Exploring Eating Disorders And Self-Image
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Though eating is a necessary part of survival, it can become a significant source of stress for many. As disordered eating habits are increasingly being recognized by health professionals, so are their far-reaching impacts—with the connection between eating disorders and self-image often playing a crucial role. Here, we'll explore the connection between self-image, self-esteem, and eating disorders, as well as warning signs and treatment methods for this type of mental illness.
What is an eating disorder?
Eating disorders are complex mental health conditions that involve extreme disturbances in eating habits as well as the distressing thoughts and feelings that accompany them. These disorders often involve an intense focus on food and, in many cases, body weight or size, and they can lead to serious physical and emotional health problems.
People with eating disorders may engage in drastic dietary restrictions, binge eating, purging, or other harmful behaviors. These can put them at high risk for physical complications and cause challenges related to emotional and social well-being too.
Types of eating disorders
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) recognizes seven different types of eating disorders, but two common types include anorexia nervosa and bulimia nervosa. While each of these conditions has its own unique challenges and symptoms, they both share a common thread: a troubled relationship with food and body image.
Eating disorder warning signs
Symptoms of eating disorders can vary depending on the specific condition, but some general warning signs can include extreme weight changes, an obsessive focus on food or dieting, withdrawal from social activities, eating in secret, making harsh comments of secondary self-criticism, and noticeable mood swings. Spotting these signs early is important because early intervention can make a significant difference in long-term outcomes for those affected by these conditions.
The link between eating disorders and body image
Eating disorders and poor self-image are often deeply connected, which can create a vicious cycle where one exacerbates the other. Physical self-image, or body image, describes how someone perceives their own physical appearance. A negative body image, or being unhappy with how one looks, can lead people to adopt disordered eating habits as a way to try and “fix” their perceived flaws. This makes poor self-image a major risk factor for disorders like anorexia nervosa and bulimia nervosa.
Low self-esteem and mental health
Low self-esteem is also a common factor in many eating disorders. When someone has low self-esteem, they often engage in negative self-talk, which can lead to a distorted view of their body. This can drive harmful eating behaviors. For instance, a person with core low self-esteem might see themselves as overweight even if they are underweight, pushing them towards extreme dieting or purging. Sociocultural factors such as fatphobia often also contribute, making people falsely believe that there’s an “ideal” body type that they should strive for.
Low self-esteem leads to the start of an eating disorder in many cases, but it can also make the disorder’s symptoms worse. As the condition progresses, the individual’s self-esteem often declines further, creating a cycle where the disorder and low self-esteem reinforce each other. Building up self-worth is often a key part of recovery.
The development of distorted body image
A disordered body image often starts to take shape during adolescence, a time when self-esteem and body perception are especially vulnerable to outside influences. During these years, young people are highly sensitive to societal beauty standards, which are often unrealistic and unattainable. Media plays a significant role here, constantly presenting narrow versions of “ideal” bodies that can shape how young people see themselves.
Exploring eating disorder statistics
It’s estimated that around 9% of the US population will experience an eating disorder like anorexia nervosa, bulimia nervosa, or binge eating disorder in their lifetime. Eating disorders often begin during adolescence, with the highest rates seen in young adults aged 18–25. However, these disorders can affect people of all ages as well as any race, gender, and body type.
Additionally, many people experience subclinical forms of eating disorders where they show some, but not all, of the symptoms of a full-blown disorder. Even though their symptoms may not qualify as a diagnosable disorder, they can still be dangerous and cause health challenges and distress. Subclinical eating disorders are particularly common among adolescents, with studies estimating that around 22% of teens experience symptoms.
Understanding other risk factors for eating disorders
Though poor self-image can contribute to the development of eating disorders, there are a number of other potential risk factors too. These include biological, psychological, and social elements.
For example, genetics can play a role, as individuals with a family history of eating disorders are at a higher risk of developing one themselves. Psychological factors can also increase risk, such as low self-esteem, negative body image, and mental health conditions like depression and anxiety.
Certain personality traits, like perfectionism and a tendency towards obsessive-compulsive behaviors, can also increase the likelihood of developing an eating disorder. Individuals with these traits may set impossible standards for themselves, especially regarding their appearance, leading to harmful behaviors aimed at reaching these goals.
Social factors, including cultural pressures to meet certain beauty standards, also play a crucial role. Media often promotes thinness as the ideal body type, which can lead to a negative body image and unhealthy behaviors as a result of trying to achieve these unrealistic standards. Additionally, interpersonal problems like bullying or being teased about appearance can worsen body dissatisfaction and increase the risk of developing an eating disorder.
