How Yoga Can Become a Game-changer in Combatting Eating Disorders

"Downward dog certainly didn't cure my eating disorder, but the practice did teach me how to relate to my body in a more compassionate way."
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This is an interview with Chelsea Roff, who took her first yoga class at the suggestion of a therapist just a few months after getting out of the hospital for eating disorder treatment . An estimated 24 million Americans suffer from an eating disorder (anorexia, bulimia or binge eating). The average cost of treating an eating disorder is $1,250 per day, and only one in 10 ever receive treatment. Eating disorders have the highest mortality rate of any mental illness. What if the over one-half of teenage girls and nearly one-third of teenage boys who use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting and taking laxatives, were offered regular yoga classes?

How did you find yoga?

I wish I could say I went because I wanted to reconnect with my body, learn to meditate, develop a spiritual practice, or something like that. But honestly, I wanted nothing of the sort. I thought yoga sounded fluffy, esoteric, airy-fairy, and way too soft for my tastes. The only reason I went was that it was the only form of exercise my treatment team approved of, and I felt insanely uncomfortable in the new body I was growing into.

The short story is that yoga brought me to a place in my recovery that no form of talk therapy or medical treatment ever had before. Downward dog certainly didn't cure my eating disorder, but the practice did teach me how to relate to my body in a more compassionate way. And more importantly, perhaps, going to yoga introduced me to community -- to the people I soon came to consider family -- and I suppose that's exactly what I needed to fully step into recovery.

Once I'd reached a sustainable level of recovery, I found myself wanting to share the practice that had been so helpful for me. That's now my main focus as a writer, speaker and yoga teacher. I now teach programs on how yoga can be used to help those of us who have struggled with food and body image issues, and speak to patient and professionals at eating disorder centers.

What originally motivated you to do this work and what continues to motivate you? How, if at all, has that motivation changed over time?

As I grew in my personal practice I felt compelled to give back, and once I completed teacher training I started a small, grassroots organization that offered yoga at homeless shelters and juvenile detention centers. I was working mostly with "at-risk" teenage girls, particularly those affected by sexual violence and neglect. Like many people, I found that service provided a deep sense of meaning and even kept me accountable in my own recovery.

I suppose what motivates me to do this work -- and I'm not sure I would call it work at all -- is the fact that I was given so much myself when I was in greatest need. I had a therapist give me almost seven years of nearly-free weekly therapy. My first yoga teacher allowed me to clean her studio in exchange for unlimited yoga classes. I had several wise and generous individuals take me under their wings and offer mentorship and support when I had no idea where to go; one of them even did so via Skype from Como, Italy!

I do this work because I feel compelled to, because it's the only way I know to repay them for the invaluable service they offered me. I do this work because I can't imagine a life without it.

Is there a standout moment from your work with those with negative body images and disordered eating?

There's one that seems to happen time and time again when I visit eating disorder centers, especially when I start speaking to the patients about how yoga can be helpful in recovery. Often the response I get, in one form or another, is: "Well, that's great for you, but I can't do yoga. I'm on exercise restriction."

The perception -- and this seems to be true of the general population, not just patients and clinicians in ED treatment facilities -- is that yoga = stretching. Yoga = moving and breathing and building muscle and burning calories. But the truth is, yoga can be much more subtle than that, and for those who struggle with eating disorders, it needs to be more in order to be valuable.

So often I encourage patients to engage in a simple breathing exercise with me. I ask them to close their eyes, place their hands on their belly, and take five deep breaths. Now I know this sounds simple and maybe even kind of silly, but I can't tell you how terrifying it was for me to put my own hands on my belly when I was in the throes of anorexia. Many people with eating disorders have worked for years to disconnect from the somatic experience of being alive. So taking five breaths to feel into the area where we experience hunger, fullness, anxiety, and a host of other emotions... it can bring up a lot. Every once in a while one of the patients will do it and then tell me with this huge look of surprise afterwards, "I felt hungry..."

