When bad body image isn't about the body

I remember going to a therapy appointment quite a few years ago, flinging myself into the chair and promptly launching into a ten-minute-long tirade about how fat this complete idiot was making me. Didn't she see how huge I was? And she still wanted me to gain weight?!?

After I came up for air, my therapist looked at me and said with a voice that can only be described as overly saccharine, "Now, Carrie, we know that bad body image really isn't about how we look. Why don't you tell me what's really going on."

The reframe sent me further into a rage. Don't patronize me, I said. I'm feeling fat because I am fat and that's it. There's nothing more to it. Period. End of story. So why don't we talk about what we're going to do about my need to lose weight now that you've porked me up.

And so on. The session would not be classified as "productive."

With time, maturity, and proper nutrition, I've come to realize that my therapist had a point. I remembered her point today, when my work schedule can only be described as a game of Whack-a-Mole on meth. I'd send one email, and other editor would ask for art. I'd send some potential images, do the changes on the previous email. While making those changes, editor #2 would write back and say those images don't work, do you have any more? So I'd search for some, and then editor #1 would write back and...well, you get the idea.

I was stressed and on edge, almost ridiculously so. Perhaps not surprisingly (to my ex-therapist, at least) the feelings of body dysmorphia, body hate, and generally feeling "fat" came back. It got me thinking to something my friend Charlotte said about her daughter. Maybe the "fat" feelings weren't really about fat at all. Maybe it was anxiety that she was trying to translate the best way she knew how. Given our culture's general angst around food and weight, maybe this is how we make sense of anxiety. It's got to be about food and weight, right? What other explanation can there be?

Obviously, this isn't the only explanation, but the more I think, the more I'm beginning to understand the validity of this. My stress today had zero to do with food or weight. Zilch. And yet I immediately started fretting about what I was eating and what I must weigh. Logically, I know my weight is probably the same as it was yesterday, and the day before that, and... I know that emails from editors don't magically make my thighs expand (seeing how many emails I get each day, that's probably a good thing). But that didn't stop my brain from diving into those old, familiar depths.

I don't think that this is the sole explanation for body dysmorphia in eating disorders--one of the emails today was from a piece about body dysmorphia that's will publish shortly--but I do think it explains why stress is such a trigger for so many of us. Our brains are just trying to make sense of something we can't explain, so we do the best we can with the vocabulary we have. My own vocabulary happens to be marinated in the larger culture of diet obsessions. Maybe Catherine of Siena would have worried about her abilities to be holy if she were in my shoes (and they had email and Whack-a-Mole in the Middle Ages). That might have been how she made sense of her compulsion to starve herself. I have the same compulsion, but a very different culture that provides a very different vocabulary.

It would have been nice--and much less patronizing--if instead of just saying "We know bad body image isn't about our bodies..." with an unavoidable patronizing undertone, my ex-therapist had said that sometimes our brains don't translate anxiety properly. That sometimes we get confused and attribute worries about something else to worries about food and weight.


hm said...

Nice reframe- capturing the thoughts in your head and getting behind the words to acknowledge the anxiety beneath them. I think you're onto something about available vocabulary- if the professionals tell the anorexic that they are afraid of being fat, then when the anorexic feels terrified they will cry, "I'm fat!" simply for the release of wrapping words around their panic and distress. If only therapists were trained in telepathy, and could feel and decode our feelings WITH us, instead of having to rely on our often inadequate words. Ah well... if my therapist could feel my feelings, she'd probably go crazy too, and that wouldn't exactly be helpful...

Extra Long Tail said...

I have always described my experiences of anorexia nervosa (AN) as NOT being about my weight and shape. I never started to restrict food and to over-exercise as an 11-year old because I thought I was fat. I over-exercised because it relieved my anxiety and I restricted food because it made me feel to be 'in control' of my anxiety. Of course, over-exercise and under-eating leads to weight loss - and so I wasted away.

And then I got stuck in a pattern of behaviours... And I got stuck because every time I tried to eat more or to exercise less, my anxiety was so overwhelming that I suffered frightening panic attacks.

Although I never thought I was fat, I did fear gaining weight. This was because as long as the number on the scale remained low and constant I felt 'safe'.

One of the most important recovery strategies I have learnt is to deal better with anxiety - i.e. employing different strategies, such as mindfulness, in place of food restriction.

I do wonder to what extent excessive talk about 'body image' merely serves to confuse people with EDs. Cultural obsession with body image sounds like a good reason for EDs, but I suspect that culture is a mere red herring in the aetiology of these illnesses.

Undenied said...

Oh wow, I was JUST explaining this to my boyfriend. All of the philosophizing and rationalization we give to our weight loss is just our brains trying to find logic amid the irrational. I don't know why losing weight makes me feel like I'm doing the right thing - it's all just malfunctioning chemicals - but people need a reason to do things, so I figure out reasons. And if you have coinciding issues like depression or perfectionism, then those get wrapped into you explanation, feeding the disorder.

Erica said...

Well said!

I also think we're so familiar and comfortable with hating our bodies (having living many years with an eating disordered lens) that it's easier to be stressed about our ED's than whatever else is going on in life. After all, if I have 10 people needing things from me all at once, I'm just going to have to deal with it. But if the problem is that I feel fat, well, that can be fixed by engaging in disordered behaviors.

