Addressing Body Image in Eating Disorder Treatment
The majority of American women are dissatisfied with their bodies. One study found that 86 percent of women want to lose weight, and in another study, 63 percent of female participants identified weight as the key factor in determining how they felt about themselves — even more important than family, school, or career.
For some, the result of this dissatisfaction is the development of an eating disorder. One cause of eating disorders, experts argue, is the negative messages women in particular receive from the media. According to studies, higher rates of body dissatisfaction and drive for thinness have been associated with the rates of exposure to soap operas, movies, and music videos. As young people spend more time watching television and movies and thumbing through magazines, eating disorders such as anorexia and bulimia are being diagnosed at younger ages (some as young as 8 or 9), and with greater frequency.
Because eating disorders are the most fatal of all mental illnesses, professional treatment is often an absolute necessity. At Center for Hope of the Sierras, a renowned eating disorder treatment program for women ages 16 and up, patients receive residential treatment and a step-down transitional program for the treatment of anorexia nervosa, bulimia nervosa, and related disorders. Each client’s comprehensive treatment plan includes individual, group, and family counseling designed to promote healing through equine programs, art therapy, meditation, yoga, body image groups, and more.
Anna Treacy, MPH, NCHES, leads weekly body image groups and individual educational sessions with Center for Hope’s eating disorder patients. As a 10-year veteran health educator who has worked at Center for Hope since its inception, Treacy has an arsenal of tools and approaches to helping women work through their body image issues. Having fully recovered from an eating disorder herself, she knows all too well the devastation a woman’s mind can inflict on her body.
Connecting the Mind and Body
According to Treacy, effective eating disorder treatment rebuilds the damaged connection between the mind and body. Women with eating disorders often suffer from a distorted body image, in which they misperceive the size, shape, or attractiveness of their body. In treatment, patients learn how to transform their distorted self-perception, identify and respond to internal cues, and begin to develop personal boundaries and a sense of self.
“Almost every woman who has come to Center for Hope has had issues with body image,” notes Treacy. “Some are completely disassociated from their bodies and won’t even look in the mirror, while others tear down their bodies to the point of self-harm. In either case, the connection between mind and body has been severely damaged and must be repaired by developing new coping mechanisms and an improved self-image.”
One body image exercise Treacy uses in group sessions at Center for Hope is for each participant to write a letter from her mind to her body, and from her body to her mind. Once she’s comfortable, the patient will share her work with a group of supportive and understanding peers “Group sessions create an enriching peer environment where women can see that they’re not alone in the world,” explains Treacy. “When they see that others have been feeling the same way, they feel more comfortable addressing their deep-seated issues.”
The patients at Center for Hope are also asked to complete an individual self-assessment, working through a list of body parts and indicating which parts they’re comfortable with, and which they are not. The women also describe any body image rituals, such as pinching fat, visually dissecting themselves in the mirror, measuring their wrist with their fingers, and seeing how much bone they can feel on their bodies.
Through this process, staff discovers what influences have impacted each woman negatively or positively, including media images and feedback from meaningful people in their lives, and how her eating disordered patterns manifest in daily life. Each patient is then asked to fill out a “body image statement of intent” to put in writing her goals during treatment and concretely describe how she wants to feel about herself and her body.
Acceptance and Self-Love
“Much of the work we do at Center for Hope centers on helping women get to know, accept, and love who they are. By the time they complete formal treatment, we want them to stand on firm ground regarding their own self-worth, in spite of negative messages from the media or the numbers on the scale, clothing labels, or tape measurer.”
Using cognitive-behavioral therapy, positive affirmations, and mirror work, Treacy helps clients restructure their rituals and self-image. In one exercise, the women take pictures of themselves and label the photos with positive body affirmations. In this way, patients begin to associate their own image with positive characteristics.
In another exercise, Treacy provides patients with diet and beauty magazines that are likely to trigger eating disordered thinking and asks them to make collages of images, words, or advertisements that lead to rituals, self-harm, or eating disorder behaviors. As a group, the participants discuss how those images affected them and what they feel ready to let go of in each collage. Together, they go outside and burn those images as a symbol of release, which leads to a discussion of actions they will take to avoid being affected by those messages in the future. For some women, this means limiting their exposure to negative media messages in television and magazines; for others, it means using positive affirmations or learning to identify and challenge negative thought patterns.
Part of the process of learning acceptance and self-love is making fewer comparisons to other people. At Center for Hope, Treacy takes the residents to a popular summer swimming spot and asks them to write down their judgments about others and themselves, as well as the way it feels to make those judgments. The women then discuss ways to avoid or limit making judgments, treat themselves and others with compassion, and align their thoughts and behaviors with their core values.
Eating disorders don’t have to be a life sentence. With intensive treatment at the appropriate level of care, women can and do go on to lead healthy, productive, and fulfilling lives. The staff of licensed clinicians, registered nurses, a dietician, chef, psychiatrist, and physician at Center for Hope of the Sierras has helped hundreds of women with anorexia, bulimia, and related disorders recover with compassion and dignity. For more information about eating disorder treatment at Center for Hope, or call (866) 690-7242.