Disordered eating behaviours and correlates in yoga practitioners: a systematic review

  • Rita B. DominguesEmail author
  • Cláudia Carmo
Review Article
Part of the following topical collections:
  1. Orthorexia Nervosa



Yoga has been increasingly used as a complementary therapy for eating disorders. However, it is still not clear whether yoga is effective in the prevention and treatment of eating disorders, as some studies suggest that yoga practitioners show elevated levels of disordered eating behaviours. The goal of this systematic review is, thus, to analyse the occurrence of disordered eating behaviours and correlates in yoga practitioners.


PRISMA guidelines for systematic reviews were used. Search was conducted in several databases and specific journals.


Twelve articles, all cross-sectional, were identified, following PRISMA guidelines. Results across studies were inconsistent. Yoga practice was usually associated with healthier eating behaviours, lower disordered eating symptoms, and higher positive body image and body satisfaction, suggesting that yoga practitioners may be at a lower risk of developing eating disorders. However, other studies suggested that a high dosage of yoga practice may be associated with a higher prevalence of disordered eating behaviours.


As yoga is increasingly used as therapy for eating disorders, understanding the relationship between yoga dosage and disordered eating behaviours is critical to guide treatment recommendations and establish yoga as a valuable complementary therapy.

Level of evidence

Level I, systematic review.


Eating disorders Yoga Therapy Risk factors Orthorexia 



The Portuguese Foundation for Science and Technology (FCT) provided funding for R.B.D. through a researcher contract (DL57/2016). We thank the editor and anonymous reviewers whose comments have greatly improved this manuscript.

