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Body image describes the way you see your body—and the way you feel in it. It refers to appearance and perception. If you have a positive body image, the way you perceive your body is realistic. You accept yourself and feel confident in your own skin. Plus, you know that your looks aren’t everything; they don’t affect your inner life or your relationships to the outside world. Unfortunately, negative body image is prevalent. It’s not difficult to see why so many people—women, men, and non-binary individuals—constantly feel ashamed and self-conscious about their bodies. Sometimes, negative body image can lead individuals to try to change the way they look; this obsession can lead to even bigger issues like eating disorders.

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How do eating disorders develop?

Pick up any magazine, and you’ll find headlines about weight loss and dieting. Turn on the TV, and you’ll see reality shows about obesity and plastic surgery. Flip on the radio, and hear talk show hosts criticizing a celebrity’s body. It happens on social media platforms, including Instagram, Facebook, and Twitter. Users who post photos often receive negative feedback about their bodies in the comments section from both strangers and friends. Body shaming is everywhere.

It’s not uncommon to internalize what other people say, especially the people close to you. Your roommate may complain that she’s “so fat” because she ate a piece of cake after dinner. What does that mean for you if you ate the same thing? Your best friend may head to the gym more than once a day to bulk up, hoping to look like models in advertisements. What is he trying to say about your body when you don’t lift at all? A classmate may comment on your photo on Instagram: “You look so skinny!” Does that mean you were overweight before?

It’s difficult to listen to so much negative talk about bodies without thinking about your own.

Everyone has days when they feel self-conscious about their bodies, but people with positive body image are able to overcome those thoughts. Negative body image, however, fosters unhealthy habits. It affects much more than self-esteem. People who hold a negative body image are more likely to feel depressed, obsess over weight loss and exercise, or develop an eating disorder.

What are the signs of an eating disorder?

Eating disorders are illnesses that severely interfere with a person’s eating behaviors. Disturbing a person’s diet and exercise habits, these disorders also affect attitudes about obesity, weight, and body shape. They are mental illnesses, but eating disorders can jeopardize physical health as well. According to the National Eating Disorder Association, they increase the risk of suffering any of the following:

• Malnutrition
• Hair loss
• Dehydration and kidney failure
• Weakness and fatigue
• Extreme weight loss or weight gain
• Organ and/or tissue damage
• Muscle and/or bone injuries
• Impaired immune function
• Irregular monthly periods and reproductive problems
• Changes in heart rate and blood pressure, which can lead to heart attack
• Death

What are the different types of eating disorders?

• Anorexia nervosa is an eating disorder with three main characteristics: a distorted and negative body image, fear of weight gain, and refusal to maintain a healthy weight. A person suffering from anorexia typically self-starves and over-exercises as part of his or her obsession to lose weight and be in control of their body. Sometimes, but not always, purging after eating (vomiting or using laxatives or diuretics) is also involved. A person with anorexia is usually thin, often dangerously so. This low body weight can lead to a host of physical health issues, such as infertility, brain damage, multi-organ failure, and death. Though these physical implications are extreme, anorexia is a mental disorder in which self-worth is intertwined with weight. To treat associated physical problems, doctors must also treat anorexia as a mental illness.
• Bulimia nervosa is characterized by frequent and unmanageable episodes of overeating followed by purging. This means that a person suffering from bulimia may try to counter his or her consumption of calories by vomiting, exercising excessively, or using laxatives or diuretics improperly. A long-term battle with bulimia often leads to dental problems, diarrhea or constipation, a chronically inflamed throat, acid reflux disorder, and severe dehydration. A person suffering from bulimia could appear thin, overweight, or in-between. He or she may rapidly lose and/or gain weight, often changing sizes.
• Binge eating disorder, like bulimia, involves overeating and the associated feeling of being out of control. People suffering from binge eating disorder are unable to manage the amount of food that they consume. Unlike with bulimia, however, binge eating is not followed by purging of any kind. People with binge eating disorder eat when they’re not hungry; eat large quantities of food leading them to feel uncomfortable, guilty, or depressed; and may elect to eat alone so no one can see how much food they’re eating. It commonly leads to obesity, high blood pressure, high cholesterol, cardiovascular diseases, and diabetes.
• Muscle dysmorphia is a disorder that is usually considered the opposite of anorexia. People with muscle dysmorphia have a distorted and negative body image, fear that they are too small or too skinny, and obsess over their physique. They may exercise and lift weights compulsively and consume protein shakes or food supplements in excess. There is also a positive correlation between muscle dysmorphia and steroid use. While most eating disorders primarily affect women, muscle dysmorphia is unique because it most commonly affects men.

