Annie B. Kay, MS, RD, LDN, RYT
© 2005 Wolf Rinke Associates, Inc. All rights reserved for this self-directed learning program. Reproduction in whole or part without written permission from the publisher prohibited.
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Customer Comments
Robin Serig: "Great course with good approaches to promote introspection while working on self change."
Jenness Keller: "Very informative, multi-faceted and interesting"
Bonnie Gene Morris: "Well researched. Good application for counseling"
Keith Reilly: "I was pleased with the depth of information--I was already familiar with the subject of yoga and I thought it was very well presented."
Karen Bargmann: "Unique & interesting. I especially appreciated the discussion of the psychopathology of disordered eating."
Dawn DeSoto: "I loved this case study course on Yoga, Meditation & Weight Loss. I think it is the missing link in traditional weight loss programs."
Sharron Dalton: "I teach a graduate course in Weight Management; this
course provides a great example of approaching weight control from a "whole
health" perspective, supported by evidence."
Table of Contents
Acknowledgement……………………………………………………………
v
Introduction…………………………………………………………………….
vii
Program Overview……………………………………………………......
vii
Tools to Aid Experiential Learning……………..……..............................
viii
Program Objectives……………………………………………….……...
xi
Chapter One
The Obesity Epidemic ………………..……………..….…………………….
1
National Trends and Statistics……………………………………………
1
National Nutrition and Physical Activity Recommendations……….……
5
A Super-sized Energy Surplus: Food Consumption and Physical Activity Trends……………………………………………………………………..
11
Indicators for the Obesity Epidemic ………………………………………
16
Assessment of Weight Status…..……………………………………...…..
19
Implications for the Individual………………………………………….…
20
References…………………………………………………………………
22
Chapter Two
The Collision of Culture and Biology: Consumerism and the
Psychopathology of Disordered Eating ……..............................................
25
The Business of Food……………………………………………………..
25
The Psychopathology of Disordered Eating……………………………….
31
The Psychopathology of Obesity………………………………………….
34
The Role of Stress in Body Weight……………………………………..…
35
Implications for the Individual………………………………………..…..
39
References…………………………………………………………………
40
Chapter Three
Yoga and Meditation: An Overview ………………………………………...
43
What is Yoga?…….……………………………………………………….
43
Yoga History………………………………………………………………
44
Yoga Philosophy……………………………………………………….…
44
Yoga Psychology…………………………………………………………
47
What is Meditation?……………………………………………………….
49
How Yoga and Meditation Aid Weight Management…………………….
50
References………………………………………………………………….
52
Chapter Four
Self-Discovery: Exploring Lifestyle Choices……….…..............................
53
Self-Assessing Diet and Lifestyle…………………………………………
53
Fostering Personal Discovery and Growth ……………………………….
61
Yoga and Meditation Exercises for Self-Discovery………………………
65
References…………………………………………………………………
74
Chapter Five
Awareness: Personalizing Goals and Plans………………………………
75
Tools for Guiding Individual Diet and Lifestyle Plans…………………….
77
Internal Awareness as a Tool to Explore Emotional Eating……………......
77
Yoga and Meditation Exercises for Body Awareness………………….…
84
References………………………………………………………………..
89
Chapter Six
Change: The Art and Science of Transformation………………………..
91
An Overview of Behavior Change Theory………………………………..
91
Individual Behavior Change Strategies……………………………………
96
Fostering Transformation and Self-Expression…………………………...
101
Yoga and Meditation Tools for Exploring Change……………………….
101
References…………………………………………………………………
108
Chapter Seven
Balance: An East-West View of Moderation ………………………………
109
What is Moderation?.………………………………………………………
109
Yogic Moderation: Standing in the Fire……………………………………
110
Teaching and Fostering Moderation: Insights for Practitioners…………...
111
Yoga and Meditation Tools for Exploring Moderation……………………
113
References………………………………………………………………….
120
Chapter Eight
Connection: Relationship and Renewal…………………………………….
121
The Role of Relationships in Physical and Emotional Health……………..
121
Developing Communities of Support………………………………………
123
Detoxification for Physical and Emotional Health………………………...
125
The Spice of Challenge and Self-Study……………………………………
127
Finding a Yoga Teacher, Finding a Therapist……………………………..
128
Yoga and Meditation Tools for Exploring Relationship…………………..
128
References…………………………………………………………………
134
Case Study……………………………………………………………………..
135
Resources………………………………………………………………………
141
Self-Assessment Questions…………………………………………………
145
Answer Key ……………………………………………………………………
155
Answer Key Explanations ……………………………………………………
157
About the Author………………………………………………………………
163
Introduction
Program Overview
Over the past 20 years, health professionals and population-watchers have observed
a weight phenomenon unprecedented in recorded history. The explosive increase
in individuals who are overweight, obese, and extremely obese may provide nutrition
professionals both the greatest challenge and the greatest opportunity of their
professional careers.
Due to the complex nature of obesity, individual response to a specific weight
management strategy may vary widely. For that reason, the development of a broad
spectrum of approaches may best serve the growing overweight population.
The blending of a science-driven approach to weight management with the complimentary
therapies of yoga and meditation may be a beneficial option for many. This self-directed
continuing education program will provide you with the basic principles of this
approach, a review of its scientific basis, and areas where further investigation
is warranted. Specific guidelines and exercises will enable you to incorporate
these Eastern spiritual modalities into your current treatment protocols.
This program begins with an overview of the trends underlying the modern weight
phenomenon: data on obesity, food consumption and physical activity trends,
and economic and political trends within the food supply which undermine normal
weight. The success of the Western market-based consumer culture has shaped
our society and perhaps our bodies to a vast degree. The role of consumerism
in eating behaviors and self-perception norms will be examined in regard to
the obesity epidemic. The psychopathology of disordered eating and the role
of stress in the lives of overweight individuals amplify the effects of consumerism.
