Exploring Eating Disorders And Self-Image

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. 

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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.