Thoughts about Treatment of Body Image

The treatment of body image is critical to eating disorder recovery. Since the urgent desire to lose weight is central to how an eating disorder keeps a hold on someone’s psyche, loosening that grip is necessary for someone to get well. Not only does a person in recovery need to eat regularly and consistently, but they also need to be able to tolerate however their body responds and to let go of the fantasy that the goals of weight loss and a perfect body is possible.

There are several components to facing body image. The process has both physical and psychological components.

First the person needs to better understand how weight and bodies work. We are taught in modern day diet culture that our body and weight are something we can control. Thus, any change in our bodies that is unwanted is considered to be our fault.

This idea could not be further from the truth. Weight, like many other factors about our bodies, is a variable the body uses to maintain health and stability. For instance, gaining a few pounds from a salty meal is a safe way the body processes and excretes extra sodium. Weight changes reflect how our bodies respond to situations and keep us well. The idea that we manage our weight based on our food decisions each day conveniently ignores basic human biology.

Similarly, thoughts about body imply that we can see our bodies clearly and truthfully. However, it is very difficult for us to see how we look. Our brains can process other people’s bodies more clearly but have trouble seeing our own physical self objectively. And this is much more exaggerated in people with eating disorders.

Often people with eating disorders say they feel good in their bodies one minute and then horrible a couple of hours later after a meal. Clearly, a body cannot change in a few hours. Our feelings can change, but our feelings are not immediately reflected in our bodies and weight.

When people say they feel fat, they usually mean they feel an emotion that is difficult and negative. Rather than identifying and reflecting on this feeling, the emotion turns into a negative body image thought. Distinguishing between a feeling and a thought about one’s body is a big step towards facing body image.

Last, body image can be very connected to identity. The goal of reaching a certain weight or clothing size is intertwined with an overall sense of self. If weight is the only way to find a positive self-image, then the treatment goal is to create an identity outside of one’s body.

The problem with developing an identity solely around weight is that there is no room to grow as a person or even to see oneself as a whole person. If all personal goals are about the physical self then there is no attention paid to an internal self, thoughts or feelings—the things that truly make up who we are.

Working on body image is necessary for true recovery. The treatment involves a clear understanding of how weight is a part of how our bodies function, the conflation of emotions and body and the need to create an identity outside of body image. These different ways to understand and change body image can help someone go from partial to full recovery.