Self-Esteem and Eating Disorders

Low self-esteem is common in eating disorders. A harsh internal critic is a source of suffering and can make recovery from an eating disorder harder.

When you get treatment for an eating disorder you may get help on self-esteem, though on its own, self-esteem work does not treat an eating disorder. It is important to also work on normalizing your weight, your eating and your exercise.

When your self-esteem is low, you treat yourself cruelly, telling yourself you are not good enough. You link how much you matter with the things you manage – or don’t manage – to do. You may have a deep belief that you are unlovable and that you need to be different, look different or act differently to justify your existence. Everyone does this to some extent, but with low self-esteem it can stand in the way of a good and meaningful life.

self-esteem and eating disorders

Self-compassion is the antidote. People with healthy self-esteem are kind to themselves when they come up against their human imperfections. Self-compassion is a validated way for people who beat themselves up to step back into their power. It enables them to be more tuned in to reality, more open to people around them, and more ready for action.

So addressing low self-esteem will not make you selfish or self-centred or complacent – quite the opposite.

How Healthy Self-Esteem Develops

As small children, we develop a sense of what is self-esteem based on cues we get from others. We rely on others to tell us if we are valuable, if we are good enough, if we measure up to their expectations of us. As we get older, we begin to internalize a sense of self-esteem and we rely less on cues from others.

If all goes well, by the time we are adults we have internalized a strong and healthy sense of self-esteem. We believe we have value. We like ourselves. We have confidence in our abilities. If all does not go well, however, we might grow up doubting ourselves. We might not believe we are valuable and we may lack the confidence we need to move through our day-to-day lives.

What You Can Do

Psychotherapy will help you with self-esteem and you can also learn self-help approaches.

One effective self-help approach is to learn self-compassion. This enables you to be steady irrespective of your accomplishments. You are a lovable person when you have excelled, and you are the same lovable person when you encounter failures. This means you don’t need to constantly do better than others, or better than your last best, in order to feel good.

Self-compassion has these ingredients:

  • You pause to notice that you’re hurting. Catch this cruel thing you’re saying to yourself.
  • You give yourself kindness and a non-judgemental understanding, recognizing that being imperfect, failing, and experiencing life difficulties is inevitable. If you find you are too harsh on yourself to do this, bring to mind someone (real or imaginary) who cherishes you and wishes you well.
  • You bring to mind how so many aspects of ourselves and the circumstances of our lives are not of our choosing, but instead stem from countless factors from our genetic makeup, life events and our environment. In other words, you accept what is instead of judging yourself for it.
  • You bring to mind our common humanity. All humans suffer. It is normal that, as a human being, you should regularly fail and suffer. You don’t need to take it so personally – you are in good company.

Self-compassion moves us out of fight-flight-freeze, a state in which our body reacts to danger signals by mobilizing all its resources to protect and defend itself. Fight-flight-freeze comes at a cost: we have little or no access to our intelligence and conscious thinking as the more primitive parts of our brain (the limbic area and brain stem) take control. Our body is affected too: if we are in this state for long periods of time we suffer from the effects of stress and anxiety.

The fight-flight-freeze response is life-saving when we’re in immediate danger from a physical threat (an attacker, a speeding car). But here’s the rub: our everyday fearful or critical thoughts trigger the same reaction. And with poor self-esteem or with an eating disorder there is a steady stream of such thoughts. The danger signals keep coming.

Fearful or critical thoughts can lock us in a state where willpower and logic have little effect. We cannot ‘get a grip’. We’re in a vicious circle where our state of fear drives more anxious thoughts, which in turn reinforce the sense that we are not safe.

Self-compassion – and of course kindness from others – is the bridge out of fight-flight-freeze. It works by sending our brain the message that all is now safe, that there is nothing to protect or defend.

So although you might worry that self-compassion will make you complacent, it will actually mobilize you to be at your best, giving you access to all your resources, all your intelligence. With time, you will find that when something bad happens, your brain has rewired itself to take you to self-compassion more often than to judgment. You will get out of fight-flight-freeze more and more easily.

For more on self-compassion, why it works and how to do it, see the many free resources produced by the expert on the matter, Dr. Kristin Neff.

Cognitive-Behavioral Therapy for Low Self-Esteem

There is a well-established cognitive-behavioral treatment for self-esteem. A self-help version is available.

Other Approaches

 self esteem

Thoughts affect our emotions, and what we tell ourselves affects our thoughts and beliefs.

Positive thinking is one approach that seeks to use these mechanisms. You tell yourself you are a wonderful person (a ‘positive affirmation’), whether you believe it or not, and the hope is that this will retrain your brain. The hope is that after a while you believe your positive affirmations and feel good.

Some people like this approach, but it doesn’t work for everyone, and may not work when you are very down on yourself. The problem is when affirmations drive your inner critic to argue how you are not a wonderful person, drowning out the positive message.

You can help yourself by looking at the glass as half-full. Humans have a negativity bias, so by reviewing the many things you can be proud of, you can consciously give less weight to the things you judge yourself about. Be cautious though: you don’t want to link feeling good about yourself with achievements. You can’t possibly always be in top form, and even Olympic champions eventually get beaten by another Olympic champion. You need to be your best ally when the chips are down too.

You can also do things that lift your mood and that you’re good at and that bring a sense of accomplishment. This moves your brain out of fight-flight-freeze –where the inner critic operates – freeing up your whole healthy self.

Here are some tips related to these approaches.

  • Make a list of your accomplishments. Include big things, like graduating from college or starting a successful business, and little things, like finishing your spring cleaning or learning to knit. Read over your list whenever you feel your self-esteem could use a boost. Continue to add to this list.
  • Learn something new. It doesn’t have to be a big thing like learning to speak Chinese. It can be as simple as learning to care for the orchid on your window sill.
  • Volunteer somewhere. Doing something to help others often boosts self-esteem, plus it may give you the opportunity to learn a new skill as well.
  • Do something nurturing for yourself, and in particular, to your body and all its senses. For some it’s a long bubble bath, for others it’s a massage, dance, listening to music, or enjoying good friends.

You can also take care of yourself by taking care of your environment:

  • Surround yourself with people that make you feel good about yourself. Limit your contact with negative people or people that are overly critical or always put you down.
  • Notice the negative effects that messages in the media or in social networking have on you. Are airbrushed, inflated accounts of other people’s success and happiness driving you to feel down on yourself? Limit your exposure. The National Eating Disorders Association states that the excessive images of extremely thin people in the popular media can contribute to a poor self-image and the development of eating disorders.

And finally:

  • Practice accepting compliments graciously. The next time someone compliments you, look them in the eye, really listen to what they say, smile and say thank you.

 

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Additional Reading:

Quiz For Self Esteem
Identity and Self Esteem

 

Updated by Eva Musby, 2016