Treating of Body Image Thoughts in Eating Disorder Recovery

Body image distortion is undoubtedly the must long lasting and difficult part of eating disorder recovery. The persistent negative thoughts about one’s body can last for a long time after normalizing eating patterns, fully healing physically and even finding new coping mechanisms for daily life.

Awareness of body image seems to have a specific pathway in the brain that involves both the visual and an emotional center. For people with eating disorders, body image thoughts often bypass the visual center and only involve the emotional center.

Theories about this difference in brain function imply that people with eating disorders perceive their body more through emotional brain center than visual ones even though they still perceive their own visual input as accurate.

Accordingly, people with eating disorders struggle even more to see their bodies as others do. Some clinicians call body image distortion a delusion, but I think this assessment is erroneous.

Instead, body image distortion appears to denote a connection between emotional centers and self-image that bypasses other brain centers which process visual information. The result is that people connect negative emotions and body automatically and subsequently attempt to change the negative emotions through eating disorder behaviors.

Treatment of body image thoughts abound. The behavioral approach focuses on exposure to one’s body in order to decrease the negative reaction. Psychodynamic therapy tries to separate negative thoughts from body image by spending time addressing and understanding the negative emotions. Other approaches include art therapy and hypnosis.

All of these treatment modalities can help, but the necessary component for improvement in body image symptoms is time. When someone in recovery eats in a consistent way and works towards finding new ways to cope with life instead of using the eating disorder, body image thoughts almost always subside.

The process takes time since it involves establishing new pathways in the brain to process and assess body image. The old pathway persists, but new thought patterns can supplant and sidestep the old negative thoughts and make body image thoughts much less distressing.

Whichever treatment works best for someone is likely the right approach. There is no right answer to help with body image thoughts. In addition, the clinician needs to stress continued work in recovery and patience that the thoughts will ease in time.