Weight & Body Image Disorders: Causes, Symptoms & Signs

Body image refers to how people see themselves. Distorted body image (also called negative body image) refers to an unrealistic view of how someone sees their body.  Like eating disorders, it is seen most commonly in women, but many men also suffer from the disorder.

Body image issues or body insecurity impact pretty much everyone at some point in their life. We live in such an appearance-focused society that it’s near impossible to not be insecure about a physical trait at some point.

American culture is obsessed with thin bodies. This cultural phenomenon is sometimes referred to as the “thin ideal”, which means that thin bodies are viewed as the most attractive body type.

This can create body insecurity for some people who are in a bigger body or feel that they don’t meet societal beauty standards. Negative body image can have a significant impact on someone’s life and mental health. While this is commonly seen in people with eating disorders, not everyone who struggles with body insecurity has an eating disorder.

What is Body Image?

Body image is the way you think or feel about your body. Your body image may be positive or negative. Everyone’s relationship with their body is different. Significant life events, such as having a baby or going through chemotherapy, can change your body image.

However, we start forming our body image from a young age. As children we are like little sponges that absorb all the messages around us. These messages shape the way we view ourselves, others, and the world around us.

Some of the messages we receive as children are direct, such as things we hear from the people around us. For example, if your family made comments about your appearance or other people’s appearance, it’s likely that you started figuring out what was considered a good or bad body based on these comments.

Children also absorb indirect messages, such as subliminal messages in media. For example, in a TV show all the popular kids might have a certain body type while the character who plays the villain or is cast as the unpopular one is overweight. This is a way to communicate that being in a bigger body is bad.

Media is known to significantly impact body image. [1] Media includes television, movies, advertisements, and social media such as Instagram and TikTok. We are constantly surrounded by messages about our bodies through these media sources.

What is Body Dysmorphia?

When some individuals have a low body image, they may develop an eating disorder or body dysmorphia. Body dysmorphia is a mental health condition. This term is thrown around often in the media and in mental health circles so you might be wondering about the actual definition of dysmorphia. [2]

This condition is included in the official diagnostic manual that doctors and other mental health professionals use to diagnose their clients. In order for someone to be diagnosed with body dysmorphia, they must meet the following criteria: [2]

  1. Preoccupation with one or more perceived physical defects or flaws that are not noticeable to others
  2. At some point while having this condition, the person struggling has performed repetitive behaviors (e.g mirror checking, reassurance seeking, etc) or mental acts (i.e comparisons) in response to their worries about their appearance
  3. Preoccupation with the perceived flaws causes clinically significant distress and impairment in one or more areas of someone’s life, such as their social or occupational functioning
  4. These body image concerns are not due to an eating disorder

What are the Signs of Negative Body Image?

Some signs of negative body image problems include:

  • Being unable to accept a compliment
  • Mood is significantly shaped by how they think they look that day
  • Constant comparisons to others
  • Only posting edited photos or videos on social media
  • Use negative phrases, such as “ugly” or “disgusting” to describe themselves
  • Seeking constant reassurance from others that their looks are okay
  • Consistently distorted body image
  • Belief that if they could reach their beauty goals then they would be happier
  • Equate thinness or other physical features with success, perfection, or happiness
  • Ongoing fear of gaining weight
  • Feelings of shame about themselves or their body

What are the Causes of Body Image Problems?

Body image is complex. There are so many things that can contribute to body image problems. [1,3] Some things that can impact body image include:

  • Media
  • Early childhood experiences
  • Trauma or abuse
  • Comments made from other people

If you are struggling with body image, there might be several factors that feed into it. Working with a qualified therapist can help you sort through these things.

Sometimes body image is negatively impacted by one or more significant events.  For example, a gymnast who is continually chided by her coach and fellow athletes to lose a little weight may develop a deeply ingrained and long-standing dissatisfaction with her body, no matter how thin she becomes.

If  you are concerned about your body image, here are some questions to ask yourself:

  • Is my perception of beauty distorted from years of media exposure that glorifies a very thin ideal that is unrealistic for most people to obtain in a healthy manner?
  • Do I find myself regularly criticizing my own appearance?

Relationship Between Body & Weight Image

A normally healthy weight range for an individual can be perceived as overweight by someone with a distorted body image.  A young person may look at themself in a mirror and see a reflection that is greater than their actual size.

Conversely, it is not uncommon for individuals in larger bodies to report that they did not realize they were as big as they are and had perceived their body as much smaller until an occasion arises where they see a photograph, video or window reflection that strikes a nerve and causes them to come to terms with their actual image.

Relationship Between An Eating Disorder & Body Image

Body image concerns and eating disorders go hand in hand.  Often, it is the early dissatisfaction with a young person’s appearance that leads them to conclude that losing weight would enhance their appearance, and make them feel better about themselves and their bodies.

Thus, restrictive eating and over-exercising are often next, frequently leading to patterns of disordered eating and weight obsession that can develop into anorexia, bulimia, orthorexia, compulsive overeating or binge eating disorder.

therapy session

Treatment For Negative Body Image

Getting treatment for distorted body image is a critical step to recovery. The problem won’t just go away by itself.

