That internal chatter and the tone you use when thinking or talking about your appearance (the positive and the negative) is all part of your body image. Here, learn about what it means to have a positive or negative body image, how body image affects your mental and physical health, and what you can do to improve yours. She adds: “Are we neutral, kind, or mean to ourselves? Do we find ourselves being critical or neutral about the observations we make about our body and appearance? Do we find ourselves making strong judgments about our body that leave us feeling unworthy, less than, or undeserving?” How we answer those questions is all part of our body image.

It was originally an effort started by fat activists to center and liberate marginalized bodies from oppressive forces such as fat phobia, racism, and ableism, says Samantha DeCaro, PsyD, director of clinical outreach and education with the Renfrew Center in Philadelphia, a residential eating disorder treatment facility. “The movement was designed to challenge the conventional definitions of health and beauty.”

Body neutrality is a different concept. “It encourages taking a neutral approach to our bodies,” DeCaro says. “The term reminds us that we do not have to love our body to respect it, to nourish it, listen to its cues, or to have gratitude for what it can do.” Embracing body neutrality rather than body positivity may be a more achievable goal for people with body image issues and those struggling with eating disorders. “It creates the space to cultivate an authentic identity that focuses less on the physical self and more on our core values,” DeCaro says. Learn More About Body Neutrality “Young kids and adolescents are very impressionable,” says Paakhi Srivastava, PhD, an assistant research professor and interim director of the Center for Weight, Eating and Lifestyle Science (WELL Clinic) at Drexel University in Philadelphia. Their body image is shaped by what they consume in traditional media and on social media, as well as via the messages they receive regarding body and appearance from adults, Dr. Srivastava says. If these messages are positive, chances are greater that the young person will establish a positive body image. A positive body image means you feel good in your skin, regardless of whether your body meets the definition of what those around you would consider the ideal shape. “It’s a feeling of satisfaction about one’s body irrespective of the societal ideal being forced at any given time,” says Jennifer Kelman, LCSW, a therapist in private practice in Boca Raton, Florida, who specializes in eating disorders and body image. For example, consider how you would feel if you tried on shorts from last year and they fit more snuggly than you remember. “A body positive way to respond would be: ‘Wow, I guess I grew this past year, but that’s okay. Bodies are made to change and adapt. I’ll find some different shorts instead so I can enjoy the summer and feel comfortable,’” Cortez says. Consider the scenario where you’re trying on that pair of shorts from last year that no longer fit. Someone with a negative body image might react to that situation by thinking that they’re a failure for gaining weight or for not being as lean as they were in the past, Cortez says. But regardless of any triggers that negative body image issues can be linked back to, it can certainly outlast someone’s teenage years. “I think it can be an issue across the lifespan — teens grow up to be adults who continue to have issues with body image,” says Jennifer Engler, PhD, associate professor and psychology chair at York College of Pennsylvania, who researches adolescent identity development. Adults can also develop a negative body image, especially if they’re prone to comparing themselves to others and feel pressure to meet socially prescribed beauty standards, she says.

How Body Image Affects Physical Health

“One of the most significant mental and medical issues that comes along with having a negative body image is the connection to the risk of developing an eating disorder,” Dr. Engler says. A negative body image can influence other behaviors as well. “You can see people who have negative body image engaging in other types of behaviors and activities to try to fix what they perceive to be problematic,” Engler says. “So maybe smoking or substance abuse to manage weight, or excessive exercise, which can lead to health issues down the road.”

How Body Image Affects Mental Health

Engler says there are some connections between depression and bulimia nervosa, as well as between anxiety and anorexia. For many people, social media shapes what defines beauty and attractiveness. And there are countless examples of people using social media to define themselves as individuals, Srivastava says. “It’s placing more importance on the body and almost objectifying it.” Social media can lead people to judge themselves harshly, if their bodies don’t resemble what they see online. “Being bombarded by images on social media can have a negative impact on body image, because in real life nobody will ever live up to the Photoshopped or perfectly curated ideal they see in their Instagram feeds,” Kelman says. That said, the body image conversations on social media aren’t all negative. “Social media can serve as another mental health resource when used mindfully and consumed critically,” DeCaro says. “There are overarching body issues [for all groups], and for each little pocket of ‘L’ and ‘G’ and ‘B’ and ‘T,’ there can be very specific challenges as well,” says Paula Atkinson, LCSW, a Washington, DC–based psychotherapist who focuses on helping people with eating disorders. “I work with a lot of male-identifying gay men, and unfortunately fat phobia is rampant in that community,” she says. Another example Atkinson gives is people with gender dysphoria, which is the desire to be another gender. Body image issues in this case can be people feeling like they’re not as feminine or as masculine as they’d like to be. That can lead to some confusion. “BIPOC people are contending not only with mainstream body ideals but also with our cultures’ specific body and beauty ideals,” Osborn says. “Those ideals can be contradictory, leaving BIPOC people feeling left out of one or both standards.” These body image issues can be exacerbated by the fact that people of color often don’t see people that look like them in the media, Osborn says. Finally, body image problems facing people in BIPOC communities may be brushed aside. “BIPOC people also face having our body image struggles belittled or dismissed by those who believe that our cultural backgrounds protect us from anti-fatness,” Osborn says. “There is sometimes a narrative that worrying about body image, especially weight, is a white-people problem, one we either don’t have the luxury of worrying about because our communities have more urgent needs or one we simply don’t need to worry about because our communities are allegedly more accepting of larger bodies,” she says.

“A large part of finding freedom and sanity around [body image] issues is committing to rebuilding a relationship with one’s body, which requires trusting that it is doing the best it can,” Atkinson says. “When one is struggling with a disability or chronic illness, that trust can be harder to come by.” It’s when these negative thoughts about your body interfere with daily functioning (for example, if you’re engaging in excessive dieting or exercise or avoiding social activities) that it may be time to consider seeking professional help from a mental health provider, Kelman says. “Everyone has negative thoughts about how they look from time to time, but when these harmful behaviors are the response to those kinds of thoughts, it’s time for professional help to work through it,” she says. If you are actively in crisis and need immediate support, call 911. You can also call the National Suicide Prevention Lifeline at 800-273-8255, or text 741-741 to reach a trained counselor with Crisis Text Line. Learn More About How to Build a Healthy Body Image