Habtemariam isn’t the only expert whose clients are experiencing dissatisfaction with their bodies right now. Many mental health pros report that this year’s lockdowns are triggering new and existing body image issues for many people. Negative body image involves “feelings of shame, anxiety, and self-consciousness,” according to the National Eating Disorders Association—and people who experience it are more likely to suffer from depression, low self-esteem, and eating disorders such as anorexia and bulimia. An unhealthy body image can manifest in a number of ways, says marriage and family therapist Kim Campbell, MFT. “[A person] can be looking in the mirror and wishing that their stomach was flatter or there are more extreme behaviors like overexercising, disordered eating, pinching themselves all the time, weighing themselves all the time, measuring themselves all the time.”
In many cases, body image issues are connected to a feeling of powerlessness. It makes sense, then, that people are experiencing them in the COVID-19 era when every aspect of daily life has been thrown into disarray. “We have lost a lot of control over our work, financial security, home life, social environment, personal relationships, and more—things that in the past may have been stable and reliable,” says Nina Vasan, MD, MBA, the chief medical officer of mental health studio Real. “We don’t know what tomorrow is going to look like, we don’t know what next month is going to look like, and all the uncertainty is very distressing.”
Some people react to uncertainty by turning their attention to one of the things they feel they can control: their bodies. This was the case for 26-year-old Emily*, who's been managing the stress of rescheduling her wedding multiple times—and pressing pause on the heavy weight training workouts that have helped her in her eating disorder recovery—after COVID-19 hit. "Before quarantine, I was probably feeling the best I ever had about my body," she says. "But since then, I've started to see a lot of things pretty negatively all over again. It's a lot of [thinking] I have to work out today, I can't rest, I don't deserve to eat this. I've had a lot of time to just sit and overanalyze myself in the mirror. It was kind of scary because it was like, I've been here before and I'm back into the same thought patterns."
Reactions like Emily's aren't unusual, according to Amanda Fialk, PhD, LCSW, LICSW, partner and chief of clinical services at mental health treatment community The Dorm. “When your mood is down, you’re spending a lot of time inside, you’re isolating, your self-esteem tends to plummet. You feel worse about yourself, generally speaking,” she says.
- Amanda Fialk PhD, LCSW, LICSW, Amanda has specialized training in DBT, CBT, addiction and co-occurring disorders, eating disorders, family therapy, EMDR and motivational interviewing. She is a member of the National Association of Social Workers and the New York Academy of Medicine and an adjunct professor at Wurzweiler School of Social Work.
- Ayana Habtemariam MSW, RDN, LDN, Ayana Habtemariam MSW, RDN, LDN is a nutrition therapist, certified intuitive eating counselor, and macro social worker. She is committed to increasing awareness of intuitive eating and weight inclusive philosophies in black communities.
- Kim Campbell, MFT, Kim Campbell, MFT is a licensed therapist in Beverly Hills specializing in helping individuals and couples struggling with challenges related to attachment, relationships, anxiety, depression, trauma, grief and loss, LGBT issues and eating disorders.
- Nina Vasan, MD, MBA, professor at Stanford University and founder and executive director of Stanford Brainstorm
The strange new reality of stay-at-home life can also contribute to negative body image. Some people are spending more time on social media, while others are staring at their likeness on video conferences all day. These two forms of screen time have been triggering for 33-year-old writer Amanda Gist, who is in recovery from bulimia and binge eating disorder. "I had thoughts surrounding how the 'after' body in the 'quarantine 15' memes looked like my body and it was what everyone was trying to avoid—my body was clearly unacceptable and God forbid anyone came out of quarantine looking like me," she says. "I would get out of the shower and skip putting lotion on because I couldn't stand to touch my body, so much shame and embarrassment returned. Also triggering has been the new commonality of Zoom calls and getting used to so much FaceTime. Seeing myself on camera in the corner brought on thoughts of how much weight I had gained due to binge eating disorder and throughout eating disorder recovery."
For 27-year-old Geena*, who is also in recovery from an eating disorder, shopping at near-empty grocery stores in the early days of lockdown proved highly triggering. "When you have that extra stress of everybody in a mask and trying to get the food they want, I think that’s very much why those thoughts were creeping back in... like Don't grab that, you can't eat that," says Geena. "I left the store shaking the first couple of times we went. I had gotten to a point where my bad body image days were maybe once every other month, and with quarantine I was having the thoughts regularly."
