Exploring Endometriosis and the relationship with food and body image

In the realm of women’s health, there has long been an understanding of the impact of conditions such as Polycystic Ovary Syndrome (PCOS) on women’s mental health. More recently there is also growing awareness of the impact of Endometriosis symptoms on body image and eating concerns.

Endometriosis is a chronic condition where cells similar to the lining of the uterus grow outside the uterus, causing inflammation in areas such as the abdomen, and in some cases quite debilitating pain. This pain, along with other symptoms like bloating and digestive issues, can result in people feeling discomfort and disconnection from their bodies.

Everyday activities can become challenging as people seek to cope with chronic pain, deal with bloating and discomfort, and navigate unpredictable digestive patterns. These uncertainties can significantly impact on how people perceive and relate to their bodies, creating vulnerability to seek out ways to feel better and cope with difficult sensations and emotions.

Research into the psychological impact of endometriosis also reveals possible impacts on body image and self-esteem, with some people feeling ‘broken and inadequate’, or struggling with the sense that their bodies are outside their control.

Of course there is an abundance of dietary information available which offers strategies to alleviate endometriosis symptoms. Unfortunately this information is often misguided and not scientifically based, encouraging people to adopt restrictive dietary patterns which can exacerbate the conflict with and confusion about their bodies, contributing to further body image distress and eating concerns.

Additionally, cultural messaging regarding body image, physical activity, and dietary choices can add pressure and contribute to this body confusion, especially when compounded by challenges from hormonal therapies, difficulties with sexual arousal and intimacy, recurrent surgeries, or fertility concerns.

Research from 2021 explored why some people with endometriosis experience higher levels of emotional distress. The findings pointed to negative body image and self-criticism as major factors contributing to psychological distress. These self-critical patterns were described by one person as ‘a vicious cycle of feeling like one's body is constantly falling short’, leading to increased feelings of failure and self-criticism.

We do however know that improving self-esteem and emotional coping strategies can contribute to improved psychological outcomes for people with endometriosis. Emphasising body acceptance and reducing self-criticism are also powerful tools in coping with any chronic illness, and this is especially so for women’s health issues and menstrual concerns.

Endometriosis and Eating Concerns

Currently there is little research on the relationship between endometriosis and eating concerns or eating disorders. Research does however show that people with endometriosis regularly make dietary changes in an effort to assist with pain management and gastrointestinal issues.

Turning to clinical and lived experience, health professionals working with women and AFAB (assigned female at birth) people with endometriosis often describe the desire to control their eating behaviours in an effort to control their body, contributing to complex relationships with eating and body image.

What Can Help?

1.     Prioritise a Healthy Relationship with Food and Body Image: While dietary changes may help manage endometriosis symptoms for some, it's important to prioritise overall health and well-being and to avoid restrictive or highly controlled eating behaviours

2.     Seek Support from Health Professionals: Consult with healthcare professionals who understand both endometriosis and eating concerns – especially if you’re considering dietary changes, it’s always best to speak to a qualified Dietitian for professional nutritional advice

3.     Emphasise Body Acceptance: Work on improving your relationship with your body and developing body acceptance to enhance overall well-being, irrespective of any physical challenges. Focus on taking care of and nurturing your body, prioritising it’s needs

4.     Develop Self-Compassion: Chronic health conditions are complex and challenging to navigate. Self-compassion involves the ability to be kind to yourself in response to health concerns, focusing on changing the relationship you have with your body, even in response to things which are outside your control. Mental health professionals can assist with strategies to enhance your self-compassion.

Navigating Social Media to Promote Positive Body Image

In our digitally driven world, social media has become an integral part of our daily lives. From connecting with friends to staying updated on the latest news, it's a tool which has immense influence on our lives. Alongside the convenience and benefits, social media also presents a number of challenges, particularly in relation to body image.

The prevalence of unrealistic beauty standards portrayed on social media can have a big impact on how we perceive ourselves. Repeated exposure to these perfected images can cause us to feel inadequate, and may contribute to body dissatisfaction.

Social media can also be a great tool to assist in promoting positive body image, fostering self-acceptance and encouraging inclusivity. The key factor is how we choose to engage with social media. Here are some tips on how to use social media in a way which promotes positive body image and can protects us from dissatisfaction or potentially disordered eating behaviours.

1. Check in with Your Feelings

Notice how you feel during and after being on social media. If certain pages, accounts or images leave you feeling negative about yourself or trigger comparison, consider whether following them is beneficial to your well-being. Your mental health should always be the priority.

