[DR. CRISTINA CASTAGNINI] Behind The Bite podcast is part of a network of podcasts that are good for the world. Check out podcasts like the Full of Shift podcast, After the First Marriage podcast and Eating Recovery Academy over at practiceofthepractice.com/network. Welcome to Behind The Bite podcast. This podcast is about the real life struggles women face with food, body image and weight. We're here to help you inspire and create better healthier lives. Welcome. Well, hello everyone. I don't think anyone listening here has not heard of body image. I think I've even discussed body image on previous podcast, but I wondered to myself, have I ever really done a good job on here of discussing what body image really is, I mean really getting into it and how it can affect someone's mental health and overall life? I realized I don't think I have. As I've mentioned in the first show that aired this month, May is mental health awareness month. So I think it is really important to bring as much awareness as possible to all things mental health and certainly body image is one of those things. Truly, I don't think it can be discussed enough, at least not in our day and age with the way our society is so seeped in diet culture. There's unfortunately way too much emphasis and pressure to look a certain way in order to be deemed healthy, attractive, and just overall acceptable and worthy. If someone is feeling all of this pressure, how could it not affect their mental health? Let's look at these standards that are all set out there. They're so unrealistic and they're unattainable. I know I've discussed this on previous podcast, but when someone tries so hard to achieve the unachievable, they feel like a failure. They say awful, horrible things to themselves. When someone does this, they're more susceptible to mental health illnesses like anxiety, depression, eating disorders, and sadly more at risk to commit suicide. Even if someone does come close to or even have that ideal look that does not necessarily mean they're immune to having mental health illnesses. Think of all the pressure that someone must feel, just if they need to maintain that look. Just because someone looks a certain way on the outside does not mean that anyone knows what they're thinking or feeling on the inside or what their life is like. This erroneous belief that people who look a certain way must be happy and living a wonderful life is a horrible narrative that I know causes people a lot of pain. I hear all the time things like, wow, look at her. I bet she's so happy. I know if I look like her, I would have the perfect life or hey, once I finally lose this weight, then I can finally be happy. Or I'm so successful in every other area of my life is not. It's just because I don't look like all the girls that the guys think are hot. That's the reason I can never get a date. I'm doomed to be alone. The rest of my life, looking like I do. I can tell you from years of clinical work, that those shiny people, I call them shiny people, the ones that everyone thinks must be so happy because they seem to have it all, the looks, the successful career, the happy relationship that they are oftentimes the least happy and the most lonely and struggling the most with mental health illnesses, like anxiety or depression. I think that's shocking to people. I can only imagine that it must be a struggle for some people listening to this right now to go be that if someone looks anything close to what is considered our society's standard for beauty, that they would be anything less than happy. I mean, think about it. How could their life not be amazing if that's the case? If they look like that, how could they just not be so thrilled and happy? Isn't everyone trying to look like them so they can be happy? I mean, that's the thought. Isn't that the key to happiness, to be accepted and to be valued by others? That's the key. You might even be thinking, if I look like them, I would be so happy. Do you know what I would do to look like that? I get it right. I was there once and I wish I could change that so people don't have that narrative. I wish I could change it so that people don't think that the key to happiness is based on looks, especially because looks are ever changing. The look that supposedly is the key to happiness is pretty much entertainable like I said, at least by what, 95% of population it's just not realistic. But when I started out discussing was body image and like I said, this is what needs more discussion in relation to mental health. It simply does not matter what someone actually looks like on the outside that determines their happiness or mental health and wellbeing. At the risk of sounding redundant, I know that may sound like a shocking statement. So I think if I were to ask anyone out here, listening, if they knew what body image is, they would say yes. Why wouldn't any of you? It's something we hear and read about all the time. Basically body image is the relationship that you have with your own body. There's actually four parts to body image, there's perception, thoughts, feelings, and behaviors. I just want to delve further into each of these a little bit. So perception's the way you and you alone see yourself. The way you see yourself is not always a correct representation of what you actually look like. So for example, a person may see their nose as extremely large and see it as disproportionate in size to the other features of their face. Or another person may look in the mirror and perceive their body to look very short when in all reality, they're really quite average height, or maybe even above average height. So basically how you and you alone see yourself is your perceptual body image. When we're talking about how someone feels about the way they look, this is their effective body image. There are the things you may like or dislike about the way you look and your feelings about your body, especially the amount of satisfaction or dissatisfaction you experience in relation to your appearance, weight, shape, and body parts is what we call your effective body image. So you may say you're embarrassed about your big ears, or you hate your stretch marks on your stomach that appeared after your first pregnancy. These are your feelings. The third part, these are the thoughts and beliefs you have about your body. These are otherwise known as your cognitions. Some people believe they will feel better about themselves if they're thinner and others believe they will look better if they develop more muscle. They have other