What Causes Negative Body Image And Low Self-esteem?

In my private intuitive eating facebook group, we have decided our next topic is Body Image and Self Esteem.

I said I would write several articles about the topic and then provide a free live training. Here is the first of those articles! 

This first blog is about the cultural and mental causes behind negative body image and low self-esteem. In this article you will learn:

• What Is Body Image?
• How Does Culture Affect Body Image And Self-Esteem?
• What Causes Body Image Dissatisfaction?
• How Does Body Image Affect Your Mental Health?
• What Can Negative Body Image Lead To?
• How Do You Deal With Negative Body Image?

This article is also heavily informed by the scientific paper written by Albertson and Neff in 2014. You can click here to download their research paper ‘Self-Compassion and Body Dissatisfaction in Women:

What Is Body Image?

According to Google's dictionary, a body image is "the subjective picture or mental image of one's own body."

The important thing to know in the context of this blog is that you can have a perfectly healthy body, yet still think you are ugly. The most typical example is a model who is on the cover of a magazine, yet goes home and sees herself as ugly. A body image is subjective. It can be irrational.

“Body dissatisfaction can be defined as a negative evaluation of one’s body that involves a perceived discrepancy between an individual’s assessment of her actual and ideal body.” - Albert and Neff

Honestly, for most women regardless of health and appearance, body dissatisfaction is their norm. Some women may have a little body dissatisfaction, while others may have more, but sadly, for most women this is the norm.

In more extreme cases, having a negative body image is called having a ‘distorted body image’. This phrase similarly means having an unrealistic view of how you see your body, but to a greater and more harmful extent than normal.

In the eating disorder field, we see that people with anorexia have a distorted body image which may seem crazy to the average person. For example, a person with anorexia may weigh 93 pounds and their rib cage may be easily visible, yet still this person may still think they are horribly obese. Isn't that crazy?! It is crazy, and that's why we have to remember that body image is subjective.

As with other eating disorders, a negative body image is found most frequently in women, but the rates of negative body images in males has also been dramatically on the rise, especially with social media. 

How Does Culture Affect Body Image And Self-Esteem?

This image shows how the United States culture’s ideal body shape has changed over time. In the 1950s and 1960s, you can see that actress Marilyn Monroe had a more curvaceous figure than her model counterparts in modern times.

I recently talked with Melainie Rogers, former president of an international eating disorder organization in New York, about how our body image definition of beautiful has changed over the decades, and caused a plethora of body image issues as the ideal physical appearance becomes impossibly thin. 

Melainie notes that models have become so skinny in the BMI range, that Italy had to impose a minimum of BMI of 18 because models were dropping dead. In parts of Europe, people are realizing that our beauty ideals and standards of appearance and body size, as you see in media images, are extremely harmful.

(BMI is a measurement of body size)

The extremely sad and ironic part about our body image concerns is that we become preoccupied with weight loss and fearful of weight gain. We try all sorts of diets to change our body weight. Yet our body only changes rarely. This causes us much unnecessary body image disturbance.

This fearfulness and anxiety about our body keeps getting worse, too. While some may blame social media messages for the reason behind our negative body image, Melainie emphasizes that our culture’s changing body ideal keeps getting thinner and thinner, and this is primarily responsible for negative body image and self-esteem struggles.

Here is a video with Melainie Rogers and I talking about the changing body standards from a haes cultural perspective:

Body Dissatisfaction Is The Norm

Authors Albert and Neff note that body dissatisfaction has been so extremely prevalent for women in 1st world societies that negative body image and self-esteem struggles have been formally described as “normative discontent.”

And as you’ll read more below, women of all ages can be affected by mental, emotional and behavioral symptoms caused by negative body image and self-esteem struggles.

These mental health struggles related to appearance can become extraordinarily intense. At a certain point when the mental and emotional symptoms get to be too intense, that’s when eating disorder behaviors start to arise. 

In addition to eating disorders, the cultural struggle to have an idealized body appearance and live up to media images can lead to what is called body dysmorphic disorder. This is where a person cannot stop thinking about their appearance and ends up having a mental disease that strips the person of any joy they once had.

Sadly, we are seeing an increase in eating disorders that parallels the rise of social media and an increasingly thin body image ideal. This is the new normal, and it's getting worse.

With the simultaneous increases in rates of disordered eating and social media use, you might wonder, “Why are body image and self-esteem so tightly tied together?”

The Link Between Media And Culture

The reason why body image and self-esteem are tied together, according to Albert and Neff, is relatively straightforward. Females living in 1st world countries learn that physical beauty is how they often are valued in society.

Therefore, having a body size that fits society's standards is seen as of utmost importance. Research backs this point and has clearly tied women’s self-esteem to be largely dependent upon meeting cultural standards of beauty. 

Yet what if cultural standards of beauty are insanely, impossibly thin? This makes having a positive body image incredibly difficult.

