Eating Disorders & Body Image

How we think and feel about our body is a significant part of our emotional and psychological health. Being able to accept our body and hold it in high esteem can be difficult in a society that places increasing focus on physical appearance and rewards certain types of appearances over others. This can result in disturbances in our thoughts and feelings about our body which may lead to mild or severe forms of disordered eating or body image issues.

Disordered Eating

“Disordered eating” refers to thoughts and feelings about food that affect
one’s eating behaviours and alters consumption/absorption of food in a
way that negatively affects someone’s physical and psychosocial
functioning.

There are three common diagnosable eating disorders as well as other unhealthy or “disordered eating” habits that are described below.

Anorexia Nervosa

In anorexia nervosa, the disturbance involves significant weight loss, an intense preoccupation with weight, and a restriction of food intake. Anorexia goes beyond the normal behaviours of someone trying to lose some weight; it involves distorted views and feelings about one’s body, leading to poor eating behaviours. For those with anorexia, the perception of one’s weight is not based in reality. Additionally, individuals with anorexia nervosa link their levels of self-esteem with their weight and thin appearance. Anorexia can lead to a variety of health conditions (e.g., loss of hair, fatigue, amenorrhea in women, etc.) and, in extreme cases, death.
Although anorexia nervosa is more frequent in women, men can suffer from this disorder as well.

In addition to the characteristics described above, some additional symptoms of anorexia nervosa include:

  • An intense and irrational fear of gaining weight or getting “fat.”
  • Constantly weighing and measuring the self or looking in the mirror.
  • The individual may feel like they are overweight even though they are underweight.
  • The individual does not recognize the seriousness of low body weight.

There are two subtypes of anorexia nervosa:

  1. The Restricting Subtype: restrictive eating and excessive exercise.
  2. The Binge-Purge Subtype: excessive eating followed by extreme efforts to get rid of what one ate (e.g., vomiting, laxative use, or excessive exercise).

Bulimia Nervosa

Similar to anorexia nervosa, an individual with bulimia nervosa has an extreme fear of gaining weight, and their self-evaluation is unduly influenced by body shape and weight.

 Bulimia Nervosa will be diagnosed if:

  • The individual demonstrates discrete periods of eating significantly more food than most people would eat in a similar period under similar circumstances.
  • A lack of control over eating (e.g., feeling that one cannot stop eating).
  • Compensatory behaviours to prevent weight gain such as self-induced vomiting, misuse of laxatives, diuretics or other medications, fasting, or excessive exercise.
  • Binge eating followed by compensatory behaviours that occur weekly for 3 months.

Unlike anorexia nervosa, those with bulimia nervosa are not necessarily underweight. They usually appear to be an appropriate weight for their age and height.

Binge Eating Disorder

If one does not meet the criteria for anorexia nervosa or bulimia nervosa, but shows the following symptoms, they may suffer from Binge Eating Disorder.

Characteristics of Binge Eating Disorder may include:

  • Recurrent instances of eating a lot of food in a discrete period of time (e.g., 2 hours), eating an amount that is larger than what most would need under similar periods and circumstances.
  • A feeling that one cannot stop eating or lacks control over what and how much one is eating.
  • Eating much faster than normal, feeling uncomfortably full or eating large amounts of food when not feeling physically hungry.
  • Eating alone due to feelings of embarrassment regarding the amount of food being eaten.
  • Distress regarding binge eating; i.e.,feeling disgusted with oneself, depressed, or guilty after eating.
  • Binge eating occurs on average once a week for 3 months.

Unlike anorexia nervosa and bulimia nervosa, those with binge eating disorders display no inappropriate compensatory behaviour or weight loss.

Emotional Eating

As previously mentioned, one does not necessarily need to be diagnosed with one of the three common eating disorders mentioned above. There are also non-clinical forms of disordered or unhealthy eating habits such as emotional eating.

There are a few possible theories as to why emotional eating may occur.

  • Firstly, overeating may be a way to escape reality when an individual is faced with negative self-awareness or negative affect in general.
  • Secondly, eating often provides positive or rewarding feelings, which compensate for the negative affect experienced prior to bingeing.
  • Thirdly, a common example of emotional eating is “stress eating”; when an individual overeats during stressful periods to avoid responsibility/feelings of stress.

Regardless of the reason for emotional eating, the root of the problem lies in unhealthy/ineffective methods of emotional regulation that need to be replaced with healthy and adaptive coping strategies.

Note that emotional eating does not just involve overeating, but it can also involve undereating.

Body Image Issues

Regardless of whether it is clinical or not, many individuals suffer from body image issues and low self-esteem. This is particularly common for adolescents; however, individuals of any age could experience these issues. Having low self-esteem and poor body image increases one’s susceptibility to a range of mental health issues such as depression, anxiety, eating disorders, and body dysmorphic disorder.

Here are a few signs (outlined by “Eating Disorder Hope”) that you may be struggling with poor body image:

  • You experience shame, anxiety, or self-consciousness about your body and are constantly preoccupied with your appearance.
  • You often compare your physical appearance to others’ and feel that your body is flawed.
  • You experience feelings of isolation, depression, and/or low self- esteem due to poor body esteem.
  • You may be engaging in unhealthy methods to try and change your appearance (i.e., dieting, skipping meals, fasting, smoking cigarettes, or engaging in the unhealthy compensatory behaviours/disordered eating described above).

Body Dysmorphic Disorder

Body Dysmorphic Disorder is characterized by an obsessive preoccupation with an imagined or exaggerated defect or flaw in one’s physical appearance. Those with body dysmorphic disorder often engage in rituals or compulsions such as looking in the mirror and examining their “flaws,” excessive grooming, attempting to disguise the flaw or defect, and/or pursuing cosmetic surgery. Body dysmorphic disorder is considered a disorder related to obsessive compulsive disorder as it involves both obsessions (i.e., constant rumination) and compulsions (i.e., rituals or compulsive behaviours). Individuals with BDD also believe that other people notice their flaws and as a result, think negatively of them.

Not all people who struggle with body image will develop Body Dysmorphic Disorder or any clinical diagnosis. However, our body image is an important part of our identity and poor body image can negatively impact our mental health. The good news is that people can improve their body image through psychotherapy. Our team of psychologists, social workers, and psychotherapists have training in helping people improve their body esteem. Contact us to learn how we can help you.