Chronic Illness, Eating Disorders, and Body Image

By Tamie Gangloff, MA, MFT, Hidden River

We’re excited to share a post originally published on Hidden River Blog exploring the intersection between chronic illness, eating disorders, and body image. 

How do we recover from an eating disorder and trust our body, in a body that is differently abled?

Many people develop an eating disorder as a result of body image disturbance and being in a body that “doesn’t work the way it is supposed to.” Chronic medical conditions and trauma associated with complex surgeries can lead to post-traumatic stress disorder (PTSD) and other psychiatric co-morbidities. Clinicians must be able to identify trauma and body image disturbances as a result of medical conditions. We can then assess and properly treat clients with these complex issues, ultimately leading to resilience and recovery.

After a major medical procedure in 2018, I was left with many questions regarding my medical condition and mental health and how they are connected. As a chronic illness warrior and a clinician with lived experience with an eating disorder and alcoholism, I set out to find some answers. 

I asked many questions about chronic illness and eating disorders that needed answers.

  • How do you recover from an eating disorder in a body that has a chronic medical condition?
  • What leads to relapse as opposed to resilience and recovery?
  • What can we do, as clinicians, to treat chronic medical conditions as separate from disordered eating?
  • How can we view a chronic medical condition through a trauma lens?
  • What is the psychology of pain? How does this concept relate to our clients?
  • Is there a difference between body image disturbance and body image distortion?

I discovered that there is an intersection between medical conditions, medical trauma, PTSD, body image concerns, and eating disorders. I created a study to learn more. I also started to consume (pun intended) books by athletes who have overcome staggering odds for survival and resilience. These books not only gave me hope but also served as a roadmap for my recovery from major surgeries. 

My journey as an athlete with a disability also led me to research how we can be helped by sports injury psychology, and it is applicable here as well.  These same skills, such as active goal setting, work for recovery from surgery or injury as well as eating disorders. 

This journey has also changed the trajectory of my life and career.

I learned not only to survive but to thrive.  I redefined what resilience means for me and learned how to develop it as a skill set that truly works and can be taught to others.

I’m excited to have the opportunity to share my study results as well as my findings on assessment, treatment goals, and modalities that work for those with chronic medical conditions and eating disorders. Plus, I’ll explore how we can take that experience and turn it into resilience.

Woman looking down at ground, with her reflection in the glass wall in front of her.

Tamie Gangloff, MA, MFT (she/her)

 

Tamie Gangloff has been involved with the treatment of eating disorders and addictions for nearly a decade and a half and began working at Hidden River in late 2023. Her roles as a therapist have included maintaining a private practice where she provided care to individuals and families as well as providing treatment within an inpatient level of care. As a member of Hidden River’s business development team, Tamie’s clinical eating disorder and addictions acumen proves invaluable to those seeking residential treatment. Her territories include Oregon, Nevada, Utah, Colorado, New Mexico, Nebraska, Texas, Minnesota, Iowa, Missouri, Wisconsin, Illinois, Louisiana, Mississippi, Tennessee, Alabama, Georgia, Pennsylvania, West Virginia, Delaware, and Hawaii as well as the Mid-Atlantic, DC Metro, Dallas-Fort Worth, and Chicagoland.

Yoga

  • Reconnect with one’s body
    • Promotes mind-body connection, awareness of self, and acceptance.
  • Stress and anxiety reduction
    • Yoga activates the parasympathetic nervous system, counteracting our body’s stress responses.
    • Deep, slow breathing can reduce cortisol  levels (stress hormone) and help calm our minds.
  • Intentional movement
    • Yoga provides a space to mindfully enjoy movement and explore a healthy form of exercise.
  • Long term healing
    • Provides a practice to safely and sustainably lean into.
  • A space for community and support
    • Oftentimes, yoga is done in a group setting, which can increase feelings of connection and lower feelings of loneliness.

After the completion of 7–12 yoga classes, a statistically significant decrease in anxiety, depression, and body image disturbance was seen (Hall et al., 2016).

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Some classes are targeted for rigorous exercise, such as “heated flow” or “power flow.” Please be mindful with what you practice, and look for “slow flow,” “yin,” “vinyasa,” and “restorative” yoga in non-heated rooms.

Music

  • Music can have a powerful effect on people’s mood

    • listening to uplifting or calming songs can help reduce stress and anxious feelings.
  • Music stimulates the limbic system, the part of our brain responsible for processing emotions
    • music triggers the release of serotonin and dopamine, which are associated with reducing feelings of anxiety, depression, and stress (which are often associated with eating disorders)
  • Slow tempo music has been shown to decrease cortisol, our stress hormone, as well as lower blood pressure and reduce heart rate.
  • Music increases the brains neuroplasticity, enhancing brain functions like mood regulation, decision making, and memory.

A study done by Mindlab International revealed that the song “Weightless” by Marconi Union resulted in a 65% reduction in participants’ overall anxiety (Dr. David Lewis-Hodgson).

