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Disordered Eating and Body Image

What is Body Image?

  • How you see yourself when you look in the mirror or when you picture yourself in your mind
  • What you believe about your own appearance (including your memories, assumptions, and generalizations)
  • How you feel about your body, including your height, shape, and weight
  • How you sense and control your body as you move
  • How you feel in your body, not just about your body

People with a negative body image have a greater likelihood of developing an eating disorder and are more likely to suffer from feelings of depression, isolation, low self-esteem, and obsessions with weight loss.

We all may have our days when we feel awkward or uncomfortable in our bodies, but the key to developing positive body image is to recognize and respect our natural shape and learn to overpower those negative thoughts and feelings with positive, affirming, and accepting ones.

Ten Steps to Positive Body Image

One list cannot automatically tell you how to turn negative body thoughts into positive body image, but it can help you think about new ways of looking more healthfully and happily at yourself and your body. The more you do that, the more likely you are to feel good about who you are and the body you naturally have.

  1. Appreciate all that your body can do. Every day your body carries you closer to your dreams. Celebrate all of the amazing things your body does for you: running, dancing, breathing, laughing, dreaming, etc.
  2. Keep a top-10 list of things you like about yourself -- things that aren’t related to how much you weigh or what you look like. Read your list often. Add to it as you become aware of more things to like about you.
  3. Remind yourself that “true beauty” is not simply skin-deep. When you feel good about yourself and who you are, you carry yourself with a sense of confidence, self-acceptance, and openness that makes you beautiful regardless of whether you physically look like a supermodel. Beauty is a state of mind, not a state of your body.
  4. Look at yourself as a whole person. When you see yourself in a mirror or in your mind, choose not to focus on specific body parts. See yourself as you want others to see you – as a whole person.
  5. Surround yourself with positive people. It is easier to feel good about yourself and your body when you are around others who are supportive and who recognize the importance of liking yourself just as you naturally are.
  6. Shut down those voices in your head that tell you your body is not “right” or that you are a “bad” person. You can overpower those negative thoughts with positive ones. The next time you start to tear yourself down, build yourself back up with a few quick affirmations that work for you.
  7. Wear clothes that are comfortable and that make you feel good about your body. Work with your body, not against it.
  8. Become a critical viewer of social and media messages. Pay attention to images, slogans, or attitudes that make you feel bad about yourself or your body. Protest these messages: write a letter to the advertiser or talk back to the image or message.
  9. Do something nice for yourself -- something that lets your body know you appreciate it. Take a bubble bath, make time for a nap, and find a peaceful place outside to relax.
  10. Use the time and energy that you might have spent worrying about food, calories, and your weight to do something to help others. Sometimes reaching out to other people can help you feel better about yourself and can make a positive change in our world.

From the National Eating Disorders Association

Eating Disorders

Society emphasizes the importance of physical appearance for success, a goal most college students strive for. Unfortunately, many of the qualities, such as perfectionism and self-discipline that helped students receive admission to Drexel are also risk factors for the development of eating disorders. Thus, while researchers estimate eating disorders affect 1-2% of the general population, up to 30% of college students experience eating disorder symptoms during their college years.

The development of an eating disorder is not simply the result of a desire to be thin, but the manifestation of deeper emotional and psychological problems. Most notably, people with eating disorders have low self-esteem and lack effective coping mechanisms for dealing with such a distorted self-image. Eating disorders can provide a sense of control and escape, allowing sufferers to temporarily forget depression, anxiety, stress, anger, and guilt. Low self-esteem also plays a role in eating disorders. Anorexics and bulimics often have high expectations of themselves. If they fall short of these expectations, they experience low self-esteem. They often overvalue physical appearance in self-evaluation.

Although eating disorders affect people of all races, genders, sexualities, and socioeconomic backgrounds, they predominantly arise in middle and upper class women. In fact, over 90% of eating disorder patients are women, who are often smart, attractive, and successful. Men involved in weight specific sports, dieting or bodybuilding are at risk of developing disordered eating problems as well.

