What is Healthy Body Image, Anyways? 

Experts, athletes, coaches, and parents agree that raising young female athletes requires careful navigation through many challenges, especially during and after puberty. We’re only starting to understand what it takes to help them flourish. Partly, perhaps, because we’re only starting to understand what it takes to help ourselves truly flourish.

In this five-part investigative report, we examine both how to #FixGirlsSports and raise a stronger, healthier next generation, as well as how to re-evaluate our own body image for the better, including the resources you need to rebuild or fortify one of the most important relationships of all—the one with yourself.

At least once a day, runner Leeja Carter pauses for a minute. She puts her hands on various joints and organs—her stomach, knees, heart, back—and thanks them for beating, bending, lifting, and digesting. “That just reminds me that this body system is working for me every day, even if there are some days when I wish it looked different,” she says.

It’s a small gesture, but a powerful one in a culture that frequently undermines women’s ability to feel good in their own skin. Nearly all those who identify as women have, at some point or another, felt insecure about their weight or the way they look. For some, body-image issues progress into full-blown eating disorders, anxiety, or depression. Even short of a diagnosable disorder, concerns about your size and shape can interfere with your health and hold you back in your career, relationships, and your running, says Laura Moretti Reece, R.D., a runner, triathlete, and sports dietitian who specializes in eating disorders at Boston Children’s Hospital.

Even Carter—a feminist sport psychologist with a Ph.D. who runs marathons—isn’t immune to negative influences. She sees the images suggesting only women who look a certain way are beautiful or can call themselves runners, and hears the words of coaches and other experts who preach that lighter is faster and leaner is more virtuous. But by grounding herself in gratitude, she’s among those defying outside pressures and reclaiming her vision as a strong, powerful, beautiful woman and athlete.

Healthy Body Image, Defined

One way to think about body image is the thoughts, feelings, and perceptions related to the experience you have of your physical form: “an inner picture of your body and the way you feel about it,” says Marci Evans, R.D., a Cambridge, Massachusetts–based dietitian. Body image is often framed, incorrectly, as a black-and-white issue: Either you feel good about yourself, or you don’t. The reality, however, looks more like a spectrum, eating disorders specialist Riley Nickols, Ph.D., says.

On the more negative or unhealthy side, your self-image is distorted and distressing. You may fixate on your flaws, and spend a disproportionate amount of time thinking about the ways you need to change your diet, exercise routine, or other habits to fix them. “Disproportionate” can’t necessarily be defined as a number or percentage of minutes or hours, but rather “the degree of interference it has on your thoughts, actions, and behaviors,” he says. A healthier perspective, meanwhile, means accepting your natural shape and size, feeling secure and comfortable in your skin, and recognizing that your appearance is just one small part of your identity.

Another helpful way to conceptualize body image is as a relationship between two entities, says Kara Bazzi, L.M.F.T., a therapist and co-founder of Opal Food & Body Wisdom, an eating-disorder treatment facility in Seattle. Like any friendship or partnership, you and your body are bound to go through ups and downs—days when you feel amazingly in sync (say, when you finish a hard workout or PR in a race) and others when you’re disconnected, frustrated, even betrayed (for instance, when you’re injured).

The key to a healthy body image, Evans says, is to get yourself to a place where you can weather the storms with confidence. The idea of loving your body stands as a worthwhile goal, and body-positive language—rooted in celebrating all shapes and sizes—resonates with many.

But if you’re in the depths of self-loathing, that degree of adoration can feel alien and inaccessible. And for perfectionist, type-A runners, it can be just another opportunity to beat yourself up—to proclaim yourself a failure each time you have a negative thought about your stomach, thighs, or nose.

The Scope of the Problem

“Pretty much everybody experiences a little bit of a dissatisfaction with how they look,” says Angie Fifer, a runner, triathlete, and certified mental performance consultant based in Pittsburgh. Women tend to be more prone to the problem than men, especially when it comes to thin ideals. In one Northwestern University study, about half of all middle-aged women reported being dissatisfied with their shape or size.

