Embodiment exercises for recovery

embodiment work and eating disorders

Why embodiment work needs to be included in eating disorder recovery

 

Before you start reading this article, pause for a second.

Take a deep breath in through your nose, hold it for a moment, and then let it fall out of your body.

Take another breath in, and this time notice the sensation of the cool air travelling in through your nose and down into your lungs. Feel your rib cage move up as the breath fills your body. Now, release the breath back out through your nose and notice the warmer air on your top lip as it leaves your body.

This short exercise only took a few moments, but it allowed you to be a little more present and a little more connected to your physical body. This is one of many examples of what practicing embodiment can feel like.

In this article, we want to highlight the importance of becoming embodied, especially in eating disorder recovery. This is something we feel passionate about – after all, it’s in our name!

The concept of embodiment and its related theories are extremely complex and based heavily in neurobiology, so we want to be transparent in the fact that this article will be a simplified summary and will really only scratch the surface of this interesting topic. However, we’ve included some resources at the bottom of this page for you to learn more.

 

What is embodiment and why should I care?

Embodiment is essentially the connection between mind and body – both the lived body (the felt and experienced body) and the physical body (the aesthetic and anatomical body). It is the act of being aware and present within the body, and having an understanding of how and what the body is attempting to communicate.

As a society, we have become disconnected from our bodies. Rather than engagement and communication, objectification of the human body has become the norm. In other words, we see the body as a purely aesthetic thing rather than as a source of wisdom and information – thanks diet culture!

The body communicates with us constantly through the five senses, internal sensations and movement. However, we are not always able to hear it.

Interoception is the processing, representation and perception of bodily signals – in other words, it is the body’s ability to sense itself from the inside. A high sensitivity to this is known as interoceptive awareness. Studies have shown that limited interoceptive awareness is strongly associated with risky decision-making, compromised cognitive function and poor self-regulation of emotions and behaviours.1 A common way that researchers test someone’s interoceptive awareness is by asking them to identify the rate of their own heartbeat without feeling for their pulse.

Disembodiment and poor interoceptive awareness occur when we are chronically outside what we call our window of tolerance.

The window of tolerance is the psychological space where we feel safe, are able to manage daily stressors and fully engage socially with the world around us. When we are outside this space, somatic dysregulation occurs. In other words, the body reacts to stress by becoming either hyperaroused (feeling anxious, angry and out of control) or hypoaroused (feeling numb, exhausted and depressed) in order to cope with what is going on around us.

Leaving our window of tolerance every now and then is a normal part of being human, and the body is designed to be able to self-regulate when this happens. However, as a result of extreme stress, trauma, mental illness and/or other factors, our window of tolerance can sometimes shrink, meaning it takes only a small disruption for us to feel unsafe. This is what happens in people with eating disorders.

 

Why is embodiment important for eating disorder recovery?

Luckily for us, embodiment work and eating disorders is a strong interest area for many researchers, which means there is constantly new information emerging about this concept.

Research has found that the body’s ability to process somatosensory information is altered in people with eating disorders, and this can persist after recovery.2 For example, the heartbeat perception test described earlier in this article was undertaken in a group of 28 females with anorexia nervosa. Their ability to accurately identify their pulse was significantly worse than people without an eating disorder, as was their ability to recognise bodily sensations related to hunger and satiety.3

Another study published in 2019 found that feeling extraneous from one’s own body (in other words, feeling disembodied) is associated with poor interoceptive awareness, and is a strong risk factor for the development of eating disorder symptoms.4 This study also found that poor interoceptive awareness is associated with distorted body image, impulsivity and compromised decision-making abilities, which are all common characteristics seen in people with eating disorders.

Studies have also demonstrated that interoceptive sensitivity predicts malleability of body-representations.5 This suggests that poor interoceptive awareness decreases the accuracy with which we view our own body, increasing the likelihood of distorted body image.

People struggling with eating disorders often see their body as the enemy.

However, disordered behaviours are one of the body’s ways of communicating underlying somatic dysregulation. As such, the body should be seen as a resource and utilised as part of the solution, rather than as part of the problem.

 

How can I feel more embodied?

There are tonnes of practices you might mindfully engage in order to become more embodied! Some of our favourites are:

  • Breathwork and meditation
  • Body scans
  • Yoga, especially Shavasana (corpse pose) and Viparita Karani (legs up the wall pose)
  • Aromatherapy
  • Tai Chi
  • Massage, including self-massage or rubbing in lotion
  • Use of weighted objects, such as a weighted blanket or toy
  • Shaking it out – this sounds silly but animals do this after a period of fight/flight! Keep your feet firmly planted on the ground and bounce, swing, sway, shake – whatever feels right!
  • Walking with bare feet on grass or sand
  • Hugging a pillow to your chest and breathing deeply, feeling your body against the cushion

 

Further resources for learning about embodiment

Books
  • Bessel van der Kolk: The Body Keeps the Score
  • Daniel Siegel: The Developing Mind
  • Giten Tonkov: Feel to Heal
  • Niva Piran: Journeys of Embodiment at the Intersection of Body and Culture

 

Websites

 

Our ultimate goal with our clients is to help them to build trust with their body in order to be able to let it guide them. Reach out to us at [email protected] for more information about how we can work with you to achieve this.

