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.