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


  1. 1.
    Saraswati SS (1976) Four chapters on freedom: commentary on the yoga sutras of sage Patanjali. Yoga Publications Trust, BiharGoogle Scholar
  2. 2.
    Singleton M (2010) Yoga body: the origins of modern posture practice. Oxford University Press, OxfordCrossRefGoogle Scholar
  3. 3.
    De Michelis E (2007) A preliminary survey of modern yoga studies. Asian Med 3:1–19. CrossRefGoogle Scholar
  4. 4.
    Domingues RB (2018) Modern postural yoga as a mental health promoting tool: a systematic review. Complement Ther Clin Pract 31:248–255. CrossRefPubMedGoogle Scholar
  5. 5.
    De Michelis E (2005) A history of modern yoga. Continuum, LondonGoogle Scholar
  6. 6.
    Field T (2016) Yoga research review. Complement Ther Clin Pract 24:145–161. CrossRefPubMedGoogle Scholar
  7. 7.
    Khalsa SBS (2013) Yoga for psychiatry and mental health: an ancient practice with modern relevance. Indian J Psychiatry 55:334–336Google Scholar
  8. 8.
    Büssing A, Michalsen A, Khalsa SBS et al (2012) Effects of yoga on mental and physical health: a short summary of reviews. Evid Based Complement Altern Med 25:25. CrossRefGoogle Scholar
  9. 9.
    Jeter PE, Slutsky J, Singh N, Khalsa SBS (2015) Yoga as a therapeutic intervention: a bibliometric analysis of published research studies from 1967 to 2013. J Altern Complement Med 21:586–592. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    McCall MM (2014) In search of yoga: research trends in a western medical database. Int J Yoga 7:4–8CrossRefGoogle Scholar
  11. 11.
    Gable SL, Haidt J (2005) What (and why) is positive psychology? Rev Gen Psychol 9:103–110. CrossRefGoogle Scholar
  12. 12.
    Hendriks T, de Jong J, Cramer H (2017) The effects of yoga on positive mental health among healthy adults: a systematic review and meta-analysis. J Altern Complement Med 23:505–517. CrossRefPubMedGoogle Scholar
  13. 13.
    Boudette R (2006) Question and answer: yoga in the treatment of disordered eating and body image disturbance: how can the practice of yoga be helpful in recovery from an eating disorder? Eat Disord 14:167–170. CrossRefPubMedGoogle Scholar
  14. 14.
    Douglass L (2009) Yoga as an intervention in the treatment of eating disorders: does it help? Eat Disord 17:126–139. CrossRefPubMedGoogle Scholar
  15. 15.
    Neumark-Sztainer D, Eisenberg ME, Wall M, Loth KA (2011) Yoga and pilates: associations with body image and disordered-eating behaviors in a population-based sample of young adults. Int J Eat Disord 44:276–280. CrossRefPubMedGoogle Scholar
  16. 16.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, ArlingtonCrossRefGoogle Scholar
  17. 17.
    Bratman S (2017) Orthorexia vs. theories of healthy eating. Eat Weight Disord 22:381–385. CrossRefPubMedGoogle Scholar
  18. 18.
    Cook-Cottone C (2015) Incorporating positive body image into the treatment of eating disorders: a model for attunement and mindful self-care. Body Image 14:158–167. CrossRefPubMedGoogle Scholar
  19. 19.
    Cook-Cottone C, Beck M, Kane L (2008) Manualized-group treatment of eating disorders: attunement in mind, body, and relationship (AMBR). J Spec Gr Work 33:61–83. CrossRefGoogle Scholar
  20. 20.
    Klein J, Cook-Cottone C (2013) The effects of yoga on eating disorder symptoms and correlates: a review. Int J Yoga Therap 23:41–50Google Scholar
  21. 21.
    Cook-Cottone C (2013) Dosage as a critical variable in yoga therapy research. Int J Yoga Therap 23:11–12Google Scholar
  22. 22.
    Cowen VS, Adams TB (2005) Physical and perceptual benefits of yoga asana practice: results of a pilot study. J Bodyw Mov Ther 9:211–219CrossRefGoogle Scholar
  23. 23.
    Valera JH, Ruiz PA, Valdespino BR, Visioli F (2014) Prevalence of orthorexia nervosa among ashtanga yoga practitioners: a pilot study. Eat Weight Disord 19:469–472. CrossRefGoogle Scholar
  24. 24.
    Bratland-Sanda S, Nilsson MP, Sundgot-Borgen J (2015) Disordered eating behavior among group fitness instructors: a health-threatening secret? J Eat Disord 3:1–8. CrossRefGoogle Scholar
  25. 25.
    Carbonneau N, Vallerand RJ, Massicotte S (2010) Is the practice of yoga associated with positive outcomes? the role of passion. J Posit Psychol 5:452–465. CrossRefGoogle Scholar
  26. 26.
    Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Daubenmier JJ (2005) The relationship of yoga, body awareness, and body responsiveness to self-objectification and disordered eating. Psychol Women Q 29:207–219. CrossRefGoogle Scholar
  28. 28.
    Prichard I, Tiggemann M (2008) Relations among exercise type, self-objectification, and body image in the fitness centre environment: the role of reasons for exercise. Psychol Sport Exerc 9:855–866. CrossRefGoogle Scholar
  29. 29.
    Martin R, Prichard I, Hutchinson AD, Wilson C (2013) The role of body awareness and mindfulness in the relationship between exercise and eating behavior. J Sport Exerc Psychol 35:655–660. CrossRefPubMedGoogle Scholar
  30. 30.
    Watts AW, Rydell SA, Eisenberg ME et al (2018) Yoga’s potential for promoting healthy eating and physical activity behaviors among young adults: a mixed-methods study. Int J Behav Nutr Phys Act 15:1–11. CrossRefGoogle Scholar
  31. 31.
    Dittmann KA, Freedman MR (2009) Body awareness, eating attitudes, and spiritual beliefs of women practicing yoga. Eat Disord 17:273–292. CrossRefPubMedGoogle Scholar
  32. 32.
    Mahlo L, Tiggemann M (2016) Yoga and positive body image: a test of the embodiment model. Body Image 18:135–142. CrossRefPubMedGoogle Scholar
  33. 33.
    Delaney K, Anthis K (2010) Is women’s participation in different types of yoga classes associated with different levels of body awareness satisfaction? Int J Yoga Therap 20:28–37. CrossRefGoogle Scholar
  34. 34.
    Neumark-Sztainer D, MacLehose RF, Watts AW et al (2018) Yoga and body image: findings from a large population-based study of young adults. Body Image 24:69–75. CrossRefPubMedGoogle Scholar