 

Karli Battaglia, APD

EHL Team x

 

 

 

References:

  1. Herbert B, Pollatos O. The Body in the Mind: On the Relationship Between Interoception and Embodiment. Topics in Cognitive Science. 2012;4(4):692-704.
  2. Eshkevari E, Rieger E, Longo M, Haggard P, Treasure J. Persistent body image disturbance following recovery from eating disorders. International Journal of Eating Disorders. 2013;47(4):400-409.
  3. Pollatos O, Kurz A, Albrecht J, Schreder T, Kleemann A, Schöpf V et al. Reduced perception of bodily signals in anorexia nervosa. Eating Behaviors. 2008;9(4):381-388.
  4. Cascino G, Castellini G, Stanghellini G, Ricca V, Cassioli E, Ruzzi V et al. The Role of the Embodiment Disturbance in the Anorexia Nervosa Psychopathology: A Network Analysis Study. Brain Sciences. 2019;9(10):276.
  5. Tsakiris M, Jiménez A, Costantini M. Just a heartbeat away from one’s body: interoceptive sensitivity predicts malleability of body-representations. Proceedings of the Royal Society B: Biological Sciences. 2011;278(1717):2470-2476.

 

The THRIVE Experience: Anastasia’s Story

We had the privilege to interview one of our past THRIVE participants – Anastasiia who shares her journey to full recovery with us. In today’s blog we share the questions we asked and her answers! 

 

Q. What were you looking for in a programme?

A. I actually perfectly remember the moment. So it was late at night and I could not sleep because I ate too much and felt physically stuffed and emotionally uneasy. I googled a few questions related to ‘why people overeat at night and I found a very relevant answer from Embody Health London. That was the moment I discovered you.

Q. How did you know you found a programme that was right for you?

Once I looked through the Embody Health London’s website and program overview I felt fairly interested as it was something of a quality and definitely not the information I can find everywhere. So I scheduled my initial 30 min consultation and it was it. Everything was just right.

Q. How would you describe the struggle you were living with prior to the programme?

Oh it was a lot. I had bulimia for years. Before that, clear signs of anorexia. Low self-esteem, excessive focus on food and out of proportion body image.

Could be partly a one way road relationship with my mum. She could be happy and loving in one moment and snap right in the next. I suffered from those swings and oftentimes thought I was the one at fault. On top of that my personality is more sensitive towards other people’s feelings way more than my own. Probably that and many more reasons combined together.

 

Q. What was your belief about the solution to the struggle prior to the programme ?

In some ways I felt it was me who needed to stop overeating, start controlling myself better and just do the right thing. Which of course hit me back harder when I could not manage to do exactly that.

 

Q. What told you, you were ready for full recovery?

As I said I was in recovery already. But I was looking for different perspectives, possible knowledge behind the scenes that will help me understand my behaviour better.

 

Q. What was it like working with Embody Health London?

Loving and warming. I was looking towards every new session. Loads of priceless information. Great exercises and just such sincere support.

Q. How if at all, has this transformation impacted your life?

It brought me to the next level of my recovery. I became more understanding towards myself. And I stonewalled my idea to never diet and to not even have thought about it. With EHL I learned so much real data of why it only hurts. Finally I really understood it.

Q. What objections did you have or doubts that you would have wanted to be addressed before committing to the programme?

I probably had some sort of quality doubts. Just because I so unexpectedly found EHL over the internet. But as I discovered the website and social media I saw I did not need to worry. And never ever I doubted it.

 

Q. How have celebrating special events changed for you since completing the programme? Christmas? Birthdays? Holidays?

Well…it became more enjoyable actually. As I know I will allow myself anything I want as long as I listen to my body and stop or maybe just take a break when it is time, I am not worried about celebrations any more. I am looking forward to them.

Q. What do you do outside of school/work for fun? What are your interests?

I love doing sports, anything to move my body. I really enjoy travelling and hope that one day I can visit London and meet Cassie and Ariana in real life 🙂 I enjoy reading books and browsing through Instagram and watching movies on Friday evenings. And of course I love hanging out with people and building communities.

If you can relate to Anastasiia’s story and you’re ready to finally get out of the recovery limbo THRIVE is for you.

Get in touch with us today if you still have queries and want to learn more at [email protected]

Team EHL x

Three signs you are ready to fully recover

eating disorder recovery thrive

 

Eating disorder recovery is no easy road – be prepared for bumps, twists, and turns along the way. There may be days where you feel on top of everything and days where you seem to be back at square one. But, we’re here to remind you that this is all a perfectly normal and healthy part of the recovery process – and our team at EHL is with you every step of the way! 