The relationship between trauma and eating disorders
Another key risk factor for developing eating disorders is past trauma. During and after experiencing a traumatic event, a person may feel a sense of a lack of control. Restricting their eating or binge eating, for example, could help them temporarily feel control over their own lives again, which is one way trauma-related eating disorders can develop.
Similarly, high levels of stress caused by abuse, loss, grief, or other life-altering situations can correlate with eating disorders. A person may engage in disordered eating behaviors in an attempt to soothe difficult emotions and trauma reactions.
Eating disorders and other mental health conditions
The relationship between eating disorders and mental health is complex and bidirectional. Eating disorders often occur alongside other mental health conditions, which can complicate both symptoms and treatment.
For example, people with eating disorders frequently experience co-occurring anxiety disorders, depression, or obsessive-compulsive disorder (OCD). These comorbid conditions can make each other worse, creating a challenging cycle to break. It’s also possible for a person to be living with distorted thought patterns or past trauma that don’t qualify as a diagnosable disorder but still exacerbate their condition.
Understanding the mental health aspects of eating disorders is crucial for effective treatment. Focusing only on the eating disorder without addressing the underlying mental health challenges can lead to incomplete recovery and a higher chance of relapse.
Understanding co-occurring conditions
Again, it’s common for people with eating disorders to also have other mental health conditions, known as co-occurring conditions. Depression is one of the most frequently seen alongside eating disorders, with a significant portion of individuals with eating disorders also experiencing major depressive disorder. This can make recovery more challenging, as depression symptoms like low energy and feelings of worthlessness make it more difficult to adopt healthier eating habits.
Anxiety disorders like generalized anxiety disorder (GAD) and social anxiety disorder are also common in individuals with eating disorders. These disorders often develop before the eating disorder does, suggesting that disordered eating might sometimes be an unhealthy attempt to manage anxiety symptoms.
OCD also has a strong link with eating disorders. Many individuals with eating disorders show signs of obsessive behaviors related to food, weight, and body image, which can resemble the compulsions seen in OCD. For example, someone with anorexia nervosa might engage in ritualistic eating habits, like cutting food into tiny pieces or eating in a specific order.
Therapy for eating disorders
Therapy is typically a cornerstone of eating disorder treatment, providing individuals with the tools to address the underlying psychological challenges that fuel their condition. Cognitive behavioral therapy for eating disorders (CBT-E) is suggested by research to be one of the most effective approaches. CBT-E helps individuals identify and challenge the distorted beliefs and thoughts that drive disordered eating behaviors. For example, a cognitive behavioral therapist might help a client realize how their belief that they must be thin to be valued is leading them to restrict their eating.
CBT-E also focuses on developing healthier coping mechanisms. Instead of using food as a way to handle stress or negative emotions, clients learn alternative strategies like mindfulness or problem-solving techniques to manage these challenges.
Exploring online therapy for eating disorders
If you’re experiencing signs of an eating disorder, it's recommended that you meet with a doctor and/or a mental health professional as soon as possible. In many cases, eating disorders will require some form of in-person treatment, such as medical care and nutritionist support. Since these can create a busy schedule, it may be easier for some people to pursue the mental health portion of their treatment virtually.
In recent years, online therapy has become a valuable resource for those living with eating disorders. Along with studies suggesting that it can be equally effective as in-person therapy in many cases, online sessions can be especially helpful for individuals who might feel more comfortable talking about their symptoms from the comfort of home. Additionally, online therapy platforms often offer a wide variety of providers, making it easier for individuals living with eating disorders to find a therapist who understands their specific symptoms and experience.
Takeaway
How do eating disorders affect your body and mental health?
According to the American Psychiatric Association, eating disorder symptoms can cause a variety of both physical and mental health complications, though these can depend on the type of disorder a person has. When it comes to mental health, poor body image and body image satisfaction, low self-confidence, psychological distress, and challenges related to interpersonal functioning and interpersonal behavior are common in those of all age groups who have certain types of eating disorders. Physical health impacts could include things like dangerously losing weight, a body mass index that's too high or too low, decreased physical fitness and functioning overall, and increased risk of health problems like diabetes, heart disease, malnutrition, decreased immune functioning, reproductive issues, and others .
Do people with eating disorders have body dysmorphia?