As Melaine notes in our podcast, much of our weight and how we look in the mirror depends simply on your genetics. For example, some research has identified three different physical expressions that are determined primarily by genetics.

Unfortunately our culture has almost no tolerance, especially for women, of larger sizes. So that means you could be perfectly healthy, but as a woman, if you have a genetic disposition of either mesomorph or endomorph, then our culture's standards of beauty will get in the way of you having a positive body image.

Admittedly, the standards for a positive body image for men are less. Historically men have had an easier time with body image. Men have had their self-esteem historically tied more to professional accomplishments and the development of various skills, as opposed to only beauty being the source of self-esteem. This trend too, however, is changing - Melainie notes that the rates of males with eating disorders are skyrocketing. 

In the eating disorder outpatient residential center where I work, this year we have had more guys than girls in residential treatment, which is something that never has happened before on this scale.

How Does Body Image Affect Your Mental Health?

Having a negative body image not only impacts how one sees their body, but also many other health outcomes. In fact there is a clear trend: Albert and Neff’s article says “When people experience their physical bodies as in some way unattractive, undesirable and a source of a ‘shamed self’ they are at risk of psychological distress and disorders.” 

Indeed, we see clearly in research that having a negative body image is one of the primary reasons people develop eating disorders in the first place. Oftentimes what is driving a person’s compulsive behavior d(whether restrictive dieting, binge eating or purging) is a distorted body image. 

In extreme cases, having a distorted body image is called body dysmorphic disorder. A person with body dysmorphic disorder might spend 5 hours in front of a mirror, per day, trying to fix every single little detail about their appearance so they can look in the mirror and see perfection. It's incredibly sick because a perfect appearance is not possible, yet these people can't stop trying and give up their lives in the quest for some impossible appearance.

Eating disorders stem from an attempt to manage emotions.

For example, people with anorexia try to manage their anxiety and depression by rigidly controlling their food. People with binge eating disorder will try to numb out their emotions with food, and then out of guilt restrict their food intake until the next binge. 

Needless to say, when one has a distorted body image of themselves, they are more likely to be stressed out!

If you walk around feeling suspicious and anxious that people are judging you and hating you, then it appears quite logical in a certain way that you would want to turn to food to manage that anxiety. For many people, an eating disorder is actually quite rational in the face of all the pressure they put on themselves!

Anxiety is not the only other mental health domain affected by a negative body image. Most frequently, people correspondingly get depressed about their body. Wouldn’t you also get depressed if you successfully lost 30-40 lbs, but then gained back the weight? And that this pattern repeated 10 or 20 times? 

Imagine too if you had slightly perfectionist tendencies.

For example, you measured your caloric intake and kept track of your weight. Yet even despite your attempts at recording and measuring, you would still binge eat occasionally and gain tons of weight. Wouldn’t this depress you to see that despite your best attempts at controlling your eating and weight, you still self-sabotaged?

While anxiety and depression are the two most common mental health outcomes associated with a negative body image, there are a host of other harmful outcomes as well These harmful mental health outcomes result in poorer quality of life, decreased physical activity, and other unhealthy behaviors like smoking. 

Overall, you can think of your mind and body as connected. If you have a negative body image and dislike your appearance, you will probably treat your body with less respect and care. On the other hand, if you have a positive body image then you will be more likely to care for your body and engage in healthful behaviors.

What Causes Body Image Dissatisfaction Effects?

We now know that many cultural forces shape our perception of our bodies. We also know that having a negative body has many negative mental and physical health effects such as lower self-esteem, anxiety and depression. But how does culture translate into negative health outcomes like getting an eating disorder? 

The link between negative mental health and a negative body image is your thoughts. Albert and Neff further talk about the cause of body image dissatisfaction by saying that a negative body is caused by a person’s “ tendency to criticize rather than accept one’s body as it is.”

Therefore your thoughts, especially your critical thoughts towards your body and self, are the primary cause of body image dissatisfaction. The best example is how one person can be a beautiful magazine model, but still think their appearance is substandard.

Critical Ruminating Thoughts

In particular, your critical, ruminating thoughts are the most clearly understood link between a negative body image and the effects of having a negative body image. Here are some examples of what critical ruminating thoughts look like, and how these thoughts can lead to negative health effects.

You constantly think to yourself “I am so fat and heavy and I can’t control myself.”

• Because you thought that you lacked control, you don’t even try to discipline yourself to finish a project on time or reply to a text message in a timely fashion

You constantly think, ‘I failed again. I always fail.’

• Because you think that you’re a failure, you don’t take risks at work or leadership projects because you’re afraid you’ll fail.

You constantly berate yourself, “I hate the way I look.”

            While you are falling asleep you suddenly have this thought get stuck in your head and worry about being too fat. This thought disturbs your sleep and keeps you up all night.

