Eating Disorders and Body Dysmorphia: Understanding the Connection
Eating disorders and body dysmorphic disorder often go hand-in-hand, and the symptoms in one condition can certainly magnify symptoms of the other condition. If you or a loved one is struggling with symptoms of either disorder, it is important to seek support. Eating disorders are among the most fatal mental illnesses, but treatment can provide necessary guidance, support, and stabilization.
Eating Disorders and Body Image Disturbances
There is a strong interplay between disordered eating habits and appearance concerns. While not everyone who feels insecure about their body image has an eating disorder, certain eating disorders, including anorexia nervosa and bulimia nervosa, tend to be closely associated with body image struggles.
Weight concerns: People with eating disorders generally have an intense fear of gaining weight. This fear coincides with inaccurate perceptions of body shape or body size. This can result in intense preoccupation with food intake and secretive or repetitive eating behaviors.
Hyperfocus on real or perceived flaws: There’s a major overlap between feeling physically unattractive and eating disorder symptoms. For example, some people engage in body checking, skin picking, or excessive grooming to cope with their distress. They may also continuously seek reassurance from others about their body weight or overall physical appearance. Unfortunately, these ritualistic behaviors don’t provide more than just immediate, short-term relief (if they provide relief at all).
Internalized shame: Both conditions tend to correlate with low self-esteem and shame. Sometimes shame over body size or weight leads to disordered eating behaviors. Furthermore, actual eating disorder symptoms may feel shameful, causing people to isolate themselves from others or struggle in other areas of functioning.
Other co-occurring issues: Eating disorders can also overlap with other mental disorders, including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), anxiety disorders, and depression. Research also shows a strong connection between ADHD and eating disorders.
Social isolation or relationship problems: Many people with eating disorders find it difficult to engage in intimate, meaningful relationships. This may be due to the pervasive secrecy, shame, and compromised self-worth associated with these conditions.
Does Poor Body Image Cause Eating Disorders?
Not necessarily. However, eating disorders are insidious and likely underdiagnosed. Research shows that nearly 8 in 10 teenage girls feel unhappy with their bodies by the time they are 17. Approximately half of girls ages 9-11 indicate they are ‘sometimes’ or ‘often’ on a diet.
Poor body image is pervasive at all ages, and it can certainly affect someone’s emotional well-being. However, struggles with body image do not inherently indicate the presence of an eating disorder diagnosis.
That said, someone with a significant body image disturbance may be more likely to develop an eating disorder if the following risk factors apply:
- history of childhood trauma, including physical or sexual abuse
- perfectionistic tendencies
- struggles with emotional expression
- being female
- family history of eating disorders
- participating in activities that strongly emphasize physical appearance (i.e. gymnastics, dance, modeling)
- Presence of comorbid diagnosis such as anxiety, depression, OCD
What Does Comprehensive Treatment Look Like?
Treating body dysmorphic disorder and eating disorders requires specialized care. Recovery can be a complicated process, so it’s important to work with a provider well-versed in understanding and managing these conditions.
Depending on the severity of the eating disorder, treatment may be multidisciplinary. Such coordination of care may entail several providers, including a therapist, psychiatrist, dietitian, and primary care physician.
In treatment, you can expect to focus on addressing some of the following concerns:
Reduction or abstinence of symptoms: Achieving a sense of stabilization is an important part of eating disorder treatment. Stabilization isn’t just about weight; it’s also about achieving emotional balance. This looks different for everyone, but it often includes reducing or eliminating concerning symptoms, including restriction, bingeing, self-induced vomiting, and excessive exercise.
Distress tolerance: At all stages of recovery, it’s important to learn how to cope with various triggers effectively. Therapy often focuses on learning new ways to manage stress and tolerate uncomfortable situations. DBT can be extremely helpful for strengthening mindfulness, interpersonal, and emotional regulation skills.
Improving self-esteem: Negative body image often relates to deeper issues, including fears of being unlovable or unworthy. Therapy typically focuses on unpacking the origins of these concerns and building individual self-worth. This may entail a combination of implementing grounding exercises, affirmations, self-compassion, and more self-care. Over time, you will internalize that you are so much more than just your physical body. In turn, this may empower you to equally want to take care of your physical body in a more sustainable and compassionate manner.
Nutritional support: In some cases, it’s helpful to collaborate treatment with a registered dietitian. A dietitian can address malnutrition and restore healthy eating patterns.
Mindfulness: Mindfulness can be an essential part of learning how to live in the present moment and improve your relationship with food and body image. Mindfulness includes many components, including meditation and grounding exercises.
Eating Disorder and Body Dysmorphia Treatment in St. Louis and Missouri
There is a strong connection between body dysmorphic disorder and eating disorders. Unfortunately, many people suffer in silence and do not receive treatment.
If you’re concerned about an eating disorder, body dysmorphic disorder, or both, you’re certainly not alone. That said, change is possible. No matter your circumstances, you can learn better ways to care for yourself, and therapy provides guidance and support through your recovery process.
My approach to treatment is multifaceted, pulling from attachment-based care, exposure-response prevention, DBT, CBT, somatic therapy, and mindfulness. I also welcome coordination with other treatment team members as needed. Please contact me today to schedule an initial consultation.
