The Role of Body Positivity in Eating Disorder Treatment & Recovery

Our relationships with our bodies are deeply personal, constantly shifting and evolving throughout our lifetimes. If you have lived experience with body image concerns, disordered eating, or an eating disorder, adopting a positive (or even neutral) mindset about your body can feel like an unrealistic—if not altogether impossible—task.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), body image disturbances are core clinical characteristics of many eating disorders. In fact, research consistently shows that body image distortion is the strongest psychosocial predictor of eating disorders and disordered eating behaviors. However, we know each eating disorder experience is unique, and as such, not everyone with an eating disorder may experience body image issues. For example, the food disturbances we see among those with Avoidant/Restrictive Food Intake Disorder (ARFID) are not motivated by distorted body image or body dissatisfaction.

A primary goal of eating disorder treatment is reaching a place of body appreciation and respect. While there’s no single “best” approach to improving body image, cultivating body positivity can play a powerful role in facilitating eating disorder treatment and lasting recovery. Through awareness and active practice, those in recovery can experience a new, more accepting relationship with their bodies.

The Connection Between Body Image and Eating Disorders

What do we mean when we talk about body image? To start, it encompasses far more than whether you like or dislike your body. Body image refers to the complex beliefs and attitudes you have about your body, regardless of what it looks like. Your body image represents and informs how you think, feel, perceive, and behave in relation to your body and carries significant implications for your everyday life.

Body image influences our self-esteem, mood, confidence, and interpersonal interactions. When body image perception is altered—for instance, when body image turns into body image distortion, negative body image, or body dissatisfaction—it can cause significant distress.

An unhealthy body image can manifest itself in various ways, including:

• Excessive body checking (compulsively looking at or touching your body to measure size, shape, or appearance)
• Body avoidance (deliberately steering clear of mirrors or activities that draw attention to your body)
• Dieting (intentionally attempting to control your weight through unhealthy food behaviors)

These are common behaviors that take a significant toll on overall psychological well-being and can quickly escalate into a full-blown eating disorder in those susceptible. What’s more, these attempts to quiet body fears and distress may actually reinforce lasting preoccupation with body weight and size.

Body Image Considerations and Pressures

Body image is fundamentally tied to your self-identity and, thus, is informed and affected by the dimensions of your identity, such as:

• Age
• Culture
• Ethnicity
• Race
• Gender
• Physical health
• Mental well-being
• Ability/disability
• Personality
• Sexuality
• Socioeconomic status
• Religion
• Geographic location
• Intersecting identities

In Western culture, body image pressures have long been shaped by capitalism and patriarchy, both of which profit off of appearance insecurities. Today, with help from the media, the $75 billion diet industry tries to convince us that success, popularity, joy, and fulfillment mean improving and controlling our bodies to achieve the ultimate, unattainable body ideal. These suffocating pressures can ignite self-criticism and judgment, negative self-talk, and comparison to others, leading to internalized weight stigma, body shame, and body image issues.

Marginalized identities face a unique set of tensions as they operate outside of White, patriarchal appearance norms and attempt to integrate aspects of multiple cultures into their lives. Each story is different. For many in the LGBTQ+ community, for example, concerns about body image may range from general dissatisfaction to body dysmorphia.

Body image disturbance is a core feature predictive of many eating disorders and eating disorder behaviors. Eating disorders are mental illnesses caused by a combination of environmental, biological, and psychological factors. While environment and culture are only part of the equation, internalizing cultural appearance expectations can result in body dissatisfaction and poor body image, setting the stage for disordered eating. Engaging in eating disorder behaviors can worsen body image insecurities, creating a vicious cycle.

What is Body Positivity?

Despite the cultural hold of Instagram hashtags and weight loss ads, body positivity isn’t about feeling 100% positive about your body. Loving your body every day can be overwhelming and simply not feasible for many people. Rather, body positivity is a social justice movement advocating for equal rights and respect for ALL bodies. The movement was created in the 1960s by and for those in marginalized bodies (e.g., nonbinary, transgender, people of color, people in larger bodies, and more) to challenge appearance-related discrimination at the workplace, in the doctor’s office, at school, and in other public spaces. Its intention is to disrupt problematic logic and the status quo about what constitutes a “good” body. Body positivity opens up inclusion to all bodies through allyship and celebration.

Formed in opposition to diet culture, these days, body positivity has been appropriated and commodified by the fitness and beauty industries and the media. Now, people in privileged bodies are at the center of conversations, heralding the importance of body performance, improvement, and transformation instead of the body positive message to accept the body, regardless of appearance or function. Body positivity is for everyone; however, people in non-marginalized bodies should show allyship by recognizing their position of privilege and understanding that reaching body positivity is different for people who face stigma and ridicule due to their appearance.

