Body Image: A Symbol of Eating Disorder Treatment Gone Awry

One place to start addressing the effect of eating disorder treatment is the idea of body image. The inception of eating disorder diagnoses began with the cultural preference for thinness spread through mass media in the 1960’s and 1970’s. Classification and treatment incorporated the concept of body image as the bedrock of recovery.

Body image distortion conflated with body dysmorphia are now considered a hallmark for any eating disorder. The novel idea at the time that a person might not see their body as others do, or may in fact see a very different body, consumed the clinical eating disorder treatment world, but without nuance or creativity. It might have been helpful to consider how and why people struggled with self-image but wholly another to use body image as a way to disempower and confuse a cohort of young women.

Rather than see body image in a broader schema, treatment philosophy took the psychological experience at face value. Therapy attempted to force the person to renounce how they see themselves. Behavioral work encouraged people to do exposures to face what others considered the reality of their bodies. Therapists told people with eating disorders that they had distorted thinking about themselves and their bodies and did not truly know themselves.

However, cultural norms widely contradicted the messages from therapists. How could society value and reward thinness while treatment philosophy said the exact opposite? How could therapists seem focused on thinness themselves in their own bodies while simultaneously encouraging the people they treated to ignore the larger world completely?

The conceit of the eating disorder treatment field is to make the patient themselves feel confused if not crazy while ignoring the realities around them. In this context, eating disorder treatment appears to be almost conspiratorial, certainly not therapeutic. In no way can it be helpful to tell people not to trust themselves and learn who they are.

In this vein, the concept of body image distortion starts to have more nefarious connotations. It’s not a stretch to imagine that the mixed messages about body that women endure are intended to gaslight all women. Why should women gathering the power and momentum in all parts of our society be handicapped by the confusion around body image?

Inevitably, a substantial percentage of women succumb to these beliefs and are taken away from their own lives by years of treatment. The constant concern women feel about their own bodies reinforces the pernicious norms of self-blame and self-doubt.

I’m not sure where to take these ideas about body image in the larger scope of treating people with eating disorders. Some elements of treatment need to stand including helping people be nourished enough to live and not lose so much mental energy around food and body. I don’t believe women need guidance about how to see themselves or how to live. They certainly don’t need anyone telling them they cannot even see themselves clearly.

Anyone with an eating disorder needs help to find the path to be themselves and live the life they want. Too much attention on food, weight and body image distracts from the real issue, one that’s all too present in today’s culture: the subjugation of women through their bodies.