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When it comes to the health of our minds (aka mental health), most of us don’t stop to consider the link between how we evaluate and feel about our physical appearance (body image) and how we feel about ourselves (self-esteem) and our lives (life satisfaction). Most of us see body image as something that only plagues women and that it is something that stands in isolation from other mental health struggles, causing us to treat it without much seriousness. After all, women are also so used to appraising their bodies negatively that it has almost become the norm for women to hate how they look, and want to be thinner, that we even expect women to speak negatively about how they look, or worse, about how other women look (which trangresses into bullying by the way).

And it’s not like all therapists are comfortable talking about body image either. So much shame is associated with our physical appearance that even therapists may not know how to respond to body image struggles, perhaps resorting to avoidance of the topic or impulsively consoling their clients prematurely in order to get over talking about body image, using statements such as ‘looks don’t matter’, ‘it’s okay you’re beautiful in your own way’, ‘beauty is in the eye of the beholder’, or ‘no one is ugly’.

The truth is, though, that solving body image problems isn’t as easy as distracting ourselves from our painful shame or forcing ourselves to believe in what’s already so hard to believe. There are reasons as to why we arrived at having a poor body image in the first place.

Factors That Influence Our Body Image

Believe it or not, how we think and feel about our appearances isn’t just influenced by us but by a plethora of factors that are biological, psychological, and social in nature. For example, the absence or presence of disease (how physically healthy we are) affects body image, and so does what we choose to eat every day, and exercising can make for better ways of perceiving our bodies because it encourages us to focus on function over form. Other biological factors include temperament, neuroticism, and mood regulation abilities. Besides that, being prone to mental health struggles such as depression and low self-esteem also predispose us to having a poor relationship with our appearance, and so do psychological traits such as perfectionism, and the tendency to objectify ourselves and to compare ourselves to ideals. Lastly, those around us such as our peers, direct and extended family, teachers, other members of our community, and the media (including social media) may create a certain kind of climate that’s conducive for us to develop a poor body image, silently hurting us with their emphasis on meeting an ideal and the ideal image of beauty being so narrowly defined. As an example, your friends and family members may be the type to make degrading comments about your appearance based on their biased attitudes and perverse values, even if subtle. Or, perhaps no one had enough empathy and knowledge to respond to your body image-related pain with some comfort and wise words.

Bottom Line

What this means is that if you don’t feel good about how you look and these feelings cause you so much distress and take away your ability to focus and enjoy everyday activities, you might want to stop being so hard on yourself because you aren’t the sole cause of your distress. However, it is within your power and responsibility to learn and practice helpful strategies to ease the difficult thoughts and shameful feelings about your appearance that continue to haunt you in your daily life (in the form of anxiety and even depression and eating disorders) [2]. In fact, you should also know that those with body dissatisfaction are at risk for not just disordered eating and depression, but reduced physical activity and less satisfying relationships [3, 4]. All in all, long-term body image disturbance destroys well-being.

10 Things to Do to Secure a Healthy Body Image

First, let’s confirm what we mean by a healthy body image. When you have a good body image, it means your evaluation (includes perception, thoughts, feelings, behavioral responses) of your physical appearance doesn’t cause you distress (in the form of anxiety, depression) and affect your ability to live a relatively peaceful day to day life— meaning you may still occasionally feel sad, disgusted, or anxious about how you look but it’s not so intense and it doesn’t last long because you manage to help yourself out of it appropriately using coping strategies— that’s how we can tell whether you have a body image that’s okay and one that’s not.

In contrast, here are the common signs of a poor body image [5]:

• Intense dissatisfaction with your appearance
• Having an overall view of yourself as being unattractive, otherwise ‘ugly’
• Fixation on how you look and having negative (and obsessive) thoughts and feelings (typically shame, anxiety, and insecurity) about it such as ‘I’m ugly’ or ‘I’m so fat’
• Seeking unhelpful ways to reassure yourself such as by grooming excessively or in others, constantly needing reassurance from others
• Social anxiety as you’re likely to believe people will judge your appearance like you do, sometimes accompanied by avoidance of social situations— which can lead to withdrawal, further intensifying loneliness and depression
• Hiding your perceived flaw with clothes, make-up, etc
• Feeling compelled to compare yourself to others’ appearance on a frequent basis (in a way where you end up evaluating your body as more flawed in comparison to others’)
• Perfectionism and extreme self-criticism, which can drive you to develop stringent rules around eating, putting you at risk for eating disorders such as anorexia and bulimia nervosa [6]
• Unhealthy habits— typically eating and exercise habits— in an attempt to influence your weight, oftentimes muscularity in men (some may smoke cigarettes to control their weight)
• Having low self-esteem, anxiety, and depression as a result of your appearance concerns
• Unsatisfactory relationships due to your body image disturbance

Last but not least, if you think you might need help with your body image, here are 10 things to do to secure a healthy body image. Use these coping strategies daily to your benefit.

