED are sedentary, engaging in any level of physical activity would likely benefit their mental health and in turn, disordered eating behaviors. ...
The current study examined the influence of physical activity and sleep on binge eating during times of typically higher-and lower-stress over the academic year (n=394, Mage=18.6). First-year undergraduate students completed surveys of physical activity, sleep, and binge eating behaviors across four waves spanning the academic year. Results of multilevel models revealed relatively stable binge eating scores across the academic year. We found no robust associations between physical activity or sleep and binge eating during times of high and low stress. Small effects in this study, consistent with other non-clinical samples, highlight that eating behaviors are resistant to change.
... Throughout different studies, various types of yoga are adopted as part of the study, while there are some papers that do not specify the type of yoga that is being practised (i.e., only the word Yoga is used in the paper), generally, Yoga practices adopted by various researchers include Iyengar Yoga [17,21], Ashtanga Yoga [22] or Hatha Yoga [19]. ...
Obesity has become an increasing concern in the world and has also become a public health threat in many countries. Governments and private sectors are working hard to develop various strategies to assist people to have a better control over their health. Regular exercise, which is part of a healthy lifestyle help to improve cardiovascular health, leading to weight loss and hence prevention of certain potential illnesses. Yoga, being one of the physical exercises, promotes body’s natural harmony and functional balance, which in turn, helps individuals to live a better life. This paper outlines the pilot study conducted in Singapore to investigate the effects of Vinyasa Flow Yoga coupled with Pranayama on the weight-related outcomes in adults, in particular, reduction of body weight and body fat percentage. The results show that weekly Yoga practices impose positive results on the reduction of body weight and fat percentage, and hence can be considered essential for a healthy lifestyle.
... Pendleton et al. [226] trialled exercise-augmented CBT in BED and also found significant reductions in binge eating symptomatology post-treatment. McIver et al. [227] found a yoga intervention significantly reduced self-reported binge eating in higher weight individuals as compared with a wait list control group who did not improve on any measure at post-test. ...
Introduction:
The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population.
Aim:
The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations.
Methods:
The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the 'Guidelines for Guidelines' process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience.
Recommendations:
Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed.
Conclusions:
This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.
... Inclusive Criteria All participants should be adolescent girls i.e. age group [11][12][13][14][15][16][17][18][19] year Girls with the symptoms of eating disorder Exclusive criteria Girls above the age group of 20 years cannot participate in this study Girls with severe psychological problem cannot participate ...
Background: Eating disorder is very common among western countries but now-a-days it is introducing in India too due to the effect of globalization, Media, Magazine and tendency to have a perfect body shape which results in different health hazards. Aims: To examine the effect of yogic practises on eating disorder cognitions among adolescent girls in India. Method: All subjects (11 to 19 years) were taken from Tata Nagar (Jharkhand). Firstly 120 subjects selected for the study from 1056 subjects. Randomly they were divided into two groups, 40 subjects for control group and 80 subjects for experimental group. During yogic intervention most of subjects left the group for their personal reason. Lastly the experiment carried out on 40 subjects. Results: Significant effects of yogic practises on experimental group were found and no effect was found on the subjects who belonged to control group. Conclusions: These finding demonstrated that the effect of yoga has a positive impact on eating disorder cognitions among adolescent girls in India.
... Similarly, more mindful individuals have reported that they consume smaller serving sizes of calorie-dense foods (Beshara et al., 2013). Moreover, studies also demonstrate that yoga and sport practice is highly related to mindful eating (Daubenmier, 2005;Kristal et al., 2005;McIver et al., 2009). One study which evaluated the effects of a multi-faceted 5-day yoga program on mindfulness, nutrition behaviors, physical activity, stress management and mood disturbance suggested significant improvement in all these outcomes after the program. ...
Mindful eating is a phenomenon to describe a nonjudgmental awareness of physical and emotional sensations while eating or being in a food-related environment. Nowadays, weight-related psychological and physiological health problems are gradually increasing. It is considered that mindful eating is one of the key components to struggle against dysfunctional eating patterns. The aim of the current study was to adapt the original five-factor structure of the MEQ and the abbreviated two-factor structure of the MEQ to Turkish culture and to determine its psychometric properties. The sample of the study was 362 university students aged between 18 and 27 (M = 20.82, SD = 3.83). Of the participants 249 (68.8%) were women, 110 (30.4%) were men, and three participants stated their sex as "other". Participants were asked to fill the Mindful Eating Questionnaire (MEQ), Eating Disorder Examination Questionnaire (EDE-Q), Intuitive Eating Scale (IES) and Brief Symptom Inventory (BSI). Results of confirmatory factor analysis showed an acceptable model fit for the correlated two-factor structure of the MEQ compared to its original five-factor structure. Internal consistency coefficient values for the overall MEQ and awareness and recognition subscales were .82, .71 and .82, respectively. The MEQ sub-scales' scores were found to be associated with EDE-Q, IES, and BSI scores, confirming the validity of the scale. The Turkish version of the two-factor MEQ could be evaluated as a valid and reliable measurement to assess mindful eating for further research and would also provide support to cross-cultural research.
... Similarly, more mindful individuals have reported that they consume smaller serving sizes of calorie-dense foods (Beshara et al., 2013). Moreover, studies also demonstrate that yoga and sport practice is highly related to mindful eating (Daubenmier, 2005;Kristal et al., 2005;McIver et al., 2009). One study which evaluated the effects of a multi-faceted 5-day yoga program on mindfulness, nutrition behaviors, physical activity, stress management and mood disturbance suggested significant improvement in all these outcomes after the program. ...
Mindful eating is a phenomenon to describe a nonjudgmental awareness of physical and emotional sensations while eating or being in a food-related environment. Nowadays, weight-related psychological and physiological health problems are gradually increasing. It is considered that mindful eating is one of the key components to struggle against dysfunctional eating patterns. The aim of the current study was to adapt the original five-factor structure of the MEQ and the abbreviated two-factor structure of the MEQ to Turkish culture and to determine its psychometric properties. The sample of the study was 362 university students aged between 18 and 27 (M = 20.82, SD = 3.83). Of the participants 249 (68.8%) were women, 110 (30.4%) were men, and three participants stated their sex as "other". Participants were asked to fill the Mindful Eating Questionnaire (MEQ), Eating Disorder Examination Questionnaire (EDE-Q), Intuitive Eating Scale (IES) and Brief Symptom Inventory (BSI). Results of confirmatory factor analysis showed an acceptable model fit for the correlated two-factor structure of the MEQ compared to its original five-factor structure. Internal consistency coefficient values for the overall MEQ and awareness and recognition subscales were .82, .71 and .82, respectively. The MEQ sub-scales' scores were found to be associated with EDE-Q, IES, and BSI scores, confirming the validity of the scale. The Turkish version of the two-factor MEQ could be evaluated as a valid and reliable measurement to assess mindful eating for further research and would also provide support to cross-cultural research.
... Similarly, more mindful individuals have reported that they consume smaller serving sizes of calorie-dense foods (Beshara et al., 2013). Moreover, studies also demonstrate that yoga and sport practice is highly related to mindful eating (Daubenmier, 2005;Kristal et al., 2005;McIver et al., 2009). One study which evaluated the effects of a multi-faceted 5-day yoga program on mindfulness, nutrition behaviors, physical activity, stress management and mood disturbance suggested significant improvement in all these outcomes after the program. ...