How can I tell if someone has an eating disorder?

Many people with eating disorders realize that their behavior or obsession is unhealthy, but their illness is so consuming that it interferes with their ability to seek help. They may try to hide their unhealthy habits, so it is particularly important for family members and close friends to speak up if they recognize patterns of harmful behavior over time. You may notice that your loved one is exercising compulsively, obsessing over calorie calculations, giving excuses at mealtime to avoid eating, disappearing into the bathroom immediately after meals, experiencing mood swings, or constantly talking about weight and bodies. You might also notice physical signs of eating disorders: extremely low body weight, dramatic fluctuations in weight, a sudden increase in muscle, etc.

If you think that you or someone that you know has an eating disorder, it is important to speak up. Reach out to your support system if you are in need or urge your friend to visit a physician.

How are eating disorders diagnosed?

Each eating disorder has its own diagnostic criteria, but all are mental illnesses in standard medical manuals (including the DSM-5, the current diagnostic manual used by mental health professionals). These disorders are particularly harmful because they also damage physical health. It is impossible to treat a physical symptom of an eating disorder—low body weight, for example—without targeting the root cause.

Because eating disorders affect mental and physical health, multiple health care professionals may work together to diagnose the illness. According to the Mayo Clinic, a medical doctor usually performs a physical exam and lab tests to eliminate other possible causes for the change in eating habits. A mental health specialist may then evaluate the patient.

How are eating disorders treated?

Treatment of an eating disorder varies person to person. It depends on the specific disorder, the progression of the illness, and physical health factors. Regardless, mental health specialists, medical doctors, and dietitians work together to treat eating disorders. The first step usually involves teaching you about nutrition and how to maintain a healthy diet.

If your physical health has completely deteriorated, you may first be hospitalized or receive inpatient care until you are stable. This is sometimes done at a rehabilitation center where people recover from eating disorders together. Some centers even offer day programs instead of full, round-the-clock hospitalization.

If you live on campus and plan to remain there as you recover, it is most likely that you will engage in cognitive behavioral therapy, a type of talk therapy that can help you develop healthier coping strategies and guide your progress. If you live at home, you may participate in family-based therapy, in which your family members help you to develop healthy eating habits. This is particularly effective because your support system is there to guide you. If you live on campus or in an off-campus apartment, your friends may decide to cook with you or accompany you to the dining hall or gym to show their support.

Medications may also be used to help treat bingeing and purging behaviors and a preoccupation with food, however medication is rarely the sole form of treatment for those suffering from eating disorders. Furthermore, because depression and anxiety are commonly diagnosed alongside eating disorders, antidepressant and antianxiety medications may be prescribed to treat those symptoms as well.

What resources exist for individuals with eating disorders?

• Crisis Text Line
  • Text "HOME" to 741741.
  • Text line is open 24 hours a day, seven days a week.
  • Texts are confidential
• National Association of Anorexia Nervosa and Associated Disorders
  • Call 630-577-1330.
  • Helpline is open Monday through Friday from 9:00 a.m. to 5:00 p.m. (EST).
• National Eating Disorder Association
  • Call 1-800-931-2237 toll-free or chat with an online representative, or text "NEDA" to 741741.
  • Helpline is open Monday through Thursday from 9:00 a.m. to 9:00 p.m. and Friday from 9:00 a.m. to 5:00 pm (EST).
  • Calls are confidential.

Page last updated: 03/2019