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Abstract

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.
Yoga Therapy and Eating Disorders
Elham Jahanbin1*
A B S T R A C T A R T I C L E I N F O
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.
Keywords: Breathing exercises, Eating disorder, Meditation, Nutrition disorders, Yoga
Citation: Jahanbin E. Yoga Therapy and Feeding and Eating Disorders. Caspian J Health Res.
2019;4(1):21-27.
Eating disorders are currently considered as one of the most
noteworthy psychological/psychosomatic disorders. This
group of disorders causes problems in physical health and
psychological functioning and disrupts the quality of life in
the affected individual and may also increase mortality. The
main cause of these disorders is still not completely
identified and their treatment is difficult, as many patients
have no desire to use the available treatments (1, 2).
In the fourth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV), anorexia nervosa
and bulimia nervosa were the two important eating
disorders. In the fifth edition (DSM-V), in addition to these
two disorders, three childhood disorders, including pica,
rumination disorder and feeding disorder of infancy or early
childhood, and also a new disorder called bulimia were
added to this group (3). In relation to eating disorders, the
main change in the fifth edition (DSM-V) was the transfer
of all eating disorders to a new category called eating and
nutrition disorders, which also includes nutritional disorders
in infancy. Although these two disorders are classified
separately, they have common features, such as age at onset,
higher prevalence in the female gender and, most
importantly, severe fear of obesity (4). The chapter on
nutrition and eating disorders in the fifth edition of DSM
includes certain changes to better show the signs and
cjhr.gums.ac.ir
Caspian J Health Res. 2019;4(1):21-27
doi: 10.29252/cjhr.4.1.21
Caspian Journal of Health Research
Jahanbin
Caspian J Health Res. 2019;4(1):21-7 | 22
behaviors of patients who live with these signs in their life.
Pica, rumination disorder, anorexia nervosa and bulimia
nervosa are the most important disorders in this category. In
addition, the name of this category was changed to reflect
the inclusion of nutrition disorders (such as pica and
rumination disorder) in the category, which are introduced
in the DSM-V as disorders usually first diagnosed in
infancy, childhood or adolescence. The present article
reviewed the definition, classification, epidemiology and
pathophysiology of different types of eating disorders and
then defined yoga and yoga therapy and addresses their
relationship and interactions with eating disorders.
The present review study was conducted through the data
collected by a search in databases including PubMed,
Google Scholar and Science Direct using the Medical
Subject Headings (MeSH) Keywords ‘yoga’, ‘feeding and
eating disorder’, ‘breathing exercises’, ‘relaxation therapy’
and ‘meditation’, without imposing any time constraints, so
as to find foreign studies published in English.
Types of eating disorders
The definition provided by the American Psychology
Association for eating disorders, which is also included in
the DSM-V, is currently the most common definition.
Eating disorders are categorized as Anorexia Nervosa,
Bulimia Nervosa, Binge Eating Disorder and Feeding and
Eating Disorders in Infancy or Early Childhood, namely
Pica, Rumination Disorder and Feeding Disorder of Infancy
or Early Childhood.
Anorexia Nervosa
The term anorexia refers to the loss of appetite, and nervosa
shows that anorexia has occurred for emotional reasons.
This terminology is somewhat incorrect, since many people
with anorexia nervosa do not lose their appetite or interest in
food, rarely experience the loss of appetite, and even then,
often in the advanced stages of their disorder. Anorexia is
self-starvation and resistance against having the normal
minimum weight. People with anorexia nervosa have mental
preoccupations about food and exhibit depression and poor
social relations. The main features of anorexia nervosa are:
(1) Resistance against maintaining a minimum weight and a
sustained energy intake limitation; (2) Phobia of obesity;
and (3) A false belief about one’s own body, such that even
excessive slimness is considered obese. The main difference
in the fifth edition of DSM over the fourth edition is that the
cessation of menstruation (or amenorrhea) is no longer
required for this diagnosis to be made (3). An impaired body
image is the main feature of anorexia nervosa. The family
members of people with this disorder suffer extensive
disappointment. The main problem in people with this
disorder is an intense psychological development crisis, and
hatred is a very popular attitude among these individuals
(5). DSM-V differentiates between two types of anorexia
nervosa: 1) Restrictive, in which self-starvation is not
accompanied by purging, and food intake is limited and
exercise is relentless and obsessive for at least three months;
2) Binge eating/purging, in which the individual regularly
self-induces vomiting or takes laxatives, and these acts
should last for at least three months (3).
