Body Image and Eating Disorders

Eating Disorders (EDs) are complex illnesses with serious emotional and physical problems that can have life threatening consequences. The three most prevalent forms of eating disorders are anorexia, bulimia, and binging.

Body-image problems occur along a continuum that ranges from mild dissatisfaction to severe body-hate. Body-image disturbance is generally seen in conjunction with self-esteem issues, depression, eating disorders, or sexual abuse.

  • They occur in females and males of every age, race, ethnicity, and sexual orientation.
  • EDs involve issues of weight, weight loss, and body image dissatisfaction.
  • Persons with an ED may be underweight, normal weight, or even overweight
  • They often start with an appropriate desire to improve nutrition and health.
  • While the exact cause is not yet known, it is believed that afflicted persons have a predisposition for the illness and recent advances in studies of the brain indicate that there are disturbances in brain mechanisms, pathways, and chemical transmitters.

Possible signs of anorexia, bulimia, and binging:

  • Weight loss- an unexplained, dramatic change in weight or lack of expected weight gain and growth
  • Menstrual Periods- decrease or loss of periods
  • Preoccupation- with nutrition, counting calories, reading labels, increased interest in cooking/baking while not actually eating the food prepared
  • Unusual Eating Habits- changes in meal patterns or food preferences, excuses for skipping meals, refusal to eat out, eating in secrecy, binge eating
  • Russell’s sign- scarring of the knuckles from placing fingers down throat to induce vomiting
  • Inappropriate- use of laxatives or diuretics
  • Dieting- despite being thin or dangerously underweight
  • Fear-of gaining weight or becoming overweight
  • Rituals-cuts food into tiny pieces, refuses to eat around others, hides food
  • Obsessive or compulsive exercising
  • Increasing Irritability, Isolation, or Depression

In contemporary American society, achieving the perfect body has become a major measure of self-worth for most adolescent and adult women. Society’s present-day preoccupation with physical appearance and self-image contributes to the prevalence of eating disorders.

Studies have shown that early detections and treatment increases the likelihood of recovery. Treatment is multidisciplinary, involving medical, psychological, and nutritional care.


National Eating Disorders Association:, 1-800-931-2237

St. Louis Behavioral Medicine Institute:

Outpatient counseling, including Intensive Outpatient Therapy, and Nutrition Services

McCallum Place and Webster Wellness:

Outpatient, Intensive Outpatient, and Residential Therapy programs

Castlewood Treatment Center:

Outpatient, Intensive Outpatient, and Residential Therapy programs

Washington University Division of Adolescent Medicine at St. Louis Children’s Hospital 314-454-2468

Outpatient medical evaluations

St. Louis University Division of Adolescent Medicine at Cardinal Glennon Children’s Hospital 314-268-6406

Outpatient and Inpatient medical treatment

NEDA Navigators (trained resource volunteers):

Website has excellent information for teens, parents, school personnel, and coaches

Of course, there are many private psychotherapists and nutritionists in the community.

Reviewed and edited by Marianne Brady-Dunstan, MD, Dept. of Adolescent Medicine, Cardinal Glennon Children’s Hospital