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How often have you stood in front of a mirror looking at your body? Did you spend time picking out what you thought was wrong? What do you think you look like? We all have bad hair days or days where we wake up feeling like we don’t look our best, but constant body image issues and seeing your body in a negative way can lead to serious problems and affect your health, especially your mental wellness.
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Body image is how someone thinks and feels about their body and what it looks like. It’s a combination of beliefs, feelings, thoughts and actions, and it’s much more complex than simply liking or disliking your body.
Body image can also include how we see ourselves when we look in a mirror, how we feel about our body (including height, weight, shape or size) and how we physically feel in our body.
Body image can be affected by both internal factors (like emotions and moods) and external factors (social interactions and media). How we were raised, childhood memories, our friends’ and families' attitudes and other factors can also affect our body image.
Research suggests our awareness about what our body looks like can start as early as three years old.
Generally, body image is our personal relationship with our body. And while we can have negative body image or insecurities, this also means that we have a lot of control over our body image if using the right coping strategies.
There are four aspects of body image that can help us better assess how we see our bodies. These are:
Perceptual. The way we see ourselves and our bodies is not always a correct representation. It’s a perception, not the objective truth. You may perceive yourself to be overweight or have wide hips when neither is the truth.
Affective. How much you like or dislike everything about your appearance is affective body language. This can also relate to how much we like or dislike certain aspects of our appearance, like weight, height, skin tone and more. Affective body image is most heavily influenced by outside factors like magazines, social media and even our own cultures.
Cognitive. The thoughts and beliefs you have about your body. Cognitive body image most often shows up in the idea that if you can just change one part of your appearance (“If I lose 15 pounds” or “If I had a larger butt”), you’d be happier. However, if you inherently dislike yourself, you’ll never be fully satisfied when achieving these goals.
Behavioral. When someone doesn’t like how they look, they may have destructive behaviors such as obsessive exercise or disordered eating. Some people may not engage socially or isolate themselves.
Negative body image or body insecurity is described as disliking certain parts of — or all of — your body. Body image issues can often be attributed to the difference between what we think our bodies look like and how they actually look.
Negative thoughts or feelings about our bodies start at a very young age. A recent study found up to 50 percent of first- and second-graders already disliked their body size or shape.
While negative body image is very common, research has found that young girls and women are more likely to have body image issues than men.
Studies show that up to 70 percent of young girls dislike features of their bodies and as much as 80 percent wish they were thinner.
An estimated 20 percent to 40 percent of women are dissatisfied with their bodies throughout their lives.
Body insecurities can vary a lot from person to person, but there are some typical symptoms, which can include:
Feeling unattractive or unworthy
Never being satisfied with your appearance
Having unrealistic beauty standards
Prioritizing your appearance over your health
Spending excessive time and energy trying to “improve” your appearance
Going to extreme measures to hit a certain body weight or size
Feeling dissatisfied with the way our body looks can worsen with puberty. Research shows that children between the ages of 12 and 19 are the most susceptible to body insecurity due to a variety of physical and social changes.
Past events and memories from our childhood can also contribute to a negative body image. Some may include:
Being bullied. If you were teased as a child for how you looked, this can affect how you think or feel about your body and lead to negative body image. Weight-related bullying can significantly contribute to distorted body image.
Having your appearance criticized. Being told you were too ugly, too fat, too thin or having any aspect of your body criticized by others can be detrimental to your body image.
Exposure to media. Any images or messages you come across in television, movies, magazines and social media can make you feel bad about your appearance.
Obesity. Those who are overweight or obese are more likely to struggle with negative body image, although not everyone who is overweight has body image issues.
Underweight. Not only those who are overweight struggle with negative body issues. Those who are underweight may also feel insecure about how their body looks or feels, either due to illness (Crohn’s disease, cancer or eating disorders) or negative comments from others.
Family and friends. Although they’re the people who love and support us the most, sometimes body insecurity can grow from well-meaning but poorly worded comments from our friends and family. Studies have even found that relationship problems between parents and children can worsen body dissatisfaction even more. The ideas and values of your family, peers, education, faith and cultural background can also shape the way you see yourself.
Body image issues are not just about whether or not you like your body and how it looks. Research shows that negative body image leads to physically or emotionally unhealthy habits.
Some of these unhealthy habits include:
Disordered eating. Several serious eating disorders, such as anorexia and bulimia, are connected to body distortion. Those struggling with these disorders have extreme concerns about body image, shape or weight and go to extreme lengths like self-starving or over-exercising in order to resolve those concerns.
Body dysmorphia. A severe form of negative body image is body dysmorphic disorder, a mental health condition characterized by frequent or persistent negative feelings and perceptions about one’s body.
Muscle dysmorphia. Obsessively thinking about the size of your muscles or thinking you are weak is muscle dysmorphia, a type of body dysmorphia. Because of the focus on the body, people with muscle dysmorphia can also struggle with other body image issues.