Observing body positivity today asks us to use an intersectional social justice framework. Sonya Renee Taylor, international speaker, artist, and author of The Body Is Not an Apology: The Power of Radical Self-Love, argues that if the movement is only positive for some bodies, it is not a body positive movement.

We can recognize the activism that started body positivity by:

• Challenging society’s narrow appearance standards
• Rejecting diet culture messaging
• Broadening your conceptualization of beauty
• Focusing less on how your body looks, and more on nurturing an awareness of the aspects of your inner self (i.e., thoughts, feelings, and bodily signals/needs)
• Examining urges to engage in disordered behaviors that might be motivated by poor body image (e.g., fad dieting, restricting, purging, and binge eating)
• Practicing mindful self-care to promote positive feelings about your body (and begin a reciprocal and self-perpetuating cycle) (e.g., enacting boundaries around unsolicited comments on your body/weight/appearance)
• Avoiding comparing yourself to others
• Recognizing sources of identity that are meaningful in your body image
• Fighting back against internalized fatphobia and body shame
• Advocating for the rights of those in marginalized bodies
• Increasing your exposure to body diversity
• Accepting and respecting all bodies as they are

Although mainstream incarnations of the body positivity movement have their flaws, when you honor the origins of body positivity, you can cultivate greater appreciation and care for your body.

Applications of Body Positivity in Eating Disorder Treatment and Recovery

As mentioned, positive body image is a protective factor that can make you less susceptible to developing or exacerbating an eating disorder. People experiencing body dissatisfaction can become preoccupied with trying to change their body shape and size, which can drive them to engage in disordered eating and can lead to intense feelings of disappointment, shame, and guilt.

When we understand body positivity as the transition from limiting body shame to cultivating body respect, it takes the pressure off of embracing all aspects of your appearance. This is a more realistic eating disorder recovery goal than full body acceptance or mainstream body positivity, which calls for individuals to love their bodies all the time. While there’s nothing wrong with holding full acceptance or love of your body as an end goal for recovery, it can feel out of reach for many people and reinforce the all-or-nothing thinking of the eating disorder. It’s normal to have days where you don’t love how your body looks.

Improving body image in eating disorder treatment is hard work. It often comes last in the therapeutic process after restoring physical health, dispelling disordered thoughts, and changing behavioral patterns. Body image is deeply ingrained, and it can be challenging to change the internal narrative you have about your body. At Veritas Collaborative, we aim to help patients place proportionate value on body image and shift their self-worth away from their appearance.

Here are some ways you can incorporate body positivity into eating disorder treatment and recovery:

1. Practice Embodiment

Many people with eating disorders experience a sense of disembodiment. This means that they’re unable to connect with how they feel in their body, what their body wants, or to recognize cues from their bodies. Embodiment is a powerful way to think about how it feels to live inside your body and identify with your own unique experience. Listening to your body’s intuition and wisdom can promote self-love.

In treatment, patients are asked to think about how it feels to embody their bodies by engaging in mindful eating. This involves reconnecting, respecting, honoring, and meeting your body’s natural hunger and satiety cues. We also integrate yoga and mindfulness into treatment. Both practices can support embodiment as ways to tune into the body and become aligned with its signals and how it feels.

Joyful movement in recovery can support an attuned relationship with your body, as well. Rather than exercising out of a sense of obligation or punishment, to manipulate your body size, or as a barometer of your worthiness, base your movement on what actually feels pleasurable. Mindful movement can be motivated by authentic enjoyment and genuine interest. It should honor your body’s limitations and focus on the process rather than the outcome. The “best” kind of movement in recovery is different for everyone. Your care team can offer recommendations based on your physical and mental state and personal preferences.

Embodiment insulates us from the risks of external body image pressures and promotes the ability to listen to our intuition, boosting our self-esteem. Engaging in practices that facilitate a mind-body connection can help you better understand and respond to your body’s cues (e.g., hunger/fullness, energy levels, feeling healthy/unwell) and, thus, better honor yourself and your needs.

2. Address Unrealistic Body Standards

Those who believe they do not have the “right” body can spend years—if not a lifetime—trying to manipulate themselves into a more socially acceptable body, all while forfeiting precious time and energy.