Recognizing and acknowledging your feelings and accompanying body sensations will help you become more comfortable in your body and lessens the tendency to suppress feelings and revert to unhealthy, negative inner diatribes to escape uncomfortable feelings.

Cognitive Behavioral Therapy, an approach where irrational thoughts are recognized, analyzed and restructured to more rational self-talk, is frequently used.

Additionally, dance and movement therapy can be employed to develop a greater trust and appreciation of one’s body based upon creating internal experiences, rather than simply evaluating one’s body aesthetically.

Many centers for eating disorder treatment specialize in body image awareness.

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Therapy Options

Body image issues are common in people with eating disorders. In fact, one of the key features of Anorexia nervosa is an intense fear of gaining weight or becoming fat. [2] It’s important to treat both the eating disorder and the poor body image.

There are evidence-based practices that can help treat these co-occurring conditions. However, it’s important to remember that everyone is different, so other approaches may also be helpful.

A mental health provider may use a combination of approaches to help you accomplish your goals in recovering from an eating disorder and body image insecurity. Some treatment approaches include:

  • Cognitive Behavioral Therapy (CBT)- CBT is a therapeutic modality that focuses on how your thoughts impact the way you feel and behave. A CBT therapist will work with you to figure out and replace any negative thinking patterns that contribute to your negative body image and disordered eating behaviors. For example, someone may have really negative thoughts about their body that lead to low self-esteem.
  • Dialectical Behavior Therapy (DBT)- DBT is an approach that can be used in individual or group therapy. DBT helps people develop coping skills, tools to regulate their emotions, and enhance their relationship skills. In eating disorder treatment, this can be useful to help people tolerate distressing emotions, urges, and situations without engaging in disordered eating.
  • Art Therapy- Art therapy can be useful for helping people sort through difficult emotions and express themselves. There are so many different art therapy interventions that can help with poor body image and disordered eating.
  • Individual Therapy- There are many different ways to work with an individual dealing with co-occurring eating disorder and body insecurity. Each individual is different and individual therapy gives you an opportunity to work through your unique circumstances. For example, someone may need help working through unrealistic body image standards while another person needs to process unresolved trauma that they are attempting to cope with through disordered eating.
  • Family Therapy- Family therapy is sometimes included in eating disorder treatment. Family therapy gives family members an opportunity to learn more about how to support their loved one and work through any family dynamics that may be contributing to the disorder.
  • Group Therapy- Group therapy is an opportunity to give and receive support from others who are in a similar situation as you. This can provide group members with a sense of accountability, connection, and support.

There are many different treatment techniques. Each treatment center and provider may offer something different. If you or your loved one could benefit from treatment, look here to find a treatment center near you.


[1] National Eating Disorders Association. (n.d). Media and eating disorders. Retrieved July 12th, 2022 from https://www.nationaleatingdisorders.org/media-eating-disorders

[2] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Weight & Body Image Articles