Mindful eating is a phenomenon to describe a nonjudgmental awareness of physical and emotional sensations while eating or being in a food-related environment. Nowadays, weight-related psychological and physiological health problems are gradually increasing. It is considered that mindful eating is one of the key components to struggle against dysfunctional eating patterns. The aim of the current study was to adapt the original five-factor structure of the MEQ and the abbreviated two-factor structure of the MEQ to Turkish culture and to determine its psychometric properties. The sample of the study was 362 university students aged between 18 and 27 (M = 20.82, SD = 3.83). Of the participants 249 (68.8%) were women, 110 (30.4%) were men, and three participants stated their sex as "other". Participants were asked to fill the Mindful Eating Questionnaire (MEQ), Eating Disorder Examination Questionnaire (EDE-Q), Intuitive Eating Scale (IES) and Brief Symptom Inventory (BSI). Results of confirmatory factor analysis showed an acceptable model fit for the correlated two-factor structure of the MEQ compared to its original five-factor structure. Internal consistency coefficient values for the overall MEQ and awareness and recognition subscales were .82, .71 and .82, respectively. The MEQ sub-scales' scores were found to be associated with EDE-Q, IES, and BSI scores, confirming the validity of the scale. The Turkish version of the two-factor MEQ could be evaluated as a valid and reliable measurement to assess mindful eating for further research and would also provide support to cross-cultural research.
... There is preliminary evidence to suggest that yoga can be beneficial in reducing levels of anxiety, depression and general eating disorder symptoms including self-objectification, body dissatisfaction, and drive for thinness in eating disordered populations [13][14][15][16][17][18][19][20][21][22][23]. Yoga is a practice traditionally rooted in Indian philosophy and spirituality comprising of ethical guidelines for living with an ultimate goal of attaining unification of mind, body and spirit [24]. ...
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.
Plain English summary
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.
... For example, research has found that participation in an embodying activity such as yoga helps cultivate a positive relationship with one's body. Indeed, yoga is related to reduced concerns with body weight and shape, less self-objectification, less body dissatisfaction, less eating disorder symptomatology, and increased motivation to make healthier food choices (Carei et al., 2010;Daubenmier, 2005;Impett et al., 2006;Mahlo & Tiggemann, 2016;McIver et al., 2009;Watts et al., 2018). ...
L’image corporelle et les habitudes alimentaires commencent à se développer tôt dans l’enfance et sont principalement façonnées par le contexte familial. La recherche sur le rôle déterminant que jouent les parents dans la transmission des normes, des croyances, des valeurs, des connaissances, des attitudes et des comportements à l’égard de l’alimentation est d’une importance capitale, étant donné que les habitudes alimentaires et l’image corporelle s’établissent durant l’enfance et l’adolescence, et se maintiennent souvent à l’âge adulte. À ce jour, les études dans ce domaine se sont largement concentrées sur la contribution parentale quant aux préoccupations relatives à la forme corporelle, au poids et à l’alimentation, mais une quantité croissante d’études explorent la façon dont les parents peuvent également protéger leurs enfants contre ces préoccupations et favoriser une image corporelle et des habitudes alimentaires positives. Le présent article contribue à cette récente tendance en offrant un aperçu de la recherche sur les pratiques parentales se rapportant à l’image corporelle, aux stratégies visant à créer un climat familial positif à l’égard de la nourriture, ainsi que sur les pratiques parentales qui favorisent des habitudes alimentaires saines chez les enfants. En nous concentrant sur les pratiques qui soutiennent une image corporelle et des habitudes alimentaires positives, nous voulons mettre en relief les façons dont les parents peuvent contribuer à prémunir leurs enfants contre la culture des régimes alimentaires et être des alliés dans la lutte contre les pressions sociales concernant le corps.
... 173)" [54] by creating a safe environment using modified yogic techniques that include reduction or elimination of corrective touch, focus on client choice, and language inviting the clients to try rather than to accomplish specific actions [11]. Clinicians have successfully utilized traditional and TS yoga practice in the treatment of various psychiatric conditions [9], including anxiety disorders [18], eating disorders [26], and insomnia [46]. A recent study by Rousseau and Cook-Cottone [45] indicated strong acceptability by clients and feasibility in the use of TS yoga in conjunction with trauma interventions in an international context. ...
... Preliminary results, also among patients affected by eating disorders, suggest that yoga holds promise of becoming a complementary therapy to standard care [14,15]. In particular, studies exploring yoga in the population with eating disorders (both on adults and adolescents) have found improvements in depression, anxiety, quality of life and shape concerns [16,17]. For this reason, its use in treatment centers for eating disorders has significantly grown over the last few years. ...
PurposeTo evaluate interoceptive accuracy (Iac) before and after a single yoga class in a population of patients with anorexia nervosa (AN) and in a population of healthy controls (HC).Methods
Fifteen patients with AN and twenty HC were included in the study. All individuals participated in a single yoga class. Before (T0) and after (T1) the yoga class, they underwent the heartbeat detection task for the evaluation of Iac. At T0, all participants also underwent a psychological assessment, including evaluation of depression, anxiety, body awareness, alexithymia, self-objectification and eating disorders psychopathology.ResultsPatients with AN had lower Iac than HC at T0. A significant improvement of Iac at T1 was found in the HC group but not in the group of patients with AN.Conclusion
We infer that our findings might be linked to the fact that patients with AN, differently from HC, did not properly attend to their bodies, despite the yoga class. This hypothesis is consistent with previous studies showing that patients with AN have decreased Iac during self-focused behavior because of body-related avoidance. Moreover, we surmise that HC might be keener to improve their perception of internal body signals even after a single yoga class because their emotional awareness system is not impaired. Patients with AN, on the contrary, may have an intrinsic impairment of their emotional awareness, making it harder for them to modulate their Iac.Level of evidenceLevel III, evidence obtained from well-designed cohort or case–control analytical studies.
... Yoga has been incorporated as an adjunct to treatment for many psychological (Büssing, Michalsen, Khalsa, Telles, & Sherman, 2012) and physiological concerns (Banerjee et al., 2007;Field, 2011;Park, Braun, & Siegel, 2015), and is one of the most popular complementary medicine practices in the United States. Notably, yoga has also been incorporated as part of eating disorder (ED) treatment (Frisch, Herzog, & Franko, 2006) and empirical support for the use of yoga during ED treatment is amassing (see Carei, Fyfe-Johnson, Breuner, & Marshall, 2010;Hall, Ofei-TEnkorang, Machan, & Gordon, 2016;McIver, O'Halloran, & McGartland, 2009;Pacanowski, Diers, Crosby, & Neumark-Sztainer, 2017). ...
Yoga practice is associated with improvements in eating disorder (ED) symptoms and body dissatisfaction. This study continued to evaluate this relationship while also assessing changes in variables negatively associated with ED symptoms (self-compassion, mindfulness, body appreciation, self-efficacy) that are emphasized throughout yoga. Men were also included in this study given studies have predominantly focused on women. Participants (N = 99, 77.8% women) were recruited from a university-implemented yoga course and completed assessments at the beginning (Time 1 (T1)) and end (Time 2 (T2)) of an eight-week yoga course meeting three times a week for fifty minutes. Body dissatisfaction (ps <.05) and ED pathology (p = .02) were lower at T2. Body appreciation (p < .001), self-compassion (p = .01), yoga self-efficacy (p = .004) were higher at T2. Some gender differences emerged. Men reported greater reductions in concern with being overweight, (Overweight Preoccupation) from T1 (M = 2.46, SD = 0.61) to T2 (M = 2.13, SD = 0.61) compared to women, T1 (M = 2.75, SD = 0.98) to T2 (M = 2.69, SD = 0.97) associated with yoga practice. Men also reported greater improvements in body satisfaction (Appearance Evaluation) from T1 (M = 3.60, SD = 0.49) to T2 (M = 3.90, SD = 0.34) compared with women, T1 (M = 3.48, SD = 0.58) to T2 (M = 3.39, SD = 0.52) associated with yoga practice. Results suggest yoga may be associated with concurrent changes in protective and risk factors for ED in a college population.
