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Taking a Look at How Eating Disorders and Body Image Are Connected – and Some Ways They Aren’t

From childhood through adolescence all the way to old age, our self-awareness is a key factor in how we relate to ourselves and the world. Indeed, it’s a key part of how we understand the world. A major component of our self-awareness is how we perceive our bodies – otherwise known as body image. Body image affects our self-worth, self-esteem, our sense of attractiveness, and all too often, our happiness.

Body image doesn’t spring entirely from within. It’s also greatly influenced by outside factors – these might include societal values, the influence of our parents, and how the media presents “ideal” bodies. Unfortunately, these influences often (some would say almost always) result in friction between a person’s self-image and what they perceive as being expected of them. In some instances, this can lead to drastic attempts to control their bodies, often in the form of trying to lose weight.

If a person’s self-perception becomes negative or otherwise distorted, the consequences can be severe – including the development of common eating disorders such as anorexia nervosa, bulimia nervosa, binge eating disorder, and others. People who are worried that they or a loved one is developing a negative body image may feel some trepidation about broaching the subject – it’s a difficult discussion to have, to be sure. Distorted body image may not even be perceptible to the individual in question, placing the burden on others to bring up the topic. However, they are essential subjects to talk about – those resulting eating disorders can be negatively impactful (and even fatal) if left unchecked.

What Is Body Image?

The basic definition (absent the many complexities to come with it) is that body image is how a person thinks about and perceives their body. Often, what a person sees as the “perfect” body doesn’t match or even come close to what their body looks like – or how they perceive it. This gap between ideal and reality might spur feelings of inadequacy and dissatisfaction. A negative body image means that an individual is generally unhappy with how they look. Many things can cause a person to feel negative about their body; not enough muscles, too many muscles, too skinny, too light, too many pimples, etc. On the other hand, a positive body image in a person usually makes them comfortable and accepting of the way that they look.

When it comes to eating disorders, body image is very often (though not always) a major contributing factor. And although it’s a sensitive subject, body image is often related to body weight. In an ideal world, all bodies would be considered good bodies, and our advertising and social media wouldn’t be inundated with fad diets, fitness gurus, and the heavily-pushed concept that only one body type is somehow acceptable. Unfortunately, these and other factors do exist, and they can frequently trigger negative body image in people of all ages and genders.

Body image is also closely connected to self-esteem and how a person socializes. When people feel good about their bodies, they are much more likely to feel comfortable around others and content with themselves. A person with high self-esteem is less likely to take drastic steps to change their body, which often manifests as a restrictive or purging form of eating disorder.  On the other hand, a positive body image fostered through treatment can help to lay a solid base for mental and behavioral health once they begin recovery. On the other hand, a negative body image at that time can be accompanied by long-term psychological and physical health consequences.

How Does Body Image Affect (or Not) the Development of Eating Disorders?

According to the psychiatric guidelines set out in the DSM-V some eating disorders, namely anorexia nervosa, bulimia nervosa, and binge eating disorder, are co-occurring with a negative or distorted body image, usually centering on the individual’s weight or body shape. There seems to be a correlation between a person’s age and body image. Especially during adolescence, when a person’s body is rapidly changing and their self-image as an adult is being formed (not to mention their concepts of attractiveness), body image can shift rapidly. Not coincidentally, the late teenage years are typically the age of onset for anorexia, bulimia, and binge eating disorder.

They can happen at any time, however, although eating disorder onset is usually associated with the late teenage years in most cases, body image concerns often begin to show much earlier. Research shows a negative body image is statistically significant, with 40 to 60 percent of girls aged 6-12 reporting that they were dissatisfied with their weight or body shape. There is no single cause or factor determining the development of eating disorders. How they perceive themselves.However, negative or distorted body image is inextricably linked to cases of depression, isolation, and disordered food relationships that can become a full-blown case of an eating disorder like anorexia nervosa.

Not All Eating Disorders Are Triggered By Body Image

Some eating disorders, however, are not triggered (necessarily) by body image distortions, although the effects can seem identical to the layperson. As an example, Avoidant/restrictive food intake disorder (ARFID) is an eating disorder that often begins with a childhood experience resulting in a phobia of a certain food. A typical instance might be a person getting food poisoning from eating a bad piece of shrimp, for example, and then pathologically avoiding anything like shrimp in the future. Parents often confuse it with simple picky eating. However, it can limit growth in children when certain nutrients are not eaten enough. ARFID affects adults as well and can cause extreme weight loss as well as make certain social situations anxiety-ridden, such as public dinners where the avoided food is the main course.

Orthorexia nervosa is another such eating disorder. In some ways it resembles anorexia nervosa; both involve the compulsive restriction of food in an attempt to take control of some aspects of a person’s life. Unlike anorexia nervosa, however, this restriction is not done with the goal of losing weight or reducing the body’s size per se. Instead, orthorexia causes an obsession with “eating healthy” in a person. The individual compulsively checks nutrition labels and cuts various foods and amounts out of their diet in an attempt to achieve optimal health. Just as with anorexia nervosa, malnutrition is a serious risk for a person with orthorexia, although the motivations may be different.

Signs That Negative Body Image Might become an Issue

AS hard as it is to notice these signs in oneself, it’s important to stay cognizant and perform mental health “check-ups” from time to time. A therapist can certainly help with this, but you can keep stock of your own mental health by keeping your risk factors in mind and knowing what to look for. For observes such as family members, it also pays off to be aware of potential warning signs that something is amiss; they can also help you organize your thoughts and concerns when trying to provide help

Here are some signs of negative body image to watch out for:

  • Constant comparisons of their boy to others’
  • Frequent self-criticism
  • Isolation and avoiding social situations
  • Avoiding activities or trying new things because of the way they feel about their body
  • Obsessive thoughts concerning food, weight, calories, dieting, or exercise
  • Perceiving flaws or excess weight where there is none
  • Constant looking in mirrors and complaints of how “ugly” or “fat” they are
  • Creating a link between eating and feelings of shame, guilt, or self-disgust

When to Seek Treatment

While it’s not an absolute, unaddressed body image issues and negativity can result in the development of an eating disorder. The best time to way to heal an eating disorder is to prevent it from happening. Talking to a therapist or body image treatment professional can help you identify risk factors and challenge disordered perceptions early on.

However, it does become an issue, specialized eating disorder treatment is available.They are usually available on both residential and day treatment bases, which can provide differing levels of care as needed for the individual as well as matching time and financial constraints. Many major insurance plans have coverage for treatment as well.   Eating disorders can be overcome; it just takes the courage to reach out for help.

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, 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.