Body Image: What It Is & How It Affects Mental Health

What Is Body Image?

Body image is a combination of a person’s perceived and ideal body image. Someone’s perceived body image is the mental picture they get when they imagine what they look like. There are varying degrees of how realistic a person’s body image may be. They may view themselves realistically, or they may see themselves much differently than others do.

Generally, the more realistic our ideal body image, the more positive our treatment of our bodies. Some people have an ideal body image that is attainable, while others adopt an ideal body image that is so unrealistic that no amount of time in the gym, dieting, or plastic surgery will help them attain their desired appearance.

Four Aspects of Body Image

Body image is an umbrella term that largely speaks to the relationship someone has with their physical body. This can include any thoughts or feelings about how they look to themselves, as well as how they believe they are perceived by other people. Body image exists on a large spectrum and can be shaped by many factors, such as social environment, culture, and temperament.

The four aspects of body image are:

• Perceived body image: Perceived body image refers to how you personally interpret the way you look. This is entirely subjective.
• Affective body image: Affective body language refers to how you feel about your body. Such feelings may include anger, disgust, dissatisfaction, happiness, pride, and more. You may have different feelings about different parts of your body.
• Cognitive body image: Cognitive body image refers to how you think about your body image. This can refer to “thinking” you are fat or “thinking” you don’t look attractive enough.
• Behavioral body image: Behavioral body image refers to the behaviors you engage in due to your body image. For example, someone might undergo a cosmetic procedure to change their appearance.

What Is a Positive Body Image?

A positive body image comes from being able to accept one’s positive attributes along with the parts of themselves that they may be less fond of. When a person learns to evaluate themselves based upon a combination of elements versus solely on their outward appearance, they will be more likely to have a positive body image.

A person with a positive body image accepts themselves and realizes that their appearance is only one facet of who they are. Avoiding comparison and perfectionism are good starting places to developing a healthy body image. If we are comparing ourselves to others and expecting ourselves to be perfect, we will never be satisfied with what we see in the mirror.

An appreciation of what our bodies can do is as important, if not more so, than liking how we look. Examples could include a mother appreciating that her body can carry and deliver a new life, a man appreciating that he is able to play baseball with his son, and a teenage girl loving that she can dance.

Why Is Positive Body Image Important?

A positive body image is important because it impacts the way we feel about ourselves. It impacts our level of confidence and how we interact in our relationships. When a person makes other factors a determinant of self-worth and self-acceptance, their appearance becomes less of a focal point.

This isn’t to say that wanting to look good is inherently bad. It means that we’re far more than our appearance and how it measures up to society’s standard of beauty. When we feel more confident, that confidence shows and becomes a part of who we are and what we do. This helps in our personal relationships, professional ventures, and pursuit of our hobbies.

3 Types of Body Acceptance

There are three types of body acceptance, including body positivity, body neutrality, and body liberation:

Signs of Body Image Issues

We have all met someone who has a negative body image. This person tries to hide behind baggy clothes, criticizes their appearance, and avoids activities such as swimming, family photos, or anything else that involves others noticing their bodies. They miss out on relationships and experiences due to the way that they view themselves in comparison to others.

Here are several signs of negative body image:

• A preoccupation with weight and body shape
• Body dissatisfaction
• Having negative emotions about their body such as self-consciousness, body shame, guilt, or anxiety
• Routinely making negative comments about their size and shape
• Feeling unhappy or distraught over even the slightest increase in body weight
• Engaging in unhealthy behaviors to modify their body such as fasting or dieting, purging, laxative abuse, smoking, or drug usage

Where Does a Negative Body Image Come From?

Negative body image generally stems from numerous sources, including cultural factors, peer influence, family values, mental health issues, and more. Each society has its own standards of beauty, and these ideals—which are often unrealistic—can be rigidly transmitted through media and pop culture. Such messaging starts affecting people from a young age, and it persists throughout their lifespan.

Some people develop a negative body image due to peer or familial influence. Each family has its own perspectives about body image and appearance, and these can pass through generations. Similarly, if someone’s friends pressure them to look a certain way, this can certainly impact body image. In addition, bullying, trauma, and experiences with discrimination can all play a role in how someone perceives their appearance.

Who Is at Risk of Body Image Issues?