... For instance, a study where yoga was practiced at a small dosage (45 min per week for 6 weeks) had no significant effects on eating disorder symptomatology [40]. Interventions that offered higher yoga dosages (60 min per week for 12 weeks: [41]; 2 h per week for 8 weeks: [42]; 60-90 min per week for 12 weeks: [43]) yielded positive results in decreasing disordered eating symptomatology or increasing positive body image. ...
Purpose
Yoga has been increasingly used as a complementary therapy for eating disorders. However, it is still not clear whether yoga is effective in the prevention and treatment of eating disorders, as some studies suggest that yoga practitioners show elevated levels of disordered eating behaviours. The goal of this systematic review is, thus, to analyse the occurrence of disordered eating behaviours and correlates in yoga practitioners.
Method
PRISMA guidelines for systematic reviews were used. Search was conducted in several databases and specific journals.
Results
Twelve articles, all cross-sectional, were identified, following PRISMA guidelines. Results across studies were inconsistent. Yoga practice was usually associated with healthier eating behaviours, lower disordered eating symptoms, and higher positive body image and body satisfaction, suggesting that yoga practitioners may be at a lower risk of developing eating disorders. However, other studies suggested that a high dosage of yoga practice may be associated with a higher prevalence of disordered eating behaviours.
Conclusions
As yoga is increasingly used as therapy for eating disorders, understanding the relationship between yoga dosage and disordered eating behaviours is critical to guide treatment recommendations and establish yoga as a valuable complementary therapy.
Level of evidence
Level I, systematic review.
... A systematic review study on the effectiveness of yoga exercises on eating disorders confirmed the positive effects of yoga, and although these effects were small, yoga did not seem to harm patients with eating disorders (38). Another study on BED and yoga showed that weekly yoga exercises at home are very effective in the treatment BED (39). ...
Background: Eating disorders are one of the most common psychological/psychosomatic disorders that cause many problems for physical health, mental functioning and quality of life. Eating disorder is identified by severe chaotic eating behaviors and includes anorexia nervosa and bulimia nervosa. The use of complementary medicine, such as yoga, has always been of interest to researchers in clinical sciences and has been proposed as a new approach to the treatment of eating disorders. Yoga essentially means connectivity and continuity. Through mind- and body-based techniques, yoga can be effective in the achievement of therapy goals in feeding and eating patients.
Methods: The data for the present review study was collected through a search in electronic resources and databases as well as manual search of library resources. The search for relevant articles and studies was performed on the internet in relevant websites and scientific/research journals using a number of keywords. This study will address yoga therapy and its relationship with and effects on eating disorders after a review of the definition, classification, epidemiology and pathophysiology of different types of eating disorders.
Results: The results showed that eating disorders are caused by emotional disorders and stress and, essentially, by subjective factors. Many people achieve relaxation and body, soul and mind balance with yoga. This practice makes it more possible to fight eating disorders.
Conclusion: Yoga creates self-confidence and a positive feeling about one’s body and appearance. Yoga has a holistic attitude toward human-beings and provides different, continuous and simple techniques for humans’ health, development, preparation and balance and is thus effective in improving nutrition and eating disorders.
... Re-establishing practical experience with healthy exercise, along with enhancing the theoretical understanding of exercise physiology may induce a more positive attitude towards exercise [4]. Some studies [17,[23][24][25][26][27] report on interventions adding structured physical exercise to treatment of BN or BED, but only one study has reported on pre-post effects on attitudes towards exercise [28]. Here, a reduction of dysfunctional attitudes towards exercise was found after completing a supervised inpatient treatment programme consisting of varied, low impact PA. ...
Abstract Background Dysfunctional thoughts- and use of physical activity (PA) are core symptoms of the eating disorders (ED) bulimia nervosa (BN) and binge eating disorder (BED). The compulsive desire for PA complicates a favourable treatment outcome; hence, regular, adapted PA led by personnel with competence in exercise science is rarely part of treatment of BN and BED. The present study compared cognitive behaviour therapy (CBT) with a new treatment combining physical exercise and dietary therapy (PED-t) with respect to the short- and long-term changes in the level of compulsive exercise and actual level of PA in women with BN or BED. Methods We enrolled 187 women with BN or BED, aged 18–40 years, with BMI 17.5–35, in an outpatient randomised controlled therapy trial. Participants were randomised to PED-t or CBT, while waitlist participants served as a control group during the treatment period. The treatment covered 16 weeks, with 6- and 12 months follow-up, and outcomes included self-reported compulsive exercise (CE) and objectively measured PA, analysed by linear mixed regression models. Results Both CBT and PED-t reduced CE from baseline (P
Yoga is effective in binge eating disorder (BED) treatment, but it does not seem effective enough to improve low physical fitness. In contrast, high-intensity interval training (HIIT) is effective in improving physical fitness but has never been studied in the context of BED. In the study, 47 young inactive females with mild to moderate BED were recruited and randomly assigned to a HIIT group (HIIT), a Yoga group (YG), or a control group (CG; age, 19.47 ± 0.74, 19.69 ± 0.874, and 19.44 ± 0.63 years; BMI, 21.07 ± 1.66, 21.95 ± 2.67, and 20.68 ± 2.61 kg/m², respectively). The intervention groups participated in 8-week specific exercises, while the CG maintained their usual daily activity. Before and after the training, participants were evaluated for BED using the binge eating scale (BES) and for physical fitness. The obtained data were compared within groups and between groups, and a correlation analysis between BES and physical fitness parameters was performed. After the training, the YG presented significant improvements in BES (− 20.25%, p = 0.006, ηp² = 0.408), fat mass (FM, − 3.13%, p = 0.033, ηp² = 0.269), and maximal oxygen consumption (VO2max, 11.51%, p = 0.000, ηp² = 0.601), whereas the HIIT showed significant improvements in body weight (BW, − 1.78%, p = 0.006, ηp² = 0.433), FM (− 3.94%, p = 0.033, ηp² = 0.285), and BMI (− 1.80%, p = 0.006, ηp² = 0.428), but not in BES. Comparisons between groups revealed that both HIIT and YG had significantly higher VO2max levels than CG (HIIT 12.82%, p = 0.006, ηp² = 0.088; YG: 11.90%, p = 0.009, ηp² = 0.088) with no difference between HIIT and YG. Additionally, YG presented significantly lower BES than both HIIT (15.45%, p = 0.02, ηp² = 0.03) and CG (11.91%, p = 0.022, ηp² = 0.03). In conclusion, Yoga is an effective treatment for BED, but HIIT is not, despite its high efficacy in improving physical fitness.
Purpose:
To develop a systematic review with meta-analysis to summarize the effectiveness of exercise, regular physical activity, and mind-body exercise on harmful exercise habits, psychological factors, and quality of life in people clinically diagnosed with feeding and eating disorders.
Material and methods:
Randomized clinical trials and pilot randomized clinical trials were considered.
Results:
Twelve studies were included. No studies evaluated athletes. No studies examined regular physical activity as the targeted intervention. Quality of life could not be meta-analyzed. Overall, meta-analyses showed that exercise or mind-body exercise was not more effective than controls in reducing depression symptoms, harmful exercise habits, eating behaviors, or emotional regulation skills. However, important methodological and clinical issues were detected in the included studies. This affected the certainty of evidence of the meta-analyzed outcomes which ranged from low to very low. No studies reported in sufficient detail their interventions to be replicated.
Conclusions:
Overall, exercise and mind-body exercise may be ineffective in improving meta-analyzed outcomes. However, the certainty of evidence ranged from low to very low and the body of knowledge in this field needs to be increased to reach robust conclusions.
