Mental Health Awareness Beyond Anxiety and Depression: Shedding Light on the Body Image Problem

Author: Kaylee Misener, Clinical Psychology PhD student at University of British Columbia Okanagan | Editors: Alex Lukey and Arrthy Thayaparan (Blog Coordinators) 

Published: January 28th, 2021

In a 2003 New York Times interview, Dr. Susie Orbach, a sociologist at the London School of Economics and Political Science, said “we're still not fully recognizing that the body-image problem is a public health emergency”. Unfortunately, this statement still rings true today. 

As a graduate student in clinical psychology and the president of the Mental Health Awareness and Advocacy Club at the University of British Columbia Okanagan (UBCO), addressing mental health stigma and promoting positive mental health is a particular passion of mine. However, throughout  my education and work in mental health, I find the same themes continue to receive most of the focus during events like Bell Let’s Talk Day. Events that promote awareness have made profound shifts in our cultural landscape regarding mental health in recent years, particularly for mental health challenges related to depression and anxiety. 

This year, I would like to draw attention to the mental health challenges related to body image and disordered eating. Despite their pervasive and serious nature, as noted by Dr. Orbach, these challenges are massively underrepresented in the broader discussions on mental health awareness. As a body image researcher and advocate, I have seen how these issues are often trivialized, dismissed, and underfunded. 

Why does body image matter?

Body image is a broad term pertaining to thoughts and feelings about one’s body. It also includes body-related behaviours one engages in.[1] Negative thoughts and feelings about one’s body are associated with a myriad of negative psychosocial outcomes including depression, low self-esteem, unsafe sex practices, smoking, increased anxiety, and school avoidance. Negative body image also predicts lower levels of physical activity and disordered eating behaviours, and is associated with increased dieting and weight gain.[7,8] 

Notably, negative body image is also one of the strongest predictors of eating disorders.[9] While less attention is directed towards their study, eating disorders are associated with the highest mortality rate across mental health disorders, outside of substance use disorders.[10] Despite these concerns, negative body image is so pervasive, particularly among women, that it is commonly referred to as “normative discontent,” indicating how normal it is to be unsatisfied in one’s relationship with their body and how much work we have left to do in this area.

What is positive body image?

While the findings noted above underscore the prevalence and severity of body image concerns, we also know that positive body image can significantly benefit overall health and well-being. For example, positive body image predicts favourable health outcomes such as increased physical activity, and decreased dieting, smoking and alcohol use.[11] Positive body image is also associated with lower rates of depression, higher self-esteem, and even greater use of sun protection.[12] 

Positive body image is commonly misunderstood as simply loving one’s appearance. However, this misconception misses the true essence of positive body image. Rather, it encompasses respecting the body by attending to its needs, accepting the body despite its perceived flaws, appreciating the body for its functionality, and working to protect ourselves from harmful outside influences such as those included in the media or physical harms.[13] 

How can we move toward positive body image?

Given the significant concerns associated with negative body image and the notable benefits associated with positive body image, it is tempting to wish we could wave a magic wand and create universal positive changes in body image overnight. While we may not have that magic wand, there are evidence-based strategies that can be used to improve one’s relationship with their body. 

1. Positive People: Surround yourself with body positive people and minimize the time you spend engaging with dieting friends and diet culture. 
2. Focus on Values: List the things you like about yourself and others that have nothing to do with physical appearance. 
3. Be Critical: Be a critical consumer of the media and messages from the diet industry. Consider who profits from you feeling like you need to change. 
4. What Will You Give Up: Consider what you give up to pursue idealized body shapes. Would you rather spend that time with friends, pursuing your dreams, or enjoying your life?
5. Enjoy Movement: Engage in types of physical activity that you enjoy. Consider movement in the context of taking care of your body instead of punishing it. 
6. Focus on Functionality: Celebrate all the things your body does for you. Make a list of everything and reflect on why those functions are important to you. 
7. Hit Unfollow: Unfollow anyone on social media that makes you feel bad about yourself. Use social media to your benefit by following accounts which make you feel good. 
8. Self-compassion: Try responding to yourself as you would a dear friend. Try self-compassion meditations or a workbook. 
9. Mindfulness: Stay in the present moment and meet it without judgement. That includes your body.  

