Low Self-Esteem: Body Image + Eating Disorders
How are self-esteem, body image, and eating disorders related?
LOW SELF-ESTEEM: BODY IMAGE + EATING DISORDERS
by Annie Malcolm (updated 1st February 2022)
This week as part of our month of self-love, we’re taking a look at body image and self-esteem.
So why is body image relevant to self-esteem? Well it is relevant only for some people. For some, the way they look has very little with how they value themselves. For others, their body and how it looks is almost the only thing they use to determine their worth.
WHAT DETERMINES YOUR SELF-ESTEEM?
Self-esteem simply refers to a person’s evaluation of his or her own worth, and everyone’s self-esteem is based on a list of things that seem important to him or her.
One person’s list might look like this:
How smart I am
What kind of job I have
How much money I make
How hard I work
Another person’s list might look like this:
How pretty I am
How fit I am
How many friends I have
Whether I have a boyfriend/girlfriend or not
What does your own list look like? Take some time to reflect on those things on which you anchor your self-esteem.
GETTING RUNS ON YOUR BOARDS…
Having low or high self-esteem isn’t just about figuring out what’s on your list. It’s also about how well you think you are doing with each item on that list.
Imagine two people have the same list – the one at the top. If intelligence, a good job, money and hard work are your yardsticks, and you happen to have just earned a degree and landed a great job, you will probably feel pretty good about yourself.
But imagine all these things are important to you, and you’ve just been made redundant, and are finding it hard to get a new job. The way you think and feel about yourself would be very different.
So different people use different yardsticks to measure their worth. And self-esteem is based firstly on what you use to judge your own worth, and how well you think you are doing with it.
Now maybe what we were saying about body image makes more sense. For some people, their body image might be positive or negative, but it has little impact on their self esteem because physical appearance just isn’t that important to them. For others it is hugely important, and will make or break how they feel about themselves overall.
BODY IMAGE + SELF-ESTEEM
Today our focus is going to be on those people who are unhappy with their bodies, and who also see physical appearance as being very important. That’s actually a pretty big portion of the population. As part of this, we are bombarded daily with images and messages that tell us what a “perfect” body looks like, and how important it is to try to attain it.
Indeed, when we look throughout history, an ideal body image has been championed for women to aspire to. Back in the Victorian era, women were driven as far as having ribs removed to create the perfect “wasp” shaped waist. Even further back, in medieval times, arsenic was swallowed as a way to improve the complexion.
In recent decades, however, there has been a strong drive towards thinness as an ideal. For instance, the weight of models appearing in Playboy, and Miss America pageants has been tracked from 1959, and shows a steady decrease[1], and alarmingly the Body Mass Index (BMI) of over half of these women would meet the BMI criteria for an eating disorder.
The message to be thinner is targeted primarily at women, and for many women is a significant factor in the development of a poor body image. Disturbingly, for females especially, this poor body image starts early in life. In Australian adolescent girls, body dissatisfaction sits at 70% and is ranked as one of the top items of concern for adolescents[2].
WHAT IS THE IMPACT OF POOR BODY IMAGE?
So if there is a fair portion of the population for whom body image is important, and who also have negative views of their body, what are the consequences? Well some of the consequences can be positive. If a person has poor body image and is actually overweight, this may motivate them to start exercising, or adopting other healthy lifestyle habits.
However, there are negative consequences too. If a person has a poor body image regarding an aspect of their body that they cannot change, rumination over their dissatisfaction can lead to low mood, frustration, hopelessness, a worsening of their self-esteem, and depression.
Self consciousness about the body can lead many to unhelpful avoidance techniques – either going to great lengths to change or disguise the body, or an avoidance of social contact itself, in the hope of dodging the imagined criticism and judgement of others. Over time, avoidance like this can lead to isolation and a loss of social support.
BODY IMAGE AND EATING DISORDERS
Another potential risk for some people who suffer poor body image and low self-esteem is that of eating disorders. Sometimes an eating disorder can begin with seemingly harmless changes. A person who is a little overweight resolves to do something about it and starts to restrict their eating.
Slowly the weight comes off, a boost to their body image and the compliments of those around them make them resolve to restrict even further. The goal posts change as the initial target no longer seems enough, and so dissatisfaction with the body returns or grows. Control of what food gets put in the body takes on more and more importance, and the thought of eating a “bad” food, or skipping an exercise session causes unease, even fear.
