Dear Kay kay,
Thank you for your message and helping me understand more on how you have been struggling with self-image especially in relation with weight.
To stop the course of eating disorder we must look at restoring our self-image.
However, restoring self-image is one of the biggest challenges of recovery from an eating disorder.
When your self-worth depends on a number on the bathroom scale or the size of your jeans, it's easy to become a victim of destructive eating habits. In order to replace those habits with healthy behaviors that truly nourish your body and spirit, you must learn to value yourself for who you are, not what you look like or how much you weigh.
Encouraging clients to build up their self-esteem is easier said than done. If you're like most people who live with anorexia or bulimia nervosa, you've invested so much of yourself in losing weight or following the "perfect" diet that you've neglected other areas of your life.
Therefore I don’t recommend addressing this issue with “trying harder” to build our self-esteem / confidence. That is simply because you have tried hard enough and you deserve a different approach that would bring more kindness and gentleness.
Although it might seem impossible in the beginning, you can learn to accept your body without being obsessed with your weight. The more your practice self-compassion and acceptance, the more likely you are to escape the psychological traps of your eating disorder.
Simply speaking, the moment we can accept our body, which is the moment we are healed from eating disorder.
A distorted body image is one of the hallmarks of most eating disorders. In fact, a disturbed body image and a preoccupation with weight are two of the diagnostic criteria for anorexia nervosa. Bulimia nervosa is also characterized by a preoccupation with weight and a tendency to judge oneself by weight or body size. Like you said, many people with eating disorders don't have a realistic sense of what their bodies actually look like.
When a teenage girl with anorexia looks at herself in the mirror, she may see an overweight body, when in fact she is already dangerously underweight. If she does realize that she's excessively thin, she may not be aware that she looks skeletal and unhealthy. In her eyes, that hard-won weight loss is the ideal that she's been striving for.
Like you said and have experienced, people with eating disorders often punish or reward themselves for "bad" or "good" eating behavior. In this way, they reinforce the importance of diet and weight control to their self-esteem. After bingeing on ice cream, cookies and potato chips, a bulimic college student may feel sick with guilt, remorse and self-loathing. At that point, her fragile self-esteem is shattered. Self-induced vomiting, fasting, using laxatives or compulsive exercise may make her feel good about herself again - at least until the next binge/purge cycle begins.
In rehab, one of the major goals of therapy is to help you recover from these destructive thought patterns. Therapeutic strategies like cognitive behavioral therapy (CBT) can teach you how to stop negative thought patterns in their tracks and replace them with positive, self-affirming statements, such as:
"I deserve to feel good about myself no matter how much I weigh."
"I can be healthy and still enjoy treats now and then."
"My body doesn't have to look like a model's body; I am beautiful the way I am."
"My identity is much more than what I look like."
It takes time and practice to get over the harmful habits caused by eating disorders. Therefore these strategies must be practiced under the umbrella of self-compassion and a desire to accept who we are rather than changing how we look like.
Your body image, or your sense of what you look like, isn't just a reflection of what you see in the mirror. It's partly based on the opinions and value judgments of others: your loved ones, your peers, the media and the culture in general. The celebrities we admire for their beauty and thinness often become the ultimate representation of what we want to look like. When we don't measure up to an airbrushed photo of a model or movie star, our body image may suffer. For teenage girls and young women, who are especially sensitive to their looks and the way they appear to others, a poor body image may quickly lead to an eating disorder, especially if the girl is overweight.
Therefore you have brought up an important factor that sometimes perhaps the best thing we can do for ourselves in the beginning of this process is to create some boundaries and distance from these toxic images / messages from our outside world.
According to the National Eating Disorders Association (NEDA), the American media and the advertising industry play a big role in the way we perceive our bodies:
In the United States, the average person sees or hears 5,000 messages from advertisers every day.
Approximately one-fourth of these advertisements include a value judgment about physical attractiveness.
Magazines directed at women and girls have over 10 times more articles and ads about weight loss than magazines for men and boys.
In women's magazine articles about fitness, "being more attractive" and "losing weight" are listed most frequently as the reasons for starting an exercise program.
Developing self-compassion means learning how to create a more realistic perception of your body, accepting how we look even if it conflicts with the idealized images you see in magazines or on TV.
In your day-to-day life, there are a lot of things you can do to build self-compassion. Becoming aware of the way you "talk" to yourself mentally is one of the most important tasks. As you go through your day, especially when you're eating a meal or thinking about having a snack, be aware of self-defeating thoughts that connect your self-esteem with your weight or appearance:
"I can't have bread with lunch today. I'll get fat. I'll be worthless if I gain one more pound in this program."
"I can't work out in those pants. They make my hips look huge. Everyone's going to notice how much weight I've gained."
"I only ran three miles today instead of my usual five. What's wrong with me? I'm going to skip lunch to make up for it."
"Everyone's going to stare at me in group counseling. I'll be the fattest girl in the room. I hate myself for being so big."
In order to counteract negative thoughts that keep you trapped in a cycle of destructive eating behaviors, you'll have to adopt positive habits, such as:
Setting realistic goals and rewarding yourself for meeting them
Refusing to compare your body to media images or celebrities
Taking up hobbies that have nothing to do with body size or appearance
Practicing self-acceptance through self-affirming statements
Forming friendships with supportive people who value you for who you are
Learning how to prepare and eat balanced, nourishing meals
Planning a diet that does not exclude any food
Managing your exercise program to keep your physical activity at a healthy level
Keeping a journal is a good way to track your progress as you're working on your self-esteem. It's also an effective way to work through the emotions you'll experience as you recover from an eating disorder. Don't hesitate to turn to your friends, therapists or family if you feel the urge to go back to your destructive habits. A strong support system can help you stay on track with your goals when you feel discouraged or afraid.
Meanwhile, relapse rates are high among people with eating disorders, especially if they still have a low self-esteem or a disturbed body image after they finish rehab. A study published in the American Journal of Psychiatry found that women who went through rehab for anorexia or bulimia had a greater chance of relapse if they were still struggling with a distorted body image. Accepting your body's assets and limitations is a crucial part of recovering from an eating disorder. Instead of striving for a perfect, unattainable ideal, work with your treatment team to create an achievable plan for what you want to be.
Therefore the goal here is NOT about changing how we look, again it’s all about accepting how we look and who we are :)
Like addiction and other chronic conditions, eating disorders don't go away overnight.
You may experience the impulse to diet excessively, binge or purge for months or years after you've graduated from rehab. Many rehab graduates find that these impulses are the most intense during times of stress, such as a divorce, a job loss or a death in the family. Even positive events, like having a child or starting a new career, can trigger a relapse if you're still living with self-doubts. Gaining a few pounds during pregnancy or after an injury may give you that panicky feeling that you need to lose weight - fast.
Therefore it is crucial that we look at all these information with the framework of self-compassion. Remember, the reason why we want to change is because we want to be kinder to ourselves, not because we hate ourselves. These may look similar but are fundamentally different. One leads to healing, the other leads to more destruction. :)
Be gentle, be kind, fight less, float more :)
We can do this together.
Please let me know if I’m being helpful so far. Looking forward to hear your thoughts,