Bulimia Nervosa
In this disorder, the individual fears weight gain and has a
distorted image of own body. The main feature of bulimia
nervosa is regular and frequent periods of binge eating
followed by periods of fasting or purging. The main cause
of bulimia nervosa is concern about the weight and body,
which may begin following a period of dieting. Bulimia
nervosa is a type of disorder associated with western
cultural ideals about a trimmed body and eating and
nutrition patterns (3). According to DSM-V, the main
features of bulimia nervosa are: (1) Periods of binge eating
with a relatively high frequency (at least once a week) and
lasting for at least three months; (2) Compensatory
behaviors following binge eating to prevent weight gain
(vomiting and misuse of laxatives or emetics; (3) Weight is
as low as in anorexia nervosa; (4) The patient has a phobia
of obesity and constantly desires a slimmer body or meets
both of these items.
People with bulimia nervosa are divided into two types. The
purging type forces themselves to throw up what they have
just eaten by vomiting or taking laxatives or diuretics. The
non-purging type tries to balance what they have eaten by
excessive exercise or fasting. According to the DSM-V, two
important features differentiate anorexia nervosa from
bulimia nervosa. The first feature concerns body image.
People with anorexia nervosa have a highly-distorted image
of their body size and imagine themselves obese even when
approaching chronic starvation. In contrast, people with
bulimia nervosa have a precise image of their body, but they
still worry about weight gain. The second feature concerns
the amount of weight lost. People with anorexia nervosa
weigh very much below their height and statue standard,
while many people with bulimia nervosa have moderate or
above-moderate weight.
Binge Eating Disorder (BED)
Binge Eating Disorder (BED) refers to frequent episodes of
binge eating. Overeating in one sitting is a feature of BED.
This disorder is a milder version of bulimia nervosa, but
unlike it, has no compensatory behaviors (purging, exercise
and fasting), and the difference between this disorder and
anorexia nervosa is that there is no weight loss in this one.
Meanwhile, the main feature of all these three disorders is
poor eating patterns (3). The criteria for BED include: (A)
Frequent binge eating episodes, identified with (1) Eating on
different occasions (for instance, every two hours); (2) The
lack of control over eating during the episode. (B) Episodes
of BED are associated with at least three of the following
cases: (1) Abnormally fast eating; (2) Eating until feeling
uncomfortably full; (3) Overeating when not feeling hungry;
(4) Eating when alone out of embarrassment over the
amount eaten. C) Being clearly upset about binge eating;
(D) Binge eating at least once a week for three months (4).
Feeding and Eating Disorders of Infancy or Early Childhood
These disorders include persistent symptoms of inadequate
intake of food, frequent regurgitation, repeated mastication
or swallowing non-food substances. The DSM-V refers to
three feeding and eating disorders in this age group: Pica,
Rumination Disorder and Feeding Disorder of Infancy or
Early Childhood.
Yoga and Eating Disorders
23 | Caspian J Health Res. 2019;4(1):21-7
1. Pica: Pica is a continuous eating of non-nutritious items
for at least one month. Eating non-food substances after the
age of 18 months is usually considered abnormal. Pica
usually begins at 12 to 24 months of age and its incidence
reduces with age. Specifically, small children tend to eat
paint, chalk, yarn, hair and cloth, while older children tend
to eat soil, animal stool, stone and paper. The disorder may
be clinically benign or dangerous depending on the type of
substance eaten. The most serious complications of pica
include lead poisoning, intestinal parasites, anemia, zinc
deficiency and severe iron deficiency.