Not everyone with an eating disorder will also have body dysmorphic disorder (BDD). However, a systematic review, meta-analysis, and statistical analysis of previous research on the topic indicates that as many as 26% percent of individuals with a weight-loss related eating disorder like anorexia nervosa also met the criteria for BDD. This suggests that although the two are separate illnesses, BDD and eating disorders tend to co-occur in the same individual in some cases—particularly in adolescent girls, young adult women, and those in other high-risk populations.
How does an eating disorder affect body image?
Some eating disorders are strongly related to body image—particularly adolescent self-image. For example, someone with anorexia nervosa or bulimia nervosa often lacks a positive body image and may instead see their body shape and size in a distorted and self-critical way. These body image concerns then often become closely intertwined with an intense desire to lose weight or avoid gaining weight. That's why eating disorder treatment usually involves talk therapy that aims to cultivate higher self-esteem in the individual and a more realistic and positive relationship with their own body.
What physical problems are often associated with eating disorders?
Eating disorder symptoms can cause a variety of physical problems over time. These can depend on the eating disorder, its severity, and if and when the person receives treatment, but can include things like malnutrition, obesity, diabetes, dangerously high or low blood pressure, organ failure, and even death. According to one report, the US economic burden of eating disorders is $64.7 billion annually, which includes billions in healthcare costs and in productivity losses. The global burden is even higher. Due to both individual health outcomes and broader societal effects, seeking treatment for eating disorders as soon as possible can be important.
How do people with anorexia see their body?
People with anorexia nervosa often have a distorted body image. Perhaps partly due to disruptions in visual processing, they may see their body as bigger than it is—even if they become dangerously underweight. This is one component of the illness that can make treatment difficult.
What triggers body image issues?
Body image issues may be triggered by a variety of factors. However, according to the tripartite influence model, media, parents, and peers are thought to be three key contributors. To combat potential negative impacts from these three sources, it may help to give parents informed consent related to what media their children consume, to train parents on body image issues and eating disorder warning signs, and to meaningfully address appearance-based peer bullying in schools.
What is the difference between body image and body dysmorphia?
Body image is the way someone views and thinks about their physical form and appearance. Body dysmorphic disorder (BDD) is a diagnosable mental illness characterized by a distorted view of one's body. A person with body dysmorphic disorder often fixates on a particular perceived flaw in their appearance, which can lead to anxiety and maladaptive coping behaviors. It is also possible to have body image issues, such as insecurity or self-consciousness, but not have BDD or another diagnosable disorder.
How to tell if someone has body image issues?
Body image issues can appear in individuals as young as age three, and the average age of onset for eating disorders is 18. That means monitoring children and adolescents for signs of body image issues and disordered eating can be critical for promoting their long-term health. Some potential warning signs include harshly self-critical talk about their own bodies, an obsession with calorie counting or losing weight, frequently comparing their body to the bodies of others, and showing signs of low self-esteem or social withdrawal due to body image concerns.
If body image issues are accompanied by potential warning signs of disordered eating, it is generally recommended that the individual’s parent or caregiver seek professional support for them as soon as possible. Therapy, medical care, and nutrition education are usually key components of treatment. While residential eating disorder treatment programs are sometimes recommended, they may not be required in every case. For example, a recent study used a normal distribution of the Mann-Whitney U test and descriptive statistics to determine the efficacy of residential treatment programs versus partial hospitalization programs. Its statistically significant findings suggest that day hospitalization treatment can be sufficient for certain patient populations. A doctor or eating disorder specialist can help devise a treatment plan that's right for a given individual.
Is body dysmorphia an eating disorder?
Body dysmorphia is not classified as an eating disorder. However, some people with body dysmorphic disorder may develop disordered eating patterns in an attempt to try and “fix” their perceived flaw. In addition, body dysmorphic disorder and eating disorders often co-occur in the same individual. Both conditions tend to involve a lack of high self-esteem on the self-esteem scale, and both may sometimes lead to lost weight due to severe dietary restraint and poor eating attitudes as a result of negative body image. One study on eating disorders in students at a medical college in India, which used an eating attitudes test, also suggests that these conditions may be triggered by stress in those already at risk—such as young women and those with a genetic predisposition.
What is the most common type of eating disorder?
Binge eating disorder (BED) is thought to be the most prevalent eating disorder today. Its clinical characteristics can have significant effects on individual health. It’s also worth noting that a cross-sectional study published by BMC Public Health suggests that while most adolescent girls and women who meet criteria for an eating disorder don’t receive treatment, women with BED or obesity are the least likely to receive treatment, making them at heightened risk of serious complications.
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