Understanding The Connection Between Eating Disorders And Self-Esteem

Eating disorders (EDs) are complex mental health conditions that can significantly interfere with a person’s sense of self, often stemming from deep-seated feelings of inadequacy, negative self-perception, and unrealistic standards fueled by internal and external pressures. Low self-esteem is a hallmark characteristic of several different eating disorders as well as a major risk factor in their development. 

Here, we’ll explore the relationship between EDs and self-esteem, including key takeaways from the current research, causes and risk factors, and tips for boosting self-esteem in recovery. With this guide, you may be better equipped to understand the complex dynamics between self-esteem and eating disorders and how addressing these issues can play a crucial role in recovery.

Understanding self-esteem and eating disorders like anorexia nervosa

Breaking this cycle of negativity is an essential component of treatment, and mental health professionals specializing in eating disorders often focus on exercises for building self-esteem and promoting healthier thought patterns. Building self-esteem at each stage of development can also be an effective way for caregivers, educators, and others to help mitigate the risk of eating disorders in children and teens.

Eating disorders and self-esteem: What the research says

Peer-reviewed research suggests a strong connection between eating disorders and self-esteem levels that are low. This may be because low self-esteem can cause a person to adopt certain distorted thought patterns, which can in turn trigger disordered eating behaviors. Here are a few key takeaways from recent studies: 

1. Low self-esteem is a significant risk factor for eating disorders

One major study combined results from multiple sources, its findings suggest that people—especially young women and girls—with lower self-esteem are more likely to develop eating disorders. This link is consistent, suggesting that low self-esteem is a significant risk factor for various eating disorders.

2. Low self-esteem and eating disorders often exacerbate each other

Another important finding is that low self-esteem and eating disorders seem to often exacerbate each other. Low self-esteem can lead to unhealthy eating behaviors, and those behaviors can, in turn, further lower self-esteem. Boosting confidence and self-esteem through therapy can be a way to break this cycle, helping to prevent or reduce the severity of eating disorder symptoms.

3. Younger women and girls with low self-esteem and low life satisfaction are at higher risk

Younger women and girls with low self-esteem and life dissatisfaction may be at higher risk of developing eating disorders. While men generally report higher satisfaction with their weight and appearance, the opposite is true for women; they are more likely to experience body dissatisfaction and related eating disorders. Lower life satisfaction further elevates the likelihood of developing eating disorders.

Causes and risk factors for low self-esteem and eating disorders

Self-esteem issues and other related challenges don’t typically arise in isolation, so it can help to understand the underlying factors that might make a person more susceptible to low-self esteem and eating disorders. Here are some causes and risk factors that can influence self-esteem and potentially contribute to the development of an eating disorder.

Co-occuring mental health disorders

Eating disorders often occur alongside other mental health conditions. Anxiety and mood disorders like depression are particularly prevalent among those with EDs, and they can also negatively impact self-esteem. Obsessive-compulsive disorder (OCD) is another risk factor for developing eating disorders, as the compulsive behaviors and obsessive thoughts can contribute to unhealthy eating patterns and negative body image.

Personality traits

Certain personality traits like perfectionism and neuroticism can put a person at greater risk of developing an eating disorder. Those with perfectionist tendencies often set unattainable standards for themselves, inevitably leading to self-criticism and low self-esteem. Neuroticism can also make individuals more vulnerable to stress and negative self-perception, further fueling eating disorder symptoms. 

Psychological factors

Certain cognitive biases can impact self-esteem and contribute to unhealthy attitudes toward food. Attentional bias, for example, may make an individual focus excessively on food-related stimuli or body image concerns. Memory bias could cause a person to selectively recall incidents that reinforce negative self-esteem. Judgment bias might lead to distorted evaluations of one’s body or eating habits.

Adverse childhood experiences

Research suggests that adverse childhood experiences such as abuse, neglect, and other forms of trauma are strongly linked to the development of low self-esteem and eating disorders later in life. These early experiences can lead to deep-seated feelings of worthlessness and a distorted sense of self, making individuals more susceptible to disordered eating as a coping mechanism.