Changes in family structure, work, and other aspects of modern society seem
to synergize to undermine the maintenance of healthy body weight.
Yoga is an ancient spiritual science thought to have begun in India over five
millennia ago. Like many alternative health practices, it is mired in an overstatement
of its benefits by its proponents, an overzealous debunking by its critics,
and a certain mystic aura by many of its practitioners. This program will provide
an overview of the history, philosophy and possible physiological implications
of a yoga and meditation practice. Benefits and limitations of these practices
will be reviewed and discussed from a practical and scientific perspective.
The process of nutrition assessment, goal setting and monitoring is familiar
to practitioners in the field. In this program yogic principles will be incorporated
into standard methods for dietary change. An overview of the science of behavior
change as it pertains to this process will be presented as well. Eastern and
Western health paradigms for weight management will be presented and combined.
Various aspects of weight management including the analysis of family and community
relationships, and of motivation and resistance, will be discussed in the context
of yoga.
Tools to Aid Experiential Learning
Meditation and yoga are experiential practices. An understanding of the principles
and benefits of these modalities cannot be fully understood without personal
experience of the process. Mastery and the ability to teach yoga come with daily
personal practice. Likewise, skillful communication and incorporation of these
practices into weight management protocols is difficult if not impossible to
undertake without the insight provided by personal experience. For this reason
it is highly recommended that nutrition practitioners undertake at least some
yoga study to determine the validity of the approach, especially prior to utilizing
yoga in their own work.
There are many styles of yoga, and teachers bring with them their own training,
personal insights and limitations. Some styles such as Kripalu, Kundalini, Anusara
and softer Hatha styles may be more appropriate for the physical and psycho-spiritual
approach described in this program. While Astanga, Bikrim and Power Yoga styles
can embody the elements of yoga philosophy and practice, their physically demanding
nature can be intimidating and injury-inducing for beginners, particularly for
those unaccustomed to regular physical activity. Skilled and compassionate teachers
exist in all yoga styles. But with yoga's explosion in popularity and with national
certification and professional standards in their infancy, there are many yoga
teachers who lack the skills and experience to safely and effectively lead a
class. Let the yoga practitioner beware.
One of the benefits of yoga is its practice of introspection. During this program,
it is recommended that nutrition practitioners participate in the exercises
to develop their self-knowledge regarding their physical and emotional landscape
and to deepen their understanding of the process of internalization. The practice
of journaling, that is, free-writing thoughts, insights, ideas and reactions
to the process within the context of the nutrition practitioner's own life,
may be useful.
This self-directed learning program is a Category 2 Continuing Professional
Education (CPE) program approved for 14 Continuing Professional Education Units
(CPEUs), meaning that the reader has general knowledge of the literature and
professional practice within the area covered. The focus of the program is to
enhance knowledge and application.
To get the most benefit from this program, I suggest that you follow these four
steps:
· Step 1: Review the objectives for the program.
· Step 2: Study each chapter. As you read, think of patients or clients
from your own practice who fit the situation described.
· Step 3: Assess what you have learned by completing the self-assessment
instrument at the end of this program.
· Step 4: Compare your answers to the answer key that has been provided.
If you score at least 80 percent correct, you are ready to transfer your answers
to the CONTINUING PROFESSIONAL EDUCATION (CPE) REPORTING FORM. If you scored
less than 80 percent correct, re-read this learning program until you score
at least 80 percent correct.
After you have successfully completed this program, mail or fax the completed
CPE REPORTING FORM to:
Wolf Rinke Associates, Inc. P.O. Box 350 Clarksville, MD 21029 Fax: (410) 531-9282
Program Objectives
Upon successful completion of this learning program, you will be able to:
· Identify the national trends underlying the obesity epidemic.
· Assess an individual's weight status.
· Identify societal, cultural and psychological factors that influence
eating and body weight.
· Describe the underlying principles, philosophy and scientific literature
on the practices of yoga and meditation, and how these practices may aid behavior
change and weight management.
· Develop individual weight management plans combining diet and yoga.
· Discuss various behavior change theories and provide examples.
· Assess an individual's readiness to change.
· Perform exercises to enhance body awareness.
· Perform exercises to explore moderation.
· Perform exercises to explore relationships.
· Perform exercises to explore renewal.
About the Author
Annie Kay, MS, RD, RYT, is a registered dietitian, registered yoga teacher and
Principal of Sage Health Education & Communications on Nantucket Island,
MA. She received a BS in Nutritional Biochemistry at Cornell University ('83)
and an MS in Nutrition Communications from Boston University ('86). She is the
former director of the Osteoporosis Awareness Program, a national model chronic
disease prevention program at the MA Department of Public Health, and was an
outpatient dietitian at Boston Medical Center specializing in nutrition for
cancer, HIV/AIDS, prenatal care, and chronic disease prevention. She was a manager
of education for the Nutritional Restart Center, a clinic serving individuals
with severe malabsorptive disorders. She is currently the Director of Nantucket
Nutrition Action, a community-based wellness program serving island seniors,
children, and the economically underserved. She is an instructor at The Yoga
Room on Nantucket. Ms. Kay has written for national publications such as Cooking
Light Magazine and Yahoo.com, and for organizations including Boston Scientific
and the National Osteoporosis Foundation. She has spoken widely on women's health
and chronic disease prevention, and conducts workshops for practitioners and
professionals on combining yoga and nutrition. Annie Kay lives on Nantucket
Island with her husband Craig and her cat, Rahu. She is a sometime chef, poet,
and gardener.
PO Box 1377
Nantucket, MA 02554
(508)228-6961
www.sagehealth.net