Anyone is at risk of developing body image issues. While boys and girls are both impacted by societal pressures, research shows that over half of American girls are unhappy with their bodies by age 13 (and this number grows to almost 80% by age 17). Nearly half of women over age 60 are considering plastic surgery, and nearly half of elementary school girls experience concerns about being too fat.¹

Many things can influence someone’s body image, including:

• Age
• Gender
• Gender dysphoria
• Being in the LGBTQ+ community
• Having friends or family who diet
• Body size
• Depression
• Bullying
• Personality traits like perfectionism

Body Image & Social Media

Social media and eating disorders can go hand in hand. Social media has a negative influence on those who are experiencing body image issues and can make these issues worse. The images on social media often promote unhealthy and unattainable body standards, and the over-exposure of these images become internalized. Images on social media are heavily edited and made to perfection and can leave the average person feeling badly about themselves. These negative feelings can trigger the use of poor coping mechanisms, and for some can lead to the development of eating disorders, depression, and anxiety.

How Is Negative Body Image Harmful?

When a negative perception of how someone looks is coupled with dieting or other unhealthy behaviors designed to improve appearance, there can be a risk to health and general well-being. These risks can be anything from poor self-esteem to disordered eating, to full-blown eating disorders.

Someone’s Job or Academics Could Suffer

People can suffer significant consequences related to a negative body image. It is difficult to focus on one’s job or academic responsibilities when the primary focus is on their appearance and how to improve it. Negative body image can result in financial consequences if job performance suffers.

Money Spent on Changing Your Body Could Cause Financial Issues

Financial issues also arise when diet products, supplements, fitness programs, cosmetics, and even plastic surgery are invested in to improve appearance. These consequences are the extremes of what most deal with on occasion.

Low Self-Esteem & Risk of Mental Health Problems

Those who struggle with severe body image issues correlate a dissatisfaction with their appearance with being less than others. They tend to obsess about their appearance relentlessly to the point of it interfering with vocational pursuits, relationships, and the development of anxiety and depression.

Mental Health Disorders Related to Body Image

The impact of negative body image extends beyond simply not liking how one looks in their bathing suit or with their new haircut. These disturbances in how a person sees themselves in relation to others and compared to societal standards of attractiveness can lead to mental health disorders as well.

Negative body image can lead to the following mental health conditions:

• Anorexia nervosa
• Bulimia nervosa
• Diabulimia (Type I diabetics manipulate their insulin intake for weight loss)
• Body dysmorphia
• Muscle dysmorphia
• Anxiety disorders
• Depression
• Self-injury

Weight stigma has been documented as a risk for depression, anxiety, and body dissatisfaction, and there can be a vicious co-occurring cycle of mental illness and eating disorders. Both must be treated simultaneously in order for the individual to fully recover.² When someone is dissatisfied with their weight or appearance, they often feel overwhelmed, depressed, and anxious in social situations. This can lead to social isolation, negative self-talk, and overeating for comfort. These behaviors all perpetuate a negative perception of self.

Unrealistic Body Image & Body Dysmorphic Disorder

When a person does not have an accurate view of themselves, they are said to have a distorted body image. There are varying degrees of distortion based upon the discrepancy between reality and perception. The most severe of these cases is a condition called body dysmorphic disorder (BDD). Body dysmorphic disorder is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).³

The primary criteria for diagnosing body dysmorphic disorder are:

1. A preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or seem slight to others
2. At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g., mirror checking, comparing his or her appearance with that of others) in response to the appearance concerns

Clinicians will also specify whether muscle dysmorphia is present, as defined by the individual being preoccupied with the idea that his or her body build is too small or insufficiently muscular.

What Is the Impact of Body Image on Mental Health?

Body dissatisfaction arises when someone is unable to attain this socially prescribed level of attractiveness despite great effort put into changing a body that they perceive to be inferior. When a person’s realistic body and their ideal body images do not match, this can often lead to mental health issues such as eating disorders, mood disorders, and anxiety disorders. Several serious eating disorders are centered around body image concerns.