Body image disorders involve dissatisfaction with a specific part or all of a woman’s body. A woman experiencing body image dissatisfaction may face psychological problems such as mood disorder, decreased self-esteem, and decreased physical activity. With the reflection of the weak-ideal woman’s appearance by society and mass media, women may be exposed to these problems and can internalize this by comparing their bodies with the idealized women’s bodies. Women may experience major hormonal changes due to pregnancy and menopause that affect their physical appearance, roles, and responsibilities in society and family, and breast and gynecological cancers. Alternative therapeutic methods for body image disorders are important for women. Physical activity and exercise, yoga, dance therapy, body awareness therapy, and manual therapy can all be recommended for women to improve body image.
The rapid globalisation and race to excel in each and every field by the people around the globe has several
negative influences on their mental and physical health. Eating disorder cognitions among adolescent girls is one of such
concerns which need to be addressed since this particular group plays very vital role in the society and directly or indirectly
affects a larger segment of the society. Eating disorders are common among adolescent girls in western countries. But from
past few years it has been introducing in India too. In India the information regarding these disorders is very limited but it
is increasing very rapidly day by day due to the effect of media and westernization. And because of its effect, adolescents
are very keen to have a perfect body figure by adopting wrong eating habits and sometimes by starving themselves. This
research paper aims to show the prevalence of eating disorder cognitions among Indian adolescent girls in the present
scenario. It also delves into BMI classification and population distribution of samples and impact of various sub-scales of
eating disorder on population distribution of samples.
The purpose of the article is to analyze and theoretically substantiate the possibility of introducing fitness technologies based on elements of hatha yoga in physical education of different groups of the population. Theoretical issues related to the application of innovative technologies in physical education of different groups of the population have been investigated. It was found that in practice, physical culture and health-improving technologies in physical education use various fitness programs. The analysis showed that one of the types of fitness programs that are used in health-improving types of gymnastics is yoga-aerobics – a combination of static and breathing postures, breathing exercises, relaxation and stretching. The effectiveness of the use of programs developed on the basis of elements of hatha yoga in the physical education of preschoolers, schoolchildren, students, in physical rehabilitation, in training sessions with athletes in order to increase their functional and physical condition, as well as to increase the emotional saturation of classes, the diversity of the scientific process has been determined, creating conditions for the development of the creative potential of different groups of the population. The necessity of specially-organized experimental research, focused on the development of physical culture and health-improving technologies of different types of respiratory activity for the process of physical education for different groups of the population, which does not require an improvement in the material and technical base and the availability of additional equipment and inventory, has been substantiated.
Objective:
Most U.S. adults are insufficiently active. One strategy individuals could use to increase physical activity is to exercise mindfully (i.e., while paying attention to present-moment experiences with acceptance (1,2)). A mindfulness-based intervention for exercise can be delivered via an audio recording, which is advantageous in regard to time demands, cost, and dissemination potential. The aims of this parallel two-arm pilot randomized controlled trial were to assess the feasibility and acceptability of an audio-recorded mindfulness-based intervention and to assess whether the intervention resulted in a clinically meaningful difference in physical activity compared to the control condition.
Methods:
Physically underactive adults (N = 50) were randomized to a mindfulness intervention condition in which they were instructed to exercise while listening to an audio-recorded mindfulness-intervention or an active control group in which they were instructed to exercise while using a heart rate monitor. Participants completed a 30-minute moderate intensity treadmill exercise bout during a baseline in-lab session in the manner in which they were randomized (i.e., mindfulness recording vs. using a heart-rate monitor), and instructed to exercise in this manner for the next week. At follow-up, acceptability was measured by self-report, feasibility by frequency of intervention use, and physical activity using both self-reported physical activity recall and an accelerometer.
Results:
The audio-recorded mindfulness-based physical activity intervention was rated as acceptable and feasible to use. Compared to the control group, the intervention also resulted in clinically meaningful differences in self-reported moderate-to-vigorous physical activity (MVPA) minutes (M difference = 67.16 minutes) and accelerometer-measured minutes (M difference = 35.48 minutes) during a one-week follow-up.
Conclusion:
The audio-recorded mindfulness-based physical activity intervention is a promising approach to increasing physical activity with good dissemination potential.
Objective
Research suggests physical activity (PA) improves behavioural, psychological and behavioural symptoms in individuals with binge eating disorder (BED), yet self‐reported PA is notably low. Little remains known about objective rates of PA and subclinical levels of maladaptive PA (i.e., compensatory or driven PA), and few studies have attempted to understand the role that dissatisfaction and overvaluation with shape and weight plays in promoting PA in individuals with BED. We sought to characterize PA and investigate whether elevated rates of shape and weight concerns contribute to rates of PA in individuals with BED.
Method
Individuals meeting DSM‐5 diagnosis of BED (N = 56) completed the Eating Disorder Examination and wore a Fitbit Flex 2 for 1 week.
Results
On average, participants recorded 7621.12 (SD = 3034.20) daily steps and 194.30 (SD = 161.45) weekly moderate‐to‐vigorous PA minutes. About 21% of participants reported subclinical levels of maladaptive PA. Greater shape and weight overvaluation predicted lower duration of compensatory PA.
Conclusion
A small percentage of individuals with BED are engaging in subclinical levels of maladaptive PA, and there is a need to identify factors that influence rates of PA in individuals with BED.
Highlights
• Objectively measured rates of PA in individuals with BED were greater compared with previous self‐reported rates of PA in individuals with BED
• A small percentage of individuals with BED engaged in subclinical levels of maladaptive forms of PA
• Greater shape and weight overvaluation predicted lower average duration of compensatory PA. Dissatisfaction with shape and weight did not predict rates of PA
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.
Objectives
This study examined formal and informal healthcare use (HCU) in community women with disordered eating, and associations of HCU with mental health-related quality of life (MHRQoL), psychological distress, mental health literacy (MHL) and eating disorder (ED) symptoms over time.
Hypothesis
We hypothesised that HCU would lead to improvement in ED symptom severity, MHRQoL, MHL and psychological distress.
Design, setting, participants
Data were from years 2, 4 and 9 of a longitudinal cohort of 443 community women (mean age 30.6, SE 0.4 years) with a range of ED symptoms, randomly recruited from the Australian Capital Territory electoral role or via convenience sampling from tertiary education centres. Data were collected using posted/emailed self-report questionnaires; inclusion criteria were completion of the HCU questionnaire at time point of 2 years (baseline for this study). HCU was measured using a multiple-choice question on help seeking for an eating problem. To test the effect of HCU over time on MHRQoL (Short Form-12 score), psychological distress (Kessler Psychological Distress Scale score), ED symptom severity (Eating Disorder Examination Questionnaire score) and ED–MHL, linear or logistic mixed-effects regression analyses were used.
Results
20% of participants sought ED-specific help at baseline; more than half of participants sought help that was not evidence based. HCU at baseline was significantly associated with improved MHRQoL and ED symptom severity and decreased psychological distress over time (Cohen’s d all >0.3, ie, small). HCU was not significantly associated with MHL over time. The predictive ability of the fitted models ranged from 32.18% to 42.42% for psychological distress and MHL treatment, respectively.
Conclusions
Formal and informal HCU were associated with small improvements in ED symptoms, MHRQoL and psychological distress but not with improved MHL. Informal services in ED management should be investigated further along with efforts to improve ED–MHL.
Background:
Obesity is a major public health problem whose prevalence has been rapidly increasing in the United States (U.S), and globally. It is one of the leading causes of preventable deaths globally and contributes to the development of many diseases.