This blog explores three key signs that could indicate you are ready to achieve a full recovery in your healing journey. Remember that recovery and the path towards it is within reach, meaningful, and you are worth it.

 

ONE: You are willing and open to seeking and receiving support.

Whether from friends, family, a therapist or medical professionals – you aren’t afraid to open up to those around you and ask for help when you need it most. Embrace your braveness, and don’t be scared to seek the support you deserve. Your vulnerability is a strength and may even empower those around you to seek help in their own lives – this mindset can bring so much further benefit.

There is plenty of research to show the power of support groups and networks in overcoming trauma and complex life events can be crucial in boosting mental wellbeing, decision-making, mood, behaviour and more. We are a social species who rely on each other in our daily lives, in countless situations and contexts – and in the lens of recovery, these relationships have a huge role to play. (1)

Studies even show negatively-correlated relationships between social connectedness and eating disorder symptoms, particularly amongst family and friends as well as the patient-healthcare professional relationship. (2, 3)

Probably all of us at some point have been in a position where we struggle to ask for help with a challenge we may be facing – so remind yourself of the courage this takes and acknowledge how far you may have come.

 

TWO: You are patient and prepared to put the work in 

As mentioned, recovery isn’t a walk in the park and will not happen passively. It takes serious momentum to get the ball rolling and also requires a lot of upkeep and persistence to reach a full recovery and not just a quasi one. So take each day as a new window of opportunity and choose the path of healing, no matter how uncomfortable this may feel at times. 

Holding yourself in positive or more neutral regard and having the persistence of effort in your recovery journey will reap considerable benefits in the long term. Limiting beliefs in our recovery process are common and may hinder your progress from time to time, but if you take steps to recover each day – no matter how small, this is significant and will add up to the big fundamental shifts that may lead to our ultimate healing. 

This could look like: breaking from a strict exercise routine and giving yourself some time off, exploring mindfulness, catching up with an old friend, booking a massage, yoga class or therapy session, developing a journalling habit or reconnecting with a food you enjoy. Find what is suitable and attainable for you and do what makes you happy.

 

THREE: You are increasingly aware of diet culture and ready to question the norm

Let’s face it; recovery is uncomfortable. It can be a very foreign place when we choose to go against something that we may have internalised for a very long time. Leaving this comfort zone initially can feel like a minefield, but taking this step and increasing our awareness of messaging and influence around us is crucial to recovery.

We know that diet culture impacts our behaviours and thought patterns regarding body image and disordered eating, our perceptions of others, our stress levels, and quality of life, to name a few. (4,5)

When you find yourself questioning diet culture, hold onto the thoughts you may experience. Ask yourself if the voice in your head comes from a place of restriction or a place of freedom – is this your eating disorder talking, or your compassionate, loving self? 

If you are able to detach from negative, destructive, and intrusive thinking, chances are you are working on your self-awareness and being more mindful of your thoughts – and getting to that place is powerful progress.

Remember, no matter where you are in your journey, you are doing a remarkable job. Know that you are capable and worthy of full recovery, and every day can be a step closer – which is for you to work towards. 

Want to work with us to heal your relationship with food? Book in a free, no-obligation discovery call today, or learn more about our THRIVE program launching in January 2022!

 

Priya Chotai, BSc ANutr

EHL Team x

 

References: 

  1. Siegel, D. (2014). Interpersonal Connection, Self-Awareness and Well-Being: The Art and Science of Integration in the Promotion of Health. Lecture, University of California, Los Angeles (UCLA).

 

  1. Nunez N. (2019). Social Connectedness and Eating Disorder Symptomatology. Psychology. 38.

 

  1. Linville D, Brown T, Sturm K, McDougal T. (2012). Eating Disorders and Social Support: Perspectives of Recovered Individuals. Eating Disorders. 20(3):216-231.

 

  1. Stice E, Ng J, Shaw H. (2010). Risk factors and prodromal eating pathology. J Child Psychol Psychiatry. Apr;51(4):518-25. doi: 10.1111/j.1469-7610.2010.02212.x. Epub 2010 Jan 14. PMID: 20074299.

 

  1. Dirks AJ, Leeuwenburgh C. (2005). Caloric restriction in humans: potential pitfalls and health concerns. Mech Ageing Dev. 2006 Jan;127(1):1-7. doi: 10.1016/j.mad.2005.09.001. Epub 2005 Oct 13. PMID: 16226298.

 

How to get through the holiday season whilst in recovery

eating disorders at Christmas

Your holiday survival guide when going through recovery

 

The holiday season can be SO overwhelming. From the packed social schedule, to reconnecting with people you haven’t seen in ages, to the pressure to find the perfect gift – it’s a lot! With many of the celebrations centred around food, the anxiety that many people face is only exacerbated for those struggling with an eating disorder.

