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Body Image

This guide will help you better understand body image issues in men, women, and children. It provides suggested resources and other information for beginning research on this topic.

Introduction

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. 

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.

National Eating Disorders Association (NEDA)

Decorative Image: Apple, Tape, and Notebook

Image Credit: Pixabay

Body dysmorphic disorder is a mental disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that, to others, is either minor or not observable. But you may feel so ashamed and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely obsess over your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress, and impact your ability to function in your daily life.

You may seek out numerous cosmetic procedures to try to "fix" your perceived flaw. Afterward, you may feel a temporary satisfaction, but often the anxiety returns and you may resume searching for a way to fix your perceived flaw.

Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.

Causes

It's not known specifically what causes body dysmorphic disorder. Like many other mental illnesses, body dysmorphic disorder may result from a combination of causes, such as:

  • Brain differences. Abnormalities in brain structure or neurochemistry may play a role in causing body dysmorphic disorder.
  • Genes. Some studies show that body dysmorphic disorder is more common in people whose blood relatives also have this condition or obsessive-compulsive disorder.
  • Environment. Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative social evaluations about your body or self-image, or even childhood neglect or abuse.

Treatment

Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.

Cognitive behavioral therapy

Cognitive behavioral therapy for body dysmorphic disorder focuses on:

  • Helping you learn how negative thoughts, emotional reactions and behaviors maintain problems over time
  • Challenging automatic negative thoughts about your body image and learning a more flexible and realistic way of thinking
  • Learning alternate ways to handle urges or rituals to help reduce mirror checking or reassurance seeking
  • Teaching you other behaviors to improve your mental health

You and your therapist can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills.

Medications

Although there are no medications specifically approved by the Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental disorders, such as depression, can be effective.

  • Selective serotonin reuptake inhibitors (SSRIs). Because body dysmorphic disorder is thought to be caused in part by problems related to the brain chemical serotonin, SSRIs may be prescribed. SSRIs appear to be more effective for body dysmorphic disorder than other antidepressants and may help control your obsessions and repetitive behaviors.
  • Other medications. In some cases, you may benefit from taking other medications in addition to an SSRI, depending on your symptoms.

Hospitalization

In some cases, your body dysmorphic disorder symptoms may be so severe that you require psychiatric hospitalization. This is generally recommended only when you aren't able to keep up with day-to-day responsibilities or when you're in immediate danger of harming yourself.

Mayo Clinic Staff

Body image refers to how people see themselves. Distorted body image (also called negative body image) refers to an unrealistic view of how someone sees their body.  Like eating disorders, it is seen most commonly in women, but many men also suffer from the disorder. You begin forming your perceptions of your body’s attractiveness, health, acceptability and functionality in early childhood.  This body image continues to form as you age and receive feedback from peers, family member, coaches, etc.  Personality traits such as perfectionism and self criticism can also influence the development of a negative internalized image of your body.

Signs & Symptoms of Negative Body Image

Symptoms of unhealthy or negative body image may include:

  • obsessive self scrutiny in mirrors
  • thinking disparaging comments about your body and frequent comparison of your own shape and size to other people
  • envy or a friend’s body, or just as commonly: the body of a celebrity or someone else in the media.

Causes of Negative Body Image

Sometimes body image is negatively impacted by one or more significant events.  For example, a gymnast who is continually chided by her coach and fellow athletes to lose a little weight, may develop a deeply ingrained and long standing dissatisfaction with her body, no matter how thin she becomes.

If  you are concerned about your body image, here are some questions to ask yourself:

  • Is my perception of beauty distorted from years of media exposure that glorifies a very thin ideal that is unrealistic for most people to obtain in a health manner?
  • Do I find myself regularly criticizing my own appearance?

Relationship Between Weight & Body Image

A normally healthy weight range for an individual can be perceived as overweight by someone with a distorted body image.  An anorexic young woman may look at herself in a mirror and see a reflection that is greater than her actual size.  Conversely, it is not uncommon for obese individuals to report that they did not realize they were as large as they are and had perceived their body as much smaller until an occasion arises where they see a photograph, video or window reflection that strikes a nerve and causes them to come to terms with their actual image.

Relationship Between An Eating Disorder & Body Image

Body image concerns and eating disorders go hand in hand.  Often, it is the early dissatisfaction with a young person’s appearance that leads them to conclude that losing weight would enhance their appearance, and make them feel better about themselves and their bodies.  Thus, restrictive eating and over exercising are often next, frequently leading to patterns of disordered eating and weight obsession that can develop into anorexia, bulimia, orthorexia, compulsive overeating or binge eating disorder.

Treatment For Negative Body Image

Getting treatment for distorted body image is a critical step to recovery. The problem won’t just go away by itself.   Recognizing and acknowledging your feelings and accompanying body sensations will help you become more comfortable in your body and lessens the tendency to suppress feelings and revert to unhealthy, negative inner diatribes to escape uncomfortable feelings.

Cognitive Behavioral Therapy, an approach where irrational thoughts are recognized, analyzed and restructured to more rational self talk, is frequently used. Additionally, dance and movement therapy are often employed to develop a greater trust and appreciation of  one’s body based upon creating internal experiences, rather than simply evaluated one’s body aesthetically.

