How Yoga Can Help With Your Long-Term Weight Loss Goals
Researcher Jessica Unicke discusses the benefits of yoga as a strategy for long-term weight-loss.
By Mark Travers, Ph.D. | March 10, 2022
To better understand the results, I recently spoke to researcher Jessica Unicke from the Department of Psychiatry and Human Behavior at Brown University in the United States. Here is a summary of our conversation.
What inspired you to investigate the topic of yoga and its relevance as a long-term weight-loss intervention?
Several years ago I decided to try yoga for the first time. I am a tennis player and was looking to increase my flexibility and strength. However, the more I practiced yoga, I began to notice how relaxed I would feel after each class and how I was more mindful of how I was feeling throughout the day (these were unexpected benefits!). More interestingly, as I talked with others within the class, I heard story after story about how yoga had literally changed people's lives. It was interesting to me how skills practiced within yoga class so easily translated to life 'off the mat.'
Being a weight-loss researcher, it piqued my interest into the role of yoga for individuals seeking to lose weight.
Surprisingly, when I reviewed the literature in this area, there weren't any prior studies that tested the combined effect of yoga and behavioral weight loss treatment. My theory as to why this was the case is because weight loss researchers tend to focus on the calories burned during exercise, and thus have overlooked yoga as an approach for improving long-term weight loss because most forms of yoga have a lower calorie expenditure compared to traditional aerobic exercise.
However, this viewpoint overlooks the psychological benefits of yoga and how these psychological changes can assist with weight loss. In other disciplines, yoga is viewed as a mind-body intervention and has been shown to effectively treat depression, cardiovascular disease risk factors, pain syndromes, autoimmune conditions, and assist with smoking cessation. This led me to want to investigate the mind-body effects of yoga within the context of weight management.
How did you study yoga within the context of weight management and what did you find?
In our study, we were interested in examining the effect of a 12-week yoga program, following 12 weeks of behavioral weight loss among overweight or obese women. Specifically, we were interested in whether individuals would attend yoga sessions, whether they would enjoy yoga, and how yoga impacted other psychological factors (e.g., stress, mindfulness, distress tolerance), eating behaviors (e.g., overeating, ability to resist dietary temptations, etc), and body weight.
Sixty women were enrolled in this study and were randomly assigned to receive either yoga or cooking/dietary education classes, which served as a 'control' comparison condition. Individuals couldn't choose which group they wanted to be in, rather it was determined by a method similar to flipping a coin.
We found that attendance at yoga classes was high (75% of all classes attended) and similar to the cooking/nutrition classes. Participants also reported enjoying the yoga program, being highly satisfied with the yoga program, and glad that they were assigned to the yoga condition. While we had too few individuals to properly examine the effects of yoga on psychological factors and body weight, our preliminary data suggest that for individuals who lost a significant amount of weight during the 12-week weight loss program (>5% of initial body weight lost), those in the yoga group lost an additional 3.5% of their body weight and had greater improvements in many psychological measures (e.g., distress tolerance, mindfulness, self-compassion, and mood), relative to the control condition.
Those who lost less weight during the initial weight loss program (<5%) had no added benefit of yoga. However, a larger study is needed to confirm these findings and to better understand why yoga may be effective for some individuals but not for others. We are also currently in the process of analyzing data related to differences in eating behaviors between groups.
Can you give a brief description of perceived stress, dispositional mindfulness, and distress tolerance and how these factors are related to long-term weight-loss?
In our study, we used questionnaires to assess the effect of yoga on several psychological factors. We included a questionnaire to assess perceived stress, or how stressful individuals perceive their life to be. This was of interest to us given previous research which shows that higher levels of stress are associated with higher body weight and more 'unhealthy' eating behaviors, and that yoga can reduce stress.
We also assessed dispositional mindfulness which assesses one's ability to pay attention to their present-moment experiences with an open and nonjudgemental attitude. This was of interest because it is common for individuals to 'mindlessly' eat in response to emotions (e.g., boredom, stress, anger, etc), rather than eating because one is hungry. Frequent emotional or mindless eating could lead to less weight loss; therefore, if yoga could increase mindfulness, it could reduce one's automatic response to eat when faced with various emotions.
Finally, we assessed distress tolerance, or an individual's capacity to withstand negative emotional and/or other aversive states (e.g., physical discomfort). Increased distress tolerance could lead to an improved ability to resist cravings or dietary temptations and ultimately lead to fewer dietary lapses.
Your research talks about unsuccessful long-term weight loss resulting from both physiological adaptations favoring weight regain, and poor long-term behavioral adherence to dietary and physical activity regimens. What are some real-life manifestations of these behaviors?