Is there any guarantee yoga will be used in healing ways? What was your experience?

Of course not! In fact, I think more often than not yoga is used in unhealthy ways by people with a history of an eating disorder. That shouldn't be a surprise to any of us, especially not clinicians who are familiar with this population. Eating disorders, especially anorexia, are sneaky and stubborn illnesses; they veil themselves (even to the sufferer) beneath cloaks of "health" and "discipline." Our society often glorifies the way the illness manifests itself (thin body, perfectionist personality, overachievement, rigorous commitment to nutrition and exercise). The truth is, underlying those seemingly "healthy" traits and behavior, there is a desperate need to control, fix, and anesthetize. Yoga can very easily turn into one more tool (like purging, starving, or over-exercising) we use to numb our feelings and try to fix a body that was never broken to begin with.

I unpack this topic more in a retreat I teach called Fall in Love With Your Body Through Yoga. The next date is June 21-23 at the Omega Institute.

How can yoga become a game-changer in preventing or reducing eating disorders?

In my experience, most treatment programs simply do not have enough time with a patient to address many of the underlying issues in an eating disorder. This isn't a criticism of the inpatient centers themselves; they do incredible work and save lives. I certainly wouldn't be alive today without the inpatient treatment I received. But insurance companies have a habit of cutting off funding for treatment long before a patient is ready to go home, often against the recommendation of doctors and staff. So you end up with patients leaving treatment -- meal and relapse-prevention plans in hand -- without all the skills they need to be successful in recovery.

Inpatient treatment gave me the skills to survive, but yoga gave me the skill to thrive. I think yoga can be a game-changer in eating disorder treatment because it provides a safe way for patients to begin to explore their body and its sensations again. It helps patients rebuild a conscious connection between mind and body, which is so often severed in the heat of an eating disorder. What does hunger feel like? What does my body do when it's experiencing fear or frustration? How do I respond when I'm faced with a challenging situation, and what tools do I have access to right now (breath, focus, self-soothing) to be with these emotions rather than trying to starve them away?

With regard to prevention, I'm a little more skeptical of whether yoga is likely to prevent eating disorders altogether. These are complex illnesses caused by a large number of factors -- genetics, early childhood trauma, etc -- and I'm doubtful that learning yoga alone would be enough to overcome all the things that makes someone predisposed to the illness.

That said, I do think yoga is a powerful tool for helping young people cultivate healthy relationships with their body and emotions, starting early in life, if it's taught with thoughtfulness and care. But I think it's important to mention that the culture surrounding yoga in this country (think detoxes, yoga butts, and sex scandals) can also make people distrustful who come to the practice with pre-existing trauma or mental illness. I try to communicate to instructors and professionals that yoga is not a cure-all, and that in fact it can be just as harmful as it is helpful if clients aren't in a place to treat themselves with compassion. First you use yoga to teach clients this self-compassion.

How has this work changed your definition of service?

Well, I've certainly learned that service is not a one-way street. Teaching and speaking on issues related to yoga, eating disorders, and public health policy has added a great deal of depth and meaning to my life. Service is not just the yoga classes I teach to those with eating disorders: I also speak with professionals about what's helpful (and what isn't), and most importantly thank them for the (often thankless) work they're doing.

I often say that I feel like a child who was once desperately thirsty, was given enough water to survive and slake her thirst, and now feels compelled to go out and give water to anyone and everyone who's thirsty. "Look! Water! I know, doesn't it taste good?? Here, drink up!" Service is the best way I know to thank those who gave me water, to carry on their legacy. It keeps me feeling connected to them and accountable in my own recovery. If my experience has shown me anything, it's that sharing with others is the key to a meaningful life.

Editor: Alice Trembour

Are you a yoga instructor giving back to underserved or un-served populations? Email if you're interested in being interviewed for this series. Thank you for all you do in the name of service!

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