Body Image Issues in Males

We historically have considered issues surrounding body image and eating disorders to be a female concern; however, in recent years, more males are dealing with body dissatisfaction. Muscle dysmorphia is more of a concern in males vs. females and involves over-exercise and restrictive eating with the goal of improving their physique.⁴

• Body image in adolescents: For the adolescent, the onset of puberty can create mood disturbance due to their changing bodies. This is a common time to experience negative body image along with anxiety and depression.
• Body image issues during pregnancy and postpartum: For females, pregnancy and the post-partum period is often a time that can create a negative view of one’s body. The media reinforces this with images of celebrities posing with their infants in toned, seemingly perfect bodies.
• Body image issues as people age: As we age, our bodies change, creating other opportunities for negative self-talk, sadness, and depression over the appearance of gray hair, wrinkles, and a realization that our bodies are capable of less than they once were.

Does Body Image Impact Physical Health?

How a person feels in their body and perceives their appearance can also have a direct impact on their physical health. It is less likely that a person who feels badly about their appearance or who has experienced negative feedback about their appearance, will feel comfortable exercising in public, seeking out medical attention, or engaging in social activities.

Those with lower levels of body satisfaction find lower levels of enjoyment while exercising in general as well.⁵ These all can lead to negative physical consequences for the individual which only serve to worsen their self-concept.  When someone feels so badly about themselves and the way that they look that they fear seeking out medical attention, the impact on their health can be quite detrimental.

These people often miss out on health screenings for cancer, diabetes, and high-blood pressure out of fear of how they might be treated for being overweight. Some even continue harmful behaviors out of fear of gaining weight if they stop such as smoking or taking stimulants.⁶

How to Improve Your Body Image

Improving your body image can be a gradual process, but it may be an important journey to consider taking. Building a healthier relationship with your body can lead to better self-esteem and more self-acceptance. It may also help you challenge unrealistic body standards, which can feel empowering. Finally, it can cultivate a sense of appreciation for how your body functions in everyday life.

Here are six ways to improve your body image:

1. Recognize & Reframe Cognitive Distortions About Your Body

People with poor body image often hold rigid cognitive distortions about themselves. For example, you might have all-or-nothing thinking where you think you’re either “fat” or “thin.” Try to challenge this distortion to determine if there’s a more realistic perception. Or, you might engage in filtering, where you only focus on what you perceive to be negative about yourself. If that’s the case, try to practice gratitude for the parts of your body you like.

2. Practice Positive Self-Talk

When possible, try to focus on implementing positive self-talk to yourself. This can sound like, “I’m glad I’m taking good care of my body,” or, “I’m nourishing my body in a way that feels good.” It can also extend beyond your body with simple phrases like, “I have worth regardless of how I look,” and, “I am a good and lovable person.”

3. Stop Comparing Yourself to Others

Although we all do it, the less frequently you compare yourself to others, the happier you’ll feel. The problem with social comparison is that you can always find someone who you deem to be superior to you. Unfortunately, this perpetuates cycles of low self-esteem, and it can reinforce bad body image.

4. Set Health-Focused Goals, Not Aesthetic Goals

There’s nothing wrong with wanting to take care of your body. But instead of only focusing on how that might change or improve your appearance, think about how you can optimize your health. For example, if you want to exercise more regularly, focus on the physical benefits of getting stronger rather than how your body might physically change.

5. Unfollow Social Media Accounts That Are Bad Influences

While social media has its benefits, it can also drive toxic messaging. For example, certain communities reinforce eating disorder content (often known as pro-ana). Other influencers notoriously filter their appearance, making them look perfect (even if their editing is obvious). Consider unfollowing these accounts to see if it improves your emotional well-being.

6. Focus on What Your Body Can Do, Not How It Looks

It may be helpful to cultivate positive body image by shifting your attention to all the miraculous ways your body functions. Focus on how your arms allow you to hug your loved ones, your legs allow you to walk through beautiful parks, and your ears allow you to listen to your favorite music.

How to Get Help for Body Image Issues

People with negative body image have a higher chance of developing eating disorders and related conditions.⁷ It is for this reason that it is important to seek out professional assistance if you or a loved one is struggling with a distorted or negative body image.

There are resources available for those who are struggling with body image and related issues. A counselor who specializes in eating disorders is an excellent starting point. These individuals are called Certified Eating Disorders Specialists (CEDS). They have specialized training in body image struggles or disorders such as body dysmorphic disorder. You can discover options for finding a therapist by asking for a referral from your primary care physician, or by using an online therapist directory, where you can sort by specialty and insurance coverage. If you or a loved one are dealing with an eating disorder, online treatment options like Within Health and Equip Health can also be convenient options.