Methods:
The search was limited to studies published in English and other languages involving both animal and human subjects. Articles selected included preclinical studies, randomized clinical trials (RCTs), observational studies, meta-analyses, narrative and systemic reviews providing primary quantitative data with a measure of obesity or food addiction as an outcome. Over 5,000 articles were found in the first round of search which was filtered to 506 articles.
Results:
Oxidative stress plays a critical role in food addiction and is both a cause and mediator of obesity. Reactive oxygen species and oxidative stress play a direct role in adipogenesis and modulate all factors involved in obesity including genetics, sleep, gut microbiome, insulin, ghrelin, inflammation, adipokines, leptin, stress, HPA axis, and the hypothalamus.
Conclusions:
The idea of thinking of combating obesity from the lens of calorie count, low carbohydrate, high or low-fat, vegetarian, vegan, plant-based, or animal-based diet is fundamentally wrong. The best way to look at obesity is through the framework of systemic redox homeostasis. Since redox homeostasis is tilted towards increased reactive oxygen species production, and excessive antioxidant intake can result in oxidative stress, an antioxidant and prooxidant food ratio of 2:3 per meal is the ideal nutritional ratio for good health and ideal weight. A ratio of 3:4 is ideal for obese individuals. Regular physical activity, good sleep quality, stress-relieving activities including yoga and meditation, maternal prenatal diet and oxidative stress promoting disease conditions are also important modulators of oxidative stress and obesity.
Objectives
This systematic review and meta-analysis sought to evaluate the efficacy of mindfulness-based programs (MBPs) on eating disorder (ED) symptoms and related outcomes such as BMI, body dissatisfaction, emotion regulation, and negative affect. It also examined moderators that predicted larger intervention effects.
Methods
A search for studies evaluating such MBPs on participants with EDs was conducted in several online databases. In total, 23 articles were included in the systematic review and 22 in the meta-analysis (10 randomized controlled trials).
Results
Results showed a within-condition effect of MBPs on ED symptoms, emotional eating, negative affect, and body dissatisfaction, and on BMI in anorectic and bulimic participants relative to pre-assessment. A significant within-condition effect sizes ranged from d = .62 (negative affect) to d = 1.05 (ED symptoms). Meta-regression analyses showed that participants with BED and women benefit more of MBPs on mindfulness skills and emotion regulation skills than participants with anorexia nervosa, bulimia, and men. A high risk of bias was correlated with a larger effect of MBPs on mindfulness skills and emotion regulation skills but a smaller effect on restrained eating. Longer treatment was correlated with a larger effect of MBPs on emotion regulation skills.
Conclusions
Results indicated some positive correlations between MBPs and outcomes but a definitive conclusion cannot be drawn since these results are on within-condition effects and that half of the included studies did not have a control condition. Results identified moderators that may be useful to refine inclusion and exclusion criteria to target those most likely to benefit from MBPs. The field needs more rigorous studies with credible alternative interventions to confirm the efficacy of MBPs for ED patients.
Pseudoscience in Child and Adolescent Psychotherapy - edited by Stephen Hupp March 2019
Cambridge Core - Health and Clinical Psychology - Pseudoscience in Child and Adolescent Psychotherapy - edited by Stephen Hupp
This program, a joint collaboration between the LSI Center for the Study of Health, Religion, and Spirituality at Indiana State University, and independent filmmaker Carolyn Speranza, will use video to express both the range of experiences that are engendered by meditation practice, and the depth of change that even brief training can produce. Meditation is a universal practice that promotes spiritual and practical wisdom by disengaging the mind from conditioned patterns of reactivity and self-concerns. Dr. Kristeller will present an overview of a multi-domain model of meditation effects, illustrated by Ms. Speranza's film "Sight of Stillness" with highly experienced meditators. This video was produced during a series of meditation workshops conducted in Pittsburgh. Ms. Speranza has also worked with Dr. Kristeller to capture on video the personal experiences of individuals participating in an NIH-funded trial that evaluated the effects of a mindfulness meditation based treatment on binge eating disorder. That research has demonstrated how the MB-EAT (Mindfulness Based Eating Awareness Training) program, a 9- week structured experience with mindful eating and other meditation practice, can substantially reduce compulsive eating in obese individuals, while improving depression and sense of self. Videotaped interviews with participants sharing their personal experiences, along with results from the study, will be presented to illustrate how focused meditative practice can produce life changes in relationship to eating and to the self. This paper is highly pertinent to the Dr. Kristeller's presentation and the film. Biography Dr. Jean Kristeller received her doctorate in clinical and health psychology from Yale University in 1983. She is currently Professor of Psychology and Director of the Center for the Study of Health, Religion and Spirituality at Indiana State University. She has been conducting research in the therapeutic uses of meditation for over 20 years. Her research areas also include the role of spirituality in adjustment to cancer. She currently has funding through the NIH Center for Complementary and Alternative Medicine for research on the use of mindfulness meditation in treating binge eating disorder, and from the Metanexus Institute through the Spiritual Transformation initiative.
How aware are people of food-related decisions they make and how the environment influences these decisions? Study 1 shows that 139 people underestimated the number of food-related decisions they made-by an average of more than 221 decisions. Study 2 examined 192 people who overserved and overate 31% more food as a result of having been given an exaggerated environmental cue (Such as a large bowl). Of those studied, 21% denied having eaten more, 75% attributed it to other reasons (such as hunger), and only 4% attributed it to the cue. These studies underscore two key points: First, we are aware of only a fraction of the food decisions we make. Second, we are either unaware of how our environment influences these decisions or we are unwilling to acknowledge it.
Mindfulness and acceptance-based approaches to the treatment of clinical problems are accruing substantial empirical support. This article examines the application of these approaches to disordered eating. Theoretical bases for the importance of mindfulness and acceptance in the treatment of eating problems are reviewed, and interventions for eating problems that incorporate mindfulness and acceptance skills are briefly described. Empirical data are presented from a pilot study of mindfulness-based cognitive therapy adapted for treatment of binge eating.
The efficacy of a 6-week meditation-based group intervention for Binge Eating Disorder (BED) was evaluated in 18 obese women, using standard and eating-specific mindfulness meditation exercises. A single-group extended baseline design assessed all variables at 3 weeks pre-and post-, and at 1, 3, and 6 weeks; briefer assessment occurred weekly.
Binges decreased in frequency, from 4.02/week to 1.57/week (p < .001), and in severity. Scores on the Binge Eating Scale (BES) and on the Beck Depression and Anxiety Inventories decreased significantly; sense of control increased. Time using eatingrelated meditations predicted decreases on the BES (r 5 .66, p < .01). Results suggest that meditation training may be an effective component in treating BED.
As part of a larger mixed-methods study, data from 20 personal journals were analyzed to examine the experience of a 12-week yoga treatment program for binge eating among a sample of 25 women who were obese. Qualitative analysis revealed a positive shift experienced by the women during the program, summarized by a general structural description: disconnection versus connection. Women’s comments suggested that the program appeared to encourage a healthy reconnection to food, as well as the development of physical self-empowerment, through cultivating present-moment awareness. Specifically, women perceived an overall reduction in the quantity of food they consumed, decreased eating speed, and an improvement in food choices throughout the program. The women also reported feeling more connected to and positive about their physical well-being. These evolving outcomes were summarized through two major themes: the way their physicality changed, and the way their food consumption changed over time. Findings provide insights relevant to therapeutic processes that might occur within eating disorder interventions that draw on meditation-based approaches.
Complementary medicine has a different philosophy from conventional medicine, presenting challenges to research methodology.
Rigorous evaluation of complementary medicine could provide much needed evidence of its effectiveness.
Good design of randomised controlled trials will avoid invalid results and misrepresentation of the holistic essence of complementary medicine.
Practitioners need to be recognised as a component in or contributor to complementary treatment.