Anorexia Nervosa

Anorexia is an eating disorder where the individual becomes preoccupied with an unhealthy pursuit of weight loss that eventually leads to distortion in body image. No matter how thin they may become, anorexics continue to believe they need to lose weight. To accomplish this desire, they starve themselves, maintain rigorous exercise regimes, and sometimes purge by vomiting, laxatives, or diuretics. Even when weight loss endangers a sufferer’s health she may not understand she has a problem that must be solved.

Most anorexics desire a sense of control, especially if they experience changes in their lives over which they have no power. Changes that can trigger anorexia may include divorce of one’s parents, receiving unexpectedly low grades, rejection in a peer relationship, having a sports injury, and entering a new school.

What are the signs and symptoms of anorexia?

Behavioral signs include:

  • Starvation and restriction of food
  • Obsession with food, calories, recipes (cooking for others, but not eating anything themselves)
  • Obsessive exercise
  • Purging by vomiting, or using diet pills, laxatives, or diuretics
  • Eating junk food, particularly candy, and drinking a lot of coffee or tea, and/or smoking
  • Unusual eating habits (e.g. picking at food, spreading it around the plate, cutting food into tiny pieces)
  • Excuses to avoid eating (e.g. “I already ate,” “I’m not feeling well”)
  • Hiding food they claimed to have eaten
  • Suddenly becoming vegan or vegetarian to avoid certain foods
  • Social withdrawal
  • Wearing baggy clothes to hide weight loss and keep warm

Physical signs include:

  • Weight loss
  • Fatigue, muscle weakness
  • Always being cold
  • Irregular menstruation or amenorrhea (loss of period)
  • Fainting spells, dizziness
  • Headaches
  • Pale complexion

Emotional signs include:

  • Persistent concern with body image
  • Complaining of being fat, even when thin
  • Depression, irritability, mood swings
  • Perfectionist attitude


Bulimia involves binge eating followed by purging or fasting. Someone who is bulimic eats an abnormally large amount of food in a short period of time and then fasts or purges using laxatives, diuretics, or self-induced vomiting because he or she feels overwhelmed with guilt and shame. Another method bulimics use to cope with such emotion is excessive exercise. Through purging, fasting, and exercise, bulimics hope to regain a sense of control they lacked while bingeing, but unfortunately they end up suffering such hunger that their cravings for food will take hold once again, making binge eating more likely. In contrast to anorexics, bulimics tend to be around average weight and realize they have a problem. The most dangerous health risk posed by Bulimia is cardiac arrest or heart attack due to an electrolyte imbalance of the mineral potassium. Individuals who abuse laxatives will find they can no longer have natural bowel movements, resulting in constipation.

What are the signs and symptoms of bulimia?

Behavioral signs include:

  • Binge eating
  • Secretive eating
  • Going to the bathroom after meals
  • Vomiting
  • Laxative, diet pill, or diuretic abuse
  • Intense exercise regimen
  • Fasting

Physical signs include:

  • Red, puffy face and watery eyes (from vomiting)
  • Weight fluctuations (usually between 10 and 15 lbs.)
  • Swollen glands
  • Fatigue, muscle weakness
  • Tooth decay
  • Irregular heartbeats
  • Chronic sore throat

Emotional signs include:

  • Mood swings
  • Depression
  • Low self-esteem
  • Persistent concern with body image
  • Feelings of guilt and shame

Binge Eating Disorder

Binge Eating Disorder is similar to Bulimia, but doesn’t involve purging or other compensatory behavior. Patients feel out of control as they ingest large quantities of food without regard to hunger or fullness. Like bulimics, they feel ashamed, disgusted, and guilty afterwards. Binge Eating Disorder may be difficult to detect because sufferers prefer to eat alone due to embarrassment and guilt. Without behavior to compensate for the calories consumed during an episode of bingeing, patients become overweight, suffering health complications similar to those of obesity. In fact, about 25% of obese individuals experience Binge Eating Disorder, which affects slightly more women than men.

What are the signs and symptoms of binge eating disorder?