Since we know what a challenging time of year the festive season can be, we wanted to share four of our best tips and tricks to help you get through it unscathed – and maybe even with a little merriness and joy!

 

  1. Have a plan to navigate challenging conversation topics

One of the biggest anxieties for many of our clients around this time of year is seeing family and friends who may not understand their eating disorder and their challenges around food and body image. So it’s good to be prepared for the unfortunate reality that is the potential for someone to say something upsetting or triggering.

You might like to pre-plan for this before the day by sending a message to your family group chat or asking a close and trusted family member to chat to the other people on the guest list on your behalf.

However, in the situation that an uncomfortable conversation or comment is made, there are a few things you can do. But first, assess the situation – do you feel safe to speak up to this person? And if so, do you have the emotional capacity in that moment to call this person in to help them to understand your experience?

If you answered no to either of these questions, that’s okay! You can still protect yourself and your mental health by ignoring them, changing the subject or leaving the room.
If you answered yes to both of these questions, you might want to initiate a conversation around why what they’ve said has upset you, how it has made you feel, and what would be helpful in the future. It can be useful to pre-prepare a few statements to help you to get your point across with thoughtfulness and compassion.

For help with this, check out our two-part blog series about how to respond to diet talk. You can find Part 1 and Part 2.

It might be uncomfortable but it doesn’t mean you’re being rude or disrespectful by initiating these kinds of conversations! Remember that you can be kind while also setting boundaries for your own wellbeing

 

  1. Beware of holiday-focused diet culture

Despite it feeling like diet culture couldn’t get any worse, it somehow amps up around the new year. This is the most popular time for new diets and exercise resolutions, and conversations seem to revolve around “detoxing” from the indulgence of the holiday season. Ugh!

We’re here to say that the festive season is no different from any other time in that there is no place for diet culture at the table (or anywhere else really!). Regardless of what you ate yesterday, you still need to eat today and you do not need to compensate in any way.

Importantly, make sure not to fuel your eating disorder by skipping meals or snacks to “save room” for holiday meals; this is a sure-fire way to end up feeling excessively hungry, uncomfortably full, and unnecessarily stressed. Keep up your regular and adequate eating, and when in doubt, follow the lead of a family member who has a healthy relationship with food.

 

  1. Make a backup plan in case things go pear-shaped

When feeling overwhelmed, it can be near-impossible to think about what will be helpful in bringing you back down to a sense of calm. Because of this, it’s vital to make a plan about how to cope before you get to that space. As part of this, it might be helpful to answer the following questions:

Who can you call or text when things feel challenging? This list might include family members, friends, or your area’s mental health support service. For example, Beat UK have a helpline and webchat that will be operating over the holiday period, which you can access.

Where can you go to have some space? While having the support of others is invaluable, sometimes all you need is a bit of alone time to relax and regroup. Think about where you might be able to go to take a breather if you need to, such as your bedroom, the backyard, a local park, or even just sitting in the car.

What can you do to soothe yourself? This could be activities like a mindfulness or meditation practice, a gentle stroll, yoga session, reading a book, listening to music or a podcast, having a cup of tea, taking a bath and so on. Whatever helps you to feel grounded and more like yourself again!

The pessimist in you might worry that making an emergency plan means you are expecting yourself to fail; however, it actually means you are setting yourself up for success! Experiencing challenges is not a failure, but an opportunity to strengthen your recovery by learning more about your triggers and coping strategies.

 

  1. Food is important but it’s not everything

The festive season can feel like a never-ending and terrifying conveyor belt of food. However, while food is important, it’s not everything!

Instead, the holiday season is about love, connection, celebration and making memories. Try to turn your attention to what is really important to you.

And lastly, give yourself permission to eat all types of food – not because they’re off limits the rest of the year, but because they have the ability to foster these warm and fuzzy feelings.

For more tips and tricks for coping with Christmas in recovery, check out our Instagram live recording with Priya Tew (our newest EHL dietitian!).

 

Karli Battaglia, APD

EHL Team x

Why recovery isn’t just about weight restoration

eating disorder recovery

Three reasons why recovery is beyond merely physical

 

Weight restoration can be a crucial indicator of recovery on one’s healing journey from an eating disorder. When weight restored, you might feel stronger and may have reversed your symptoms related to starvation syndrome – which is already a significant and remarkable achievement!

While reaching your restored weight can positively affect your pathway to food freedom, it is also a hugely uncomfortable challenge to face eating what feels like vast amounts of food and experience rapid weight change. We empathise with you!

Studies have shown that eating disorder recovery heavily involves biological and neuropsychological factors, where those who are on the recovery journey report hope, support from others, and self-acceptance as integral in the process. (1)

Recovery is non-linear, and there is a need for more complex and flexible measures to understand the endpoints, timelines and processes of recovery. (2) It is necessary to recognise why it may not be too helpful to make weight our sole focus of recovery – and why it’s vital to think much further outside the box.