2. Rumination Disorder: According to the DSM-V,
rumination disorder is the frequent regurgitation of foods
already chewed in children or infants following a period of
normal functioning. The signs should last for at least one
month. This disorder generally begins after the age of three
months, and the food may be re-swallowed or spat out after
it is thrown up. Ruminating infants try to return the food
into their mouth and appear to enjoy these efforts.
Rumination is a rare disorder that seems to be more
common between the ages of three months and one year and
among mentally-challenged children and adults.
Psychodynamic views on the etiology of rumination have
proposed turmoil in the mother-child relationship as a
potential cause of this disorder. The mothers of these infants
are often immature and engaged in marital conflicts and do
not pay much attention to their children. Behavioral
interventions such as pouring a few drops of lemon juice in
the infant's mouth during rumination may be effective in
reducing this behavior. This method appears to be the
quickest and most effective method for eliminating
rumination within three to five days.
3. Feeding Disorder: According to the DSM-V, this
disorder is the persistent inability to eat adequately, which
leads to the lack of significant weight gain or a significant
weight loss over one month. This disorder begins before the
age of six years (6).
Epidemiology
The major effect of eating disorders on health has made the
WHO include them in the list of the highest-priority
psychiatric diseases in children and adolescents (7). Many
patients with eating disorders insist on not using treatment
by a professional team (8), and their failure to seek a proper
treatment makes the epidemiological study of these
disorders difficult (1). Eating disorders have been reported
all over the world, including in developed and developing
countries such as Brazil and China (9, 10).
In a study conducted on a large number of 9-14-year-old
American children and adolescents, 7.1% of the boys and
13.4% of the girls showed the behavioral symptoms
associated with eating disorders (11). Overall, women are
more affected by eating disorders than men, and the
prevalence of anorexia nervosa and bulimia nervosa in a
lifetime is 0.9% and 1.5% in women and 0.3% and 0.5% in
men (12). The incidence of anorexia nervosa is most
common in women aged 15 to 19 years, and has increased
steadily between 1935 and 1999 in women aged 15 to
24 years (13).
In assessing the prevalence of eating disorders in older
people (aged 50 to 94 years), 88% were women, and
anorexia nervosa was observed in 81% and bulimia nervosa
in 10%, and 60% had major depression as a comorbidity of
eating disorders. Behavioral and medicinal interventions
were successful in them, as 42% were successfully treated.
Mortality from eating disorders was reported as a secondary
disorder and its complications were reported as 21% (14). A
study on eating disorders in women and men and the
mortality from these disorders reported that anorexia
nervosa is very common among women and has not reduced
significantly compared to the past and there is still an
increased risk for women aged 15 to 19 years. The incidence
of bulimia nervosa may have been declining since the
1990s. All eating disorders pose a potential risk of mortality,
and anorexia nervosa is the most unpleasant of them.
Compared to other eating disorders, bulimia is more
common among men and older adults (15). Although 60%
of the patients with eating disorders presenting to clinics for
out-patient services have an unspecified eating disorder, this
type of eating disorder has less been studied than the other
types (13). An unspecified eating disorder is a broad
diagnosis that includes patients with symptoms similar to
the symptoms of anorexia nervosa or bulimia nervosa but
does not have all the diagnostic indicators of these two
disorders (16). According to various studies, 40% to 70% of
patients with an unspecified eating disorder seek treatment
for their disorder (17, 18).
Very few studies have been conducted on eating disorders in
Iran. In a study conducted on the female students of one of
the universities in Tehran, the prevalence of eating disorders
was 21.5%, and the prevalence of anorexia nervosa and
bulimia nervosa was 1.8% and 7.8%, respectively (19). The
prevalence of anorexia nervosa and bulimia nervosa in
female high school students was reported as 1.7% and 1.7%
in Kerman (20). In the first epidemiological study of eating
disorders in Iran, the prevalence of anorexia nervosa and
bulimia nervosa in 3100 second-year high school girls in
Tehran was reported as 0.9% and 3.2%, respectively (21).