  • Spring break can often be a time that promotes diet fads and crazes.  Poor body image can make individuals susceptible to self-criticism and low self-esteem.  Learn more about the signs of poor body image, ways to strengthen your self-esteem, and boost your confidence.
  • There are a lot of people who want to “drop a few pounds” or “get healthy”, so many that “losing a few pounds” has created a $50 billion industry. Often, the people trying to lose weight will chase a fad diet and the misinformation that goes with it. Unfortunately, these diet fads can be dangerous to your health and can lead to an eating disorder.
  • It is widely believed that being obese is detrimental to one’s health. However, are people who are obese really unhealthy? How strong is the evidence that supports this belief? There may be evidence that contradicts the norm established over the past two decades. Is Obesity Really a Problem?
  • Body Image Disturbance is complex and much more that just I Hate or Love My Body. The dissatisfaction can range from a little to a severe body-hatred, and the poor body image can be tied to self-esteem issues, depression and eating disorders. It may be challenging to improve ones body image or support another in this effort, but it is essential to recovery from anorexia, bulimia and binge eating disorder.
  • Body Dysmorphic Disorder is a serious affliction that needs to be carefully evaluated. It is a condition where a person develops an imagined defect in their appearance and begins to fixate on this imagined flaw. It becomes such an obsession that the BDD begins to negatively affect the person’s life. Unfortunately, those suffering from Body Dysmorphic Disorder attach strong personal meanings to their beliefs about their appearance.
  • Our perception of our body plays a pivotal role in our self esteem. If we are critical of our bodies, we are likely to feel inadequate, alienated from and ashamed of our bodies.  Often eating disorder sufferers tend to disown uncomfortable feelings and turn toward negative body obsessing as a distraction. Learn more about to one’s true feelings and authentic self, and our relationship to our body image.
  • The pressure to fit in is paramount during our school years.  One’s body has come to be perceived as a billboard for expression of one’s success, power, desirability and status. Preschooler’s have indicated fears of being fat and concern about all the social stigma that goes along with being viewed as obese by their peers. This is coupled with a societal message that kids can and should mold their bodies into the thin ideal so popular in our culture today. Learn more about body image issues in students.
  • From about the age of 10 through 19, it is a roller coaster of body changes, varying and intense emotions and a fledgling sense of identity.  This can be a very painful and difficult time. The good news is parents have the opportunity to greatly influence their child’s developing body image and self esteem. Focusing on children’s unique talents and inner attributes, coupled with unconditional love, offers a strong foundation for a lifelong positive body image. Learn more about creating a healthy body image in your child.
  • What is a healthy weight?  Should it be based on the shifting tides of public opinion over time?  Should it be based on an important sounding mathematical equation, such as BMI?  Or is a healthy weight a unique matter for each individual based on their genes, lifestyle, age and other factors unrelated to societal expectations of what they should look like? Identifying the myths is the first step in determining what is a healthy weight. Read more about healthy weight and body image perception in the media.
  • Two different behaviors are connected with body image: comparison and fantasy. Understanding the root of body image concerns can better help individuals who are struggling with eating disorders. Learn more about the fantasy aspect of body image and how this can give greater insight into what is fueling an eating disorder. Read more about Body Image and Fantasy vs. Comparison
  • Overcoming a negative self-perception and poor body image can seem like a daunting and impossible task. Unfortunately, being overly critical of oneself over long periods of time can lead to deeply ingrained thoughts and behaviors that cannot easily be broken. As you begin a journey towards self-acceptance, it is crucial to realize that rising above destructive thoughts and behaviors requires a fundamental change in how you think about yourself. Body Image and Self-Talk: Do Affirmations Help? Learn about it here.
  • With staggering statistics pointing to the number of adolescent women struggling with eating disorders, poor body image, and low self-esteem, middle-aged women can easily fall to the wayside in the struggle for recovery and wellness. Learn more about how middle-aged women can feel about their body image here.
  • Body image disturbance is one of the most common clinical features attributed to eating disorders. Most contemporary theories consider body dissatisfaction to be the most immediate or proximal antecedent to the development of an eating disorder and empirical studies indeed confirm this association. Learn more about how body image relates to eating disorders here
  • From our earliest days, we hear our physical appearance is critically important in every facet of our life. One off-putting look or perceived slight can send us into crisis mode. If we are not careful, we pass this mindset onto our inner circle and to our children.We know how we get here. The question is, how do we break out of this unhealthy mindset and get not only comfortable with our bodies, but have a healthy self-esteem? Read more about how to do that here.
  • It is not uncommon to hear someone complain about their body or express dissatisfaction with a particular body part. As a culture, we are entrenched with the faulty ideas of body perfection, living in a society that continually reminds us that we are not good enough. Learn more about the dangers of Body Dysmorphic Disorder here.
  • “Males face a unique struggle because society has evolved to tell us that to have body image issues is a sign of weakness. We therefore keep it to ourselves and are much less likely to seek treatment than females. I have had male tell me they are afraid their wives will leave them, they will lose their jobs, and that their sexuality will be questioned if they reveal their eating disorder.” Learn more about Brian Cuban’s experiences with body image here.
  • Loneliness is defined not just by a yearning to be connected to others, it is equally a feeling of disconnectedness from one’s self. This is a pain that anyone who has ever suffered from an eating disorder knows all too well.
  • Due to the exclusive nature of sororities, including the process for joining and establishing membership within a Greek-letter organization, there are many who might argue that these groups influence a culture that could be potentially damaging to a young woman’s body image and self-esteem. Research has revealed that women with higher BMIs have had negative experiences in their attempts to gain membership in certain sororities.
  • Interview with Lois Metzger – “A Trick of the Light” is the story of a 15-year-old boy, Mike Welles, who develops an eating disorder. He has a voice in his head—and for a long time he thinks the voice is on his side. The voice encourages him to get fit, get strong. It tells him to eat less so he can get rid of everything weighing him down.
  • After decades of research on the causes and contributing factors of obesity, the current scientific perspective from experts in the field is that obesity is a multifaceted disease that most commonly develops in response to an interplay of determinants.
  • Meal replacement is precisely that–it reduces food to handy bags of non-appetizing particles that are mixed with water. The idea of it taps into a person’s desire to provide their body with good solid nutrition in the shortest amount of time possible.
  • I figured people had already started the night before when stores opened at 5 pm on Thanksgiving which I felt was absurd. After my entrance into the store, I witnessed a customer yelling at a sales clerk, a wife yelling at a husband, and a mother yelling at a kid – all within 7 minutes.
  • The food pushers. Recognized by their uncanny attention to details about how much you have or have not eaten. Identified by such phrases as, “Eat some more of this dear”, “Or why don’t you try a bite of this?” No matter how well intentioned, food pushers can drive you right over the edge when you are fighting for your life in recovery from an eating disorder.
  • Remember, hunger is a good thing and it reminds us that our metabolism is working correctly. Include a little protein, such as nuts and cheese, at meals and snacks to keep you satiated. Our bodies slow down toward the evening and so does our metabolism.
  • There are so many ways the media promotes unhealthy messages about what beauty is or how a woman’s body should look through photoshopped and distorted images, marketing for fad diets, and promotion of unhealthy or excessive exercise plans.


Reviewed & Approved on 11.2.22 by Jacquelyn Ekern, MS, LPC