Danielle Payton, the 30-year-old co-founder of digital fitness platform Kuudose, was just getting familiar with a new low-FODMAP eating plan to help manage endometriosis symptoms when the pandemic hit. Once she started limiting her grocery store trips, she experienced a resurgence in the body dysmorphia that's plagued her for years. "They told us we shouldn't leave our houses for two weeks, and that’s when it started to get hard," she says. "When I couldn’t go out to the grocery store, I was like, do I eat what's in the house and not take a risk [of contracting COVID-19]... and then the next day I look in the mirror and I look six months pregnant because I have an endometriosis flare-up? When I have a flare-up [during the pandemic] it's drastically worse because I don’t have the same resources."
On top of these stressors, the more time we spend holed up at home, the fewer distractions we have, and the more easily our thoughts and emotions are amplified. “We may have been able to suppress those emotions pre-COVID, but there are so many things going on—protests, all of those things—and people are feeling a lot,” says Habtemariam. As a result, “they might be eating more and they might be beating themselves about that.”
Whatever the causes for increased body dissatisfaction during quarantine, there are plenty of therapist-approved ways to feel better. But the first step is to treat yourself with radical kindness. “A client of mine said to me, ‘There are so many things I could have done [during quarantine] if I wasn’t thinking about my body,’” says Habtemariam. “But you have to be gentle with yourself and understand that it’s okay.”
Read on to learn how to navigate body image issues during COVID-19 quarantine.
1. Explore what’s behind any negative feelings towards your body
Negative body image isn’t always about the body itself—often, there are deeper feelings of unworthiness at play. If you find yourself having harsh thoughts about your body, take a minute and dig into why that might be. “Ask yourself, What is it that I’m really feeling here? What am I looking to prove or not prove to myself in this moment? Is it that I have value? Is it that I’m okay?” says Campbell. “The act of turning that critical lens on ourselves is just a defense against feeling those deeper feelings. If we can stop ourselves, get in touch with those feelings, and perhaps write about them instead of tearing ourselves apart, we’ll get some insight into what is really going on internally.”
2. Celebrate what makes your body powerful
Next time you feel negativity creeping in, Campbell suggests thinking about all of the cool things your body can do for you. Maybe your mind helps you write beautiful poetry, your legs carry you through thousands of steps a day, or your big heart makes you a great friend or dog mom. “When we’re in a negative mindset, we lose the perspective of the other things that are valuable about us,” says Campbell. "Everything gets reduced down to the size of our jeans, which is so diminishing and dismissive of the holistic creatures that we are.” If you have trouble being kind to yourself, Dr. Vasan and Habtemariam are both fans of the “best friend test”: Are you talking to yourself as kindly as you would if you were talking to your best friend? If not, make a point to do so going forward.
3. Limit social media consumption and focus on supportive communities for body image issues
In a recent survey conducted by behavioral health treatment facility FHE Health, 23 percent of American women said that social media has the greatest impact on how they feel about their bodies—a greater impact than traditional media or IRL relationships. If you’re feeling more down on your appearance than normal, consider that it could be linked to your scrolling habits. “The need for social comparison right now is quite great because we’re in this situation together and we want to see how other people are doing it,” says Campbell. “So, when we’re on Instagram and we see somebody who has the body type or the skin or the hair that we think we should have, then we turn a critical lens on ourselves.”
It doesn’t help that many of the messages on social media right now center around daily at-home workouts, home cooking, and avoiding the “quarantine 15.” “It creates a lot of pressure to measure up to an ideal that’s probably not even very attainable,” says Dr. Fialk. “And yet it feels like everybody else is doing it so why can’t I do it as well? It’s triggering old issues and it’s also instigating new ones.”
Of course, not all social media accounts feed negative body image. In fact, online communities can provide valuable support for those who feel alone in their body image concerns. “I think it’s helpful to cultivate an online or in-person community that you feel safe in—people who look like you or share the same beliefs as you when it comes to the body and people who accept all bodies for what they are,” says Habtemariam. “Until we can dismantle this oppressive system that demonizes certain bodies and puts certain bodies on a pedestal, we have to support each other.”