Below are three reasons why eating disorder recovery goes beyond the return to a ‘normal’ weight and other factors to consider on your healing journey, too. 

 

ONE: Health goes beyond physical measures.

We know that our whole health, particularly in eating disorder recovery, comprises far more than just weight. Mental, social, environmental, occupational, spiritual and emotional health are all relevant and valid facets when it comes to our health, too.

For example, if someone was injured in a potentially fatal car accident, but their fractures had now recovered, we wouldn’t assume that all of the trauma and fear that may have surfaced from this singular event has magically disappeared. 

It could take this person years before they feel comfortable travelling by car again. This could cause restriction in other areas of their life – such as in their occupation or social life – perhaps even evoking feelings of guilt or isolation. From this sole experience, we can see the consequential impacts on multiple forms of our health.

In the same way, although a stable weight may be reached, this doesn’t mean that we are in the best mental or emotional state that we would be considered ‘recovered.’  The weight gain itself could stir up inner conflicts too, so it is important to learn about how to cope with this.

These additional pillars of health cannot be defined or measured by a number on a scale or a portion size. So, putting weight as the threshold by which one is recovered can be seen as reductionist – losing sight of the broader picture.

You must also consider your emotional resilience, the relationship with have with your body and how you interact with the world around you.

 

TWO: Remembering the power of cognition.

Only looking at weight restoration as a measure of healing from an eating disorder assumes that this objective measure is the only indicator of recovery – and that our personal experiences and cognition is also healed through weight restoration.

Thought and behaviour play a massive role in our recovery. Although our weight may have normalised, this doesn’t mean that our mindset is positively aligned with achieving a complete and sustainable recovery. It is also beneficial to identify and detach our recovery ‘self’ from our eating disorder ‘self.’

Reaching a place of freedom, intuitive eating, and body compassion is no easy feat, and particularly for someone with an eating disorder, this may still feel like a lifetime away. They may still experience body shame and have a massive fear of gaining weight or continue to feel extreme hunger throughout the day. All of these can be signs that they may still be a long way off recovery. (3)

Those healing from an eating disorder may feel guilt for any weight changes or uncomfortable eating large amounts of food and limiting their heavy exercise routines.

Although recovery may be visible from a weight perspective, we do not know the whole story of someone’s mental state and any silent disordered thinking that they may experience. 

A big part of healing from an eating disorder is our mental health and self-talk – so again, ignoring this misses out a significant factor of one’s recovery path.

 

THREE: There is no such thing as a ‘normal’ weight.

It is important to remember that weight is an individual and relative term and that there is no one-size-fits-all approach when it comes to our bodies. 

You may have reached what is considered a ‘normal range BMI,’ but this is a social construct and one that has been criticised in the media time and time again for its potential inaccuracy. Weight is not a highly accurate measure of health – read why here.

Weight is personal to you – it goes beyond a number on a scale and involves how you feel and perceive yourself at that weight. It also doesn’t account for our unique build and other health conditions or situations that may shift our set point weight or what feels ‘normal’ for us. (4)

Focusing on weight implies that people are recovered through reaching a number on a chart and may further reinforce the visual stereotype of an eating disorder – being thin, emaciated, and usually female. 

We know this stereotype is often inaccurate, and eating disorders can manifest in any body shape, gender or race. The idea that all eating disorders look the same on the surface is simply not true. 

This may lead people to believe that they are not ‘sick enough’ due to their now-restored weight, and they may not feel an urgency to continue to recover or may feel they no longer need to. Being unwell is not a ‘look’ – and so it’s important to consider health from a more holistic viewpoint. (4)

We hope you enjoyed this article and are sending you plenty of strength and positive energy, no matter where you are right now. This kind of self-work takes immense courage, and we are here to support you along each step of the journey. 

Reach out to us at [email protected] to chat with one of our specialist dietitians and book a discovery call today!

 

Priya Chotai, BSc ANutr

EHL Team x 

 

 

 

 

 

 

References

  1. Bardone-Cone AM, Hunt RA, Watson HJ. An Overview of Conceptualisations of Eating Disorder Recovery, Recent Findings, and Future Directions. Curr Psychiatry Rep. 2018 Aug 9;20(9):79. DOI: 10.1007/s11920-018-0932-9. PMID: 30094740.
  2. LaMarre A, Rice C. Recovering Uncertainty: Exploring Eating Disorder Recovery in Context. Cult Med Psychiatry. 2021 Dec;45(4):706-726. doi: 10.1007/s11013-020-09700-7. Epub 2021 Jan 2. PMID: 33389444.
  3. Bardone-Cone AM, Johnson S, Raney TJ, Zucker N, Watson HJ, Bulik CM. Eating disorder recovery in men: A pilot study. Int J Eat Disord. 2019 Dec;52(12):1370-1379. DOI: 10.1002/eat.23153. Epub 2019 Aug 16. PMID: 31418898.
  4. Hayden, M. Why ‘Weight Restoration’ Isn’t Recovery — ThoughtsbyKenz. 2021 Jan; Retrieved Nov 26 2021, from https://thoughtsbykenz.com/posts/2021/7/11/why-weight-restoration-isnt-recovery

Beliefs holding you back from full recovery

limiting beliefs

Three limiting beliefs your eating disorder has you believe

 

Recovery is hard enough as it is, not to mention when we hold unhelpful limiting beliefs that prevent us from reaching our full potential.

