How Body Image Affects Health and Well-Being

Your internal monologue when you look in the mirror — and whether the tone is more “My thighs look too big” or “My legs look strong” — can bear a lot on your health and well-being.

Body image is how you see your body’s physical characteristics and your attitude toward them. According to the Office on Women’s Health, a healthy body image means you feel comfortable in your skin and are generally positive about the way you look.

A negative body image, on the other hand, leaves you feeling shame, anxiety, and self-consciousness, according to the National Eating Disorders Association.

Here’s how your body image can impact your emotional wellness, your risk of eating disorders, and your physical health.

How Your Body Image Affects Your Emotional and Mental Health

Negative feelings about the way your body looks don't necessarily, but can very easily, translate into negative feelings about yourself as a whole. This negativity can take a toll on mental and emotional health.

A negative body image often leads to low self-esteem, which can lead to problematic behaviors, such as obsessing over exercise and extreme dieting, or social isolation.

Low self-esteem can also be problematic because it can lead to stress, anxiety, and loneliness, increase your risk of depression, and interfere with your relationships and performance at work or in school, according to the University of Texas at Austin Counseling and Mental Health Center.

People with a negative body image often suffer from distorted thinking.

“They think they weigh more than they should, or they feel like they have to be thinner in order to be happy,” says Jennifer Engler, PhD, a professor and the psychology chair at York College of Pennsylvania, who researches how adolescents develop a sense of identity.

A preoccupation with one’s body or weight can be the symptom of an underlying emotional issue, too, says Jennifer Kelman, LCSW, a therapist in private practice in Boca Raton, Florida, who specializes in eating disorders. Depression and anxiety are both strongly linked with negative body image, according to Mindwise, an Australian organization that provides mental health services.

One study found that in a group of 563 women, 40 percent of those with major depressive disorder or any anxiety disorder experienced at least one instance of disordered eating, whereas 11 percent of those without a history of depression or anxiety reported the same.

“It is important to remember that when someone says, 'I feel fat' — that fat isn't a feeling,” Kelman says. “An overfocus on body and weight can be an indication of avoidance of dealing with deeper feelings.”

On the flip side, having a positive body image and high self-esteem can influence your behaviors and improve your overall quality of life, boosting everything from your communication skills to your mood, which can combat symptoms of anxiety and depression.

Research indeed suggests that people with more body image satisfaction scored higher when it came to measures of physical, psychological, social, and environmental quality of life.

When and Why Body Image Issues Lead to Eating Disorders

A negative body image may lead to unhealthy and dangerous behaviors, including those associated with eating disorders.

“Our thoughts directly impact our emotional experiences, including our bodily sensations, urges, and behaviors,” says Samantha DeCaro, PsyD, the director of clinical outreach and education at the Renfrew Center in Philadelphia, a residential eating disorder treatment facility. “Negative self-talk about the body often precedes harmful behaviors such as chronic dieting, isolating, restricting, overexercising, or bingeing and purging.”

It’s important to note that eating disorders are usually multifactorial. Biological, psychological, and sociocultural variables can all play a role.

It’s also worth noting that body dissatisfaction has been identified as one of the most common contributors to eating disorders.

This link has been well-documented in peer-reviewed scientific studies.

“If a negative body image starts someone down the road to dieting, and dieting then increases the chances of engaging in other disordered eating behavior, I think that's one of the most significant risks of a negative body image,” Dr. Engler says.

Body Image and Other Problems With Physical Health

A negative body image can lead to problems that go beyond your emotional and mental health. Feeling bad about your body can affect your physical well-being if you avoid visiting the doctor out of fear of being judged or shamed and therefore miss out on key preventive care measures, Dr. DeCaro points out.

A negative body image that leads to an eating disorder may endanger your physical health. “Those who restrict their [food] intake might experience various health complications such as malnourishment, cardiac abnormalities, gastrointestinal issues, muscle loss, and osteoporosis,” DeCaro says. “And those who struggle with binge eating might experience high cholesterol, type 2 diabetes, or high blood pressure.”

The effects of an eating disorder, in severe cases, can be fatal, according to the National Institute of Mental Health.


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A positive body image, on the other hand, tends to be associated with better physical health. It’s linked to more physical activity, less smoking and alcohol consumption, and a lower instance of negative eating habits, according to research involving teenage girls.

A word of caution, however: While a positive body image is generally a good thing, being unrealistically positive can cause you to overlook real health issues. “There's so much [in our culture] about body acceptance — that you should accept your body the way it is — but sometimes that can give the wrong message to individuals who are at an unhealthy body weight,” says Paakhi Srivastava, PhD, an assistant research professor and interim director of the Center for Weight, Eating and Lifestyle Science (WELL Clinic) at Drexel University in Philadelphia.

For instance, obesity can put you at higher risk of various medical conditions, and if you avoid taking steps to mitigate those risks and improve your health (in the name of being body positive or for any other reason), that can be dangerous, Dr. Srivastava says.

Can Body Neutrality Foster a Healthy Body Image?

While there are a lot of harms linked to a negative body image, not everyone needs to have a positive body image to have a healthy one. Working toward body neutrality, which DeCaro says involves respecting your body for what it can do rather than strictly what it looks like, can be beneficial. “Body neutrality can decrease the guilt and shame associated with a ‘bad body image day’ or feeling frustrated with your body,” DeCaro says.

Any overfocus on your body can be problematic, Engler says. So if a more neutral stance keeps you from thinking about and overthinking your appearance, well-being benefits should follow.

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