Consensus-Based Recommendations for Yoga as Adjunct Therapy in Eating Disorder Treatment: A Delphi Study.
Eleanor Trethewey, Subhadra Evans, Shane Mciver, Michael De Manincor, Janani Janakiraman, Arvind V Iyer, Melissa O'Shea
The International journal of eating disorders June 1, 2025 DOI: 10.1002/eat.24420 via PubMed
Summary
Experts in eating disorders and yoga instructors agreed on key considerations for safely and therapeutically applying yoga to anorexia nervosa, bulimia nervosa, and binge-eating disorder. Using a two-round modified Delphi technique, 12 clinicians and 16 yoga instructors (with 10 and 13 completing the second round) rated the importance of yoga components such as style, frequency, duration, environment, safety precautions, language, instructor qualifications, postures, breathwork, and meditation. General recommendations were organized into six core areas: yoga style, environmental factors, dosage, language and expression, the instructor's role, and integration into treatment. Technique-specific recommendations addressed postures, breathwork, and meditation across the eating disorder spectrum. The findings emphasize trauma-informed, individualized approaches and highlight the need for further research to develop comprehensive guidelines.
Study at a glance
| Characteristics | Modified Delphi technique Peer reviewed |
|---|---|
| Sample size | 28 |
| Population | Eating disorder clinicians and yoga instructors |
| Keywords | Anorexia nervosa Binge‐eating disorder Bulimia nervosa Consensus‐based statements Eating disorders |
| Citations | 1 |
| Key finding | Consensus-based statements were developed for transdiagnostic and disorder-specific application of yoga in eating disorder treatment, emphasizing trauma-informed, individualized approaches and covering six core areas and technique-specific recommendations. |
Abstract
This study aimed to develop consensus-based statements, combining the expertise of eating disorder (ED) clinicians and yoga instructors, on key considerations for applying yoga for individuals with anorexia nervosa, bulimia nervosa, and binge-eating disorder. A two-round modified Delphi technique was conducted via an online survey platform. Participants rated the importance of various yoga components to ensure the safety and therapeutic usefulness of yoga for the EDs. Survey items covered key aspects of yoga, including style, frequency, duration, environmental factors, safety precautions (e.g., medical monitoring), language and expression, instructor qualifications, postures, breathwork, and meditation practices. A total of 12 ED clinicians and 16 yoga instructors participated in the first round, with 10 clinicians and 13 instructors completing the second round. General recommendations were developed for both the transdiagnostic and disorder-specific application of yoga. These were organized into six core areas: yoga style, environmental factors, dosage, language and expression, the instructor's role, and the integration of yoga into ED treatment. Additionally, the yoga panel provided technique-specific recommendations addressing postures, breathwork, and meditation practices for both transdiagnostic and disorder-specific application across the ED spectrum. This study offers preliminary recommendations for integrating yoga into ED treatment through developing consensus-based statements. The findings emphasize both transdiagnostic and disorder-specific considerations for EDs, while highlighting the importance of trauma-informed, individualized approaches. Further research is needed to develop comprehensive guidelines for the therapeutic use of yoga in eating disorder treatment.