Mood disorders. Research shows that people who struggle with body insecurity are more likely to be depressed, anxious and even experience suicidal ideation. People already diagnosed with anxiety, obsessive-compulsive disorder or depression may develop negative body image.
Negative body image and body insecurity not only affects our physical wellness, but our mental health, too. Since our body image is comprised of how we think and feel about our bodies, it’s not surprising that these thoughts and feelings affect our mental well-being and lives.
Body image issues are characterized by unhealthy and intrusive thoughts that are persistent, overwhelming and hard to control or suppress, similar to other mental health disorders.
When these thoughts consume our daily lives, not only are our routines, habits, behaviors and more affected — our mental health is affected too.
Some research has found that those with body image issues are likely to develop anxiety, decreased self-esteem, depression and other mood disorders.
When someone dislikes their weight or appearance, they can also feel overwhelmed and anxious in social situations. People struggling with body image may also feel the need to isolate themselves and may intentionally or unintentionally sabotage relationships.
Research has also found that poor body image can greatly affect eating habits, leading many young girls and women to follow strict diets and restrict food.
Although it can be difficult to determine whether mood disorders are caused by body image issues or vice versa, there’s a vicious cycle of both that affects our mental health. Recovery is possible with the right treatments though.
“Fixing” body image issues isn’t something that happens overnight. But with the right combination of treatments, you can find a way to a healthy and more positive body image.
Asking yourself the following questions can help you figure out how positive or negative your body image is:
Do your feelings about your body interfere with your life, including relationships, work or activities?
Do you take extreme measures to avoid seeing your body?
Do you compulsively check and recheck your body — either by weighing yourself, measuring body parts or examining yourself in the mirror constantly?
Do you use baggy clothing to hide your body?
Do you use harsh or unkind language to describe your body?
Do you experience powerful negative emotions when you think about your body?
Cognitive behavioral therapy (CBT) is a form of psychotherapy often used to treat stress, anxiety, depression, eating disorders, serious mental disorders and more.
Multiple studies have shown that one of the most effective ways to improve your relationship with your body is through CBT.
A CBT-trained therapy professional can help you to identify and break the pattern of harmful thoughts. Furthermore, CBT can even help replace those thoughts with new, healthy behaviors and thoughts about your body and appearance.
You can learn more about this treatment method in our guide, What Is Cognitive Behavioral Therapy? to see if it may be right for you.
Research on the treatment of body image issues has shown that selective serotonin reuptake inhibitors (SSRIs), which are often prescribed for anxiety disorders, are effective in improving body image. Medication can be especially helpful for overcoming anxiety related to body insecurity when combined with things like CBT techniques.
Some commonly prescribed SSRIs include:
Citalopram (Celexa®)
Escitalopram (Lexapro®)
Fluoxetine (Prozac®)
Paroxetine (Paxil®)
Sertraline (Zoloft®)
If you think medication might help, be sure to talk with your healthcare provider first about what’s involved.
A licensed mental health professional or counselor can help you talk through the causes, triggers, memories and associations you may have with your body image.
Talking about early experiences may help reveal the complicated beliefs you have about your body. A therapy professional can also help you learn about the ways a negative body image harms your mental and physical health.
One-on-one work with a professional can be beneficial, while settings like group therapy may provide the additional support of peers who understand what you’re experiencing.
You can start an online consultation to find a mental health professional to talk about what your needs are and what would benefit you most.
Every day we’re exposed to the message that advertising, celebrity culture and social media push that, to be considered worthy and lovable, we must be thin and beautiful.
Studies have also shown that when your peers share these ideals, the effect it has on you is even more powerful.
To create a healthier body image, you may have to unlearn some of what you’ve been taught from media sources.
Recognizing harmful media messages — whether they’re being sold by advertisers or pushed by online accounts — is the first step.
Looking for and appreciating the diversity of body shapes and sizes is another way to unlearn the message media has pushed on us.
You can even take a detox or break from social media for days, weeks, months or more, depending on what you need.
We all have moments of feeling self-conscious about our appearance or waking up to a new pimple on our face. But when these thoughts and feelings interfere with our day-to-day lives and affect our mental well-being, it’s time to get help.
If you notice you’re going to extremes to modify or alter your appearance, or you’re constantly thinking about losing weight, you could be struggling with body image issues.
Working with a CBT-trained therapy professional, as well as seeking medical help for anxiety from a healthcare professional can help you repair your relationship with your body image.
Positive body image isn’t just the opposite of negative body image. Instead, it’s the practiced love, care and acceptance of our bodies exactly as they are. It can take time to unlearn what we’ve grown to believe is “wrong” about our bodies.
What would it be like not to think of how your body looks, but instead what it can do? With a combination of time and the right treatments, you can learn to love the body you’re in.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing.
She is also an active member of the American Academy of Nurse Practitioners.