Pathophysiology
A) Genetic perspective: The female gender is the most
important potential risk factor for developing eating
disorders; however, it is still not exactly clear whether this
relationship is due to biological or social factors. According
to studies conducted on families and twins, anorexia
nervosa, bulimia nervosa and BED seem to be complex
genetic diseases with a hereditary risk factor of 50% to 80%
(1, 22). The relatives of a person with eating disorders have
been shown to be ten times more likely to develop eating
disorders in their lifetime than the relatives of a healthy
person (23).
B) Biological perspective: The biological perspective
considers eating disorders a result of biochemical
abnormalities with a potentially genetic connection. People
with eating disorders suffer from abnormalities in their
norepinephrine and serotonin neurotransmitter systems.
Serotonin seems to have a role in regulating feelings of
hunger or satiety. The lack of serotonin appears to be
associated with feelings of hunger (leading to overeating)
and its excess with satiety (leading to the loss of appetite).
More than 20% of the calorie intake is consumed in the
brain, and the brain is greatly dependent on glucose. The
brain tissue is thus severely vulnerable to poor nutrition, and
poor nutrition can thus adversely affect the brain functions
Jahanbin
Caspian J Health Res. 2019;4(1):21-7 | 24
and appetite. Epidemiological studies have shown that most
eating disorders emerge during adolescence, when the brain
is in a very important developmental stage, and malnutrition
can adversely affect the progress of these disorders
significantly (22).
C) Psychological perspective: In the psychological
perspective, eating disorders are caused by people's inner
turmoil for self-management. Some people with bulimia
nervosa have a history of sexual and physical abuse in
childhood. Abuse is also associated with reduced cortisol
levels (i.e. the stress hormone). People with eating disorders
gradually fall into the trap of disease-like patterns due to
their reluctance to change their thought processes. This
group insists on negative thoughts, resists change, avoids
problems and has hedonistic ideas. It seems that the
personality trait of dependence is closely associated with
obsession and the symptoms of overeating (9).
D) Environmental factors: The environment has a major
role in the development of certain eating disorders. Some
environmental factors associated with eating disorders
include public harms, such as being ignored by others,
physical or sexual abuse and harmful experiences associated
with food and weight, such as family’s dieting, childhood or
parental obesity, family’s or others’ criticisms of the
person’s eating and body form or job-related pressures to be
slim (1). In western countries, harmful experiences
associated with food and weight work to sensitize
individuals to their body form and encourage dieting. These
experiences mostly affect women, since the environmental
and social pressures for being slim are greater for this
gender (10).
Definition of Yoga
Yoga is the art of living and a knowledge that should
become an integral part of everyday life for all people, since
it has significant effects on all aspects of life, including the
physical, psychological and mental aspects. Yoga is
composed of the term "Yog", meaning "unity and
integration". In spiritual terms in Sanskrit language, this
unity means the alliance of pure personal knowledge with
the cosmic soul. Yoga creates harmony and balance between
the body, mind and soul. The scientific-practical system of
Yoga creates this balance through physical exercise,
Pranayama, Mudra and Bandha, Shatkarma, and Meditation.
These exercises enable the individual to find the real truth of
their body (24). Swami Sivananda, the father of the modern
scientific Yoga, states: “Yoga is the union and harmony of
thought, words, actions and deeds, or the harmony of the
head, heart and hands, which is achieved through yoga
exercises”. As a system, yoga develops a union between the
physical, mental and emotional aspects of human existence
and reveals how each aspect affects the other and also their
conflicts with each other, and eventually, this knowledge
leads to a subtle understanding of the truth and existence.
Yoga has a tendency toward inner knowledge. Yoga is a
technique of direct, immediate, accurate and clear thinking.
The entire yoga system is directed toward connecting our
nature, thoughts, life and existence (25).
Yoga Therapy
The combination of yoga with other sciences creates a tool
to rebalance bodily disorders. It is the duty of skilled experts
to test out effective combinations of yoga and medical
sciences (25).