Body positivity is about social inclusion. It introduces the idea that there is far more than one way to look and that every body is worthy of love and acceptance. Combatting your inner self-critic can help build confidence and respect for your body. When you notice negative thoughts and internalized body shame or experience distorted body image, try to counteract them with more helpful reframes like, “I’m treating my body with love,” “This is an unhelpful cultural belief; it doesn’t have to be mine,” or “My [weight/size/appearance] does not define my worth.”

Rehearsing daily self-compassion and body appreciation affirmations can help improve your body image narrative. In addition, try to avoid content that reinforces the belief that certain bodies are “bad.” Be a critical media viewer and learn to spot how cultural depictions might contribute to a negative sense of self. Limit or restrict your engagement with online personalities or social media accounts that uphold fatphobia and mainstream beauty standards. Consider expanding your social feeds to include more body representation, listening to podcasts about body diversity, avoiding stereotyping people based on their appearance, and acknowledging the systemic issues preventing so many folks from feeling safe and comfortable in their bodies.

Pursuing more inclusive representations of bodies can liberate you from societal ideologies of what constitutes a “good” body. We all deserve better than our culture’s attacks on body diversity.

3. Separate Your Worth From Your Appearance

We’re taught from a young age to equate our worth with our appearance and body size, which are fragile foundations for identity. It makes any changes to our body and appearance—think: changes related to age, puberty, illness, injury, mental health, loss, pregnancy, postpartum, menopause, medication, and more—a personal failing. When your body is tangled up with your identity, your happiness and self-worth are contingent upon reaching the “perfect” body ideal (however you define it). It can make you more vulnerable to self-criticism, sociocultural appearance pressures, disordered habits, body comparison, and lower levels of positive body image. It also makes it even harder to cope with possible physical changes to the body in eating disorder recovery, like essential weight restoration.

Research shows that for those who experience positive body image, “the body itself is peripheral.” When your self-worth transcends your body and appearance, it opens you up to personal empowerment and the opportunity to find happiness with who you are from within. Focusing on your positive qualities, strengths, skills, and values can help you redefine who you are and grow in appreciation for your whole self.

You’re a lot less likely to chase society’s impossible ideals and view your body as the enemy when you explore different aspects of yourself unrelated to body and appearance. Set aside time to identify and cultivate activities that align with your internal qualities and talents, such as:

• Making time for creative pursuits
• Engaging in community service
• Practicing recovery coping strategies
• Building new relationships and strengthening existing ones
• Learning new skills
• Advocating for social issues
• Seeking ways to improve work-life (or school-life) balance
• Prioritizing relaxation
• Reflecting on your recovery goals
• Writing in a gratitude journal

You are so much more than what you look like. Within body positive relationships, changes to the body are not contingencies for self-worth or self-care. Practice cherishing whatever it is that makes you special.

Looking Beyond Body Positivity

Remember that it’s okay if body positivity doesn’t come immediately in eating disorder treatment and recovery. Body acceptance and body neutrality may offer a more enticing middle ground between body image distress and body love. The body acceptance movement, for example, allows space for bodily insecurities and bad body image days. For a person with body dysmorphic disorder, this way of thinking can help cultivate acceptance of their perceived “flaws” without resorting to disordered eating or exercise behaviors. Body neutrality takes a “no judgment” approach, arguing that a person’s body is neither good nor bad. It’s the idea that we can still care for our bodies even if we don’t view them in a positive light. Body neutrality frees you from the expectation of having to love your body all the time, allowing you to process your self-image without fear of judgment.

There is no singular “right” approach to improving your body image. You can utilize aspects of all three movements (body positivity, body acceptance, and body neutrality) in treatment and recovery. Explore what resonates with where you are now and where you want to be. Know it is fully possible to reach a point in recovery where you can experience an outpouring of genuine love and respect for your body. Remember that trusting the authority of your own body experience and listening to your body’s intuition can profoundly impact how you relate to yourself and the world around you.

Envisioning a life that is more than being at war with your body? If your body image struggles are negatively impacting your life, straining your self-worth, and perpetuating eating disorder symptoms, don’t delay care. You are worth recovery now. Call us at 1-866-955-0757 or fill out our online form.

Veritas Collaborative is a specialty healthcare system for the treatment of eating disorders. Providing a range of services for individuals of all ages, Veritas offers Inpatient, Residential, Partial Hospitalization, Intensive Outpatient, and Outpatient levels of care. Multidisciplinary treatment teams – made up of physicians, psychiatrists, dietitians, culinary professionals, therapists, nurses, and skilled therapeutic assistants – aim to equip individuals, families, and communities with the skills necessary to continue recovery in the home environment. For more information, please visit: veritascollaborative.com.