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  • Ludovico Einaudi
  • Claude Debussy
  • Johann Sebastian Bach
  • José González
  • Laraaji
  • Bill Evans
  • Vance Joy
  • The Paper Kites
  • Moby
  • Tycho

Aromatherapy

  • Aromatherapy can be a helpful, low- cost (or free) tool for people managing eating disorders.
  • Aromatherapy involves using essential oils to help manage emotions and restore balance.
  • Scents can help ground people, encouraging mindfulness about physical and emotional sensations.
  • Can promote a tranquil environment and give a sense (& scent) of peace.
    • creates an atmosphere for individuals to feel safe in processing emotions

Lavender has been shown to reduce anxiety levels. It is seen as a “anxiolytic” solution to providing a coping method for those with anxiety disorders (Yoo & Park, 2023).

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  • Lavender: calm, sleep, relax
  • Chamomile: calm
  • Rose: anxiety reduction
  • Lemon: energy, nausea reduction, concentration
  • Orange: brighten, uplift
  • Jasmine: anxiety reduce, sleep
  • Peppermint: alertness
  • Ylang ylang: calming, stress and anxiety reduction
  • Rosemary: focus

Art

  • Art can help provide a safe space for communication.
  • It can promote a sense of relaxation, and become a calming, meditative like experience (especially in “flow state”).
  • Gives an outlet and coping mechanism for managing difficult emotions.
  • Helps develop healthy habits and routines for self-management.
  • Increases an individuals sense of awareness and understanding of their emotions and thoughts.

Art can boost cognitive function, emotional resilience and self-confidence. It has also been shown to reduce stress and aid in conflict resolution (Hudson University, 2024).

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  • Coloring books
  • Digital coloring or drawing
  • Collaging
  • Sketchbook/journaling/ diary
  • Painting
  • Water coloring
  • Air dry clay (model magic) or traditional clay (ceramics)
  • Photography (use your phone!)
  • So much more!

Creative Journaling & Writing

  • Journaling allows space for self reflection, and emotional release.
  • Free writing can help you connect to your inner voice without judgment.
    • This can look like a steam on consciousness, a short story, or even poetry.
  • Both of these can give you space to problem solve, and look at a situation from a new angle.
  • Try out a prompt, or guided writing exercise if free writing isn’t your thing.
    • Examples & resources below!

Positive writing has been shown to promote positive emotions, as well as positive cognitive mechanisms in the general population (Lai et al., 2023).

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  • What are three things I’m grateful for today?
  • Write a letter to your future self. What do you want to tell them?
  • Write about a positive affirmation you want to start telling yourself.
  • How do you like to relax? Write about your favorite way to unwind.
  • What does “peace” look like to you? How can you bring more of it into your life?
  • What is something that always makes you laugh or brings you joy?

Self-Care / Self-Talk

Positive Self Talk

  • Positive affirmations are short, encouraging statements that can help build our self-esteem and challenge negative thoughts.
  • Repeating these statements daily can help foster a more loving relationship with yourself over time.
    • “Mirror-work” is when you look into the mirror and say kind, positive affirmations to yourself. It might feel awkward at first.
    • Try statements such as “I am enough,” “I am deserving of all the good things life has to offer,” or “I am strong, capable, and confident in everything I do.”
  • This can help build mental resilience, making it easier to cope with challenges and setbacks.
  • They can elevate your mood and promote a more optimistic view of life.
  • They help build confidence and self-worth by focusing on your strengths and capabilities.

Self Care

  • Self-care directly impacts emotional, psychological, and physical well-being.
  • Engaging in regular self care practices helps maintain balance and resilience, ensuring we can cope with life’s challenges.
  • Regular self-care allows the body and mind to recover, recharge, and maintain a sense of calm.
  • Taking care of yourself helps prevent burnout by ensuring you have the energy and mental capacity to meet the demands of life.
    • Without regular self care, you may become overwhelmed, leading to fatigue, frustration, and decreased productivity.
  • Giving yourself mental space helps clear your mind, improving focus, decision-making, and problem-solving.
  • Allows you to engage in activities that bring you joy, pleasure, and fulfillment. These experiences elevate mood and provide moments of peace and happiness.

Positive Self Talk

Affirming personal values has been linked to boosting ones happiness and meaning in life (Nelson et al., 2014). MRI’s show that self- affirmations affect brain activity! (Cascio et al., 2015).

Self Care

“Engaging in a self- care routine has been clinically proven to reduce or eliminate anxiety and depression, reduce stress, improve concentration, minimize frustration and anger, increase happiness, improve energy and more. From a physical health perspective, it has also been clinically proven to reduce heart disease, stroke and cancer” (Glowiak, 2024).

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POSITIVE SELF TALK

 

SELF CARE

  • Up to personal preference, ideas listed in the guide
  • Sleep: Make sure you get enough hours in
  • Making time for hobbies: painting, gardening, etc.
  • Doing chores: cleaning dishes, doing laundry, cleaning space, decluttering
  • Spending time outdoors: taking nature walks, sitting in a park
  • Being with people you love: friends, family, partners
  • Reading or learning: something of interest, and limiting technology/screen time
  • Personal care: shower, bath, deep breathing, meditation, massaging
  • Treating yourself: occasionally indulging yourself with something you love (ex: buying a new book, or a coffee from your favorite shop)
  • Mental care: attending peer support groups (for free with ANAD!), going to therapy (we can help connect you with someone)