One of the main achievements of yoga is the treatment of
the body and the soul. Its most important and influential
effect is creating a strong harmony and union between the
body and the soul. Yoga techniques and exercises are
currently used for the definitive treatment of diseases such
as asthma, diabetes, hypertension, arthritis, gastrointestinal
diseases and certain psychosomatic diseases in which
modern medicine has failed. According to medical reports,
yoga therapy is one of the most successful treatment
methods, because yoga creates the harmony needed between
the nervous system and the endocrines, which directly
affects the internal systems of the body and its organs. In
this stressful world, yoga has become the easiest way for
most people to achieve health and happiness. Asanas relieve
much of the daily fatigue caused by work activities such as
sitting behind the desk or the effects of karmas. In addition,
yoga techniques are often relaxing for the mind and psyche.
Regardless of personal needs, yoga is a means of fighting
anxiety and social restlessness (25).
When yoga concepts are combined with the available
psychoanalysis, psychotherapy and psychological treatments
for managing psychological abnormalities, a highly
powerful tool is created for awakening the mental powers.
Yoga is described as a technique for controlling the thought
or mind waves. Yoga is a systematic approach to uniting
with existence and a school of mind meditation that
encourages people and helps them achieve their highest
potentials and put them into action. The term "yoga" means
connecting; that is, connecting the body, mind and soul. Our
mind is constantly active and its positive and negative
waves can affect our body and soul. The aim of yoga is to
balance the human body, mind and soul. When we accept
the human-being as a single entity consisting of the body,
mind and soul, then we will deal with diseases in a different
way. For instance, in dealing with a patient with backache,
in addition to the physical factors (muscle weakness,
mechanical pressures, wrong ways of sitting and standing),
we will also consider mental (anxiety, concern, false
ideations, etc.) and psychological (depression, etc.) factors,
which is exactly what holistic medicine does (25).
Yoga therapy is a branch of holistic medicine. Patients
treated with this method find out that, in addition to the
main complaint which has been the reason for their visit,
their other complaints will also be gradually abated. Yoga
therapy uses different yoga exercises, such as Asanas,
relaxation techniques, breathing exercises and meditation,
which help people with a wide range of physical and mental
health conditions. Yoga therapy can complement medical
care or, in certain cases, even replace traditional approaches
such as medication therapy or surgery. Yoga therapy often
does the job of individual counseling. This method is similar
to other medical care measures. Yoga therapy can also be
used for a group of participants with similar conditions who
seek similar treatment outcomes. In individual assessments,
a certain level of detail can be gathered that contributes to
planning an appropriate course of treatment for the patient.
In group yoga therapy, however, the assessment is generally
limited and the treatment plan is less individualized (26).
Mankind can be studied and assessed in three basic and
interdependent dimensions, namely the physical,
psychological and social dimensions. The physical
dimension involves all the physical and organic features and
Yoga and Eating Disorders
25 | Caspian J Health Res. 2019;4(1):21-7
attributes of human-being. The psychological dimension is
concerned with mental processes, such as thoughts,
perception, deduction, logic, analytical power, judgment,
emotions, excitability, emotional states, etc. The social
relations dimension deals with how the person relates to
others and his social adaptability, social functioning, etc.
These three dimensions have interactive and complex
effects on each other, and disruption in one affects the
others as well. People’s physical, psychological and social
health is determined by the proper functioning of all these
three dimensions. With this knowledge, psychologists and
researchers have tried to find ways to protect people against
the flood of problems. Certain trainings can make humans
physically stronger, more powerful and healthier and
psychologically tougher and more resilient and adaptable.
Psychological resilience training includes wide and varied
lessons, such as techniques for strengthening the body and
mind and making them healthy, techniques for coping with
stress or adapting to them and lessons for effective social
communications. As a method of well-being, yoga protects
human health by its various dimensions. The physical
benefits of Asanas and the breathing techniques of yoga can
be summarized in the following themes: (1) The removal of
excess body fat, body fitness and the strengthening of the
body organs and systems, and generally, improving physical
strength; (2) Facilitating blood circulation and nervous
system flow in the body; (3) Regulating and balancing the
body hormones and the exocrine and endocrine functions;
(4) Relieving fatigue, muscle spasm and causing the
flexibility of the joints and muscles; and (5) Strengthening
the immune system. The benefits of yoga include the
following cases: (1) Recognizing one's mental processes,
such as thoughts, emotions, perceptions, contemplation,
mental mechanisms, expectations, motivations, desires, etc.;
(2) Control over mental processes; (3) Concentration of
mental forces; (4) A sense of peace, relief and liberation;
and (5) Mental flourishing and transcendence (27).