These emotions have real consequences. About 20 million women will meet diagnostic criteria for an eating disorder sometime in their lifetime, according to the National Eating Disorders Association. While not every person with an unhealthy body image will rank among them, nearly everyone who does develop an eating disorder starts out with a low or weak body image, Nickols points out.

Athletes are at higher risk, and the issue isn’t limited to elites: A 2016 University at Albany study in the journal Body Image found both appearance- and performance-related body dissatisfaction was linked to eating-disorder symptoms among women running community races.

While it’s not always clear which comes first, experts know body-image struggles are often “the tip of the iceberg,” Nickols says, linked to anxiety, depression, obsessive-compulsive disorder, and exercise addiction. Even if you’re not diagnosed with a psychological condition, the lack of a healthy body image can alter your behaviors and relationships, leading you to isolate or underestimate yourself in a way that can affect everything from dates to business negotiations.

“Negative body image takes up a lot of mental space. It’s emotionally very, very draining. It kills confidence. And so it really shrinks down a person’s full capacity,” Evans says.

And, it can interfere with your running. If you line up for a race but find yourself overwhelmingly focused on how your body compares aesthetically to that of the competitors around you, you’re unlikely to have the confidence and focus you need to perform your best. Your fears may then become self-fulfilling prophecies, says Brittany Lash, Ph.D., an assistant professor of communication at the University of Dayton who has studied body image in female athletes.

Insecurities can also affect your motivation, making it harder to get out the door in the first place—a vicious cycle, because physical activity has been shown to help boost self-confidence. When Carter worked with first-timers training for the Chicago Marathon a few years ago, many reported concerns about whether they could go the distance because their bodies didn’t look like those of typical runners, a sentiment she spent significant time dispelling. Body fixation also may sap the joy from your miles, she notes. It’s tough to stay zen on a run if you spot your reflection in a window and immediately feel disgust or disdain for it.

You might never get to a place where you love every bump, wrinkle, and fold, and that’s OK, Evans says. However, with time and mindful, conscientious effort, it is possible for most women to shift away from hatred, far enough along the body image spectrum so you’re not consumed by your shortcomings—to a place where a glance in the mirror, weight gain, or a serious setback like an injury won’t overwhelm you. Here’s how to get there.

Identifying the Issue

Evans often takes a straightforward approach to assessing if someone has a healthy body image, asking clients to rate theirs on a scale of one (in the gutter) to five (fab!). But it’s not always that easy to be in touch with your own self-image. If you’re unsure of where you’d rank, consider this list of thoughts and behaviors. Any one might not be a big deal, but the more—or the more often—you have them (or notice them in a friend or loved one), the higher the level of concern.

• Do you frequently body-check—evaluating yourself in every nearby reflective surface, or have a certain item of clothing you continually try on to see whether it fits?
• Do you avoid certain situations, such as group runs or dates, because of the way you feel about your body?
• Do you constantly attempt to change your body through diet, exercise, or other means?
• Do you believe you’ll be happier or perform better once you reach a specific goal weight or body size?
• Do you feel motivated to run or do other workouts primarily for weight-loss or body-composition reasons?
• Do you exercise or run primarily to avoid negative emotions—such as guilt, shame, or sadness—rather than to experience positive feelings?
• Do you feel guilt or shame around the amount of time you spend either thinking about your appearance or trying to change it?

Eating disorders have a number of additional symptoms, and the sooner you get help, the better. You can call the National Eating Disorders Association Helpline at 1-800-931-2237. For a 24-hour crisis line, text “NEDA” to 741741. These signs include, but aren’t limited to:

• Fractures and other injuries (and continuing to run or work out through them)
• Drastic changes in eating or exercise habits or in weight
• Extreme mood swings
• Preoccupation with weight, counting calories, or restricting food groups
• Rituals or secretive behavior around food
• Menstrual irregularities
• Gastrointestinal issues

Even if you don’t think you meet the criteria for an eating disorder or other psychological condition, you can still seek treatment to work on your body image, Reece says. Look for a dietitian or mental health provider who has experience with body or eating issues and has worked with athletes.

Read On

This is How You Raise Healthy Female Athletes

How Coaches and Parents Can Keep Girls Running

6 Factors That Can Affect Your Body Image

9 Simple Tools for a Stronger Body Image