Low self-esteem is an integral part of eating disorders like anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), often driving many of the disordered thoughts and behaviors that characterize these conditions.

But that doesn’t mean this low state of mind has to define the people who struggle with eating disorders.

It’s possible to overcome low self-esteem in eating disorder treatment and recovery with a number of therapeutic techniques and tools that can help you reestablish a healthier outlook and relationship with yourself, your body, and the food you eat.

Low Self-Esteem And Eating Disorders: What’s The Link?

Low self-esteem can cause, or be caused by, eating disorders, but the two nearly always go hand-in-hand. In fact, one study on the subject found that chronic low self-esteem was a prerequisite for developing an eating disorder of any kind. [1]

There are generally two types of self-esteem issues that impact people with eating disorders: [2]

Core low self-esteem: This describes people who have little-to-no self-worth and continually low opinions of themselves. They also often struggle with pervasive pessimism and hopelessness.
Secondary self-criticism: This trait often centers around comparisons. Someone may feel lesser than, as in not as thin or attractive as other people, or they may feel they don’t stack up to their own goals around weight and appearance.

Of course, it’s possible for someone to also struggle with both of these conditions. In either case, low self-worth and negative comparisons can work to develop a negative body image and drive problematic eating behavior. Disordered eating behaviors can also then work to continue driving body dissatisfaction and low self-esteem.

Low self-esteem has also long been related to depression, and depression has long been understood as one of the most frequently co-occurring mental health disorders with eating disorders of all types. [3,4]

Therapy to Overcome Low Self-Esteem

Low self-esteem can seem impossible to work through, and the depressive nature that often accompanies the trait can make it feel even harder.

However, there are a number of therapeutic techniques and other exercises that may help you improve your self-esteem during eating disorder treatment or recovery.

Those techniques are divided into two major schools of thought: Cognitive-behavioral approaches and interpersonal approaches.

Cognitive-Behavioral Treatments

Cognitive behavioral therapy (CBT) is one of the most common types of treatment for eating disorders like binge eating disorder and bulimia nervosa.

The concept centers around the idea that disordered behaviors are borne of disordered thoughts, and the treatment sessions focus on helping patients recognize these unhelpful thoughts and redirect them, with the overall goal of eventually stopping these thoughts altogether. [5]

This course of treatment has also been found to help people develop better self-image and self-esteem. In one study, patients tested for improved body image, weakened thoughts of poor body image, higher self-esteem development, and enhanced feelings of physical fitness and sexuality in as little as three weeks of treatment. [6]

Types of Cognitive Behavioral Therapy

While CBT is the foundational version of cognitive-behavioral therapy, the technique has branched out to several other therapeutic schools of thought, including:

Diagnostic behavioral therapy (DBT): Similar to CBT, but with an additional emphasis on accepting the duality of nature. In the case of people with eating disorders, they focus on both the need to change and love themselves. [7]
Enhanced cognitive behavioral therapy (CBT-e): Enhanced cognitive behavioral therapy was actually developed specifically to help patients work on issues like low self-esteem. While the majority of the treatment follows the same format as CBT, additional modules are added to address core low self-esteem and other external obstacles to change. [8]

Interpersonal Psychotherapy

Self-esteem may come from within, but the way someone feels about themselves can also be influenced by outside factors and relationships. Addressing these social dynamics is the goal of interpersonal psychotherapy (IPT).

The technique was developed primarily to address depression, and it strives to help people recognize changing or unhelpful relationship dynamics in their lives and make changes to feel more positive about their social roles. [9]

Patients are also given tools to help them better relate to others, more confidently express their thoughts and needs, and more clearly define their boundaries. As a result, the method has been found to help raise self-esteem, among other benefits. [9]

How to Stay Positive Through Eating Disorder Recovery

Eating disorder recovery rarely takes place in a straight line. There are often setbacks, relapses, or pauses in progress, and this can be particularly troubling for those with low self-esteem.

But there are a number of therapeutic techniques and other exercises that may help you stay positive and hold on to your progress, in spite of setbacks, during eating disorder treatment or recovery.

Use Positive Affirmations

The power of suggestion is strong in the mind.

Continuously telling yourself something, even if you don’t believe it at first, can help reshape your mind and thoughts around the idea until you sincerely believe it. And this can have a powerful effect when the message you’re telling yourself is positive.