thoughts, they think their teeth are too crooked and believe if they smile, people won't like them. So basically the way you think about your body is what's known as your cognitive body image. Then the fourth aspect is your behavioral body image. These are the things you do in relation to the way you look. So when a person is dissatisfied with the way they look, they may do very harmful and destructive things like excessive exercise or fast for several days in a row to attempt to change their appearance. Some people may isolate themselves because they feel bad about the way they look. So any behaviors you do as a result of your body image is what's known as your behavioral body image. So those are the four areas. When you put all of these together, you can have an overall positive, negative, or even neutral body image. When someone has a negative body image what does that look like? They may look in the mirror and think to themselves, something like, oh, I hate my stomach. It always puffs out after I eat. Why isn't it ever just flat? They may tell themselves think like all the girls on Instagram always have flat stomachs. What am I doing wrong? I am so disgusting. Just look at me. Nobody will ever want to date me looking like this. That's it. I'm going to stick to my diet starting right now and go to the gym every day, no excuses. I'm going to finally have that flat stomach once and for all. Then I'm going to be able to buy all those cute crop tops and wear bikini, and finally be happy. I can just imagine next summer, when I walk on the beach and everyone will stare at me as I walk by. Now, imagine this person is thinking all these things to themselves and they look in the mirror, but yet this person's loved ones friends might be shocked to know that this is what's going on inside of her mind and that this is how she's thinking and feeling. They may not understand why she eats so rigidly and so devoted to her workouts because to them, they see her for how she really looks. They see a person who is very frail and has bones sticking out and they see someone who's not eating near enough and they're worried about her health and wellbeing. Every time they try to talk to her, she just pretends to listen and continues just to go about her day. In this example, you can see somebody's own body image is so drastically different from reality. That's how that works. It doesn't really matter what somebody looks like. Their own body image is their perception. Likewise, someone else may be staring at themselves in the mirror, feeling sad and hopeless thinking oh my gosh, look how old and tired I am. Look at all these new wrinkles. They may be telling themselves there's no point in even trying to pretend that they can get out there and have fun traveling or even think about dating again. They may have thoughts like, ugh, at my age, looking like this who'd even so much as glance at someone so old and haggard? They might have thoughts like maybe if I got a facelift or what if I go make an appointment with a plastic surgeon, maybe that could be my only hope in being able to have a life again. Or maybe I just accept reality in the fact that the best years of my life are behind me and I'm going to be alone the rest of my life. Yep, again, it might be surprising if you saw this person in real life, someone who's a youthful looking woman in her mid-thirties, who's just starting to get the first showings of crow's feet around her eyes, but barely visible if at all, to anyone else. But to see her perception to her, she's seeing these things as new and she's fixated and focused on them. She's convinced that everything on her face has changed. Nobody else can point out to her what she really looks, like her own thoughts and feelings about her changes in appearance, no matter how minuscule are, what matter to her, her actions to isolate or even go so far as to get surgery are related to her own negative body image. So I'm pointing these things out. I know they're like very over the top, but someone's body image can have a very profound impact on someone's life, whether it's positive or it's negative. I pointed out here in those last two examples, negative body image, but I want to bring up positive body image because I often get asked things about it; how can positive body image affect someone and is it really the most important thing to have as a goal for therapy? Well, okay, in general, people with positive body image will have a higher level of physical and psychological health and better personal development. And positive body image will affect several things in our lives, one our self-esteem. Self-esteem dictates how we feel about ourselves and this can affect every aspect of our life. So people with higher self-esteem are more likely to engage and be present in all areas of their life because they tend to be more sociable and they tend to be on top of like their bills. They tend to just be more engaged in life and they just tend to have higher levels of happiness and wellbeing. And positive body image also affects someone's self-acceptance. So the more positive a person's body image, the more likely that person is to feel comfortable and happy with the way they look. So a person with positive body image is less likely to feel impacted by unrealistic images in the media and societal pressures to look a certain way. So that's a great thing, just to have that as a buffer. And people who have positive body image also tend to have better physical and psychological wellbeing because they have better self-care. So they tend to be more in tune with and respond to their needs of their body. So if they feel hungry they're likely to stop and find food to feed themselves, or if they feel tired, they're likely to start the wind down for the night and head to bed rather than stay up late and have a poor night of sleep. So they value and respect themselves and when someone does this, they're much more likely to do things, to take care of themselves. I hear all the time that people cannot imagine ever having a positive body image. You know what, maybe that's the case. If for years and years you've been having very critical, negative thoughts and feelings about your body and the way it looks, I can imagine it might be very difficult to get to a point where regardless of how you look, you're going to be like, wow, I love my body. I've thought about it. It might be more realistic if you have a neutral body image and people have said, what the heck is a neutral body image. So what it is is rather than focusing on the