Discussing Body Image in Eating Disorder Recovery

When discussing body image with someone with an eating disorder, the difficult concept to understand is that the person’s actual body is not the issue. As much as the conversation revolves around their actual body, it’s the body image that’s in question.

For a clinician, family member or friend, the urgency of the discussion around body is very powerful. It feels like a reasonable conversation about how the person looks and whether or not their body has changed and that it needs immediate attention.

However, the essence of body image distortion is that the person cannot really see their body. Instead, the thoughts and images in the person’s mind don’t reflect their actual body. These thoughts are dominant and painful, but there is no resolution by explaining how the thoughts are distortions or rationalizing how these thoughts can’t be true.

Body image thoughts at their core feel true. They cause so much internal stress because it’s impossible for the person to question them and see how they are false. Instead, the thoughts circle in their mind and the urgency that comes across in conversation is due to the strong desire for the thoughts to stop.

There is no reasoning that will make them go away.

The way to support someone struggling with body image thoughts is to not discuss their body no matter how frustrating that is for the person and no matter how counterintuitive it feels.

The key to this part of recovery is to focus on the fact that one’s body knows how to respond to regular food or how the person will be able to learn how to function with a body that is nourished and healthy or that the goal is to focus on living. It may seem impossible but it’s crucial to know these thoughts will diminish in time by taking these steps.

Sidestepping the need to talk about body image consistently can provide a framework that pushes aside the body image thoughts. By diminishing the importance of this distortion, the person can focus on the necessary steps of recovery and not get lost in endless ruminations.