10.5: Body Image

One of the greatest difficulties we have as a society is achieving and maintaining a healthy weight, while also maintaining a healthy body image. Body image is how you see yourself when you look in the mirror or when you picture yourself in your mind. It encompasses:

• What you believe about your own appearance (including your memories, assumptions, and generalizations).
• How you feel about your body, including your height, shape, and weight.
• How you sense and control your body as you move. How you feel in your body, not just about your body.

Below are examples of negative and positive body image:

Negative Body Image

• A distorted perception of your shape--you perceive parts of your body unlike they really are.
• You are convinced that only other people are attractive and that your body size or shape is a sign of personal failure.
• You feel ashamed, self-conscious, and anxious about your body.
• You feel uncomfortable and awkward in your body.

Positive Body Image

• A clear, true perception of your shape--you see the various parts of your body as they really are.
• You celebrate and appreciate your natural body shape and you understand that a person’s physical appearance says very little about their character and value as a person.
• You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight, and calories.
• You feel comfortable and confident in your body.

We all may have our days when we feel awkward or uncomfortable in our bodies, but the key to developing positive body image is to recognize and respect our natural shape and learn to overpower those negative thoughts and feelings with positive, affirming, and accepting ones. For more information you can visit the website for the National Eating Disorder Association. Their message is simple: Accept yourself. Accept your body.

Eating Disorders

People with negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss.

Anorexia Nervosa

Anorexia nervosa, or anorexia, is a type of eating disorder that mainly affects adolescent girls and young women, but can also affect men. A person with this disease has an intense fear of gaining weight and severely limits food intake. Individual may:

• Have a low body weight
• Refuse to keep a normal body weight
• Be extremely afraid of becoming fat
• Believe they are fat even if they are very thin
• Women may miss three (menstrual) periods in a row (for girls/women who have started having their periods)

Anorexia affects your health because it can damage many parts of your body. A person with anorexia will have many of these signs:

• Loses a lot of weight
• Talks about weight and food all the time
• Moves food around the plate; doesn't eat it
• Weighs food and counts calories
• Follows a strict diet
• Won't eat in front of others
• Ignores/denies hunger
• Uses extreme measures to lose weight (self-induced vomiting, laxative abuse, diuretic abuse, diet pills, fasting, excessive exercise)
• Thinks she's fat when she's too thin
• Gets sick a lot
• Weighs self several times a day
• Feels depressed
• Feels irritable
• Doesn't socialize
• Wears baggy clothes to hide appearance

A health care team of doctors, nutritionists, and therapists will help the patient get better. They will:

• Help bring the person back to a normal weight
• Treat any psychological issues related to anorexia
• Help the person get rid of any actions or thoughts that cause the eating disorder

Some research suggests that the use of medicines — such as antidepressants, antipsychotics, or mood stabilizers — may sometimes work for anorexic patients. It is thought that these medicines help the mood and anxiety symptoms that often co-exist with anorexia. Other recent studies, however, suggest that antidepressants may not stop some patients with anorexia from relapsing. Also, no medicine has shown to work 100 percent of the time during the important first step of restoring a patient to healthy weight. So, it is not clear if and how medications can help anorexic patients get better, but research is still in progress.

Some forms of psychotherapy can help make the psychological reasons for anorexia better. Psychotherapy is sometimes known as "talk therapy." It uses different ways of communicating to change a patient's thoughts or behavior. This kind of therapy can be useful for treating eating disorders in young patients who have not had anorexia for a long time.

Individual counseling can help someone with anorexia. If the patient is young, counseling may involve the whole family. Support groups may also be a part of treatment. In support groups, patients, and families meet and share what they've been through.

Some researchers point out that prescribing medicines and using psychotherapy designed just for anorexic patients works better at treating anorexia than just psychotherapy alone. Whether or not a treatment works, though, depends on the person involved and his or her situation. Unfortunately, no one kind of psychotherapy always works for treating adults with anorexia.

Bulimia Nervosa

Bulimia nervosa, or bulimia, is a type of eating disorder. Someone with bulimia eats a lot of food in a short amount of time (bingeing) and then tries to get rid of the calories by purging. Purging might be done in these ways:

• Making oneself throw up
• Taking laxatives (pills or liquids that increase how fast food moves through your body and leads to a bowel movement)

A person with bulimia may also use these ways to prevent weight gain:

• Exercising a lot (more than normal)
• Restricting her eating or not eating at all (like going without food for a day)
• Taking diuretics (pills that make you urinate)

Bulimia is more than just a problem with food. It's a way of using food to feel in control of other feelings that may seem overwhelming. Purging and other behaviors to prevent weight gain are ways for people with bulimia to feel more in control of their lives and to ease stress and anxiety.

Unlike anorexia, when people are severely underweight, people with bulimia may be underweight, overweight, or have a normal weight. This makes it harder to know if someone has this disease. However, someone with bulimia may have these signs:

• Thinks about food a lot
• Binges (normally in secret)
• Throws up after bingeing
• Uses laxatives, diet pills, or diuretics to control weight
• Is depressed
• Is unhappy and/or thinks a lot about her body shape and weight
• Eats large amounts of food quickly
• Goes to the bathroom all the time after she eats (to throw up)
• Exercises a lot, even during bad weather, fatigue, illness, or injury
• Unusual swelling of the cheeks or jaw area
• Cuts and calluses on the back of the hands and knuckles from making herself throw up
• White enamel of teeth wears away making teeth look clear
• Doesn't see friends or participate in activities as much. Has rules about food — has "good" foods and "bad" foods