I believe you worded it brilliantly when you said "sometimes our brains don't translate anxiety properly." Carrie, thanks so much for sharing this insightful perspective!

Anonymous said...

Great post! I love thinking of this body anxiety in terms of a poor translation.

Katie said...

I agree with you Carrie, although I think the mistranslation can extend further than body image. I always suddenly "needed" to lose weight when I was very stressed out even though my body image didn't enter the equation. It just sort of popped into my head as a perfect solution to whatever problem I had regardless of what my weight or perception of myself was at the time. It wasn't like it just occurred to me either, it would be a really strong urge to act on those thoughts and terror at the idea of not doing so, even if I had been in a tenuous state of attempted recovery for a few months. That's how a good few relapses started, although if you can call them relapses when I wasn't really recovered in between I don't know...

I think eating disorders are like chameleons. They can fit into whatever anxieties a person has regardless of how connected to weight/size or not they are. Somehow restricting becomes relevant to every situation.


I am flattered. Just saying.

As a non-eating disordered person, before anorexia came to pay us a mercifully short visit, I would always cry "I'm fat" when I was anxious and uncomfortable - going out and not knowing what to wear, being frustrated at work, being tired after trying to cope with 2 children under 2, having a bad hair day, falling over yet another piece of pink plastic, etc etc etc.

I can look back now and see that I wasn't fat, or any fatter at that particular moment. In fact I was just the same shape and size I had been for about 15 years. I was not unhappy with the way I looked or fitted into my clothes and (you are so right Carrie) my thighs had not expanded overnight because the washing machine had broken. I just felt frustrated, anxious, angry and sad all at once and translated these feeling into words that everyone else could understand - I feel fat. It is just that. A feeling. A translation of anxiety.

The switch in my brain didn't then tell me to stop eating or restrict or diet. It told me to go and do something about my frustration - shout at husband, bang door, weep, attack concrete block with claw hammer, turn on car engine and rev car (Huh?).

I no longer say "I'm fat" and, if I hear other people saying it, I tend to turn round and say "So what is making you anxious?". This can be highly embarassing if you do it in the checkout queue at the supermarket to someone you have never met (Blame chemobrain!)....

Love you, Carrie. xx

Anne-Sophie said...

Great article. I know exactly what it feels like to *suddenly* feel x pounds heavier after having a stressful or uncomfortable situation.
I too wish that therapists were a bit more direct at times, but I guess they want us to find it out for ourselves?

wendy said...

Carrie - Another great post on a very important aspect of ED and how it morphs back to body image.

I remember saying the same words your therapist said to you to my 23 y/o D when she was getting her weight to where it needed to be.

Each time she would fixate on her "fat body" and how awful she looked, I calmly said to her

"Is there something else that you are worried about?"

and, most times, she would talk about what was really troubling her.

This was an invaluable part of her recovery - to get more in touch with the anxiety she was feeling in dealing with LIFE stressors, whether it be at work, her relationships, or feeling inadequate in other areas.

I am going to copy and send this to my D as I've done with all your wonderful posts that address these important revelations with recovery.

So proud of you and thanks, once again, for being instrumental in my being able to help my young adult daughter recover

Unknown said...

What you describe makes a great deal of sense and I wish we could get people to reframe it the way you have, or at least to consider it. It frightens me the way people join the focus on the body as the problem rather than the distress itself.

hm said...

Well, the body is an easy solution though, isn't it? There is always something you can DO to it. You can't always expand your paychecks or reduce your bills, bring back someone you lost or make someone not be upset at you... but you can always DO something to your body. It's tangible, and it's always readily available. It is difficult to let anxiety just "float" out there, unattached to tangible things, and unfixable.

Unknown said...

Interesting way of looking at it. I know my d's body image issues came together with an irrational worry about taking up too many resources, which showed itself as her not wanting to spend any money on her but also in extreme worry about the environment. Seems that perhaps in a culture where people don't worry about fat, her other worries would seem more prevalent (although she still would have the ED).

Carrie Arnold said...


I have a lot of those worries, too, although they are almost as much a product of the ED as a cause. But I've always felt extremely guilty at having money or things that other people didn't have. It just makes me horribly uncomfortable, and the food aspect got subsumed into that. It's still a big struggle to spend adequate money on food and such because of the double guilt of spending money (oh the horror!) and actually purchasing food. Alas.

Wondering Soul said...

Dear Carrie,

As someone who is 'trying' to move their BMI up from 13.7 ( I say trying but I'm beyond my wits with terror everytime my weight moves up) your words are a bit like fresh water in a desert.
Thank you for making such sense.
You can't know how timely this post is for me... tonight... It's amazing.

I'm only sorry that the hideous illness is still your mind's first port of call when in distress.
It's a really hard place to go... Fantastic though, that you recognise it so well for what it really is.

Thank you for your wisdom.


HungryMac said...

Whoa! I needed to read this today! My brain's staging a bit of a coup d'etat right now and the Zoloft barricade needed some outside reinforcement. Thank you for supplying that!!

awells said...

I loved reading this entry. I struggle the most with body image and have been in therapy for 15 years. the logical part of my recovery knows that is has nothing to do with my body but I am in a stuck place.
I wake up stressed out to the max about getting dressed. I sometimes wish I could burn all my clothes and start over.
I get up earlier than my husband who helps me process my thoughts when he is awake. Any advice?



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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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