Clearly, eating disorders are not a widespread consequence of poor body image, however it may be more widespread that you think. Between 1995 and 2005 the rates of disordered eating behaviour in Australia doubled for both males and females.
Eating disorders currently affect around one million Australians[3].
Around 15% of women will experience an eating disorder in their lifetime. Eating disorders as associated with other mental health issues - around 64% of individuals with an eating disorder also experience anxiety, 45% to 86% experience depression, and 58% experience a personality disorder.
The mortality rate when it comes to eating disorders is 12 times above that for individuals without eating disorders, and recovery will take an average of 7 years. For those who do recover, there are often permanent health consequences[4]
HOW TO HELP YOUR BODY IMAGE ISSUES
So what can we do? Well if you recognise some of the signs of restrictive eating or of eating disorders as outlined above, the best thing to do is to seek help. Go to a family member, a friend, your GP, speak to a psychologist, reach out in whatever way feels possible for you.
What if you don’t quite have the symptoms of an eating disorder but recognise that you have poor body image, low self-esteem, and want to avoid going down that path? Well, there are several things which psychologists call “protective factors”, or things you can focus on to help protect you from a poor body image spiralling out of control.
Protective factors include a supportive family which does not emphasise weight and appearance, a family which eats meals together, a social network that includes more than one group of friends, a focus on achieving academic challenges, good assertiveness and problem solving skills and an acceptance of the diversity of different body shapes and sizes[5].
Finally, want some more general tips to improve body image and self-esteem? Then consider these six steps:
1. Focus on the things you like about your body.
2. Remind yourself that no one is as critical about your body as you are. The people around you probably have things about their own bodies they are just as self conscious about.
3. Be a critical consumer of media. Remember many images are touched up and unrealistic.
4. Don’t compare yourself to others - we were all born with different bodies.
5. Would you judge someone else’s worth based on his or her weight or appearance? If not, why do it to yourself?
6. Remember that your physical appearance is just one of the things that make you who you are. Every time you hear some self criticism about your body, remind yourself of one of your strengths.
So if you’re one of those people with a poor body image try to ease up on yourself today. Remember your body is breathing, walking, talking, thinking, digesting and sleeping for you every day – it’s a pretty amazing thing, so enjoy it!
If you’d like assistance with self-esteem, body image, and problematic eating, why not Contact us to make an individual appointment?
REFERENCES
[1] Wiseman et al. “Cultural expectations of thinness in women: an update” International journal of eating disorders, 11, 85 – 89. 1992.
[2] Mission Australia Youth Survey 2013. https://www.missionaustralia.com.au/publications/research/young-people?start=10.
[3] The National Eating Disorders Collaboration. (2012). An Integrated Response to Complexity – National Eating Disorders Framework 2012. http://www.nedc.com.au/files/pdfs/National%20Framework%20An%20integrated%20Response%20to%20Complexity%202012%20-%20Final.pdf.
[4] Sullivan, P. (1995). Mortality in Anorexia Nervosa. American Journal of Psychiatry, 153, 1073-1074.
[5] Shisslak, C.M., & Crago, M. (2001). Risk and protective factors in the development of eating disorders. In J.K Thompson & L.Smolak (Eds), Body image, eating disorders, and obesity in youth: Assessment, prevention, and treatment (pp.103-125). Washington, D.C,: American Psychological Association.
Eating disorders: A quick guide
The term ‘eating disorder’ may get used often, but what constitutes an eating disorder and how is it linked to disordered eating? Read on to find out more.
EATING DISORDERS: A QUICK GUIDE
By Joyce Chong
Hot on the heels of our previous articles on Food, Mood + The Brain, and How to Really Make Diets Work we're taking a look at when your relationship with food and eating becomes unhealthy.
THERE ARE MANY DIFFERENT TYPES OF EATING DISORDERS
Eating Disorders, in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [1] released in 2013, are grouped together with other disorders linked with food to form the diagnostic category of Feeding + Eating Disorders. Despite the varied types of disorders, they are all marked by certain commonalities, namely:
1) Disturbed pattern of eating (or eating behaviours) that leads to compromised consumption or absorption of food;
2) There exists significant impairment to functioning, be it occupational, physical, or psychosocial.
Overall, the disorders listed in the Feeding + Eating Disorders category include:
Pica where non nutritious substances (e.g. dirt, chalk) are repeatedly eaten
Rumination Disorder which involves repeatedly regurgitating (in the forms of re-chewing, re-swallowing, and spitting out) food after eating.