body's appearance? Body neutrality prioritizes the body's function and what the body can do. So you don't have to love your body. You don't have to hate your body, but you can feel neutral toward it. And personally, I think this is a great goal to strive for if you're someone who has a negative body image. I do think it can feel very daunting and like I said, even unrealistic for someone to think that they can ever truly believe statements that they say to themselves like, oh my gosh, I love my stomach. Like I said, for years, they've been saying horrible, negative things to themselves about it and experiencing very painful emotions in relation to these thoughts. I think it's much more realistic and it could possibly be even better self-esteem and really overall mental health and wellbeing if people focused on what their bodies allow them to do. Our bodies are amazing. They really are. It's so sad because so many of us focus so much time and attention hating on our bodies and wishing they were different. We focus so much on what we believe is wrong with them and we try to alter them and make them what we're told they're supposed to look like and be like in order for us to have value and be happy. But the thing is we are missing out on actually being happy by doing this. This is a miserable existence doing this. By saying such horrible things to ourselves and engaging in such awful behaviors like restrictive diets and doing strenuous workouts that don't feel good in our bodies, that is not happy. We're doing way more harm than good, not only to our physical bodies, but to our mental health and wellbeing. Focusing your mind on what is so wrong with your appearance, what does that do? It keeps your mind from focusing on all of the great, wonderful things that it could be focusing on instead, like appreciating your body's ability to hear and speak so that you can have a wonderful conversation with a loved one. Or appreciating the fact that your body has the ability to see a beautiful sunset or being grateful that your legs allow you the ability to walk through a forest and see petrified redwoods with your grandchildren for the first time or loving that your body has the ability to smell a fresh cup of coffee brewing in the morning, which you can then taste. Your body allows you to do all of those things. We have sights and smells and all of these things that our body does and allows us to experience. But when we spend so much time focusing on just the external appearance of our bodies, we miss out on the true value and worth of our bodies. That's so sad. We miss out on so much joy and happiness that our bodies are capable of allowing us to experience in our lives. Our bodies will get older. Our appearance is constantly changing. I don't know about you, but I certainly don't look the same as I did at the age of five, kind of silly, but I don't, or 15 or 25 or 35 or even 40. I know I won't look the same when I'm 60 as I do now. As many of you know I've had my own struggles with an eating disorder and body image issues. I can tell you that just by simply asking yourself things like what feels good in my body and choosing to do the things that come to mind when you ask that question makes a big difference. For instance, getting a massage or taking a leisurely walk with my dogs, or even taking a hot bath feel good in my body. But back when I was really struggling with my body image issues, I did not even think to ask questions like that. I did not like my body so I did not think to take care of it like that. Instead I wanted to only do things that I thought would change it and make it look how I thought it needed to so that I could be happy. That to me back then was going to feel good. Only nothing I ever did felt good in my body or felt good in general. Doing crazy hard, long workouts hurt me physically and emotionally. To be honest, there were consequences. I now look back on that brought me further from the happiness that I really wanted. All of those behaviors took time and focus away from me, engaging in my life. I missed out on being with people and on experiencing things that I really, I regret. I told myself I needed to go exercise or I told myself things like, I didn't feel good enough in how I looked to be around others so I just stayed home. In all reality, I was the only one who thought negatively about myself, was my negative body image that negatively impacted me and kept me from living my life. So yes, negative body image can and does have an influence on someone's mental health. It can really truly have a profound effect on someone's life, all areas of it. So if you're out there listening and are struggling with your body image, just know there's help. You may be going well, how do I really know if I'm struggling? Well, a licensed professional can help you to know and understand more about you and your own individual situation. But in general, if you have thoughts and feelings about your looks or body that get in the way of you enjoying your everyday life, then this is a big clue that you may need to seek help. Or if you spend way too much time worrying about what you look like and believe you can only really be happy once you look different, then this is also indicative of you having a negative body image. As I come to a close today, I want to challenge all of you out there to find one thing about your body that you appreciate, and really think about that as much as you can today, once you find that thing you appreciate. This may sound like a difficult thing to do if you have a very negative body image, but I can assure you that there is never so much of a wake up call about how amazing your body is until it is either unhealthy, broken, or very sick. I learned how much I was taking my body for granted. Once parts of it were not functioning like they always were once I was not able to go about my daily life and function like I was used to. I can tell you something, I wanted nothing more than to just have my body back the way it was. I could have cared less about what it looked like or what the number on the scale said, because when you can't engage in your life because your body hurts or it's not working, it is interesting just how much you start to have a different perspective on it. Go out there, I'm challenging you, I'm interested to hear from any of you, if you want to share DMA or email me and let me know, what's the one thing you appreciate about your body. All right, guys. As always, thanks for listening. This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.