I have struggled with body image, and had an unhealthy relationship with food for years. Then my best friend asked me to be a bridesmaid at her wedding, which brought on a very intense diet and exercise programme. I’ve had general anxiety for years and spent most of the last decade in a cycle of dieting/bingeing. All of this has felt worse in the last year, partly because I moved to London. The move meant I had to come out of a period of control, and led to a long period of unhealthy eating, And the punishing routines brought on by anxiety about my friends’ wedding this July has really exacerbated it all and felt like the last straw. Any help you can give would be gratefully received. Poppy, 27, Wandsworth

Michaela Says

I am so glad you have written in about this, because the single most important thing in beginning to shift your negative thoughts around body image is to be open about how you are feeling. And that can be very hard, because body image issues almost always start early in your childhood. Infancy is the time that all your ideas about identity, appearance, roles, and acceptability start to form. And infancy is also a time when you do not have the vocabulary to talk about these feelings, and may not even recognise that you are forming a negative body image. However, as you well know, if they are not addressed, these issues can often lead to eating disorders and anxiety in later life.

So while, I am sorry to hear that moving to London and the stresses of being asked to be a bridesmaid have made things feel very difficult for you and triggered unhealthy eating patterns, I am glad that you were able to reach out for help. Beginning to tackle this negative body image is hard work. It requires a lot of courage, and will raise all sorts of difficult emotions. So the more you can identify those feelings, and the more you are able to talk to people about them, the more those people can support you in carrying that burden, and the more you will be able to work things through.

Another thing that can be really helpful is recognising that negative body image is a cognitive distortion (or an exaggerated thought pattern). And it is not what others see when they look at you. Talking to others will enable you recognise that they don’t see you the way you see yourself  more frequently.

Body image is really complicated and fraught and difficult for almost everyone – and most especially for people who have a history of an eating disorder. Be patient and have compassion for yourself. Body acceptance and neutrality around this are difficult concepts that can take time and require a lot of hard work. So give yourself that time, acknowledge how hard you are working to address these issues, and consider going into therapy or joining a body-image group so that you have enough support while you are going through this.