Fear, worry and chronic mental pressures may present as
loss of appetite and thereby weight loss. Food is tasteless
when the mind is toiling with many preoccupations. Mental
pressures and anxiety may present as concern about being
slim, which often leads to more pressure, a loss of appetite
and further slimness. On the other hand, concern about
obesity also leads to anorexia nervosa. Refusing to eat turns
into a prolonged fasting state, and the desire for food is lost
in this state and severe hunger develops, but for fear of
obesity, the person still refuses to take food (28).
The principles of yoga provide psychological relaxation and
a balance and harmony of the pillars of the human psyche
and promise significant improvement in physical and mental
well-being (29). The relaxation exercises of yoga reduce the
symptoms of depression and anxiety in patients with
psychological problems (30). The students’ participation in
yoga classes offers psychological benefits by inducing
changes in the body self-concept and components including
flexibility, physical activity, endurance and self-esteem (31).
Yoga classes increase compatibility and convergence
between the perceived self and the idealized self-image (32).
Reviews have shown that yoga has positive effects on
cognitive and emotional functions. These exercises lead to
reductions in the activity of the central and autonomic
nervous systems in all stressful situations, and also seem to
be able to reduce the plasma catecholamine level and
decrease the activity of the sympathetic nervous system
significantly (33). Yoga exercises can affect a feeling of
general health by increasing the adaptability of the mental,
nervous, immune and cognitive systems, moderating the
autonomic nervous system, increasing physical endurance
and body resistance and moderating the immune system (33).
A study conducted to review three articles on the efficacy of
yoga therapy interventions in eating disorders and seeking
to answer the question of whether yoga is an effective
strategy for the management of eating disorders showed that
yoga exercises, including the asana, pranayama and
relaxation exercises, can reduce the severity of eating and
related disorders. Nevertheless, there is no evidence to show
that yoga is an effective primary treatment for eating
disorders, even though its results are very promising as a
complementary medicine in conjunction to psychological
and psychiatric techniques (34). In assessing the role of
body awareness and mindfulness in exercise and eating
behaviors, the results regarding the amount of food intake
and eating disorders showed that, for clinically-ill patients
and those at risk of eating disorders, the body awareness
offered by various forms of exercise, including yoga, can be
even more beneficial than changing the amount of food
intake and food regimen in the general population (35).
Along with these results, a study conducted to investigate
mindful eating and its relationship with BMI, BED and
anxiety and its negative effects showed that people who are
less mindful of their eating behaviors are more obese and
anxious and show more negative effects and have less
control over their eating habits, and these variables can be
predictors of eating disorders (36).
One study showed that yoga-practicing women have better
bodies and are happier with their body and tend to use
healthier and more appropriate weight control techniques,
while obese women who only do yoga under certain
circumstances, use unpleasant methods such as smoking and
drinking alcohol for weight control (37). 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).
A great amount of attention has been paid to eating
disorders in recent years; however, further studies may still
be required for understanding the factors affecting the
creation, persistence and treatment of these disorders.
Moreover, a lot of interest has been raised in
complementary medicine on the side of other methods such
as yoga and meditation, especially mindful eating, which
have fairly favorable effects on eating disorders and their
comorbidities, including depression and anxiety, by exerting
concurrent effects on the body and mind and leading to self-
confidence and positive feelings about the body and
appearance. Yoga therapy is recommended to be further
considered and used for its holistic approach to humans and
the specific techniques if offers for human health,
Jahanbin
Caspian J Health Res. 2019;4(1):21-7 | 26
development and preparation at any stage of life and in all
its dimensions.
Not applicable.
Authors declared no conflict of interest.
None.
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