Body image disorders rarely get better on their own.
In fact, they usually get worse.1-3
You become more…
- Consumed with thoughts about your appearance.
- Compulsive about checking yourself in the mirror.
- Socially isolated and insecure.
- Likely to engage in dangerous behaviors like self starvation.
- Likely to commit suicide.
At this point, there are only 3 treatments that actually seem to help people with body image disorders. Let’s take a look at what they are.
1. Cognitive Behavioral Therapy (CBT).
Cognitive behavioral therapy, or CBT, is a kind of psychological therapy where you learn to understand and change the thoughts and behaviors that contribute to your problem.
Most studies indicate that cognitive behavioral therapy is probably the most effective treatment for body image disorders.1-5
One study found that CBT helped around 80% of the people with body image disorders feel better.4
The “cognitive” part of CBT is usually based on cognitive restructuring. This involves identifying and addressing negative thoughts, and creating strategies to help keep them from interfering with your life.6,7
Usually, a therapist will ask you questions to help you see what negative thoughts are contributing most to your disorder. Then you and the therapist would work together to figure out different coping mechanisms for these thoughts.
Another part of cognitive restructuring is “thought-recording.” Therapists will often ask you to document your feelings so you can both discuss them more clearly.
Exposure-response prevention (ERP) is one of the most effective kinds of the “behavior” aspect of CBT.8 With this method, you put yourself in situations where you’re tempted to act on your negative behaviors. Then you use different strategies to help yourself refrain from doing so.4,7
For example, if you’re scared to be “exposed” around other people because of how you look, you might make yourself go to a crowded restaurant. Then, you would prevent your normal response by not wearing a hat or extra makeup to hide or change your appearance.7
It’s probably best to use both cognitive restructuring and exposure-response therapy to overcome body image disorders..3,4
Most studies indicate that cognitive behavioral therapy is more effective than drugs, but there’s also plenty of evidence that medication can help, too.
2. Serotonin-Reuptake Inhibitor Drugs (SRIs).
Cognitive behavioral therapy is not always enough.
Studies have shown that a class of drugs called serotonin-reuptake inhibitors, or SRIs, can be extremely helpful for people with body image disorders.1,2,7,9 They also tend to have relatively few side effects and seem to work with a number of psychological illnesses like depression.9
SRIs work by preventing brain cells from reabsorbing serotonin, a neurotransmitter that affects mood and anxiety. When brain cells don’t reabsorb serotonin, it hangs around in the space between the brain cells (the synapse) longer. Researchers think this probably helps improve mood and body image disorder symptoms.
Researchers are still debating about whether or not serotonin causes depression or if SRIs work, at least the way we think they do.10-13
However, there’s good data from a number of studies showing that people with body image disorders who take serotonin reuptake inhibitors experience “…less frequent obsessions, decreased urges to perform compulsive/safety behaviors, and better control over BDD [body dysmorphic disorder] obsessions and compulsions. BDD-related distress also usually improves.”
Some studies have also found that taking SRIs helps people develop a more realistic perspective of their disorder.9
Here are the most common kinds of SRIs, with their brand names in parenthesis:
- Citalopram (Celexa).
- Escitalopram (Lexapro).
- Fluoxetine (Prozac).
- Sertraline (Zoloft).
- Fuvoxamine (Luvox).
- Paroxetine (Paxil).
- Clomipramine (Anafranil).
There isn’t much evidence that other drugs help with body image disorders.9
While drugs can help, only taking medication is also probably a bad idea. Most studies indicate that medication works best when it’s combined with cognitive behavioral therapy.4,9
Note: You should obviously work with a licensed medical professional to learn whether or not you should consider taking medication.
A very small number of people with body image disorders do get better on their own, without any professional or pharmaceutical help. It’s rare, and we don’t know if they might get better faster if they got help, but it does happen.
Even if you do get cognitive behavioral therapy and take serotonin reuptake inhibitors, you still may need to wait a long time before feeling better.
Your Options Are Limited, But They’re Still Good
People with body image disorders generally feel worse about themselves if they don’t get help. However, cognitive-behavioral therapy, serotonin-reuptake inhibitors, and patience tend to help many people feel better.
CBT seems to be the most effective, especially when combined with the right combination of meds. Whether you get treatment or not, you’re probably going to have to wait a while before you feel better.
While some people with body image disorders do get better on their own, most don’t. The best way to increase your chances of recovery is to talk to a therapist.
But if you’d like to try to deal with this problem on your own first, [become an elite member of *Evidence Magazine*](https://evidencemag.com/join-evidence). You’ll get access to the book *Your Need to Know Guide to Body Image Disorders*. It will help you understand and overcome your insecurities about how you look.
> Did you enjoy this article? [Click here to check out my book, *Flexible Dieting](https://evidencemag.com/flexible-dieting-book)*. Want an even more in-depth education on how to lose weight, build muscle, and get stronger and healthier? [Join Evidence Mag Elite](https://evidencemag.com/elite) and get member’s-only reports and interviews.
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13. Blier P, Mansari El M. Serotonin and beyond: therapeutics for major depression. Philos Trans R Soc Lond B Biol Sci. 2013;368(1615):20120536. doi:10.1098/rstb.2012.0536.