Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Mind and body

Reverse body image distortion can be a big health problem

Lavinia Rodriguez

Lavinia Rodriguez

Those of us who treat people with eating disorders are used to addressing body image distortion with our patients. Body image distortion has to do with a person's perception of her body size. Compared to the real body size, any difference in their perception of it is a distortion. We all distort our body image to some extent, since we cannot view ourselves from someone else's perspective. The closest we come to viewing our whole body accurately is through mirrors and images of ourselves, yet those, too, distort our true size to some degree.

Some distortion is normal, but when the distortion is extreme, it can be a serious problem. You see this with people who have clinical eating disorders such as anorexia and bulimia. In such cases, people perceive their bodies to be significantly bigger than they really are. An anorexic woman who weighs 90 pounds can think she is obese.

Less common is a body image distortion in which people perceive their bodies to be smaller than they are. While this may not appear to be much of a concern, it can lead to a host of problems. Here are some:

Gaining excessive weight: Particularly if you're not active and tend to eat mindlessly, perceiving yourself as being thinner than you are can lead to weight gain that creeps up. It's not unusual for a person with a reverse body image distortion to suddenly realize, usually after a significant life event, that he or she is obese.

Denying health needs: Because of the mistaken belief that if a person isn't overweight he's healthy, overweight people with a reverse body image distortion (believing that they aren't overweight) may think there's no need to be concerned about their health. Or it may not even enter their mind. Important health issues that should be addressed, such as exercise, nutrition and health screenings, may be ignored.

Missing dangerous symptoms: Significant health problems such as diabetes, heart attack and stroke may seem to appear suddenly to the person with a reverse body image distortion, though there were signs all along that a problem was brewing. Bill, for example, would periodically get a tightness in his chest, but it would go away fairly quickly. It wasn't until he landed in the hospital that he realized the symptoms were serious, and that they related to his health and weight. From Bill's perspective, his body hadn't changed much in 30 years, but it had.

Lacking motivation to change: Combining a reverse body image distortion with denial leaves a person with little motivation to change behavior or lifestyle. Having a good grasp of reality is important to fuel the motivation to be healthy.

Rationalizing: We all rationalize on occasion, but if you do it chronically about your health and self-defeating lifestyle because you perceive yourself to be smaller than you are, you're likely to put important things off that affect your health.

Distorting the size of others: Sometimes parents distort the size of their children. There have been cases of parents of morbidly obese children who verbalize that their child is "pleasantly plump" or "just big for his age." These may be extreme examples, but there are other cases of differing degrees that are just as concerning. A young child's well-being is dependent on caregivers, as children don't have the same ability as an adult to make logical decisions about their health. Even if they did, they don't have the power to follow through with such decisions without the help of adults. Parents must look at children objectively, setting aside biases they may have about how they want things to be.

What should you do if you suspect you have a reverse body image distortion? Look for signs that you might be distorting and, as a result, not facing reality. Perhaps people have been trying to get you to see that you need to take better care of your health or that of your children. Maybe lab results have been inching in the wrong direction. Perhaps you have clothes in the back of your closet that you don't wear anymore because they no longer fit. Or you might be wearing loose clothes with elastic bands, not because they're more comfortable but because they make you less aware of weight gain.

Working on a reverse body image issue and its effects can be complicated, so don't be concerned if you can't seem to get things under control on your own. It's not unusual to need the help of a qualified professional.

Dr. Lavinia Rodriguez is a Tampa psychologist and expert in weight management. She is the author of "Mind Over Fat Matters: Conquering Psychological Barriers to Weight Management." Send questions to her at

Reverse body image distortion can be a big health problem 07/24/14 [Last modified: Thursday, July 24, 2014 7:06pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Record $417 million awarded in lawsuit linking baby powder to cancer


    LOS ANGELES — A Los Angeles jury on Monday ordered Johnson & Johnson to pay a record $417 million to a hospitalized woman who claimed in a lawsuit that the talc in the company's iconic baby powder causes ovarian cancer when applied regularly for feminine hygiene.

    A bottle of Johnson's baby powder is displayed. On Monday, Aug. 21, 2017, a Los Angeles County Superior Court spokeswoman confirmed that a jury has ordered Johnson & Johnson to pay $417 million in a case to a woman who claimed in a lawsuit that the talc in the company's iconic baby powder causes ovarian cancer when applied regularly for feminine hygiene. [Associated Press]
  2. Search under way for missing sailors; Navy chief orders inquiry


    SINGAPORE — The U.S. Navy ordered a broad investigation Monday into the performance and readiness of the Pacific-based 7th Fleet after the USS John S. McCain collided with an oil tanker in Southeast Asian waters, leaving 10 U.S. sailors missing and others injured.

    Damage is visible as the USS John S. McCain steers toward Singapore’s naval base on Monday.
  3. Told not to look, Donald Trump looks at the solar eclipse


    Of course he looked.

    Monday's solar eclipse — life-giving, eye-threatening, ostensibly apolitical — summoned the nation's First Viewer to the Truman Balcony of the White House around 2:38 p.m. Eastern time.

    The executive metaphor came quickly.

    President Donald Trump and first lady Melania Trump view the solar eclipse from the Truman balcony of the White House, in Washington, Aug. 21, 2017. [Al Drago | New York Times]
  4. Secret Service says it will run out of money to protect Trump and his family Sept. 30


    WASHINGTON — The Secret Service said Monday that it has enough money to cover the cost of protecting President Donald Trump and his family through the end of September, but after that the agency will hit a federally mandated cap on salaries and overtime unless Congress intervenes.

    Secret service agents walk with President Donald Trump after a ceremony to welcome the 2016 NCAA Football National Champions the Clemson Tigers on the South Lawn of the White House on June 12, 2017. [Olivier Douliery | Sipa USA via TNS]
  5. After fraught debate, Trump to disclose new Afghanistan plan


    WASHINGTON — President Donald Trump will unveil his updated Afghanistan policy Monday night in a rare, prime-time address to a nation that broadly shares his pessimism about American involvement in the 16-year conflict. Although he may send a few thousand more troops, there are no signs of a major shift in …

    U.S. soldiers patrol the perimeter of a weapons cache near the U.S. military base in Bagram, Afghanistan in 2003. Sixteen years of U.S. warfare in Afghanistan have left the insurgents as strong as ever and the nation's future precarious. Facing a quagmire, President Donald Trump on Monday will outline his strategy for a country that has historically snared great powers and defied easy solutions.  [Associated Press (2003)]