Both specific and non-specific outcome measures with long follow up are needed to adequately encompass the essence of complementary medicine
The new discipline of whole systems research (WSR) targets the study of complex CAM therapies as system-level phenomena, as opposed to single-agent or uni-dimensional effects. This article describes the pre-defined goals, issues that were developed, and opportunities that were revealed in a workshop held in Vancouver BC, in which scientists, practitioners, and policy makers met to lay the foundations of WSR. Important issues were identified, such as treatment individualization, problems of diagnosis, patient-practitioner interaction, varying therapeutic contexts, and patient-determined outcome values. Research design issues that were addressed included a variety of challenges to the study of intact systems, in relation to both synergy and emergent behaviors, and the opportunities to innovate the conventional RCT. As the network of CAM scientists and practitioners engaged in WSR expands, a common nomenclature and body of techniques will help us to a better understanding of the ways in which whole systems affect healing.
Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity.
Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity.
Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode.
The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
Although yoga is historically a spiritual discipline, it has also been used clinically as a therapeutic intervention. A bibliometric analysis on the biomedical journal literature involving research on the clinical application of yoga has revealed an increase in publication frequency over the past 3 decades with a substantial and growing use of randomized controlled trials. Types of medical conditions have included psychopathological (e.g. depression, anxiety), cardiovascular (e.g. hypertension, heart disease), respiratory (e.g. asthma), diabetes and a variety of others. A majority of this research has been conducted by Indian investigators and published in Indian journals, particularly yoga specialty journals, although recent trends indicate increasing contributions from investigators in the U.S. and England. Yoga therapy is a relatively novel and emerging clinical discipline within the broad category of mind-body medicine, whose growth is consistent with the burgeoning popularity of yoga in the West and the increasing worldwide use of alternative medicine.
To determine the efficacy of a dietary supplement ingredient containing proprietary extracts of Magnolia officinalis and Phellodendron amurense in helping overweight, otherwise healthy, premenopausal female adults, who typically eat more in stressful situations manage their body weight.
Randomized, double-blind, placebo-controlled clinical study. Setting Miami Research Associates, a clinical research organization consisting of 32 board-certified physicians, Miami, Fla.
Healthy, overweight (BMI 25 to 34.9), premenopausal female adults, between the ages of 20 and 50 years, who typically eat more in response to stressful situations and scored above the national mean for women on self-reported anxiety.
Two-hundred-fifty-mg capsules or identical placebo capsules 3 times a day for 6 weeks.
Salivary cortisol levels, weight change, psychological measures of stress and anxiety.
Twenty-eight subjects completed the study. Extracts of M officinalis and P amurense were well tolerated. There was a significant weight gain during the study for the placebo group (P < ,01), but no significant weight gain for the group receiving extracts of M officinalis and P amurense (P < .89). Paired t-tests comparing baseline to post-treatment weight showed an average gain of 1.5 kg in the placebo group and no change in the treatment group (P = .89). When groups were divided into gainers (ie, participants who gained at least 1 kg or more) and maintainers or losers, 75% of the control group were gainers versus 37% of the treatment group (P < .04). There was a nonsignificant trend for lowered average cortisol in the treatment group at the end of the study (group X time interaction, F = 1.1, P < .15). This difference was due to a treatment effect on evening cortisol. There was a marginally significant group X time interaction (P = .06), showing the treatment group tended to have lower levels of cortisol in the evening, whereas the control group tended to have higher levels of cortisol in the evening. Bedtime cortisol levels decreased in the treatment group and increased in the placebo group. Participants in both the treatment and placebo groups had improved scores on a number of psychological measures during the study. There was a correlation between perceived stress and weight change.
The results of this pilot clinical study indicate that obese subjects who eat in response to stress may benefit from taking a dietary supplement ingredient containing proprietary extracts of M officinalis and P amurense. The mechanism of action appears to be through reduction of cortisol levels and possibly perceived stress, thereby helping participants maintain body weight. The sample size was small, however, and there was higher attrition in the control group than in the treatment group.
This chapter discusses the treatment for eating disorders. The Diagnostic and Statistical Manual of Mental Disorders recognizes two primary eating disorders: anorexia nervosa (AN) and bulimia nervosa (BN). It also includes binge eating disorder (BED), sub threshold versions of AN and BN, and other disordered eating patterns. The most widely researched treatments for eating disorders are based on cognitive-behavioral procedures and have focused on BN and BED. Acceptance-based methods for treating eating disorders deserve increased attention, and several interventions that incorporate mindfulness training and acceptance-related procedures. Some of these are adaptations of previously developed interventions. For example, dialectical behavior therapy (DBT) has been adapted for BED and BN; mindfulness-based cognitive therapy (MBCT) has been adapted for BED; and acceptance and commitment therapy (ACT) has been applied to AN. In addition, mindfulness-based eating awareness training (MB-EAT) is developed specifically for BED. MB-EAT is developed by integrating elements from MBSR and CBT with guided eating meditations. The program draws on traditional mindfulness meditation techniques, as well as guided meditation, to address specific issues pertaining to shape, weight, and eating-related self regulatory processes such as appetite and both gastric and taste-specific satiety.
This edited volume provides chapters on the leading evidence-based mindfulness interventions as of 2006: mindfulness-based stress reduction, mindfulness-based cognitive therapy, dialectical behavior therapy, and acceptance and commitment therapy. Applications for clinical, medical, and nonclinical but stressed populations, as well as children, adolescents, and older adults, are described. Each chapter includes a detailed case study illustrating how the intervention is implemented, conceptual background, empirical support, and a discussion of practical issues that clinicians wishing to use these treatments must consider. A second edition (2014) focusing on MBSR, MBCT, and related treatment programs is also available.
36 competitive sportsmen and 36 inactive men carried out a maximal exercise test to volitional exhaustion on abicycle ergometer. In a second session, they were randomised to 20 minutes exercise at a high intensity of 70% maximal oxygen consumption (VO2 max), a moderate intensity of 50% of VO2 max or a light exercise control, with 12 sportsmen and 12 inactive men in each condition. Mood was assessed with ratings of tension-anxiety, mental vigour and exhilaration. Sportsmen but not inactive men showed a decrease in tension-anxiety across the maximal exercise test, while exhilaration increased in both groups. Increases in mental vigour and exhilaration were recorded two minutes after exercise at 70% and 50% VO2 max, and these responses were significantly greater than those in the control condition. In the case of exhilaration, effects were maintained after 30 minutes post-exercise recovery. The sportsmen and inactive men did not differ in these responses, nor were there differences between the two exercise intensities. Mood changes were not influenced by negative affectivity, or the intensity of cognitive and somatic anxiety. The relevance of the immediate mood effects of exercise for the understanding of long-term psychological changes with regular exercise is discussed.
findings related to binge eating in obese individuals are reviewed and unresolved issues are emphasized
prevalence of binge eating in obese individuals / binge-eating behavior in obese Ss [diagnostic considerations; binge behavior; purge behaviors; dieting, shape, and weight concerns] / comparisons of obese binge eaters and non-binge-eaters [dietary attitudes and behavior, eating behavior, psychiatric status, response to treatment] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Binge eating is a common problem associated with distress and dysfunction. Mindfulness-based interventions are attracting increasing attention, and the recent empirical literature suggests that they may be effective for a variety of disorders. Current theories about the etiology and maintenance of binge eating suggest that mindfulness training may be helpful for this problem. This report describes the use of mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002) in the treatment Of a client with subthreshold binge eating disorder. Posttreatment and 6 month follow-up data showed excellent improvements in binge eating symptoms as well as increased levels of mindfulness.
