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How Does Body Image Influence Eating Disorder Development in Teenagers?

Body image influences almost everyone at some point in their lives, if not constantly throughout their lives. It’s how a person sees themselves; do you see yourself as tall? Short? Pretty? Ugly? Skinny?

Important to developing eating disorders – “fat?”

As children enter into adolescence, they go through several different physical and emotional changes. During this crucial time, various internal and external factors can combine to influence the child’s self-image and how they perceive their body. Simply because a child is beginning to deal with body image doesn’t necessarily mean that they will develop an eating disorder. On the other hand, distorted body image is a causative factor in almost every case of anorexia nervosa, bulimia nervosa, and other eating disorders. So how can body image influence these mental health disorders?

What Is Body Image?

As noted, body image is the way that people view their bodies, which can be much different from how their body appears in reality. Body image is a very complex construct, especially in prepubescent and adolescent children whose self-image and personality are being formulated. There is a range of body image perceptions from excessively positive to excessively negative and this can have a serious impact on a person’s general health, mental state and relationships. For teenagers, who are already at a higher risk of developing an eating disorder, body image is still formulating – it can go either way. Positive body image in teenage girls and boys means that the child has an objective perception of their appearance and the ability to separate their personal value from the way that they look.

The Impact of Negative Body Image

Negative body image in teenagers is defined by an overall dissatisfaction with their appearance. In girls (and to a lesser, but not insignificant extent, boys), this often manifests as a dissatisfaction with their weight or body shape. This can often manifest in more than a negative self-image, but disordered behaviors such as frequent dieting and food avoidance. Research shows that up to 50 percent of pre-teen girls and 30 percent of pre-teen boys have negative feelings about their bodies. Similarly, 60 percent of adult women and 40 percent of adult men have a negative body image.

Body Image Issues and Their Relation to Eating Disorders

Eating disorders are extremely serious mental health conditions that researchers agree are caused by various genetic and environmental factors – with negative body image in teen girls and boys being a major potential contributor. A preoccupation or even obsession with body shape and weight is a symptom of most common eating disorders, including binge eating disorder, anorexia nervosa, and bulimia nervosa. For example, a diagnosis of anorexia nervosa usually means that an individual has a distorted perception of their weight and size, imagining themselves as overweight even if all rational evidence proves otherwise. There are similar issues at play in bulimia nervosa and other major eating disorders.

Treatment for Negative Body Image as Part of an Integrated Program

There are myriad therapeutic treatment methods which can be employed to correct distorted or unrealistic body image in teenager. Studies indicate that body image is one of the central symptoms to address during the eating disorder treatment process. In most adolescent eating disorder treatment facilities, immediate medical, nutritional, and weight recovery issues are addressed first, while psychological recovery is addressed after the client is stabilized.

Some of the most common treatment options for negative body image concerning eating disorders include:

  • Cognitive-Behavioral Therapy
  • Mindful Movement and Exercise Training
  • Self-Esteem Workshops
  • Media and Self-Image

Positive Activity Can Affirm a Better Self-Image

One of the easiest ways families can work together to prevent negative thoughts and feelings surrounding body image is to avoid certain self-defeating practices, like compulsive or excessive exercise, frequent weighing or calorie counting, spending lots of time looking at the mirror, or buying clothes that hide the body’s shape.

It can help to replace these practices with constructive body-enhancing activities such as yoga, dance classes, or regular pleasure walks. Self-care is also important – it can be something as simple as going to see a movie or listen to your favorite music.  With therapy, and positive, self-affirming activities, body image can be repaired.

Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.
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