Peer pressure

Peer pressure, especially during adolescence, can play a crucial role in the development of low self-esteem and eating disorders. The desire or pressure to fit in or meet societal standards of beauty can lead individuals to engage in unhealthy eating behaviors. Constant comparison with peers can exacerbate feelings of inadequacy, driving disordered eating patterns.

How to improve self-esteem and body image in recovery

Enhancing confidence, self-esteem, and body image can be key to ED recovery. Here are some tips that may help, in conjunction with seeking professional treatment:

1. Engage in confidence-building activities

While an eating disorder can make it feel like high self-esteem is tied to appearance, we generally value ourselves more for our achievements, life successes, and positive traits. When addressing body image issues, it can help to engage in activities that make you feel good about yourself, such as by partaking in hobbies or challenging yourself in new ways. 

2. Learn to “change the channel”

A common technique used in ED treatment is called “changing the channel.” When you notice a negative thought arise, try replacing it with a more positive thought instead—just as you would change the channel on the TV. For example, rather than dwelling on a meal you had that brings up feelings of guilt, you might choose to focus instead on the healthy meals you have planned for the upcoming week.

3. Use positive affirmations

Positive affirmations are another method that may help in overcoming negative thoughts and boosting self-esteem. Try repeating positive statements to yourself or posting written versions where you’ll see them regularly. To create positive affirmations that work for you, try turning self-criticism into praise. For instance, you might write down “I love my body for what it can do” to replace an unhealthy thought about your appearance.

4. Find new ways to nurture your body

Just as you replace the unhelpful thoughts that drive the ED, it’s just as important to replace unhealthy behaviors. Consider how you might find new ways to nourish and thrive in your body, such as joining a sports league, trying a new exercise class, or learning a new way of cooking. Talk to your therapist about ways to improve your relationship with your body in ways that align with your recovery.

5. Tap into your support system

If you’re feeling nervous about the challenges of recovery, it can help to ask someone within your support system to assist or accompany you. For example, you might ask a friend to come with you to a restaurant or ask a family member if they can help you prepare a meal. While taking these steps alone can feel daunting, your support system can be a source of motivation and encouragement.

Effective therapies for eating disorder recovery

Eating disorder treatments often focus on addressing the underlying psychological factors that contribute to disordered eating behaviors. Cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and family-based therapy (FBT) are three well-established approaches that have shown significant success in helping many individuals recover by targeting thought patterns, emotional regulation, and family dynamics.

• Cognitive behavioral therapy for eating disorders (CBT-ED): This specialized form of CBT focuses on helping individuals recognize and reframe the negative thought patterns fueling body image issues and disordered eating behavior. 
• Dialectical behavior therapy (DBT): DBT is another form of CBT that can help treat EDs. It incorporates mindfulness practices to help boost emotional regulation, reduce impulsivity, and strengthen relationships. 
• Family-based treatment (FBT): FBT is often used in situations when a child or adolescent has an eating disorder. It involves the family in the treatment process, helping inform and guide them as they support their loved one through recovery.

Before recommending one of these, a mental health professional will typically make a diagnosis, if applicable. This will help them decide on the appropriate course of treatment. They may use a variety of diagnostic tools to do this, such as the Eating Attitudes Test, and may do a comprehensive mental health evaluation in this process. They may request or recommend the individual receive a medical evaluation as well.

Online mental health support for eating disorders

Eating disorders tend to not resolve without professional treatment. If you’re experiencing signs of an eating disorder, it’s recommended that you seek mental health support as soon as possible. While many eating disorder cases may require the in-person support of a doctor, nutritionist, and/or other providers, seeking mental health therapy virtually can be a useful and convenient addition to the treatment plan.

With BetterHelp, you can match with a licensed therapist and attend weekly online sessions from the comfort of home or anywhere you have an internet connection. Research suggests no significant difference between online and in-person therapy, and many find the convenience, flexibility, and cost-effectiveness of teletherapy preferable to that of face-to-face sessions.