The hardest part about critical, ruminating thoughts is that things get worse with each additional thought. In each of the above examples, the negative thoughts lead to failure and inaction. Then failure and inaction become further evidence of failure and inaction. 

Can you see how insidious a negative body image can be? A negative body image can haunt you wherever you go. Standing in line at the grocery store, you glance at the magazine covers and see evidence of your failure. Once triggered into thinking about your body, you can easily spiral off into negative thinking and self-sabotage yourself in many areas of life unrelated to health. 

How Do You Deal With Negative Body Image?

While there are different ways to deal with a negative body image, in this blog, we will specifically focus on self-compassion as written about in the original research done by Albert and Neff.

Self-compassion is highly promising and is a great life skill to learn regardless of body image struggles. In this particular article which I mentioned at the top of this post, Albert and Neff found that women who learned self-compassion, in comparison to two different control groups, had much better outcomes in terms of body appreciation, body image, and self-esteem. 

Even better, the women who learned and benefitted from self-compassion did so in only 3 weeks. 

Plus, learning self-compassion doesn’t have to be difficult. All the women had to do was listen to a variety of self-compassion tapes for 20 minutes a day for 3 weeks (the average woman in the self-compassion group reported only listening to a tape every other day). 

You can access the exact same tapes on SelfCompassion.org.

There are three elements of self-compassion, according to Dr. Neff’s research: kind self-talk, a global perspective, and mindfulness. Each of these elements can contribute towards lessening a negative body image. 

Kind Speech

Neff writes that self-compassion teaches women and men to be kind, gentle, and understanding towards oneself rather than being harsh and judgmental. This is the exact opposite of criticizing yourself. By learning to speak lovingly towards yourself, you are literally counteracting the primary cause of a negative body image, which is self-criticism. 

For example, in the self-compassion study, some of the tapes the participants listened to gave specific phrases the person could practice in real life, such as:

• May I be happy and free of suffering
• My body is a vehicle for my life, but I am not my body. I am more than my body
• It’s okay to make mistakes; everybody makes mistakes

Having these phrases in your back pocket can be remarkably helpful to counteract the negative things you may say to yourself when your negative body image gets triggered. Instead of triggering an endless spiral of critical ruminating thoughts, you can practice self-compassion quietly to yourself instead.

Global Connected Perspective

In addition to speaking kindly towards yourself, self-compassion also teaches a person to look at their body from a bigger viewpoint. For example, many people are ashamed of their bodies in part because they feel that their bodies are evidence of personal failure. 

However, through the lens of self-compassion, a person can see that many people have health and body struggles. Instead of dwelling upon their personal failure, people can see that these struggles are universal. This helps take away much of the sting from the body image when you realize that you are not alone.

fIn the self-compassion tapes. This often is taught by simply reflecting on the incredible suffering in this world. There are people starving. There are people dying of diseases. People are getting murdered. Horrible things are happening to good people. Everybody dies eventually. Slavery is real, children are sold into the sex trade. Terrible things are a reality and always have been. 

Your problems, in comparison, are not so different. Yes. your problems are real, but overly focusing on your problems becomes less of a problem when you can see them in the context of the overall meaning of what it means to be human. 

Here is an amazing TED talk about body image, which essentially recommends this global perspective solution. The speaker, who has struggled with weight and body image her whole life, at one point tells a story of how girls in Africa were kidnapped and held hostage somewhere in the city, just a few blocks away, but at an uncertain location. She said that losing your daughter to random violence is terrible, but having a few skin folds is not the end of the world.  

Mindfulness

Learning mindfulness can help people face their thoughts and emotions with composure. Instead of falling into rumination, a person can simply notice their thoughts, let the thoughts pass by, and then refocus on their body, which helps reduce the recurrence of the thoughts. 

Oftentimes in mindfulness, you are instructed to first scan your body and to feel the physical sensations of your body. When you feel the sensations of your body, you are using a different part of your brain other than the thinking part.

An approximation of the brain is thinking in terms of left and right brains, where your left brain is your feeling brain whereas your right brain is your thinking brain. When you are feeling your body via mindfulness, you are using your right brain, which means that your left-thinking brain is turned off while your right brain is activated.

After you have connected to your body and practiced body scanning, deep breathing, and relaxation - all of which are basic mindfulness techniques - then you can more easily bring nonjudgmental awareness towards your body, and the thoughts that arise when you think about your body.

Relaxed and calm, you can see your thoughts coming up, and floating away. With the global compassion you developed earlier, you realize that these are not necessarily your thoughts per se, but also thoughts that many others are having. These thoughts come and go like clouds, and you don’t need to get stuck on them. These thoughts are not necessarily true either.

In conclusion, mindfulness and self-compassion are tools you can easily learn to help stop the barrage of harmful thoughts associated with our culture’s negative body image ideal.