Body Image and Dysmorphia

Body Dysmorphic Disorder (BDD) is a mental health condition within its own right. As far as eating disorders are concerned the focus tends to be on weight and size and body shape. Sufferers may agonise over areas of fat or weight gain (real or perceived) and will regularly check their appearance in the mirror.

What is body image and why does it matter

Body image is an integral part of our experience of being human. After all, we each live in a body that uniquely identifies us, to others and to ourselves. We have personal thoughts and feelings about our bodies – about its size, shape, attractiveness, health, and changes. Most people take time and effort trying to make their bodies what they want it to be. People diet, work out, style their hair, and choose nice clothing, wear cosmetics and jewellery etc. That’s what body image means, and it’s a complex and powerful part of our lives.

Research shows that many people find it hard to accept how they look and this is more prevalent today with society’s emphasis on looks and the media’s messages that to be acceptable you must be attractive, or thin, or well-built, or tall, or blonde etc. These pressures, along with other psychological issues can lead to negative body image problems that are part of eating disorders. All of these factors lower overall self esteem, and cause feelings of depression, anxiety, and social self consciousness.

What part does body image play in eating disorders

A slim woman standing in front of a mirror, seeing an overweight reflection looking back at her.

Sufferers of eating disorders have a particularly difficult relationship with their bodies. People with anorexia for example, often believe that their value as a person is related to their weight and how they look. They think that this is what makes other people like them. And that other people will like them more if they are thinner; they see their weight loss as positive. They often have a distorted view of what they look like (body image). For example, they think they look fat when they are not. They may try to hide how thin they are, by wearing loose or baggy clothes.

Body image problems are not limited to anorexia. Although anorexics usually have a distorted body image, thinking they look fat when they see themselves in a mirror, sufferers of other eating disorders like bulimia, or compulsive overeating are usually able to see their true body size and shape. They just feel bad about how they look.

It is this perceived negative body image that contributes to an eating disorder developing. Sufferers want to change the way they look so that they can feel better about themselves and losing weight is one way to do this. Someone with an eating disorder therefore might diet, starve themselves, over exercise, or use laxatives or diuretics (purging), believing if only they could change their body to match their ideals, they would be in control of themselves and their life. Feelings about the body exert more and more influence over the eating disorder sufferer’s feelings about themselves.

Of course, over time all that happens is that suffers actually become less in control of their eating, emotions, and their body and body image. Negative body image thoughts, feelings, and behaviours also serve to perpetuate the eating disorder once it has begun, intensifying the sufferer’s struggles.

Research suggests that a persistent negative body image puts sufferers at greater risk of relapse after professional treatment has helped restore healthy eating behaviours and, in the case of anorexia nervosa, a healthy body weight. Most anorexics set out to lose weight again once free of re-feeding treatment.

Greater body acceptance brings about better self esteem, lessens depression and anxiety, as well as encouraging healthier eating attitudes, but this is difficult for sufferers of eating disorders to achieve.