Better Mental Health: Body Image & Bariatrics

Better Mental Health: Body Image & Bariatrics

What is body image?

Body image is how you see yourself when you look in the mirror or when you picture yourself in your mind. It encompasses:

  • What you believe about your own appearance
  • How you feel about your body, including your height, shape, and weight
  • How you physically experience or feel in your body

We start to internalise messages about body image from a really young age that can be either positive or negative and which may impact our mental wellbeing and our relationship to food.

Body image concerns often begin at a young age and endure throughout life. By age 6, girls especially start to express concerns about their own weight or shape, with between 40-60% of teenage girls being concerned about their weight or about becoming too fat and use unhealthy weight control behaviours such as skipping meals or fad diets to control their weight.

Our self-esteem and how we feel internally is impacted by our physical appearance and we are starting to see an increase in compulsive and restrictive eating disorders, aesthetic surgery and body dysmorphia. More people are suffering from feelings of depression, isolation and low self-esteem.

While all ages, genders, and cultures are equally at risk for body image issues, there are traditionally different triggers and appearance-related pressures depending on one’s gender. A healthy body image is an important part of mental wellbeing and preventing eating disorders.


In our Western culture, women feel the pressure to succumb to societal appearance-ideals, whereas men are often faced with social pressures to be lean and muscular. When you scroll down Instagram you instantly see these idealised body images in which many aspire to this perfection. In fact, most of us don’t post our worst pictures, but instead we are accustomed to using filters to present the best version of ourselves.

The impact of this is we have a distorted view of body image. For the last 18 months’ my psychotherapy work has been focused on bariatric patients and I have delivered a number of assessments, one to one sessions and group therapy to people suffering with compulsive or binge eating disorders.

Most of the patients I work with are contemplating surgery on the stomach or intestines to prevent them overeating. This may sound extreme to most people, but if you have suffered your entire life with food and have not been able to regulate your eating, then bariatrics surgery is literally a life saver. The clinic I am currently working with also offer a less invasive non- surgical intervention the swallowable balloon.

A common question I ask patients is how they think they will they feel inside when they have reached their target weight. At times this is often hard and painful for them to imagine, as they feel trapped inside a body that is completely out of their control. It strikes me when working in this area a common theme or thread of a patient story is  the feelings of guilt and shame connected to not being able to achieve this which perpetuates emotional eating and self-loathing.

The place of self loathing is lonely, isolated and often painful, perhaps like the abyss of a hungry stomach where exploring these emotions confronts a deep emptiness. I often wonder if the compulsive need to be full or satiated keeps feelings of emptiness at bay, a defence against anxiety. The journey is different for every patient but it highlights how much self-esteem or self-worth is tied up in body image.

Better Mental Health

This month is the official launch of the ‘Better Mental Health’ podcast. We all have mental health and we all need to take care of our emotional wellbeing. The podcast explores a range of mental health topics with everyday people. Sharing personal experiences and giving expert opinions or advice.

For mental health awareness week we are exploring the topic of body image with some amazing experts on body image. Subscribe to keep updated.