A limiting belief is a state of mind, conviction, or belief that you think to be true that limits you in some way.

We work with hundreds of clients who feel limited in their recovery due to these beliefs. Whilst, of course, we are all unique, there are some common limiting beliefs that many of our client’s experience. 

In today’s blog we are going to explore a handful of these beliefs and hopefully shed some light on why they are worth reframing. Because after all, beliefs are ever-evolving – not static.  

 

#1 FULL RECOVERY ISN’T POSSIBLE

Let’s start by saying… full recovery IS possible and it’s never too late to begin!

Why do we feel so strongly about this? Because we witness this possibility every day and research says it is, too.

With the right support and willingness to make change, you CAN recover.

What is full recovery?

It could be defined as an improved quality of life due to being free of all eating disorder symptoms and returning to a healthier body weight (if underweight). Beliefs and attitudes about body image, food and exercise are also normalised and healthy.

Factors that make it more challenging:

  • Not being aware of the eating disorder or of having a problem: If you’re here reading this, this likely isn’t you! Therefore, the world is your oyster! For those that are not aware, the right medical support is needed to ensure they are stabilised and then there is scope for engaging in recovery. 
  • Severity and duration of the eating disorder: The longer and more severely you have lived with your eating disorder the longer it may take to recover. But don’t let that put you off. Think about how much your life is impacted by the eating disorder – do you really want that to continue into your future? How much longer can this go on? You’ve got a life to live!
  • Anxiety or depression: Eating disorders often present with anxiety, depression, or obsessive-compulsive disorder (OCD)1,2,3. Therefore, to recover fully it can be helpful to have the right therapeutic interventions to deal with the anxiety and/or depression alongside the eating disorder.
  • Low self-esteem and perfectionism: It have been shown that some of the maintaining factors of an eating disorder are underlying clinical perfectionism and low-self-esteem4. This tells us how engaging in a therapy is helpful to address underlying causes. 

 

#2 I WANT TO RECOVER IN A “HEALTHY” WAY

You want to have a go at recovery, but don’t want to eat that because it’s “not healthy”, right?

Holding onto “healthy” or “clean” eating is keeping you trapped. Healthy/clean eating in the context of eating disorder recovery is likely just a restriction dressed up with a halo.

We have to be very careful of this, because we also run the risk of recovering from one eating disorder into another – for example, from anorexia into orthorexia. This is NOT a good thing. It can be just as harmful and is not freedom!

Healthy eating has many definitions. It is perceived as a “good thing to do” in society and therefore if we suggest that our choices are based on “healthy eating” then it can be a get out of jail card for the eating disorder, and it can continue to go under the radar.

What do we know about the eating disorder staying under the radar?

Eating disorders THRIVE in isolation. If you are not allowing yourself to be honest with your intentions for healthy or clean eating, you are not allowing yourself to find food freedom.

It’s immensely important to challenge ALL foods as part of your recovery – including “fun foods”. If this doesn’t happen, food fears will continue to creep in and limit you from living a full life.

 

#3 I WANT TO RECOVER, BUT STILL BE IN CONTROL OF MY WEIGHT

In order to fully recover, we need to be able to accept that our body will change. Our body’s weight will change across our life. If we are still gripping onto the idea that we can “stay skinny” or “not gain any more weight” then we are letting our eating disorder control us.

The desire to still be in control of weight is driven by FEAR. We are scared. We fear what weight gain might look like, people’s opinions, what it might feel like, and what it may mean about us.

In order to overcome the fear of weight gain, we have to stop and move away from any weight-controlling behaviours. This is absolutely necessary. Every time we engage in weight control behaviour, we teach our brain that it needs to be afraid of weight change and that keeps us trapped in a negative loop of other unhelpful eating disorder behaviours such as the restriction-binge cycle or purging and over-exercise.

When we learn to let go of the control of our weight, we make room for SO MUCH more in our life. How much time a day do you spend thinking about your weight or ways to control it? Yes, too much. What else could you do with that time? Imagine the possibilities!

Your weight is the least interesting thing about you. Don’t give it so much of your energy. You are a whole person, you have so much to give to the world – the world needs that.

To learn more about how our dietitians can support you in your eating disorder recovery, book a free discovery call.