The above suggestions are just the tip of the body image iceberg. Often, the first step is simply starting the discussion on body image issues, particularly in the context of mental health. Everyone has a body and everyone has a relationship with their body. It is only through increased awareness and stigma reduction that societal-level shifts can be made to promote positive body image. By starting on the individual level and starting small, we can be part of this necessary wave of change. 

References

1. Cash, T. F. (2004). Body image: Past, present, and future. Body Image, 1, 1-5. doi:10.1016/S1740-1445(03)00011-1
2. Paxton, S. J., Neumark-Sztainer, D., Hannan, P. J., & Eisenberg, M. E. (2006). Body dissatisfaction prospectively predicts depressive mood and low self-esteem in adolescent girls and boys. Journal of Clinical Child & Adolescent Psychology, 35, 539–549. doi:10.1207/s15374424jccp3504_5
3. Schooler, D. (2013). Early adolescent body image predicts subsequent condom use behavior among girls. Sexuality Research and Social Policy, 10, 52-61. doi:10.1007/s13178-012-0099-9
4. Howe, L. J., Trela-Larsen, L., Taylor, M., Heron, J., Munafò, M. R., & Taylor, A. E. (2017). Body mass index, body dissatisfaction and adolescent smoking initiation. Drug and Alcohol Dependence, 178, 143–149. doi:10.1016/J.DRUGALCDEP.2017.04.008
5. Vannucci, A., & Ohannessian, C. M. (2018). Body image dissatisfaction and anxiety trajectories during adolescence. Journal of Clinical Child and Adolescent Psychology, 47, 785–795. doi:10.1080/15374416.2017.1390755
6. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. Journal of Adolescent Health, 39, 244-251. doi:10.1016/j.jadohealth.2005.12.001
7. Hayden-Wade, H. A., Stein, R. I., Ghaderi, A., Saelens, B. E., Zabinski, M. F., & Wilfley, D. E. (2005). Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers. Obesity Research, 13, 1381–1392. doi:10.1038/oby.2005.167
8. Sonneville, K. R., Calzo, J. P., Horton, N. J., Haines, J., Austin, S. B., & Field, A. E. (2012). Body satisfaction, weight gain and binge eating among overweight adolescent girls. International Journal of Obesity, 36, 944–949. doi:10.1038/ijo.2012.68
9. Rosenvinge, J. H., & Pettersen, G. (2014). Epidemiology of eating disorders part II: An update with a special reference to the DSM-5. Advances in Eating Disorders, 3, 198-220. doi:10.1080/21662630.2014.940549
10. Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all-cause and suicide mortality in mental disorders: A meta-review. World Psychiatry, 13, 153-160. doi:10.1002/wps.20128
11. Andrew, R., Tiggemann, M., & Clark, L. (2016). Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study. Developmental Psychology, 52, 463–474. doi:10.1037/dev0000095
12. Gillen, M. M. (2015). Associations between positive body image and indicators of men's and women's mental and physical health. Body Image, 13, 67-74. doi:10.1016/j.bodyim.2015.01.002
13. Tylka, T.L. (2011) ‘Positive psychology perspectives on body image’, in T.F. Cash and L. Smolak (Eds) Body image: A handbook of science, practice and prevention, 2nd edition (pp. 56–67), New York: Guilford.
14. Neighbors, L. A., & Sobal, J. (2007). Prevalence and magnitude of body weight and shape dissatisfaction among university students. Eating Behaviors, 8, 429-439. doi:10.1016/j.eatbeh.2007.03.003
15. Stice, E., & Shaw, H. (2002). Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings. Journal of Psychosomatic Research, 53, 985-993. doi:10.1016/S0022-3999(02)00488-9
16. Duenwald, M. (2003, June 22). Body Image: One size definitely does not fit all. The New York Times. https://www.nytimes.com/2003/06/22/health/body-and-image-one-size-defin…