Unfortunately, many individuals who lose weight go on to regain the weight they previously lost. While reasons for weight regain are extremely complex and not universal across individuals, we know that there are both biological and behavioral factors that can contribute to weight regain. For example, hormonal and neural changes occur in our bodies as a result of weight loss. This can lead to an increase in appetite, it can make our body more efficient (i.e., we burn fewer calories), and it can make food more rewarding (i.e., greater preference for highly palatable foods).
Behaviorally, long-term weight loss success often requires individuals to remain diligent to important weight-related behaviors (e.g., continued high levels of exercise and careful monitoring of calorie intake). As you may imagine, staying motivated to stick with these behaviors long-term can be challenging, especially when weight loss begins to slow and the perceived costs of adherence gradually exceed the perceived benefits. This is why we are interested in the psychological benefits of yoga, as we believe that this may help individuals overcome some of the behavioral challenges necessary for successful long-term weight loss.
What are the practical takeaways from your research for someone seeking long-term weight loss?
We know from previous research that frequent dietary lapses can lead to weight regain and that those who are successful at keeping weight off long-term have an improved ability to manage thoughts, emotions, and behaviors which can reduce the frequency of dietary lapses.
While our findings are preliminary, our data suggest that after a period of successful weight loss, practicing yoga twice per week may help improve mood and enhance skills which are important for regulating emotions and reducing lapses (e.g., increased self-compassion, increased ability to persist with important behaviors even when it is uncomfortable, and greater awareness of internal thoughts and feelings which could overcome lapses in weight control practices).
Yoga practice over 12 weeks also led to continued weight loss during this time and we suspect that it is likely because of these above-mentioned improvements in emotion regulation skills. Most individuals in our study also had never practiced yoga before and many were unsure whether they would like it.
Despite this, our study found that women seeking weight loss greatly enjoyed yoga, they were willing to engage in yoga classes, and they experienced many benefits from practicing yoga. Therefore, my advice for individuals who have lost weight and are looking to keep the weight loss long-term would be to remain mindful of their dietary behaviors and give yoga a try! You may enjoy it more than you expected and you may find that the skills practiced during yoga assist with sticking to important weight control behaviors.
Did something unexpected emerge from your research? Something beyond what you hypothesized?
Our study was designed to assess in-person, group-based yoga classes within the context of weight loss treatment. However, as a result of the Covid-19 pandemic, we were forced to conduct group yoga classes online (delivered via videoconferencing software) for our second cohort of study participants. This provided us with the unique opportunity to compare attendance and satisfaction ratings for in-person yoga classes (cohort 1) with online yoga classes (cohort 2). Interestingly, attendance for online yoga classes was higher than attendance for in-person classes (90% vs. 70% of classes attended) and program satisfaction ratings were similar between in-person and online formats.
Participants attending the online classes stated liking these classes because they were convenient, they did not require a commute, and there was no need to rush to a facility and deal with traffic.
In our minds, this was a very important and interesting finding given that these two formats of yoga delivery had never been examined within the context of weight management and also because they suggest promise for using online yoga classes within the context of weight loss programs. This would eliminate many barriers to yoga participation and also allow more individuals to enroll in these types of programs.
How important are efforts to implement remote weight-loss and well-being practices such as yoga for increasing participant accessibility and commitment to these programs?
In the past, only individuals who live close to universities or research centers have been able to participate in weight loss trials; thus limiting the generalizability of study findings. However, offering remote-based programs which combine yoga and weight loss treatment can reduce cost, improve diversity (i.e., enrollment is not limited to specific geographical regions), and minimize other barriers common to in-person treatment (e.g., time to travel, traffic/parking, lack of childcare).
Further, as a result of the Covid-19 pandemic, more individuals have become accustomed to meetings via videoconferencing software or telehealth appointments. In fact, early data suggest that many individuals prefer online healthcare interventions over in-person interventions. For these reasons, it is important that research continues to move in the direction of remote-delivered interventions so that more individuals seeking to lose weight can have access to these types of programs.
Do you have plans for follow-up research? If so, where do you see your research heading in the future?
We plan to continue to seek funding to do yoga and weight loss research, particularly given our promising initial findings and the fact that few studies have assessed yoga as a weight management tool. We believe that there is a great need for high-quality studies in this area.
Specifically, we are interested in continuing to explore the combined effect of yoga and behavioral weight loss treatment in a larger and more diverse sample of individuals and also examine whether the effects of yoga can be sustained over longer periods of time. We also have great interest in examining for whom yoga is most effective and exploring mechanisms through which yoga may impact body weight, as these mechanisms are not fully understood. Finally, we want to design effective programs which would allow a greater number of individuals to participate; thus we are highly interested in combining and testing remote-based yoga and weight loss programs.