Behavioral signs include:

  • hiding food
  • going on many different diets
  • secretive eating patterns
  • avoidance of social situations where food will be present

Physical signs include:

  • weight gain
  • fluctuations in weight

Emotional signs include:

  • feeling out of control over eating
  • low self-esteem
  • depression
  • anxiety
  • loss of sexual desire
  • feelings of guilt and shame
  • disgusted with self
  • suicidal thoughts

Compulsive Eating

When an individual no longer eats food for nutrition or enjoyment, but for emotional reasons ranging from happiness to depression, he or she probably suffers from Compulsive Eating. Similar to victims of other eating disorders, compulsive eaters use eating habits to cope with difficult emotions, or even to celebrate joyful events. They frequently suffer from low self-esteem and depression, hoping food will fill the void, or at least help them escape from feelings of stress, anxiety and anger. Compulsive Eating involves addictive behavior with food.

Parenting is a major factor in the development of Compulsive Eating. If friends and family members offer comfort in the form of food, children will be less likely to develop more effective coping mechanisms. Learning to associate food with emotion initiates a tragic cycle in which the individual turns to food for comfort, but then feels ashamed for gaining weight and not being “good enough.” The more weight that’s gained, the more a victim will try to diet, which unfortunately causes hunger that will lead to another bingeing episode. This cycle of dieting and binging can go on forever unless the emotional attachment to food is broken.

What are the medical complications of binge eating disorder and compulsive eating?

  • obesity
  • menstrual irregularities
  • diabetes
  • high blood pressure
  • high cholesterol
  • decreased mobility
  • shortness of breath
  • heart disease, as a result of high triglyceride levels
  • gallbladder disease
  • cardiac arrest and/or death

Compulsive Exercising

Compulsive exercising is not a formally recognized disorder because it is usually a symptom of Anorexia Nervosa, Bulimia, or Obsessive-Compulsive Disorder. People who suffer from compulsive exercising spend about 2 to 5 hours exercising every day, often compromising other areas of their life to maintain extremely high levels of physical activity. Like patients with other eating disorders, compulsive exercisers are motivated by psychological factors. Their goal is not simply good physical appearance and performance, but control and self-respect. They seek to rid themselves of negative feelings and emotions through exercise, even if that means running with an injured ankle or through the snow. Other symptoms include lying about the amount of time spent in the gym, skipping work or school to exercise, continually increasing the intensity and frequency of workouts, and continuing with exercise despite injury. Compulsive exercisers are in danger of dehydration, stress fractures, osteoporosis, heart problems, kidney failure and other risks associated with low body fat.

Online Resources

Disordered Eating Presentation

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Helping a Friend

Plan to approach your friend directly. Pick a time when both of you are feeling calm and have plenty of time to sit down and chat. Accusations, confrontations, or pleas to change will only result in closing any potential lines of communication. Be sure to tell your friend why you suspect there’s a problem, using “I” statements to point out specific eating and exercise patterns that worry you. Helping a friend with an eating disorder requires a lot of patience because the person is not going to change his or her behavior overnight. However, just talking with your friend and being supportive is an important first step. If you start to get frustrated, ask if you can continue the conversation at another time. Try to anticipate what kind of response your friend is likely to give. It may be one of relief and admission of the problem, but it could be defensive and angry.

Do not ignore symptoms of binging, such as open containers and empty food wrappers. Although bulimics and binge eaters eat secretly, they frequently leave clues about their unhealthy habits, kind of like a cry for help.

It’s important to understand that eating disorders stem from a variety of psychological and emotional issues, and that recovery means far more than breaking habits of starving, bingeing, compulsive exercise, and purging. Sufferers must not only learn how to eat healthy, but also discover and correct the underlying problems that contributed to the development of an eating disorder. Complete recovery can only be achieved with the help of professional doctors and therapists, but you can play an important role as a supportive and encouraging friend.

Reach out and let your friend know that you are concerned, and that there are better ways to deal with life’s problems than stuffing and starving. Encourage professional help, but expect denial and resistance. Don’t dwell on weight or appearance, but discuss health, relationships, and mood. Your friend likely has a distorted body image and will not be persuaded to find help by comments that suggest she is too thin (in fact, she may celebrate such a remark). Be a good listener, don’t give advice unless it is asked for, and be prepared to suggest where your friend may go for help if she wants it.

Finally, you may refer your friend to the Counseling Center.

The content provided here is intended for informational purposes only. It is not intended for self-diagnosis or self-treatment, nor should it replace the consultation of a trained medical or mental health professional. Please note that outside links are not under our control, and we cannot guarantee the content contained on them.