Addressing Over-Evaluation of Body Shape and Weight in Treatment of Bulimia, Anorexia and Other Eating Disorders
Treatment of anorexia, bulimia and other eating disorders is complex and often requires an integrative approach, comprising medications, psychotherapy, coaching and mindfulness.
Did you know that eating disorders affect both mental and physical health? Eating disorders can cause other illnesses and even premature death. Individuals with eating disorders are at higher risk for suicide and medical complications. Fortunately, eating disorders are treatable but must be detected as early as possible for a better recovery.
Similar to fever, eating disorders may arise as non-specific responses triggered by a diverse range of underlying factors. Consequently, while the main goal remains the alleviation of distressing symptoms—ranging from overeating and bingeing to purging and starving—it’s crucial to explore the fundamental causes of these reactions to achieve a comprehensive and lasting resolution.
One of these possible contributing factors is the over-evaluation of body shape and weight, which will be discussed in this article.
The Basis of Self-Worth in People With Disordered Eating
- People with eating disorders, especially with anorexia or bulimia, place an abnormally high value on controlling their shape, weight and eating, and they evaluate their self-worth accordingly. They may go to extreme lengths to restrain their weight and shape.
- As a result, they become excessively concerned about their weight, shape and eating. It maintains how they judge themselves–according to how well they control their weight and eating.
- This over-evaluation of body shape and weight and preoccupation with control over shape, weight and eating perpetuates the vicious cycle of disordered eating.
- Essentially, people with disordered eating need to develop and extend other (non-shape/weight/eating-related) dimensions of their lives.
The Basis of Self-Worth in People Without Eating Disorders
Most people evaluate their self-esteem or self-worth based on different factors, such as their hobbies, relationships, achievements at work or school and other abilities. They might estimate how happy they are, based on how well the meaningful things in their lives are going.
Let us consider an example of Ashley.
Ashley, 21, works as a bank clerk. She shares a flat with a friend and has been with her boyfriend, Ben, for a year. Ashley and Ben both play tennis. Ashley loves to play volleyball and is a member of a volleyball club. She visits her parents regularly and is close to her brother, although they only communicate via the phone as her brother lives in another country. Ashley is putting money aside for an overseas holiday with Ben. She is also saving up for one of her future pursuits, going to university. Ashley is often concerned about her looks. She often thinks she does not look feminine, but Ben has told her he likes her exactly as she is. Let us see how Ashley considers her self-worth. The below pie chart (Figure 1) illustrates how influential the various things in her life are to her.
Figure 1. Self-Worth Pie Chart of People Without Eating Disorders
The most meaningful things in Ashley’s life are her boyfriend, family, friends, future goals and sports activities. Her body shape, job and travelling are also significant to her, but to a lesser extent. Typically, people with diverse interests might have pie charts analogous to the one of Ashley. When evaluating their self-worth, they might look at their personal qualities, relationships with family, partners and friends, sense of humour, loyalty, kindness, accomplishments and skills, such as the ability to play a musical instrument, cook or play sports.
Judging Self-Worth Based on the Ability to Control Eating, Body Shape and Weight
People exhibiting disordered eating patterns tend to evaluate their self-worth based primarily on their weight, shape and capability to control these. They may have other interests, but over time other interests seem to play a lesser role in their lives. This self-evaluation strategy may have formed through particular life experiences and the impact of media, friends and family. In Westernised cultures, the pressure to be skinny can be transmitted through TV shows and magazines that endorse thin, appealing models and actors and promote diet products.
Being thin is equated to being successful, attractive and desirable, or simply being of worth. Somebody with an eating disorder is especially sensitive to these statements. They believe they are only worthwhile if they can control their shape and weight and are slim or slimmer than earlier. Their ability to restrain their weight and eating comprises an extensive slice of their pie chart and becomes excessively important in their lives. They begin to view their self-worth based on this ability to control their weight, shape and eating. Here is an illustration (Figure 2) of how their pie chart for self-worth might appear.
Figure 2. Self-Worth Pie Chart of People with Eating Disorders
Putting Most of the Eggs in one Basket
This pie chart demonstrates how somebody with an eating disorder puts most of their “eggs in one basket”. They are banking on this ONE area of their life to work out for them so they can feel worthy. Doing this is dangerous! If they evaluate their self-worth primarily on their ability to control their weight, shape and eating, and they are having difficulties with this–it is highly likely that that leads to them considering themselves worthless.
When somebody bases much of their self-worth on only one dimension of their lives, they place enormous stress on making it work out. That is why it is not surprising that people with eating disorders are excessively aware of and try so demandingly to restrain their weight and eating. It is also habitual that they frequently feel anxious, depressed and irritable. Furthermore, they encounter mood swings and judge themselves negatively. They are happy only when they view their body weight and shape as acceptable. Yet, even this might be provisional because they have to ensure it remains that way!
Treatment of Eating Disorders: Decreasing Over-Evaluation of Body Weight and Shape and Widening the Other Pie Chart Pieces
One effective way to decrease your over-evaluation of body weight and shape (and control over them) is to extend other domains of your life – widening the other pieces of your pie chart. When you start doing this, you will find that your life becomes more “proportional” and balanced, and you will feel more tranquil over time.
Placing all your eggs in one basket and banking on one extent of your life to work out for you is likely not helpful in achieving self-confidence and happiness. You not only place a lot of stress on yourself to make that domain work out, but you might also become hugely preoccupied with it. You must try to develop and expand the other areas of your life!
Start determining the other dimensions of your life that might influence your self-worth but have now taken a smaller place (or become smaller pieces in your pie charts). Select one area you would like to begin with and then consider some activities you could engage in to aid you in doing that.
Motivation may not Appear on its own
Sometimes, before you start an activity, you might realise you are thinking that you do not feel like doing it and want to postpone it until you are in the right mood.
People often want to postpone those new activities until they feel really motivated before they act. Yet, another essential thing to bear in mind, motivation may not appear on its own.
However, when you start ACTING first, motivation will then follow. Remember, ACTION, MOTION OR EFFORT before MOTIVATION, and you will soon discover that your life is more balanced and you have stopped being obsessed with only one area of your life.
Treatment of Eating Disorders: Conclusion
People with eating disorders, especially with anorexia or bulimia, may be excessively critical of their appearance, overly concerned with their weight and body image and preoccupied with food, weight and dieting. This maintains how they judge themselves–according to how good they are at controlling their weight, shape and eating.
Individuals with disordered eating need to expand other (non-eating/weight/shape-related) domains of their lives.
It needs to include forming a sense of self-worth that is not based merely on their ability to control their body shape, weight and eating. But to develop a sense of self-worth that accounts for other aspects of life, such as future goals, relationships, hobbies and accomplishments. Additionally, it is essential to focus on developing healthy coping skills to manage stress and emotions rather than relying on disordered eating behaviours. Finally, it is critical to seek professional help if disordered eating interferes with your daily functioning.
If you think you might have an eating disorder, you must reach out to your family doctor. Many physical and psychological complications can emerge from purging, losing weight very fast or being at an abnormally low weight. In addition, during the treatment of anorexia, bulimia or other eating disorders, a mental health counsellor may help you explore the underlying emotional factors contributing to your condition.