2. Curate Your Feed

Follow accounts and people who promote body diversity and inclusivity, and unfollow those which perpetuate harmful beauty standards. Exposure to a broad variety of body types, shapes, ages, genders, and ethnicities can reshape your perception and foster inclusivity.

3. Remember: It's Not Reality

Keep in mind that what you see on social media is often a curated portrayal of someone's life… the highlights reel. Remember also that images may be edited, filtered or enhanced, so what you’re seeing may be not be real. Remind yourself of this when comparing your life to others. Share authentic moments from your own life to contribute to a more genuine online community.

4. Combat Comparison

As the saying goes, ‘Comparison is the thief of joy’, and this is especially so on social media. Remember that you’re comparing yourself to the best possible version of another persons life, and if you begin to slip into critical self-talk, it’s probably time to move away from social media for a while to do something which focuses on your own life, your own opportunities and achievements.

5. Prioritise Health and Well-being

Move your focus away from appearance, to instead pay attention to your overall health and well-being (which is much broader than just the things we’re able to photograph and share on the socials). Embrace discussions about what makes you feel good physically, mentally, and emotionally.

Social media can either perpetuate harmful beauty standards or serve as a platform for promoting positive body image and inclusivity. By curating our feeds, being aware of our emotional responses, and fostering empowering content, we can contribute to a healthier and more accepting online community.

Navigating Diet Talk and Body Image Concerns During the Holiday Season

The holiday season is a time for celebration and relaxation. It's a time to gather with people we care about, and hopefully also a time for some rest. However this can also be a time when diet culture ramps up, creating pressure in the warmer weather to focus on our ‘bikini body’, attending events which are usually centered around food and eating, and the impending wellness focus of New Year's resolutions – all of which can make the holiday period a minefield of diet talk and body image distress.

In this article, we'll explore strategies to help you navigate the challenges of diet talk and body image concerns during the holidays. Different factors such as your environment, relationships, personal history, and comfort levels can influence which strategies are most effective for you – so think about how you can personalise this information for your own circumstances.

Setting Boundaries

Where possible it can be helpful to set some boundaries prior to an event. Depending on your relationship with the people involved and your comfort level, it might be possible to let people know how they can support you – maybe you could communicate these boundaries in person or via text. Some examples could include:

• ‘I'd appreciate it if we don't talk about 'good' vs. 'bad' foods’

• ‘It would be really helpful if we could avoid any discussions of weight during the holidays’

• ‘I really want to have fun with you over New Years, which will be a lot easier for me if we don’t talk about diets’

• ‘It’s important for my recovery that we don’t talk about ‘working off’ Christmas dinner’

Responding to Body or Diet Talk

Despite setting boundaries, it’s possible that instances of unhelpful diet or body talk could still arise. In these situations, it can be helpful to have some practiced strategies for responding. Here are some ideas:

• Remove yourself: Remember it's okay to leave the conversation or the situation. Excuse yourself for a bathroom break or step outside for some fresh air

• Redirect the conversation: Change the topic to something more neutral or comfortable to steer the conversation away from diet talk

• Express discomfort: Be honest about your feelings, eg. ‘I'm not comfortable with this conversation’

• Question the body talk: Gently question the person engaging in body talk, eg. ‘I've noticed you make a lot of comments about good and bad foods. For me, this contributed to a really unhealthy relationship with food’

• Plant Seeds: eg. ‘I've found it helpful to learn more about my relationship with my body, if you're interested, I can send you some podcast or book recommendations’

• Direct Response: In some cases, you may need to be more direct and assertive, eg. ‘I'm not engaging in diet talk’

Focus on What You Can Control

Despite our best attempts, we have limited control over other people’s body and diet talk, and we may not always feel comfortable or have the capacity to challenge them. In these situations, focus on what you can control:

• Remind yourself of your personal journey: Tell yourself that you’re on the path to recovery and that it's important to prioritise your wellbeing

• Practice empathy: If it feels safe, try to empathise with those around you who might be caught up in diet culture, and be dealing with their own food and body image concerns

• Focus on positives: Concentrate on positive aspects of yourself, list three things you're proud of accomplishing

• Consider the source: Reflect on the source of comments and ask yourself whether it's helpful to place much value on their perspective

• Use mindfulness techniques: To let go of unhelpful thoughts, such as mentally saying, ‘I'm having the thought that...’

• Practice self-compassion: Engage in self-compassionate thoughts and soothing activities after challenging interactions

Ultimately, prioritise your wellbeing, and before you know it the holidays will have passed – hopefully without too much stress or challenge along the way. Be sure to schedule in some of your favourite activities, and spend time with the people who you know are good for your spirits.