Four hundred fifty-five females from a community-bgased, randomly sampled population were interviewed by telephone to estimate the prevalence of binge eating and to describe demographic and topographical characteristics of binge eating behaviour. Binge eaters were classified according to the DSM-111-R criteria for bulimia, excluding purging behavior. The estimate for subjects meeting criteria was 1.8%, while the percentage of females who met all but frequency criteria was estimated at 3.8%. The majority of binge eaters in this study was found to engage in behaviors typically associated with binge eating episodes. On average, this group of binge eaters was older and heavier than has been reported previously, which supported observed associations between binge eating and overweight in clinical populations [Telch, Agras, & Rossiter (1988). International Journal of Eating Disorders, 7, 115-119]. © 1992 John Wiley & Sons, Inc.
Diagnostic criteria have been developed for a new eating disorder, binge eating disorder (BED), to describe the many individuals who have problems with recurrent binge eating but do not engage in the characteristic compensatory behaviors of bulimia nervosa, vomiting, or use of laxatives. The results of a multisite field trial involving 1,984 subjects indicate that the disorder is common (30.1%) among subjects attending hospital-affiliated weight control programs, but is relatively rare in the community (2.0%). The disorder is more common in females than in males and is associated with severity of obesity and a history of marked weight fluctuations. Based on these results, the DSM-IV Work Group on Eating Disorders has recommended that the disorder be considered for inclusion in DSM-IV, either as an official category or in an appendix of categories requiring further study.
Study 1 tested whether yoga practice is associated with greater awareness of and responsiveness to bodily sensations, lower self-objectification, greater body satisfaction, and fewer disordered eating attitudes. Three samples of women (43 yoga, 45 aerobic, and 51 nonyoga/nonaerobic practitioners) completed questionnaire measures. As predicted, yoga practitioners reported more favorably on all measures. Body responsiveness, and, to some extent, body awareness significantly explained group differences in self-objectification, body satisfaction, and disordered eating attitudes. The mediating role of body awareness, in addition to body responsiveness, between self-objectification and disordered eating attitudes was also tested as proposed in objectification theory (Fredrickson & Roberts, 1997). Body responsiveness, but not awareness, mediated the relationship between self-objectification and disordered eating attitudes. This finding was replicated in Study 2 in a sample of female undergraduate students. It is concluded that body responsiveness and, to some extent, body awareness are related to self-objectification and its consequences.
Obesity arises when energy intake exceeds energy expenditure over a long period. Excess weight has an energy value of 7000 kcal/kg. Theoretically excess weight might be gained either because energy expenditure was too low or energy intake was too high. Many studies have shown that on average obese people expand more energy than normal so, notwithstanding dietary histories to the contrary, they must on average have a higher energy intake to maintain body weight. However it is not possible to show that obese people have any significant defect in short-term regulation of energy intake. The likeliest hypothesis is that obesity is a disorder arising from a failure of the long-term regulation of energy intake, in which cognitive factors play an important part.
The purpose of this study was to conduct an assessment of binge eating severity among obese persons. Two questionnaires were developed. A 16-item Binge Eating Scale was constructed describing both behavioral manifestations (e.g., eating large amounts of food) and feeling/cognitions surrounding a binge episode (e.g., guilt, fear of being unable to stop eating). An 11-item Cognitive Factors Scale was developed measure two cognitive phenomena thought to be related to binge eating: the tendency to set unrealistic standards for a diet (e.g., eliminating "favorite foods") and low efficacy expectations for sustaining a diet. The results showed that the Binge Eating Scale successfully discriminated among persons judged by trained interviewers to have either no, moderate or severe binge eating problems. Significant correlation between the scales were obtained such that severe bingers tended to set up diets which were unrealistically strict while reporting low efficacy expectations to sustain a diet. The discussion highlighted the differences among obese persons on binge eating severity and emphasized the role of cognitions in the relapse of self control of eating.
Binge eating is a common problem among obese individuals, and a simple, accurate way to identify obese binge eaters is needed. This study measured the concordance of the Binge Eating Scale (BES) and the Eating Disorder Examination (EDE). Women seeking obesity treatment (N = 126) were identified as binge eaters or nonbinge eaters using the BES, and then interviewed by clinicians blind to BES score using the EDE, a semistructured interview considered to be the "gold standard" for eating disorder diagnosis. The BES accurately identified nonbinge eaters; 39 of 42 (92.9%) BES-identified nonbinge eaters were confirmed by the EDE. However, the BES did not accurately identify binge eaters; only 43 of the 83 (51.8%) BES-identified binge eaters were confirmed by the EDE. Reasons for the discrepancy between the BES and the EDE in the identification of binge eaters were explored, and modifications to the BES that might improve its accuracy were considered.
To assess the methodologic quality of approaches used to allocate participants to comparison groups in randomized controlled trials from one medical specialty.
Survey of published, parallel group randomized controlled trials.
All 206 reports with allocation described as randomized from the 1990 and 1991 volumes of four journals of obstetrics and gynecology.
Direct and indirect measures of the adequacy of randomization and baseline comparisons.
Only 32% of the reports described an adequate method for generating a sequence of random numbers, and only 23% contained information showing that steps had been taken to conceal assignment until the point of treatment allocation. A mere 9% described both sequence generation and allocation concealment. In reports of trials that had apparently used unrestricted randomization, the differences in sample sizes between treatment and control groups were much smaller than would be expected due to chance. In reports of trials in which hypothesis tests had been used to compare baseline characteristics, only 2% of reported test results were statistically significant, lower than the expected rate of 5%.
Proper randomization is required to generate unbiased comparison groups in controlled trials, yet the reports in these journals usually provided inadequate or unacceptable information on treatment allocation. Additional analyses suggest that nonrandom manipulation of comparison groups and selective reporting of baseline comparisons may have occurred.
The study was designed with the aim of determining whether extending group cognitive-behavioral therapy (CBT) would enhance outcome among individuals with binge eating disorder (BED) who failed to stop binge eating after an initial 12-week CBT intervention.
Forty-six participants who met diagnostic criteria for BED were randomly allocated to either a 12-week group CBT intervention or a waiting list control condition. At the end of 12 weeks, treated participants who met clinical criteria for improvement subsequently received 12 sessions of behavioral weight loss. Remaining participants received 12 additional sessions of CBT for binge eating.
Fifty percent of treated participants improved with the initial 12-week course of CBT. There was a strong trend for the extension of CBT to affect improvement in binge eating among initial nonresponders (6 of 14 subjects no longer met diagnostic criteria for BED). Overall, extending CBT led to clinical improvement in 66.7% of all treated participants, with treatment gains occurring through session 20.
The results suggest that an extended course of CBT (i.e., longer than 12 weeks) will likely maximize the number of potential responders to treatment.
Bulimia nervosa and binge-eating disorder are characterized by a persistent course, are associated with comorbid psychopathology, and can result in serious medical complications. Although current treatments for these disorders show promise, they are not effective for approximately 40% of clients. Significant advances have been made in psychosocial research on the etiology and maintenance of bulimia nervosa and binge-eating disorder, as well as on the predictors of treatment response. This article reviews these advances and discusses the clinical implications of these findings. Research on etiology and maintenance suggests that eating-disorder treatments might be improved by focusing greater attention on promoting healthy weight-control techniques, increasing resiliency to sociocultural pressures to be thin, reducing thin-ideal internalization, and fostering adaptive affect-regulation skills. Research on the predictors of response to treatment suggests that matching treatments to client characteristics might further bolster intervention effectiveness.