4. Check your attitudes toward food and exercise
Many of Habtemariam’s clients who suffer from anxiety—like so many of us during COVID-19—have perfectionistic tendencies when it comes to their wellness habits. “What I usually see is people being hyper-fixated on doing things ‘the right way.’ They feel like if they aren’t doing the right things, their body image is going to suffer and it's their fault,” she says.
This is why Dr. Fialk says it’s important to approach food and exercise from a place of non-judgment. “There’s a difference between saying ‘I want to exercise because it lifts my spirits’ and saying ‘I have to exercise because if I don’t, I’m worthless.’ It’s about perspective and reframing the way we look at it. You can set goals of wanting to exercise because it makes you feel good and also not beat yourself up if you’re not able to do it on a certain day.” Danielle chose early in the pandemic to stop wearing her fitness tracker, as she felt triggered by its constant urging to get up and move. "For a girl who has body dysmorphia, it is not going to be beneficial if it's reminding me every hour how many calories I didn’t burn," she says.
On the food front, Dr. Vasan says to avoid labeling any meal as “bad” or “good,” as this can create feelings of guilt. Instead, she says to pay attention to how your body is feeling and to feed yourself accordingly. “Find ways to comfort yourself that don’t include food,” she says. “But if you are eating more every now and then, let yourself enjoy it.” Habtemariam also suggests paying attention to when you’re not eating enough. “It’s really hard to deal with our emotions if we’re not nourished,” she says. “If you have to schedule times to eat and put a reminder on your phone, that’s okay. Just make sure you're getting some form of nourishment throughout the day.”
5. Get back into a routine
Sorry to break it to you, but this tip requires a break from sweatpants, aka the official uniform of COVID-19. “There’s something that makes you feel better when you get up, brush your teeth, take a shower, put on some work clothes, and act as if [it's a normal day],” says Dr. Fialk. “The more we sit around and fall into poor sleep-wake cycles, that generally adds to dissatisfaction with self.”
That said, remember to be kind to yourself if you fall off of your schedule for a few days and lose yourself in old Curb Your Enthusiasm episodes. “There’s no such thing as a perfect day, especially in the coronavirus world. We have to be really patient and gentle with ourselves because we’re all experiencing a trauma right now,” says Dr. Fialk.
6. Stay connected to loved ones
If you’re prone to ritualistic “checking” behaviors—looking at yourself in mirrors, weighing yourself, etc.—you may be tempted to do more of that while self-isolating. “The more time we spend isolating, the more time we spend in our own heads, and when you struggle with how you feel about your body, that isn’t always the best place to be,” says Dr. Fialk. As an antidote, she suggests scheduling regular virtual hang-outs with friends and family, doing things like virtual games, movie nights, or scavenger hunts.
And while you might not want to talk to everyone in your life about your body image concerns, Emily has found it helpful to share her feelings with those she trusts. "I talked to a friend who I didn’t know was struggling with the same issues and it helped me feel a little bit better," she says. As it turned out, that friend was seeing a therapist and the conversation convinced Emily to start therapy, too. "Really rely on your community and don't be afraid to be vulnerable when things go wrong," she says.
7. Talk to a mental health professional about body image issues
With the rise of teletherapy, it’s easier than ever to get professional help for mental health concerns, body image issues included. “You don’t have to wait until you’re under your covers every day crying, not wanting to get out of bed,” says Dr. Fialk. “In fact, you tend to feel better quicker when you ask for help sooner rather than later.”
Geena, who has just started working with a life coach and has a support team in place for eating disorder recovery, agrees that getting outside help is powerful when it comes to making peace with one's body. "I know [negative body image] is gonna come up again, but I'm gonna react differently to it next time because I know what the thing is that is driving it," Geena says.
Above all, says Gist, don't forget that it’s important to be forgive yourself for any not-so-nice thoughts about your body. "This can be such a traumatic time for someone with food or body issues, and the last thing we need is to beat the crap out of ourselves on top of those struggles," she says. Adds Dr. Vasan: “Remember that your body is meant to change at different parts of life, and it’s okay if it changes during quarantine. After all, everything else has.”
If you or someone you know is experiencing an eating disorder, contact the National Eating Disorders Association’s hotline at (800) 931-2237.
*Last names have been omitted to protect source's privacy.
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