This week is Mental Health Awareness week. The theme this year is body image. Last week, Body Brilliant went to be printed. (*small scream*) The theme is body image. All my work is focused on mental health but this is the first to focus directly on body image. I found it fascinating and empowering – but not easy! – to write.
Here are three ways in which body image is relevant to mental illness
- It can be connected to eating disorders. This doesn’t mean one causes the other, just that there is very often (but not always) a link. So, many/most (but not all) people with eating disorders have a distorted negative body image, believing that they look different from how they actually do.
- Body Dysmorphic Disorder – a mental illness where someone has a significantly distorted view of their appearance and where it really interferes with daily life and social activity – is a striking and extreme example of negative body image.
- Although disordered eating* isn’t strictly a mental illness, it can evolve into an eating disorder. Disordered eating is closely connected to negative body image, typically with a strong desire to lose weight or build muscle or in some other way alter body shape via restricting food and/or over-exercising
(*Many people don’t have a specific named eating disorder but do have ‘disordered eating’, which means that they share some symptoms and behaviours of actual disorders. Each eating disorder has a particular list of symptoms and some people don’t fall neatly into one set of symptoms. Disordered eating can sometimes become a disorder or it might just continue as a negative relationship with food, such as frequent dieting or patterns of restricting certain foods or having restrictive rules or rituals.)
Body Brilliant is not a book about mental illness – although it does contain very important chapters on eating disorders and Body Dysmorphic Disorder, which are mental illnesses, and also touches on self-harm. It is – in common with my other work – not so much about mental illness as mental health. How do we keep ourselves mentally healthy, avoiding mental illness? How do we live a mentally and physically healthy lifestyle, building up our well-being levels to protect us from illness or adversity?
Body Brilliant takes the view that first we need to understand the mental aspect of body image, which I reveal in the first section, In The Mind, Second, in the section called Making Your Body Brilliant, I share how we can do all sorts of lovely, healthy things to make our body the best it can be: the strongest, fittest and healthiest. Including via our relationship with food.
And just as food often has close links with body image mentally, it also created great difficulty for me when I had to give healthy living advice in Body Brilliant. This was a major challenge because we are all fed (sorry!) extremely mixed messages on this topic. Especially in one area: fat. Even if you only listen to major authorities, such as governments, charities and diet experts, the messages very often contradict each other.
On the one hand:
- We are told there’s a growing obesity crisis in most developed countries, including the UK – and the news reports are almost always accompanied by a picture designed to make us feel bad about fat
- We are told that being overweight – and even, according to recent news, even being slightly overweight – risks all sorts of serious and life-shortening diseases
- We are often told to watch our calorie intake and increase our exercise
- We are told what a healthy or unhealthy BMI is and told that we must deal with it if it’s unhealthy
- Food labelling increasingly has calorie values and a traffic-light system for fat, sugar, salt etc
- All the official, public messages seem to be: you’ll be healthier if you are not overweight – and the advertising/media messages are also: you’ll be happier if you are. (Wrong.)
On the other hand:
- We are told that diets don’t work – and the same organisations that promote the messages above keep telling us this (they are correct – people who most often regain the weight they lost and end up heavier than those who don’t diet).
- Eating disorder experts strongly advocate NOT calorie-counting, no division of foods into healthy and unhealthy, no removal of certain foods from the choices – obsession with calories is one of the symptoms of disordered eating and eating disorders.
- Dietitians specialising in young people disapprove of advice that encourages young individuals to be particularly conscious of what they’re eating – I was guided away from any advice that sounded like “eat this food more than that food”. For example, it was NOT regarded as OK to suggest that limiting sugar intake.
- Being too selective, cautious, judgemental and restrictive about certain foods can lead to disordered eating (the type of super-health-conscious or restrictive eating that can precede or be a part of actual eating disorders) – this explains the previous three points.
- The ‘body positive’ movement (which seeks to help people feel great about and respect their bodies whatever size they are) has also been criticised for a) focusing too much on appearance and b) ignoring health messages relating to having too much fat.
At its simplest, the problem is that different people actually need different messages. And that’s partly because all the words and phrases we use are relative and in the eye of the beholder: fat, over-weight, lose weight, healthy food, exercise more, too much, too little. They mean different things to different people. Some people would be healthier if they lost some weight; others of the same weight wouldn’t. Some people just need one simple nudge to set them on the road to a fantastic balanced lifestyle; for others that same nudge could tip them into self-loathing and negative behaviours.
In many ways, this book would have been easier to write if I could have written two versions: one for people at risk of eating disorders and one for people not at risk of them but needing advice about a healthy lifestyle (which might sometimes include losing weight.)
However, a difficult task just makes me work harder, try harder, listen harder. And so I did.
Here are my key messages about healthy lifestyle for young people, with the twin aims of 1. helping at risk people avoid slipping into mental illness connected to negative body image and 2. helping everyone have a genuinely healthy lifestyle, particularly in attitude to shape, size and fat. (Body Brilliant is about so much more than shape, size and fat!)
- If you are a young person and you are thinking a lot about wanting to lose weight or are very unhappy about some aspect of your appearance, do not try to deal with this yourself. Start by seeing your GP, who can refer you to the appropriate help, depending on lots of things about your health, lifestyle, BMI etc. Going on a diet yourself is most likely to lead to a negative outcome and increase your risk of disordered eating. This is the big link between mental illness and body image.
- Your brain and body cannot do their job if they don’t get food which is both enough in quantity and sufficiently nutritious in content. Don’t count calories; just make sure your daily intake is as follows:
- plentiful, so you don’t go hungry
- varied – by having a big variety you make it almost certain that you’ll get all the nutrients you need
- enjoyable – food isn’t only fuel
- You are bombarded by many undermining messages about body image on social media: every picture of a so-called ‘perfect’ body – whether slim or ripped, petite or tall – suggests to you that that’s what you should aim for. But there’s so much more out there: choose what you look at. Don’t look at unnatural undermining stuff. Have a social media diet, not a food diet!
- Balance your activities – many people don’t get enough physical activity but some people do too much. If you’re not sure whether you get too little or too much, ask an informed adult or go onto an official website such as the NHS.
- Your body is the vehicle for your life, your skills, potential, aspirations, character, the person you can become: respect it, nurture it, give it everything it needs and it will give back.
So, for Mental Health Awareness Week, I urge you to think about how your body image affects your physical and mental health: does it make you eat wonderful nourishing food and take fantastic, enjoyable exercise or does it make you restrict what your body needs, work your body too hard, and fail to respect it for the brilliant, powerful, ambitious body it is?
“Some people just need one simple nudge to set them on the road to a fantastic balanced lifestyle; for others that same nudge could tip them into self-loathing and negative behaviours.”
Make sure you stay healthy in mind and body.
Later, towards publication on July 11th of Body Brilliant, I’ll be making some free teaching resources and posters available. Watch this space!