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Body Image Distress: Signs and Treatment Options



To start, let’s define body image distress, which, in an extreme form, can also be called body dysmorphia or body dysmorphic disorder. It is a mental health condition characterized by dissatisfaction with body and appearance. It may lead to behaviors like dieting, obsessive body checking in mirrors or by other means, and social anxiety and/or avoidance. It is a symptom of most eating disorders, but the two conditions do not always go hand-in-hand (i.e. an individual can struggle with body image distress without having an eating disorder).


This condition affects millions of men, women, teenagers and children worldwide. It is particularly prevalent among young people, made worse by the curated and filtered feeds of social media. In fact, The Wall Street Journal recently revealed some alarming findings from an internal Facebook presentation. “32 percent of teen girls said that when they felt bad about their bodies, Instagram made them feel worse,” researchers wrote in a slide from a March 2020 presentation. “Comparisons on Instagram can change how young women view and describe themselves.”


Moreover, in 2019, the company went so far as to say, “We make body image issues worse for one in three teen girls.” Along with these body image issues, users also report increased rates of mental health conditions like anxiety, depression, eating disorders, and even suicidal ideation.


Signs of Body Image Distress

From a clinical standpoint, in order to address a problem like body image distress, it’s important to understand the signs and symptoms as well as treatment options. Behaviors associated with negative body image and body dysmorphia can be time-consuming and difficult to control, ultimately causing unwanted issues in your daily routine, including school, work, and your social life. They may include:

  • Feeling distressed by body size

  • Being extremely focused with a perceived appearance flaw that can’t be seen by others or is barely noticeable

  • Feeling as though a defect makes you ugly or deformed

  • Belief that others pay particular attention to a negative feature and/or make fun of your appearance

  • Engaging in behaviors to “fix” the flaw, such as frequently checking the mirror, picking your skin, or grooming

  • Trying to hide the defect with styling, makeup, and/or clothes

  • Constantly comparing yourself to others

  • Exhibiting perfectionist tendencies

The most common features that people fixate on are their:

  • Waist, stomach, legs, or hips/butt size

  • Toning or musculature

  • Face, including the nose, shape of face,, complexion, wrinkles, acne, and other blemishes

  • Hair, such as appearance, thinning, and baldness

  • Overall look of skin and veins

  • Breast size and shape

  • Muscle size and tone

As an example, earlier this summer, Holly Madison opened up about her own struggle with body image distress, particularly as it relates to the size of her thighs and her overall weight.“I’m sharing this because I think it might help people to realize that sometimes our body dysmorphia is off the charts,” she said in a TikTok video. “I really feel like worrying about what I look like has gotten in the way of me living my best life and being as happy as I could be. It’s not worth feeling bad about yourself.”


Treatment Options for Body Image Distress

If you are experiencing the signs and symptoms noted above, make an appointment with a mental health professional or your primary care provider. Body image distress does not usually get better on its own and can lead to bigger health problems, including eating disorders, social anxiety, severe depression, and even suicidal thoughts or attempts. When it comes to treatment options, cognitive-behavioral interventions during individual or group therapy, combined with medication if needed, typically have the best outcomes.


If you or a loved one is struggling with body image distress and/or an eating disorder, reach out to Dr. Kelli Malkasian, PsyD, CEDS at Coral Reef Counseling, and schedule a free consultation or a telehealth appointment today.

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