We have updated our Privacy Policy and Terms and Conditions. By using this website, you consent to our Terms and Conditions.


Body Image and the Development of Eating Disorders

Adolescence is a time of great change in everyone’s life. As a person beings to develop from a child into an adult, there are major changes in their physical state, their psychology, and the way they perceive their body. These changes can carry a risk, however. Eating disorders most commonly begin during late adolescence and early adulthood, when a person’s body and body image are still developing. Please note that eating disorders can happen at any time – although the statistics indicate that they begin between the age of 16 and 23, they have been observed in children as young as 7 and well into middle age.

A teenager’s body image is a huge concern for many families, and with good reason.  As children enter adolescence, they go through several different physical and emotional changes. Most often, negative body image in adolescence is a telling first symptom in the development of an eating disorder, although a distorted or unrealistically negative body image does not necessarily lead to disordered eating. Most experts, though, agree that eating disorders and body image are inextricably linked. So how are the development of common eating disorders and body image in teenagers related to each other?

What Is Body Image and How Does It Affect Teenagers?

Body image is the way people perceive their bodies, which can be distorted in many cases. People with body dysmorphia (AKA distorted body image) may imagine flaws or that they’re overweight despite evidence to the contrary. Note that “overweight” is a medical term here; societal expectations are a different concern. When a child is beginning to understand their place in the world as a burgeoning adult, they take their cues from their parents, their peers, and often, media presentations. All these can lead to both dissatisfaction and distorted perception of their weight and attractiveness.

Body image in teenagers is especially complex in that adolescents’ bodies and self-image change so rapidly. The way that teens see themselves and their bodies can have an impact on their general health, mental state, and relationships as well. A well-adjusted body image in teenage girls and boys means that they can objectively see their positive as well as negative qualities as regards their physical appearance, and that allows them a chance to avoid slipping into harmful behaviors as a way to counteract imagined flaws.

The Impact of Negative Body Image

Negative body image in teenagers is usually characterized by an overall dissatisfaction with their appearance. They will often engage in behaviors to counteract this negative body image such as frequent dieting and excessive exercise. Especially when encouraged to y their parents, developing adolescents can put undue stress on losing weight, which is potentially unhealthy as their bodies and personalities are still developing.

The results from NEDA studies show that up to 50 percent of pre-teen girls and 30 percent of pre-teen boys admit to disliking their bodies. As age creeps up on them, body dissatisfaction increases; 60 percent of adult women and 40 percent of adult men have a negative body image. This dissatisfaction can lead to disordered eating; according to the DSM-V, anorexia nervosa, bulimia nervosa, and binge eating disorder all contain distorted body image as part of their diagnostic criteria. This isn’t to say negative body image always leads to eating disorders, but it is an important contributing factor in their development.

The Relationship Between Eating Disorders and Body Image Issues

Eating disorders (in particular anorexia nervosa) are more than going on a diet or trying to keep your weight down; they’re among the most dangerous kinds of mental health issues. Unfortunately, the exact causes have yet to be identified, with environment and genetics being the most likely. However, negative body image in teenagersis one potential contributor. Families need to keep in mind that negative body image is a good indicator of the development of eating disorders because the majority of people with an eating disorder place a high value on how their overall body shape and weight are perceived.

An obsession with body shape and weight is a symptom of many common eating disorders like anorexia nervosa and bulimia nervosa. For example, a diagnosis of anorexia nervosa usually means that an individual restricts how much they eat because of the way they perceive their body weight or shape. Additionally, anorexia nervosa usually results in extreme weight loss, even though the individual with the disorder continue to see themselves as overweight. Bulimia nervosa often has similar causation, although the behavioral symptoms are different.

Therapy for Negative Body Image

With a greater understanding of the impact that body image has o behaviors in past decades, a variety of mental health treatments have been developed and can be applied to treating both negative body image and eating disorders. In most eating disorder treatment facilities, behavioral changes and weight recovery, are physically necessary and even lifesaving, while psychological recovery is addressed after the client is stabilized or in outpatient treatment.

Some of the most common and effective treatment options for negative body image with eating disorders include:

  • Cognitive-Behavioral Therapy
  • Nutritional education
  • Peer Group Therapy
  • Understanding Media Imagery
  • Trauma-informed Therapy
  • Mindful Movement

Eating disorder treatment has levels of care applicable to a variety of client needs. The most intensive is residential care. This is recommended for severe cases where less restrictive attempts have not been successful and for ones in which constant medical care is needed. Residential care usually begins at 30 days but can extend longer; during this time, the client’s daily routine focuses exclusively on therapy, nutrition, and recovery.

For other cases where a person cannot commit to this level of care or ones in which daily treatment is not needed, day treatment or outpatient care is recommended. It’s also useful for step-down care and relapse prevention after a person has completed residential treatment. The therapy in day treatment is usually the same as in residential care; a combination of behavioral therapy, group therapy, nutrition and meal planning, and mindful movement is the norm. Day treatment is available in-person. Increasingly, in virtual or telehealth settings.

Self-Acceptance and Avoiding Weight Biases

Body image distortions lead to a person becoming overly critical of their weight, which may lead to disordered behaviors. People with negative body image and their families must learn to accept their weight and understand their disordered thoughts to effectively manage the disorder and restore a healthier life. Some of the prominent ways families can work together to prevent negative thoughts and feelings surrounding body image are to avoid certain self-defeating practices. These include:

  • Compulsive exercise
  • Weighing
  • Spending too much time in the mirror
  • Over-shopping for clothing

It can help to supplement these practices with body-accepting activities such as yoga, dance classes, listening to music and regular pleasure walks. Activities that allow a person to live in the moment and rationally understand their disordered urges without acting on them are paramount.

Negative body image or warped self-image in teenagers is a symptom of growing eating disorders – but they can be halted.  Reach out to an eating disorder treatment facility near you if you are worried about your son or daughter – you can stop eating disorders before they start.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.