  35. 35.
    Neumark-Sztainer D, Watts AW, Rydell S (2018) Yoga and body image: how do young adults practicing yoga describe its impact on their body image? Body Image 27:156–168. CrossRefPubMedGoogle Scholar
  36. 36.
    Le Grange D, Eisler I (1993) The link between anorexia nervosa and excessive exercise: a review. Eur Eat Disord Rev 1:100–119. CrossRefGoogle Scholar
  37. 37.
    Jois KP (2010) Yoga mala, 2nd edn. North Point Press, New YorkGoogle Scholar
  38. 38.
    Jarry JL, Chang FM, La Civita L (2017) Ashtanga yoga for psychological well-being: initial effectiveness study. Mindfulness (NY) 2012:1–11. CrossRefGoogle Scholar
  39. 39.
    Iyengar BKS (2015) Light on yoga: the definitive guide to yoga practice. Harper Thorsons, LondonGoogle Scholar
  40. 40.
    Mitchell KS, Mazzeo SE, Rausch SM, Cooke KL (2007) Innovative interventions for disordered eating: evaluating dissonance-based and yoga interventions. Int J Eat Disord 40:120–128. CrossRefPubMedGoogle Scholar
  41. 41.
    McIver S, O’Halloran P, McGartland M (2009) Yoga as a treatment for binge eating disorder: a preliminary study. Complement Ther Med 17:196–202. CrossRefPubMedGoogle Scholar
  42. 42.
    Carei TR, Fyfe-Johnson AL, Breuner CC, Brown MA (2010) Randomized controlled clinical trial of yoga in the treatment of eating disorders. J Adolesc Heal 46:346–351. CrossRefGoogle Scholar
  43. 43.
    Hall A, Ofei-Tenkorang N, Machan J, Gordon C (2016) Use of yoga in outpatient eating disorder treatment: a pilot study. J Eat Disord 4:38CrossRefGoogle Scholar
  44. 44.
    Cramer H, Sibbritt D, Park CL et al (2017) Is the practice of yoga or meditation associated with a healthy lifestyle? Results of a national cross-sectional survey of 28,695 Australian women. J Psychosom Res 101:104–109. CrossRefPubMedGoogle Scholar
  45. 45.
    Ross A, Friedmann E, Bevans M, Thomas S (2013) National survey of yoga practitioners: mental and physical health benefits. Complement Ther Med 21:313–323. CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Gannon S (2008) Yoga and vegetarianism: the diet of enlightenment. Mandala Publishing, San RafaelGoogle Scholar
  47. 47.
    Sweeney M (2005) Ashtanga yoga as it is. The Yoga Temple, TaiwanGoogle Scholar
  48. 48.
    Cramer H, Quinker D, Pilkington K et al (2019) Associations of yoga practice, health status, and health behavior among yoga practitioners in Germany—results of a national cross-sectional survey. Complement Ther Med 42:19–26. CrossRefPubMedGoogle Scholar
  49. 49.
    Bucchianeri MM, Fernandes N, Loth K et al (2016) Body dissatisfaction: do associations with disordered eating and psychological well-being differ across race/ethnicity in adolescent girls and boys? Cult Divers Ethn Minor Psychol 22:137–146. CrossRefGoogle Scholar
  50. 50.
    Stice E, Shaw HE (2002) Role of body dissatisfaction in the onset and maintenance of eating pathology: a synthesis of research findings. J Psychosom Res 53:985–993. CrossRefPubMedGoogle Scholar
  51. 51.
    Stice E, Marti CN, Durant S (2011) Risk factors for onset of eating disorders: evidence of multiple risk pathways from an 8-year prospective study. Behav Res Ther 49:622–627. CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Fredrickson BL, Roberts T-A (1997) Objectification theory. Psychol Women Q 21:173–206CrossRefGoogle Scholar
  53. 53.
    Schaefer LM, Thompson JK (2018) Self-objectification and disordered eating: A meta-analysis. Int J Eat Disord 1:20. CrossRefGoogle Scholar
  54. 54.
    Park CL, Riley KE, Braun TD (2016) Practitioners’ perceptions of yoga’s positive and negative effects: results of a National United States survey. J Bodyw Mov Ther 20:270–279. CrossRefPubMedGoogle Scholar
  55. 55.
    Bąk-Sosnowska M, Urban A (2017) Body image in women practicing yoga or other forms of fitness. Arch Psychiatry Psychother 19:58–68. CrossRefGoogle Scholar
  56. 56.
    Park CL, Braun T, Siegel T (2015) Who practices yoga? A systematic review of demographic, health-related, and psychosocial factors associated with yoga practice. J Behav Med 38:460–471. CrossRefPubMedGoogle Scholar
  57. 57.
    Birdee GS, Legedza AT, Saper RB et al (2008) Characteristics of yoga users: results of a national survey. J Gen Intern Med 23:1653–1658. CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Park CL, Riley KE, Bedesin E, Stewart VM (2014) Why practice yoga? Practitioners’ motivations for adopting and maintaining yoga practice. J Health Psychol 17:161–171. CrossRefGoogle Scholar
  59. 59.
    Donini LM, Marsili D, Graziani MP et al (2004) Orthorexia nervosa: a preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eat Weight Disord 9:151–157. CrossRefPubMedGoogle Scholar
  60. 60.
    Moller S, Apputhurai P, Knowles SR (2018) Confirmatory factor analyses of the ORTO 15-, 11- and 9-item scales and recommendations for suggested cut-off scores. Eat Weight Disord 24:1–8. CrossRefGoogle Scholar
  61. 61.
    Missbach B, Hinterbuchinger B, Dreiseitl V et al (2015) When eating right, is measured wrong! A validation and critical examination of the ORTO-15 questionnaire in German. PLoS One 10:1–15. CrossRefGoogle Scholar
  62. 62.
    Missbach B, Dunn TM, König JS (2017) We need new tools to assess orthorexia nervosa. a commentary on “prevalence of orthorexia nervosa among college students based on bratman’s test and associated tendencies”. Appetite 108:521–524. CrossRefPubMedGoogle Scholar
  63. 63.
    Heiss S, Coffino JA, Hormes JM (2019) What does the ORTO-15 measure? Assessing the construct validity of a common orthorexia nervosa questionnaire in a meat avoiding sample. Appetite 135:93–99. CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Centre for Marine and Environmental Research (CIMA)University of Algarve, Campus de GambelasFaroPortugal
  2. 2.Research Centre in Psychology (CIP)University of Algarve, Campus de GambelasFaroPortugal

Personalised recommendations