Eating Disorder Hope

Body-shaming manifests in many ways:

1) Criticizing your own appearance, through a judgment or comparison to another person. (i.e.: “I’m so ugly compared to her.” “Look at how broad my shoulders are.”)

2) Criticizing another’s appearance in front of them, (i.e.: “With those thighs, you’re never going to find a date.”)

3) Criticizing another’s appearance without their knowledge. (i.e.: “Did you see what she’s wearing today? Not flattering.” “At least you don’t look like her!”).

No matter how this manifests, it often leads to comparison and shame, and perpetuates the idea that people should be judged mainly for their physical features.

This leads to the question: if it has such harsh consequences, why is body-shaming so common? An example we often discuss at the Braintree Adolescent Intensive Outpatient Program (IOP) is dealing with conflicts with peers. Why, when we are upset, annoyed, or intimidated by someone, do we default to criticizing their appearance?  “Whatever, she’s ugly,” can be a go-to defense in these situations, particularly during adolescence and the young-adult years. In some ways, it feels easier to shoot for something that will hurt, like targeting physical appearance, rather than expressing what is really going on emotionally.  Saying, “I’m really hurt by how my friend treated me,” or “I’m terrified of losing this friendship” opens us up and makes us more vulnerable, and therefore feels easier to bury underneath the body-shaming comments that rush to mind.

How do we challenge this?  In situations like those listed above, expressing true feelings rather than physical criticisms can be a great first step.  While recently discussing this with the Adolescent IOP, several patients admitted that it is hard to identify ways of expressing frustration without using body-shaming, as this has become an almost automatic response. 

Practice identifying why you are upset about a situation.  For example, it’s unlikely that you’re mad at a friend because she’s breaking out, and more likely that you’re upset about a miscommunication or feeling of rejection.  Practice thinking it, and eventually, verbalizing it.

Identify who in your life is body-positive – or even body-neutral.  Think of people who celebrate their body for what it can do, and people who refuse to comment on others’ physical appearances.  Spending time with these people can be especially helpful while you are struggling with your own internalized body-shaming, and help you view yourself – and others – more positively.

Confront those who perpetuate body-shaming.  Once you’ve become more aware of your own body-shaming behaviors, you may notice how often your friends, family or co-workers do it.  Talk to them.  Discuss why it bothers you and help them see how it may also be hurtful to them.

Find something (or things!) you LIKE about your body.  We spend so much time witnessing advertisements about how to make our eyelashes millimeters longer and how to get whiter teeth that it’d be nice to counter some of that by celebrating what we do have.  Maybe, despite your body image struggles, you love a new hairstyle you discovered.  Maybe you’ve noticed how much stronger you feel with balanced eating.  Find something physical or nonphysical that makes you YOU and celebrate it every day.

Erika Vargas, Walden Eating Disorders Treatment

Super skinny size-zero models in ads and catwalks are controversial. Are they contributing to anorexia and other eating disorders? Should they be banned? 

Size-zero is a women's clothing size in the US size system. This translates to a bust-waist-hips ratio of 32–22–33 inches. The use of size-zero models in advertisement and fashion shows has come under fire. The exposure to images of very skinny models may be a contributing factor to the development of eating disorders such as anorexia. 

Beside aesthetic considerations the topic of models' size have become increasingly relevant. Public opinion in Western countries is increasingly aware and concerned about the potential impacts of super skinny models may have in particular on teenagers. Being skinny is now a trend and increasingly thinner models in advertisement and catwalks have served to consolidate this beauty paradigm shift. 

The problem emerges because now being extremely thin is considered a sign of beauty. Most people would like to be as similar as possible to the models and celebrities that best incarnate this new ideal of beauty. Some people practice sports or fitness to stay thin, others try diets to lose weight.  However, there is growing discrepancy between the size of average women (but also men) and those the beautiful models working for the most iconic brands. Not only in average the population in the West has become fatter, but also models are now thinner than they ever were. Additionally, in the fashion world, Photoshop is frequently used to make models in ads and front pages slimmer than what they actually are.  

Anorexia, as other eating disorders, is a socially transmitted disease. Some academic studies indicate that exposure to super skinny models may contribute to the spread of this mental condition among our youth. Teenagers look at these models as examples to follow. But, even if there is a causal effect between skinny models and anorexia, banning size zero models is problematic and many people claim goes against freedom of expression. 

Netivist

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Databases

eBooks + Books

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Suggested Websites

Office on Women's Health, U.S. Department of Health and Human Services

Improves the health of women and girls through policy, education and model programs.

WebMD

Time health and medical news and information.

Eat Right

Academy of Nutrition and Dietetics

Just for guys:

KidsHealth (A Guy's Guide to Body Image)

Provides families with perspective, advice, and comfort about a wide range of physical, emotional, and behavioral issues that affect children and teens.

Mirror-Mirror: body image men

Support for people with weight problems and eating disorders.

Videos

A young woman careens through her adolescence, prying at the grip of BDD. Panic and anxiety kaleidoscopically blur the world around her as she fights for her own self-acceptance.