Can Poor Body Image Lead to Relapse?

Recently, I have been experiencing intense feelings of anxiety related to a number of personal challenges. I’ve lain awake at night with racing thoughts. My concentration during the day has been interrupted. My ability to be present with friends and family has been compromised. Why?

Because, in my anxious state, my brain is actively seeking ways to solve the perceived problems and resolve the anxious feelings. In the same way, an individual with poor body image will find his or her mind focused (or shall we say obsessed) on fixing the perceived problem of an unattractive or overweight body.

Table of Contents

    How Do Body Image and Relapse Relate?

    What does this have to do with relapse? If you think that flaws in your body are the primary reason you are depressed, anxious, or lonely, then changing your body will be the main focus of your energy and attention. When you see the body as the primary problem in your life, you will make fixing it the primary goal of your life.

    Unfortunately, the body is merely the perceived problem, and ‘fixing’ it through the use of eating disorder behaviors does not resolve the anxiety. This lines up with research that suggests that poor body image can predict relapse and body image therapy can help prevent it.1,2

    Developing a Healthy Body Image

    Developing a healthy body image is no easy task. Many things must be considered: cultural factors, family attitudes, and traumatic experiences, to name a few. For the remainder of this article, I want to consider how we view and talk about the body and the role these have in improving body image.

    How We View the Body

    Dr. Thomas Fuchs, in his paper The Phenomenology of Shame, Guilt and the Body in Body Dysmorphic Disorder and Depression, describes two ways in which we experience our body. What he calls the lived body describes our experience of living in our body:3 

    “The lived body means not only the felt body, the subjective space of bodily sensations, but comprises my prereflective experience as a whole, insofar as it is conveyed by the medium of the body, by its senses and limbs.”

    By this he means how we go about our daily lives, walking, talking, smelling, and touching our physical world. The lived body is the body we experience when we enjoy a hug, a walk on the beach, the warm sun on our skin. When we are in our lived body, we don’t experience the body as separate from us; we experience our lives in an embodied way.

    The Corporeal Body

    On the other hand, what he calls the corporeal body is the “anatomical object…which can be observed, grasped and even manipulated—an object.”3

    The corporeal body is often most apparent to us when we perceive there to be something wrong with it. When we feel tired, injured, sick, we begin to say things about the body. “My legs are sore” as opposed to I’m sore. My head hurts as opposed to “I hurt”.

    The corporeal body experience is something all humans experience but, I would suggest, is more intense for those with body dissatisfaction.

    The Body as Something to be “Fixed”

    For someone with poor body image, the body is seen as something to be fixed. It becomes an object of scorn. There is a distancing between the sense of self and the bodily form. Fuchs writes:3

    “When the body becomes objectified, it feels more ‘alien’ to me, takes up more of my attention and energy, and may even feel like an enemy.”

    Feeling like the body is the enemy is a common experience, not only for those with an eating disorder but for many in our culture, as evidenced by how we talk about bodies.

    How We Talk About the Body

    In a 2015 New York Times article, Renee Engeln, a psychologist at Northwestern University, wrote about the damaging effects of “fat talk”.4 An example of “fat talk” is adolescent girls talking about the shape or size of their bodies, usually in a negative way.5 This is an acceptable cultural way of viewing the body as a corporeal body rather than a lived body. She writes:

    “Conversational shaming of the body has become practically a ritual of womanhood (though men also engage in it). In a survey that a colleague and I reported in 2011 in the Psychology of Women Quarterly, we found that more than 90% of college women reported engaging in fat talk—despite the fact that only 9% were actually overweight.”5

    Fat Talk Is Common

    In another survey, published in the Journal of Health Psychology, thousands of women ranging in age from 16 to 70 were canvassed. Contrary to the stereotype of fat talk as a young woman’s practice, we found that fat talk was common across all ages and all body sizes.6

    Making the ‘imperfect’ body (particularly the female body) the target of scorn, hatred and objectification seems to have become a national pastime. For women, this appears to have significant mental health consequences as studies have found that such talk contributes to depression, anxiety, body shame and sexual dysfunction.7

    Seeing the Body in Healthy Ways

    So how do we better see and live in the body in such a way to prevent eating disorders and relapse? There are lots of ideas out there. For now, I want to suggest one: valuing function over form.

    In our culture, when we talk about the body, the emphasis is almost always on how it looks (form) and on comparison, critique, and a desire to manipulate and change its appearance. When taken to an extreme, this directly corresponds to eating disorder behaviors such as restricting, purging, laxative use, and excessive exercise.

    On the other hand, valuing what the body allows you to do (function) results in a lived body experience; one where you are experiencing life through the body rather than separate from it.

    Expressing Gratitude for Your Body

    To build this type of thinking, try this exercise for the next month: every night before you fall asleep, identify 3 things your body allowed you to do that day and express gratitude. Here are some examples to get you started:

    • Walk with a friend
    • Listen to music
    • Hug a baby
    • Pet a dog
    • Feel the wind on your skin
    • Complete a craft
    • Write a letter
    • Read a book

    Become a proponent of healthy body image and begin changing the cultural conversation.

    Resources

    1. Keel PK, Dorer DJ, Franko DL, Jackson SC, Herzog DB. (2005). Postremission Predictors of Relapse in Women With Eating Disorders. The American Journal of Psychiatry; 162(12).
    2. Stice E and Shaw HE. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research; 53(5):985-993. 
    3. Fuchs T. (2003). The Phenomenology of Shame, Guilt and the Body in Body Dysmorphic Disorder and Depression. Journal of Phenomenological Psychology; 33(2). 
    4. Engeln R. (2015). The Problem with ‘Fat Talk.’ The New York Times. 
    5. Salk RH and Engeln-Maddox R. (2011). “If You’re Fat, Then I’m Humongous!”: Frequency, Content, and Impact of Fat Talk Among College Women. Psychology of Women Quarterly; 35(1).
    6. Englen R. (2015). The Problem With ‘Fat Talk’. The New York Times. Accessed August, 2026.  
    7. Medical Daily. (2015). Body Image and Social Media: Scientists Analyze Harmful ‘Thinspiration’ Photos of Women. (2015). Accessed August, 2026.