Zoe Light, RD

EHL Team x

 

 

 

References: 

  1. Godart N.T., Flament M.F., Perdereau F., Jeammet P. Comorbidity between eating disorders and anxiety disorders: A review. Int. J. Eat. Disord. 2002;32:253–270. doi: 10.1002/eat.10096.
  2. Godart N.T., Perdereau F., Rein Z., Berthoz S., Wallier J., Jeammet P., Flament M.F. Comorbidity studies of eating disorders and mood disorders. Critical review of the literature. J. Affect. Disord. 2007;97:37–49. doi: 10.1016/j.jad.2006.06.023
  3. Garcia S.C., Mikhail M.E., Keel P.K., Burt S.A., Neale M.C., Boker S., Klump K.L. Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders. Int. J. Eat. Disord. 2020;53:1844–1854. doi: 10.1002/eat.23366
  4. Fairburn C.G., Cooper Z., Shafran R. Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behav. Res. Ther. 2003;41:509–528. doi: 10.1016/S0005-7967(02)00088-8

 

The power of yoga in eating disorder recovery

yoga and eating disorders

Yoga as an embodiment practice

 

There is a growing interest in the benefits of practicing yoga for those struggling with an eating disorder. You might be wondering how a form of exercise could help with eating disorder recovery – however yoga is about so much more than moving from pose to pose or sitting cross legged on the floor. By promoting slowing down and turning the awareness inwards, yoga encourages a harmony between the mind and body that is lost through the eating disorder.

In this article, we’ll do a deep dive into the benefits of yoga in eating disorder recovery and the evidence supporting it.

 

What does the research say?

There is plenty of evidence supporting the benefits of yoga in eating disorder recovery. To describe a few…

One study of a group of women with Bulimia Nervosa or EDNOS found a significant decrease in eating disorder psychopathology after six months of twice-weekly yoga classes.1 The most significant impact was seen in a reduction in eating concern, weight concern and restriction.

Similarly, a study of women between the ages of 18-30 found a reduction in body-image dissatisfaction and spent less time focused on their appearance when they practiced yoga twice a week for twelve weeks.2

Another small study of adolescents with an eating disorder being treated as outpatients found a significant decrease in anxiety, depression, and body image disturbance after completing a weekly yoga class for twelve weeks.3

 

What is it about yoga that supports recovery?

Yoga can be uncomfortable, both physically and emotionally. By offering a safe space that is free of distraction, there is the opportunity to process and release emotions that may have been pushed down for a long time or coped with through the eating disorder. You might also find you can prove to yourself that you can survive hard things and that discomfort will pass. Learning to sit with discomfort and respond to your feelings rather than react are key skills for eating disorder recovery, as they allow you to navigate the urge to engage in disordered behaviours.

Another idea that is emphasised in most yoga classes is meeting yourself where you’re at. This means not comparing yourself to others, or even to your own “best self”. Instead, yoga encourages you listen to your body in any given moment, and to give it what it needs. Some days your healthy self will want a little more movement; some days it will need rest. Both are okay!

We said earlier that yoga is not just about the poses, but they have their place too! Moving (or holding still) with mindful intention allows you to connect in with your body without any focus on appearance. Despite an often-obsessive focus on the body, eating disorders leave us feeling incredibly numb and disconnected from our physical selves. Too often, we treat the body like the problem, when reconnecting with it can actually be the solution.

 

What should I look for in a yoga class?

Not every yoga class is going to be helpful, especially in the early stages of recovery. Choose classes that are gentle and focused on relaxation and stretching rather than more intensive movement. These classes are sometimes called “Yin yoga” or “restorative yoga”. Yoga classes that are trauma-informed, or even specifically directed towards eating disorder recovery are also out there – we suggest Googling what is available in your area.

Like almost all good things, diet culture has unfortunately found its way into some parts of the yoga community. While many studios are “safe” spaces, not all will be. Have a look at their website and social media to see what kind of messaging they promote and avoid any that refer to using exercise or food to change your physical appearance.

It should also be noted explicitly that while we obviously believe in the power of yoga in supporting eating disorder recovery, it should be practiced in combination with other treatment modalities and should NOT replace traditional evidence-based treatments. Make sure you discuss with your team before you introduce any exercise!

To learn more about how our dietitians can support you in your eating disorder recovery, book a free discovery call.

 

Karli Battaglia, APD

EHL Team x

 

References

1. Karlsen K, Vrabel K, Bratland-Sanda S, Ulleberg P, Benum K. Effect of yoga in the treatment of eating disorders: A single-blinded randomized controlled trial with 6-months follow-up. International Journal of Yoga. 2018;11(2):166.

2. Ariel-Donges A, Gordon E, Bauman V, Perri M. Does Yoga Help College-Aged Women with Body-Image Dissatisfaction Feel Better About Their Bodies?. Sex Roles. 2018;80(1-2):41-51.

