The Impact of Eating Disorders on Body Image
Eating disorders are mental illnesses defined by abnormal dietary habits, such as eating excessively small or large amounts of food, that have the potential to cause major physical and mental problems. Most common eating disorders are anorexia, bulimia and binge eating disorder. A distorted and unhealthy body image often accompanies these conditions. For instance, those who suffer from anorexia nervosa entertain an irrational fear of obesity to the point of becoming underweight. Bulimia sufferers compensate episodes of binge eating with purging or excessive exercise because of the same fear of gaining weight. Eating disorders are often characterized by an obsessive preoccupation with body image—a characteristic they share with another mental illness, namely body dysmorphic disorder.
What Is BDD?
Body dysmorphic disorder, commonly known as BDD, is a mental illness characterized by fixation on one or more self-perceived body flaws, leading to serious mental distress and inability to properly function socially. Sometimes the defect in the individual’s appearance is real but utterly exaggerated; other times, it is imagined. Patients may be preoccupied with a facial flaw, such as a long nose, asymmetric features, acne, scars or wrinkles, a perceived defect in any other part of the body, or with their overall body appearance and size. They obsessively try to hide the real or imaginary defect and, while they understand others do not perceive them as “ugly”, their “ugliness” is painfully real in their eyes.
Their preoccupation with appearance leads to obsessive rituals, such as constantly checking their image in the mirror, perpetual grooming, attempts to camouflage the flaw with makeup or clothes, permanently seeking reassurance from others, excessive exercising, etc. Such repetitive habits make this aspect of BDD strikingly similar to OCD (obsessive-compulsive disorder). In fact, these two often coexist.
Social phobia, anxiety and a diminished quality of life are common comorbidities. Sufferers of BDD may become depressed, socially isolated, avoid intimate relationships for fear of being humiliated or even attempt suicide. Suicidal ideation (unusual preoccupation with suicide) is a very common occurrence among those with BDD.
How BDD Relates to Other Disorders
A negative body image is a key factor in both eating disorders and BDD; however, the similarities do not end here. Jon E. Grant and Katharine A. Phillips from the Department of Psychiatry and Human Behavior at Brown Medical School noticed that, for instance, anorexic people can develop excessive concerns related to other body aspects than weight. Their research on anorexia nervosa as a subtype of body dysmorphic disorder was published in the Harvard Review of Psychiatry. Sufferers may be preoccupied with skin or nose appearance or the size of their arms, thighs or other body parts. Repetitive behavior, such as constant body measuring or mirror checking, may also be present in anorexic patients. Sometimes, anorexic patients avoid places or activities that can incite or aggravate their self-consciousness related to their perceived body flaws. It is evident that, in some cases, there is a blurred line between anorexia and BDD.
Even if these similarities pose problems in recognizing the condition, they do not suggest that anorexia is a form of BDD. Similarities only show that sometimes the two are co-occurring conditions tied by the presence of a negative body image. It may be assumed that, in these cases, BDD is a component or a consequence of anorexia, as shown below.
How Disorders Affect How People See Themselves
A negative body image is a key feature and a symptom of many eating disorders. Unfortunately, it is only augmented by such conditions, so it can be considered a consequence of these diseases. The patients enter a vicious circle in which a distorted body image leads to desperate attempts to change their appearance which may induce even more feelings of self-loathing and make them even more susceptible to view their body in a negative way.
It is important to notice that malnutrition contributes to an ever-developing negative body image. Excessive dieting has a direct effect on the brain and, consequently, the way a person sees herself. Therefore, the impact of eating disorders on body image is a powerful link that the patient must break by using professional help.
It can only be presumed that such a negative body image may then lead to BDD; however, the relationship between eating disorders and BDD is still debated. Yet, it is a fact that the two can often coexist and that those who suffer from both are more ill and functionally impaired while also having a higher risk of attempted suicide. In short, the presence of both conditions exacerbates the symptoms.
Other Interesting Suppositions
There are a few observations related to the relationship between BDD and body image that deserve to be mentioned. A UCLA study indicates that impairment to the visual cortex is present in those with BDD. In other words, BDD patients suffer from abnormal visual processing. Therefore, it is possible that the way they perceive themselves has something to do with them simply seeing things differently. The study does not prove whether this visual impairment is a cause or an effect of BDD but opens the discussion regarding the influence of more biological factors on the distorted body image that is a key feature in BDD and most eating disorders.
Given the fact that eating disorders and BDD are potentially deadly diseases, it is best to find professional help whether in a residential treatment facility or an outpatient treatment center. Eating disorders and BDD treatment programs offer cognitive behavioral therapy aimed to challenge patients’ self-image and eliminate destructive habits. Talk and group therapy helps patients to feel less isolated, while nutritional counseling introduces them to lifelong healthy eating habits.