Science Monday: Treatment for body image problems?

One of the key hallmarks of those suffering with eating disorders is their tendency to define their self-worth primarily by body shape/weight or should I say by their perception of their body shape/weight as this group tends to overestimate their size and shape.

What treatments help a person to regain a realistic sense of body shape as well as to us a different measuring stick to measure their worth? Given the obsessive-compulsive symptoms (weight checking and compulsive restricting) do OCD treatments help here as well?

I wish we had great answers for this one but we don’t. Here’s a few things we know:

1. Information is not enough. One study done last year tried to influence women’s self-perception by showing them hard data about the fact that most men are attracted to “normal” sized women than they are to skinny, very thin women. Results indicate that though women were more open to seeing other women as healthy, they continued to maintain their own distorted body image.
2. Stopping compulsive negative body checking. Some brief studies attempting to get women to stop self-critical checking of the body (especially their details in front of a mirror). Women who refrained from those specific self-critical exams and made global, more balanced assessments had better body images (read less distorted and more accepting). Problem here is that as soon as the study was over, the ones who made positive gains went back to their old ways…
3. Exposure and response prevention. The classic treatment for individuals with eating disorders is exposure to feared stimulus (eating food) and prevention of typical response (either purging, restricting, or self-loathing). So, in opposition to #2, women who were exposed to mirrors and practiced non-judgmental responses, seemed to decrease their level of obsessional thinking about their body shape. In this way, treatment may be quite similar to OCD.
4. Challenging moralistic, legalistic responses to “weaknesses.” It is clear that many with ED struggle with law-oriented thinking and believing. Weaknesses should be punished, successes are aberrations. While counselees do better with more grace-based living, crossing over from a pay for your sins to allowing Christ to pay for your sins divide can be a challenge.
5. Medications may not be all that helpful. With a true body dysmorphia (significant fixation on a body part that is deemed ugly or disgusting), Pimozide (Orap), an antipsychotic, may be of some help.


Filed under counseling science, eating disorders

3 responses to “Science Monday: Treatment for body image problems?

  1. I don’t know much about ED, but I was wondering if there is a relationship between the general culture of sexual objectification of girls and women, and Eating Disorders? Again, I don’t have much contact with this world, but the drive to control seems to be related.

  2. Barb

    On the way home from class tonight, I was thinking of a seminar at which Dr. Theresa Burke spoke on the subject of Post-abortion. (her book on this subject is “Forbidden Grief”). Her interest in the subject was piqued during her internship with an ED group, when 80% or so of the women reported being post-abortive. Dr. Burke recommends that counselors query women with ED regarding their pregnancy history, particularly pregnancy loss.

    I wonder what you might think of that? Is the ED an attempt to control the body in a way that may have seemed “out of control” during an unplanned/unwanted pregnancy?

  3. Paul, I suspect there is a strong relationshipo between eating disorders and sexual objectification (i.e., you are your body. You are only as good as your breast size, hair, and waist size). Thus, the drive to control is to control and protect from failure to measure up (with the persisting fear that one has already failed).

    Barb, I can well imagine that an adolescent woman might turn to ED after an unplanned abortion. Personally, I haven’t experienced that in my counseling sessions–or at least no one has acknowledged that.

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