For persons with multiple sclerosis (MS), good nutrition has the potential to enhance quality of life and reduce the risk of lifestyle diseases and secondary conditions. The purpose of this study was to describe nutritional intake of women with MS and to determine what factors influenced their intake. Based on 3-day food diary data, participants had an inadequate intake (< 10% lower than recommended) of carbohydrates, dietary fiber, vitamin E, calcium and zinc. In contrast, they consumed saturated fat, protein, vitamin A, vitamin C, folate and iron at higher levels than recommended. Age was significantly related to nutritional intake with older women consuming fewer calories, total fat and saturated fat. Despite evidence supporting the importance of following recommended nutritional guidelines, nutritional intake for participants in this study was not optimum in many important areas. This study supports the need for interventions to promote good nutrition among persons with MS.
This study examined the factors associated with the diagnostic outcome of obese individuals with and without binge eating disorder (BED) 1 year after completing a very low calorie diet (VLCD) program.
Participants included 63 individuals with BED, 36 individuals with subthreshold BED, and 29 individuals with no binge eating symptoms. Diagnoses before and after VLCD were obtained using the Structured Clinical Interview for DSM-IV (SCID) interviews. The severity of psychiatric symptoms were assessed using various rating scales.
Fifty-six percent (n = 36) of the participants who met criteria for BED at baseline did not meet diagnostic criteria 1 year later. None of the baseline factors were statistically associated with outcome.
Although the main hypothesis was not supported, absence of a BED diagnosis at 12-month follow-up after a VLCD diet appears to be associated with less weight gain at 1-year follow-up regardless of baseline diagnosis.
The role of walking, as compared with vigorous exercise, in the prevention of cardiovascular disease remains controversial. Data for women who are members of minority racial or ethnic groups are particularly sparse.
We prospectively examined the total physical-activity score, walking, vigorous exercise, and hours spent sitting as predictors of the incidence of coronary events and total cardiovascular events among 73,743 postmenopausal women 50 to 79 years of age in the Women's Health Initiative Observational Study. At base line, participants were free of diagnosed cardiovascular disease and cancer, and all participants completed detailed questionnaires about physical activity. We documented 345 newly diagnosed cases of coronary heart disease and 1551 total cardiovascular events.
An increasing physical-activity score had a strong, graded, inverse association with the risk of both coronary events and total cardiovascular events. There were similar findings among white women and black women. Women in increasing quintiles of energy expenditure measured in metabolic equivalents (the MET score) had age-adjusted relative risks of coronary events of 1.00, 0.73, 0.69, 0.68, and 0.47, respectively (P for trend, <0.001). In multivariate analyses, the inverse gradient between the total MET score and the risk of cardiovascular events remained strong (adjusted relative risks for increasing quintiles, 1.00, 0.89, 0.81, 0.78, and 0.72, respectively; P for trend <0.001). Walking and vigorous exercise were associated with similar risk reductions, and the results did not vary substantially according to race, age, or body-mass index. A brisker walking pace and fewer hours spent sitting daily also predicted lower risk.
These prospective data indicate that both walking and vigorous exercise are associated with substantial reductions in the incidence of cardiovascular events among postmenopausal women, irrespective of race or ethnic group, age, and body-mass index. Prolonged sitting predicts increased cardiovascular risk.
The increasing drive to adopt evidence-based practice within the mainstream health service creates a sense of urgency for high quality, rigorous research to support CAM. The RCT is seen as the gold standard for allopathic research. However, the tenets of the RCT cannot simply be just picked up and applied to CAM research. Critics of the RCT propose that it fractures and fragments the essence of many complementary therapies. Challenges including standardisation, blinding, randomisation, practitioner influence, placebos, and controls are explored and some possible solutions are presented. CAM researchers need to be creative so that they capture some of the intangibles that currently slip through the reductionist net of the RCT.
The current study assesses concordance between self-administered measures and a diagnostic standard for assessment of binge frequency and diagnosis of binge eating disorder (BED) in a sample of binge eaters.
The Questionnaire for Eating and Weight Patterns-Revised (QEWP-R), Binge Eating Scale (BES), two items from the Eating Disorder Examination Questionnaire with Instructions (EDE-Q-I), and the Eating Disorder Examination (EDE) were administered. Participants were 157 adults volunteering for a clinical study, of whom 129 (79%) were diagnosed with BED using the EDE as the diagnostic standard.
In the identification of BED, the QEWP-R yielded a sensitivity value of .74 and a specificity value of .35. The BES yielded a sensitivity value of .85 and a specificity value of .20. Frequency of binge eating days and episodes on the EDE-Q-I correlated highly with the EDE (.65 and .48, respectively; p < .001).
The accuracy of diagnosis and symptomatology among self-administered questionnaires is variable. The BES and the QEWP-R performed satisfactorily as initial screens for the diagnosis of BED, but were less accurate in identifying non-BED individuals and the frequency of binge eating. The EDE-Q-I most accurately assessed the frequency of binge eating.
Yoga has become increasingly popular in Western cultures as a means of exercise and fitness training; however, it is still depicted as trendy as evidenced by an April 2001 Time magazine cover story on "The Power of Yoga." There is a need to have yoga better recognized by the health care community as a complement to conventional medical care. Over the last 10 years, a growing number of research studies have shown that the practice of Hatha Yoga can improve strength and flexibility, and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity. This review presents a summary of medically substantiated information about the health benefits of yoga for healthy people and for people compromised by musculoskeletal and cardiopulmonary disease.
Yoga is promoted or weight maintenance, but there is little evidence of its efficacy.
To examine whether yoga practice is associated with lower mean 10-year weight gain after age 45.
Participants included 15,550 adults, aged 53 to 57 years, recruited to the Vitamin and Lifestyle (VITAL) cohort study between 2000 and 2002.
Physical activity (including yoga) during the past 10 years, diet, height, and weight at recruitment and at ages 30 and 45. All measures were based on self-reporting, and past weight was retrospectively ascertained.
Multiple regression analyses were used to examined covariate-adjusted associations between yoga practice and weight change from age 45 to recruitment, and polychotomous logistic regression was used to examine associations of yoga practice with the relative odds of weight maintenance (within 5%) and weight loss (> 5%) compared to weight gain.
Yoga practice for four or more years was associated with a 3.1-lb lower weight gain among normal weight (BMI < 25) participants [9.5 lbs versus 12.6 Ibs] and an 18.5-lb lower weight gain among overweight participants [-5.0 lbs versus 13.5 Ibs] (both P for trend <.001). Among overweight individuals, 4+ years of yoga practice was associated with a relative odds of 1.85 (95% confidence interval [CI] 0.63-5.42) for weight maintenance (within 5%) and 3.88 (95% Cl 1.30-9.88) for weight loss (> 5%) compared to weight gain (P for trend .026 and .003, respectively).
Regular yoga practice was associated with attenuated weight gain, most strongly among individuals who were overweight. Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight.
Survey research is demonstrating that binge eating and compulsive eating may be a significant problem in the obese population. There is higher incidence of binge eating among women, associated with subjective distress and poor prognosis for weight control. Despite attendant health risks, researched clinical responses have not been developed. A before and after uncontrolled pilot study aimed to evaluate the effectiveness of group therapy for women who binge eat and compulsively eat. Participants attended a weekly integrative therapy group for 6 months. Measurements before and after the group intervention were taken using the Binge Eating Scale and Clinical Outcomes in Routine Evaluation inventories. Before and after interviews were thematically analysed for changes in eating behaviour. Following the group intervention, all participants demonstrated changes in eating behaviour measured by the Binge Eating Scale, the overall effect from baseline to 1 year demonstrates statistical significance. Qualitative data revealed four categories that underpinned reduction in binge eating: changes in dichotomous thinking, awareness of eating behaviour, detachment from food and dietary changes. An integrative model of group therapy warrants further research and refinement for this population, a group protocol for nurses working in the field of obesity and eating disorders could be developed.
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