3. Hall A, Ofei-Tenkorang N, Machan J, Gordon C. Use of yoga in outpatient eating disorder treatment: a pilot study. Journal of Eating Disorders. 2016;4(1).

 

Why ‘calories in, calories out’ is oversimplified

calories in calories out

How energy balance is oversimplified and what to consider instead.

 

The ‘calories in, calories out’ model suggests that the number of calories consumed must equal the calories expended to maintain a stable weight and have good health. You have likely heard this before, and perhaps it even unknowingly has made you feel guilty for consuming a large meal or not feeling up for a workout. 

However, there are many points we want to highlight that make this statement grossly inaccurate and oversimplified. This infamous statement is so popularised by the pesky perils of diet culture, making it easy to forget all of the other factors that play a role in our health and wellbeing. 

You may have read our previous blogs on why calorie counting doesn’t serve you and how to stop calorie counting. Here are three reasons why there is MUCH more to the ‘calories in, calories out’ equation, and what you can think about instead:

 

Nutrients, not numbers 

Food is much more nuanced than we think. First, it’s important to remember that all food has some nutrition, and no food has zero nutritional value. So yes, a cookie may not seem like the ‘healthiest’ option out there – but it probably is packed full of satisfying carbohydrates, energy-boosting sugars, iron and B vitamins in the flour. 

When we break it down, a calorie is a universal unit of energy across all food and drink.

However, this doesn’t mean that calories from one food will give us the same amount of nutrition as it may from another – it’s important to consider the nutritional profile of the food too.

To offer an example, glucose and fructose are both sugars with similar calorific quantities but are metabolised and work in very different ways. They may have quite distinct effects on our blood sugar levels, insulin resistance, and cholesterol levels. (1)

Calories of differing sources may also affect our appetite differently. Consuming 200 calories worth of sweets may not fill us up as much as consuming 200 calories of lentils, for example. Simplifying foods to their calorific quantities denies the variation and diversity of foods and the importance of balance in one’s diet. (2)

 

Food is pleasurable, too

The ‘calories in, calories out’ agenda fails to acknowledge the fact that foods can and should be enjoyed for pleasure. Historically, and still to this day, food holds substantial cultural, social and emotional value. Eating can often be the theme of elaborate celebrations and festivities, and there are many celebrations each year where food is made and consumed in pretty large quantities. 

Thankfully (and conveniently,) the ‘calories in, calories out’ approach tends to be forgotten in these cases – and diet culture messages may take a break, kicking in in the media following a season change or New Year period.  

But perhaps taking this approach to everyday life may hold more value – why should we wait until a particular day of the year to eat freely and enjoy food? Food can be a crutch to people in a challenging time or life event. A specific flavour or dish may bring back memories of childhood, a vacation or a particular experience. And all of this deserves to be recognised and accepted!

 

Individual differences 

Another major point to remember is that as individuals, food and movement affects us all in different ways. According to the set point hypothesis, we all have an individual weight range and body type. With hunger and fullness hormones, ghrelin and leptin, working to maintain this, comparing ourselves to others may not be helpful. (3)

Energy balance is an equation that considers basic metabolism, digestion, thermogenesis and physical activity, however it fails to consider genetics, environmental factors among others. There are so many other fundamental components of this equation that we shouldn’t ignore.

Additionally, the potentially disempowering use of fitness tracking apps and devices such as a Fitbit or using MyFitnessPal to log our food intake also isn’t entirely accurate.

Fitness trackers often work with general averages and ask for little details about your health upon sign-up. Even food intakes measured by diet professionals themselves have been shown to be significantly inaccurate. (4)

Calorific differences can present according to variations in where food is grown, how it is processed, and the ways in which it is prepared and eaten – so again, they are averages. They don’t include every dish or ingredient on the planet, which can lead to a lot of guesswork and uncertainty.

So the next time diet culture tells you to ‘balance’ your calorie intake, remind yourself of all the reasons why this statement is too general and potentially damaging.

You’re doing an amazing job wherever you are on your journey, so please take this as a reminder to keep choosing recovery and shower yourself with some self-care and compassion today and every day!

 

Priya Chotai, BSc ANutr

EHL Team x 

 

References:

  1. Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010 Sep;110(9):1307-21. doi: 10.1016/j.jada.2010.06.008. PMID: 20800122.
  2. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 2009;119(5):1322-1334. doi:10.1172/JCI37385
  3. Soares M, Cummings N, Ping-Delfos W. Energy metabolism and the metabolic syndrome: Does a lower basal metabolic rate signal recovery following weight loss?. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2011;5(2):98-101.
  4. Champagne CM, Bray GA, Kurtz AA, Monteiro JB, Tucker E, Volaufova J, Delany JP. Energy intake and energy expenditure: a controlled study comparing dietitians and non-dietitians. J Am Diet Assoc. 2002 Oct;102(10):1428-32. doi: 10.1016/s0002-8223(02)90316-0. PMID: 12396160.