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Content Warning: Body Image Disturbances and Eating Disorders

This article discusses topics related to mental health and coping mechanisms, including body image disturbances and eating disorders, which may be distressing to some readers. Please prioritize your wellbeing and engage with this material at your discretion. If you or someone you know is in crisis or experiencing thoughts of self-harm and/or suicide, please seek help from a trusted professional or contact local support services.

‍If you need 24-hour emergency support service in Indonesia, you can reach out to the following services:

https://www.healing119.id/suicide‍
Hotline Kesehatan Jiwa Kemenkes: 119 (pilih ekstensi 8)

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What is Body Image Disturbance?

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This content was developed in collaboration with , who contributed their expertise through peer review and specialized input to ensure comprehensive, accurate information.

Body Image

Body image refers to how we perceive our appearance, not just in the mirror, but also in our thoughts, feelings, and behaviours related to our body. It encompasses our beliefs about body size, shape, weight, and attractiveness, as well as how we behave in response to those beliefs.

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Body image disturbance

Body image disturbance is a psychological disruption in the way someone experiences or relates to their body shape or weight. It affects three key components of body image:

Affective-cognitive component
Perceptual component
Behavioural component

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Affective-cognitive component

This refers to the emotional and mental evaluation of one’s body. People experiencing this type of disturbance often feel deeply dissatisfied with their body and base their self-worth on how they look.

Common feelings: Self-loathing, disgust, sadness, anxiety, shame, and anger
Common thoughts:
- “My body needs to be thinner.”
- “I’m not good enough because of how I look.”
- “I feel disgusting in my own skin.”
- “I would be happier if I had more muscle.”

The overemphasis on body shape or weight in forming one’s self-image is often referred to as overvaluation of body image, and is a known contributor to low self-esteem and mental health struggles.

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Perceptual Disturbance

This involves a distorted mental representation of one’s body size or shape. The person’s perception doesn’t align with reality.

Example: A person sees their body as significantly larger than it actually is. For instance, perceiving themselves as “double their size”.

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Behavioural Disturbance

This includes actions taken in response to negative thoughts or feelings about one’s body. These behaviours reinforce body image issues and can severely disrupt everyday functioning.

Common behaviours:

Body checking
- Constantly looking in the mirror
- Frequently measuring body parts
- Repeatedly asking for reassurance from others about one’s appearance
Avoidance behaviors
- Avoiding mirrors or reflective surfaces
- Refusing to weigh oneself
- Avoiding tight or revealing clothing
- Wearing only baggy clothes to hide perceived flaws
- Avoiding social situations or certain people/places due to body shame

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Why Body Image Disturbance Matters?

Body image disturbance is more than just dissatisfaction, it is a clinical risk factor closely linked to disordered eating behaviours. It is now officially recognised in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) as part of the diagnostic criteria for anorexia nervosa and bulimia nervosa.

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What might contribute to disturbances in one’s body image?

Certain biological, psychological and social risk factors may contribute to someone developing disturbances in their body image.

Psychological risk factors may be exacerbated when someone internalizes societal beauty ideals or places a high value on outward appearances, making them more likely to develop body image disturbances.

‍Social or environmental influences can play a large role in contributing to body image disturbance. It can range from:

Biological risk factors

Body mass index (BMI)
Premenstrual period discomforts (for women)
Genetic factors that influence body shape

Psychological risk factors

Mental health conditions (particularly depression and anxiety)
Low self-esteem
Perfectionistic tendencies
Tendency to compare oneself with others
Tendency to internalise or value beauty ideals

Social or environmental risk factors

Can play a particularly large role in contributing to body image disturbance.

Appearance teasing or weight-related bullying
Adverse childhood experiences
Having friends or family who diet for weight loss and express a lot of body image concerns
Portrayal of beauty ideals through the media
High level of social media use

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Appendix

References

Carey, M. and Preston, C., 2019. Investigating the Components of Body Image Disturbance Within Eating Disorders. Frontiers in Psychiatry, [online] 10. https://doi.org/10.3389/fpsyt.2019.00635

Cash, T., & Deagle, E. (1997). The nature and extent of body-image disturbances in anorexia nervosa and bulimia nervosa: A meta-analysis. International Journal Of Eating Disorders, 22(2), 107-126. https://doi.org/10.1002/(SICI)1098-108X(199709)22:2<107::AID-EAT1>3.0.CO;2-J

Cash, T., & Smolak, L. (2011). Body image (2nd ed.). Guilford Press.

Fairburn, C., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research And Therapy, 41(5), 509-528. https://doi.org/10.1016/s0005-7967(02)00088-8

Kearney‐Cooke, A., & Tieger, D. (2015). Body Image Disturbance and the Development of Eating Disorders. The Wiley Handbook Of Eating Disorders, 283-296. https://doi.org/10.1002/9781118574089

National Eating Disorders Collaboration. (2011). Fact Sheet - Body Image [Ebook]. Retrieved from http://www.confidentbody.net/uploads/1/7/0/2/17022536/nedc_body_image_fact_sheet.pdf.

Hosseini, S., & Padhy, R. (2020). Body Image Distortion. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546582/#:~:text=To%20date%2C%20various%20factors%20that,behavior%2C%20religiosity%2C%20and%20spirituality.