Avoidant/Restrictive Food Intake Disorder where problems in eating lead to weight loss or nutritional deficiencies.
Anorexia Nervosa is where there is significant restriction to dietary intake in response to an intense fear of gaining weight.
Bulimia Nervosa involves a cycle of binging and engaging in unhealthy behaviours aimed at preventing weight gain due to a heighted focus on body weight and shape.
Binge-Eating Disorder involves eating an excessive amount of food in one sitting. Unlike in Bulimia Nervosa there are no attempts to minimise weight gain through unhealthy behaviours.
Today we’ll talk a bit more about Anorexia Nervosa, Bulimia Nervosa, and Binge-Eating Disorder as these are the more common presentations that we see in our clinical work. It’s estimated that Eating Disorders affect around 9% of the Australian population.[2]
ANOREXIA, BULIMIA + BINGE-EATING DISORDER
Anorexia Nervosa refers to a condition wherein there is continued restricted intake of food, an intense fear of weight gain or behaviours that prevent weight gain, and a distorted perception of weight or shape.
Bulimia Nervosa is wherein there are recurring instances of binge eating, behaviours (e.g. vomiting, laxative/diuretic use, excessive exercising) designed to prevent weight gain, and a heightened focus on weight or shape. The binge/purge cycle must occur at least once each week for a period of 3 or more months.
Binge-Eating Disorder refers to recurring instances (at least once a week for 3 months) wherein an excessive amount of food is consumed relative to what most would consume in a similar amount of time, there’s a sense of lack of control associated with the binge, and there is significant distress associated with the bingeing.
PSYCHOLOGICAL FACTORS LINKED TO EATING DISORDERS
Several psychological mechanisms have been proposed to underlie the above eating disorders, including:[3]
Low self-esteem. Negative self-evaluations are a feature of eating disorders. They can derail positive progress by impacting on belief in capacity to change, dismissing any improvements, and impact on treatment adherence.
Overemphasis on weight and shape. One of the defining criteria for Anorexia and Bulimia (but not Binge-Eating Disorder) is an overemphasis on one’s weight and shape, typically characterised by a drive for thinness. It’s been suggested that factors contributing to this drive for thinness include gender, cultural factors, and the media.[4]
Perfectionism is another feature linked to eating disorders – in particular, the relentless pursuit of unrealistically high standards when it comes to controlling weight and shape, thus setting oneself up for failure.
Negative moods and difficulties tolerating such negative moods have been suggested as triggers for binge eating and compensatory behaviours designed to mitigate any weight gain due to bingeing.
Unhelpful thinking styles including Labelling of oneself in a negative way (weak, failure, fat), Black and White thinking wherein minor transgressions of the rigid diet are considered a complete failure, and Catastrophising where the consequence of eating a ‘bad food’ is over-exaggerated. For more on unhelpful thinking styles, check out this post.
SEEKING HELP FOR EATING DISORDERS
It’s essential for an individual with an eating disorder to seek appropriate assistance. Anorexia and Bulima, in particular, are linked with an increased risk of suicide. [1]
So if you recognise the signs in yourself or in a loved one, here are some simple steps to take:
Educate yourself on eating disorders and its challenges from a reputable website such as The Butterfly Foundation or the National Eating Disorders Collaboration.
Open up about what's going on or about how you feel, rather than trying to carry the burden on your own.
Seek assistance It’s important to get checked out when you’re dealing with an eating disorder so that you can start to make changes. Depending on the severity of the eating disorder, a hospital admission (or similar) may also be required. Getting help with an eating disorder means drawing on the skills of a whole team – including your GP, psychiatrist, nurse, dietitian or psychologist (Contact us to make an appointment).
Want more? You can connect with The Skill Collective in the following ways:
Contact us to make an individual appointment to get started on making changes.
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REFERENCES
[1] American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.
[2] http://www.nedc.com.au/eating-disorders-in-australia
[3] Fairburn, C.G., (2003). Cognitive behavior therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
[4] Weissman, R.S., & Bulik, C. (2007). Risk factors for Eating Disorders. American Psychologist, 62, 181-198.
Keep track of your anxiety by monitoring your mood and sticking with healthy habits. Here we outline how the humble planner can help you to achieve your goals when it comes to anxiety.