Some positive affirmations you may want to try include:

I am good enough.
I am worthy of recovery.
My body is beautiful, just as it is.
My body is strong. It carries me and provides me with many wonderful experiences.
I am stronger than my eating disorder.
I am beautiful.
I am worthy of happiness.

Positive affirmations can also help train your mind to look for the good in things. This shifting mindset can help you stay away from negative self-talk long term and help you develop a greater sense of peace and appreciation for life.

Utilize Your Support System

Cultivating a strong support group in eating disorder treatment is one of the most important things you can do to maintain positivity throughout the experience.

Eating disorder symptoms may thrive in isolation, but exposing your thoughts and behaviors to the light can help dissipate the bad feelings that drive them. An eating disorder support group, group therapy group, or even your loved ones can be great places for you to express these concerns.

Support groups, in particular, are wonderful forums to receive feedback and advice from others who are going through or have gone through similar situations. These meetings also offer good opportunities to practice new skills around improving self-esteem and overall mental health.

Practice Self-Care

Self-care is another essential ingredient for building high self-esteem. Taking time for yourself to indulge in things you enjoy can help make you feel better and enhance your sense of self-worth.

Going for a walk, writing in your journal, calling a friend, taking a long bath, or doing other enjoyable activities can help you relax. This can help prime you to stop over-thinking things and cultivate a greater sense of acceptance, which can help you feel better about yourself. [10]

Making the time specifically to treat yourself to these things can help reinforce the point that you deserve the happiness they bring into your life.

Practice Mindfulness

Like self-care, mindfulness practices can introduce a number of beneficial changes to your perspective.

The technique involves focusing on the present moment, informed by both inner- and outer sensations. From an observational point of view, you take in these experiences without judgment. This mindset can help you separate objective reality from your thoughts and feelings, which can leave more mental space for you to grow your self-esteem and self-image.

The practice has been found to not only improve someone’s self-esteem and sense of self-worth but to improve overall quality of life. [11]

Conclusion

Low self-esteem can be a diabolical symptom to overcome, as the nature of the trait itself can make it more difficult to do something about the bad feelings it incurs. But with the right kind of help and a little bit of practice, it is possible to take a more positive view of yourself and your situation—and the results can be powerful.

Cultivating and maintaining positive self-esteem is one of the best ways to combat unhealthy eating pathology and keep you or your loved one firmly on the road to recovery. With the right kind of mindset, nearly anything is possible, including overcoming eating disorders.

References

Silverstone PH. (1992). Is chronic low self-esteem the cause of eating disorders? Medical Hypotheses; 92(4):311-315.
Dalle Grave R. (2022, April 2). Low Self-Esteem and Eating Disorders. Psychology Today. Accessed September 2023.
Orth U, Robins R. (2013). Understanding the Link Between Low Self-Esteem and Depression. Current Directions in Psychological Science; 22(6):455-460.
Blinder B, Cumella E, Sanathara V. (2006). Psychiatric Comorbidities of Female Inpatients With Eating Disorders. Psychosomatic Medicine; 68(3):454-462.
What is Cognitive Behavioral Therapy? (2017). American Psychiatric Association. Accessed September 2023.
Butters JW, & Cash TF. (1987). Cognitive-behavioral treatment of women’s body-image dissatisfaction. Journal of Consulting and Clinical Psychology; 55(6):889–897.
Dialectical Behavior Therapy. (n.d.). Psychology Today. Accessed September 2023.
Murphy R, Straebler S, Cooper Z, & Fairburn CG. (2010). Cognitive behavioral therapy for eating disorders. The Psychiatric Clinics of North America; 33(3):611–627.
Markowitz JC, & Weissman MM. (2004). Interpersonal psychotherapy: principles and applications. World Psychiatry; 3(3):136–139.
Self-Care Tips for the Body & Soul. (n.d.). Duke University. Accessed September 2023.
Chandna S, Sharma P, & Moosath H. (2022). The Mindful Self: Exploring Mindfulness in Relation with Self-esteem and Self-efficacy in Indian Population. Psychological Studies; 67(2):261–272.

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated on April 5, 2024
Published on EatingDisorderHope.com

How Do I Overcome Low Self-Esteem in Eating Disorder Recovery?