By Dr. Terri Griffith

What do you like about your body? As the clinical coordinator for Sheppard Pratt’s Center for Eating Disorders, that’s a question I often ask my patients to begin the process of helping them shift the narrative they tell themselves about their own bodies. For some patients, it might be difficult to acknowledge something they like about their bodies. So sometimes the question has to be changed to, “What are you okay with about your body” or even “What can you tolerate about your body?” Go ahead and reflect on your own body image and think about that question for yourself. What do you like about your body?

It’s an important question because all of us can find things that we do not like about our bodies. Most people struggle in some way with their body image. Especially in the summer, as the warmer weather causes us to wear less clothing, you may be even more aware of your own body and compare it to other bodies around you. As certain populations are at higher risks for mental health difficulties, they are also more significantly impacted by body dissatisfaction. These groups include people of color, individuals with existing mental illnesses and, yes, the LGBTQ community.

In fact, somewhere between 50 to 60% of LGBTQ individuals express body dissatisfaction, compared to approximately 30% of their heterosexual peers. These numbers are even higher for individuals who identify as transgender, as their body image is typically impacted by where they currently are in their transition process. For example, they may still physically present as their born gender, which might not feel comfortable to them. Or they may question their ability to “pass” as the gender in which they are transitioning. These are complex issues that can be best navigated with the help of a competent, skilled, LGBTQ-affirming mental health professional.

Another reason the LGBTQ community may report body dissatisfaction is due to the higher rates of anxiety and depression experienced among LGBTQ individuals. Lack of acceptance, difficulty finding a group to belong to, and overt and subtle prejudice are all factors that contribute to higher incidences of depression than the general population. And unfortunately, depression can be the first step in a downward spiral of a negative feedback loop: depression leading to poor self-esteem, contributing to negative body image, which often leads to harmful habits such as eating disorders, substance use, or self-injurious behaviors.

I facilitate therapy with individuals who have eating disorders every day. It is the most difficult mental illness to treat because it encompasses so many other mental health challenges. Many of my patients use their eating disorder to manage symptoms of other emotional difficulties. For example, some patients might binge on foods in an effort to drown or suppress their feelings. Others develop anorexia, a condition that restricts food intake as a means to gain control of difficult emotions, their bodies or some aspect of their lives. Others develop bulimia, where they might binge and purge as a physical way to rid themselves of difficult emotions, numb emotions, or in effort to change their bodies.

These patients reflect the most severe cases of body dissatisfaction. Though everyone reading this article might not be able to relate to the severity of difficulties that individuals with a diagnosed eating disorder experience, many people can relate to having some insecurity about certain parts of your body. As such, the guidance that we offer to patients with eating disorders can be applicable to everyone.

1) No brain, no gain – “Gym rats” are famous for living by mantras that motivate them to work harder, such as “no pain, no gain.” But I say – “no brain, no gain”! To develop a positive body image, you must first start with your mind. Body image work is heavily cognitively driven. Through this work, individuals learn to identify feelings of depression, hopelessness, symptoms of past trauma, as well as identify and eventually learn to challenge maladaptive thoughts that contribute to further distress. A trained mental health expert can be a great facilitator of this process. Ultimately, the goal is to train your mind to tolerate, and eventually appreciate your body without trying to change it.

2) Strategic shopping – I always advise people to invest in clothes that fit and are comfortable. Wearing things that are not too big or tight, but are physically comfortable then sends a message to your brain that your body is ok just as it is, which can help manage a lot of insecurities, self-consciousness, and body image concerns.

3) Mindful media – Be aware of what media you’re consuming. Do you follow people who are obsessed with body image? Do your favorite shows have characters to whom you compare yourself? Remove those influences that negatively impact your mental state.

4) Train your thoughts. Begin to track and consciously change the narrative you tell yourself. For example, do you constantly “body check” – deliberately or unknowingly touch your stomach if you feel pudgy, or compare yourself to others in the room? Recognize when those thoughts come up and replace them with thoughts that are less judgmental, critical and are more accepting.

You’ll notice that none of these tips focus on weight loss or exercise. We do not promote “diet culture.” We find that imposing regimens of eating specific foods and exercises do not promote long-term success. The very best way to achieve a positive body image is to first focus on training your mind to accept and appreciate your body for all that it does; and eventually loving it for it’s uniqueness and imperfections. t

Terri Griffith, Psy.D., is the clinical coordinator of the intensive outpatient program for the Center for Eating Disorders at Sheppard Pratt.