• Work on your self-esteem. Focus more on what it feels like to be you instead of paying attention to what you look like. Get in touch with the core of you, what makes you unique (write and keep a list of all your wonderful traits and strengths) and how it feels to be that way. Psychotherapy may help
• Manage symptoms of stress, anxiety, and depression. Correct beliefs and assumptions that lead you to conclude that you’re horribly unattractive and not worthy of love (they’re usually connected, especially for women)
• Practice mindfulness: How we physically feel inside our bodies also influences our final evaluation of how we look. Being more attuned to internal sensations can actually help us feel more whole inside out [7]
• Take care of your physical health. Exercise and stay active/ be in your body. Have nutritious meals. Sleep well. Try to keep at a weight suitable for your height
• Monitor your perfectionism and give yourself some freedom to be human and look human by striving for a balance when it comes to how you expect yourself to appear and what you eat
• Mourn past pain if you were shamed, criticized, bullied, and rejected into judging and hating your appearance. Mourning may involve acknowledging the ways in which you were affected and regulating the emotions related to those events that you still feel today by trying to understand and make helpful sense out of those emotions.
• Consider what you now need in order to feel whole in your body after years of body shaming (usually what you need is for you yourself to be on your side). What you certainly do not need are unrealistic ideals (don’t hold on to these), the habit of comparing yourself to these ideals. Self-objectifying is also something you do not need: Self-objectification is when you constantly view yourself as an object that mainly exists to be looked at and evaluated and that your value lies therein [8] 
• Consume media consciously with a few cautionary reminders in mind, such as that what you see isn’t exactly how those people really look, at least not all of the time, without the help of make-up and photoshop, and that most people don’t look like that [9] 
• Don’t listen to those who hold you against certain standards and make critical judgments about your face and body, and if you can, spend the least amount of time possible with people who deliberately trigger your anxiety, shame, and insecurity around your appearance concerns. If you must still be around such people, create a list of affirmations and coping statements that challenge your self-defeating self-talk about your looks so that anything people say about you will be less likely to affect you intensely. The point is to always build yourself back up in the face of unnecessary scrutiny
• Create a new standard for yourself that’s based more on compassion, unconditional acceptance of yourself & others, and an appreciation of what your body does i.e. how you live your life using your body, rather than how your body looks [10]

Final Words   

When your body dissatisfaction causes you overwhelming emotional pain to the point where you find it hard to focus on what you want to accomplish every day, it may be time to take a step back and evaluate the relationship you have to your body. A poor body image will slowly break you, disconnecting you from fulfillment, pleasure, and possibilities that await you, leaving you feeling ashamed, afraid, frustrated, resentful, and even hopeless [11], and can even put you at risk for suicide [12]. It’s not surprising then that 80% of those with Body Dysmorphic Disorder experience suicidal ideation throughout their lives [13], a percentage that’s much higher than for depression (in contrast, a study found that 48% of those with depression are at risk for suicidal ideation) [14].

It is therefore essential for us to find ways to work on improving our body image, and when we do that, we’ll also be reducing our risk factors for other kinds of mental health problems. Starting with the list of  ‘10 things to secure a healthy body image’ shared above can help.

*Reminder: Like many other forms of psychopathology (a big word used to refer to features of mental health disorders), in poor body image, ‘bio-psycho-social’ factors influence our final perception of our appearance, which means what we see isn’t always the truth— and in the most severe forms of poor body image such as in the case of body dysmorphic disorder [15 ], the mirror really can lie. Consult a professional for some assistance.

Resources

[1] Sussex Publishers. (n.d.). Body image. Psychology Today. Retrieved September 5, 2022, from https://www.psychologytoday.com/us/basics/body-image 

[2] Mazurkiewicz, N., Krefta, J., & Lipowska, M. (2021). Attitudes towards appearance and body-related stigma among young women with obesity and psoriasis. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.788439 

[3] Heron N, Kee F, Cupples M, Tully M (2015). Correlates of Sport Participation in Adults With Long-Standing Illness or Disability. BMJ Open Sport Exerc Med. 1(1):e000003. doi: 10.1136/bmjsem-2015-000003.

[4] Retznik, L., Wienholz, S., Seidel, A. et al. Relationship Status: Single? Young Adults with Visual, Hearing, or Physical Disability and Their Experiences with Partnership and Sexuality. Sex Disabil 35, 415–432 (2017). https://doi.org/10.1007/s11195-017- 9497-5

[5] Cash, T. (2012). Encyclopedia of body image and human appearance. Elsevier. 

[6] Wade, T. D., & Tiggemann, M. (2013). The role of perfectionism in body dissatisfaction. Journal of Eating Disorders, 1(1). https://doi.org/10.1186/2050-2974-1-2  

[7] Nauman, Emily. Can mindfulness foster a healthy body image? Greater Good. Retrieved September 5, 2022, from https://greatergood.berkeley.edu/article/item/can_mindfulness_foster_a_healthy_body_image 

[8] Engeln, R. (2018). Beauty Sick: How the cultural obsession with appearance hurts girls and women. Harper. 

[9]Wolf, N. (2002). The beauty myth: How Images of Beauty Are Used Against Women. Vintage Books. 

[10] Kite, L., & Kite, L. (2021). More than a body: Your body is an instrument, not an ornament. Mariner Books. 

[11] Brown Brené. (2022). The gifts of imperfection. Hazelden Publishing. 

[12] Brausch, A. M., & Muehlenkamp, J. J. (2007). Body image and suicidal ideation in adolescents. Body Image, 4(2), 207–212. https://doi.org/10.1016/j.bodyim.2007.02.001 

[13] Phillips K. A. (2007). Suicidality in Body Dysmorphic Disorder. Primary psychiatry, 14(12), 58–66.

[14] Brådvik L. (2018). Suicide Risk and Mental Disorders. International journal of environmental research and public health, 15(9), 2028. https://doi.org/10.3390/ijerph15092028

[15] Grant, J. E., & Phillips, K. A. (2005). Recognizing and treating body dysmorphic disorder. Annals of Clinical Psychiatry, 17(4), 205–210. https://doi.org/10.1080/10401230500295313