Eating Disorders & Bodywork

Touch and How It Positively Affects Body Image, Self-Esteem, and ED

Copyright 2004 Laura E. Garrard ~ Written March 1, 2004

Massage has the power to change people’s lives. Touch allows people to reconnect to themselves and rediscover their bodies in the process. The body is then able to come forth, in a sense, and reclaim its desire to sustain a healthy lifestyle and formulate healthy physical and emotional relationships with others and the world. What Ben E. Benjamin calls the “magic of connection” occurs on the physical level and also affects the mental, emotional, and even spiritual states.

It has been proven that infants require touch for normal emotional, mental, and social development, and even that touch promotes growth in premature babies. It makes sense, then, that humans of all ages need loving touch. In addition, love helps one adapt to her environment and encourages her to accept her faults and the imperfections of others. Therefore, love and loving touch lead a person to possess a positive self-worth and self-esteem. In the absence of love, addictions can rise in the attempt to fulfill what isn’t present.

Keeping these tenets in mind, massage and touch may greatly help those whose low self-esteem, heightened perfectionism, and distorted body image have contributed to addictions with food intake: those who suffer from eating disorders. While psychological and nutritional work is imperative for those with eating disorders, massage can be instrumental in providing “nurturing, restorative, educated, and nonjudgmental” touch to these clients, who may receive little to no touch, according to Ruth Werner (author of A Massage Therapist’s Guide to Pathology).

The Causes of Eating Disorders

Eating disorders include anorexia, bulimia, binge eating disorder, and compulsive overeating – serious psychological illnesses having physical dangers. Those with eating disorders use irregular eating patterns to cope emotionally. About 10% of America’s girls and women have been diagnosed with eating disorders, and approximately 50,000 will die because of it.

There is a range of factors that can cause eating disorders, including psychological, socio-cultural, interpersonal, and biological and biochemical factors. Psychological factors can be low self-esteem, perfectionistic tendencies, depression, anxiety, anger, loneliness, and feelings of inadequacy and lack of control. Those with eating disorders may turn to irregular eating patterns in an attempt to ignore their feelings of depression, anger, or loneliness.

Socio-cultural factors originate from a culture that values appearance and thinness over internal qualities. Pervasive media messages encourage us to compare our bodies to an impossible standard: men and women appearing on the covers of the ten most popular magazines make up just .03% of the population. Our cultural definition of beauty is currently based on the appearance of these supermodel types. In trying to achieve the perception of what’s beautiful in our society, our culture is obsessed with dieting, probably causing a high rate of chronic dieting among teens. About 50% of all female teens think that they are fat and are dieting as a result. Cultural messages (and also those from peers and parents) regarding thinness can negatively affect one’s body image and self-esteem.

A Distorted Body Image

“Psychologists and counselors agree that a negative body image is directly related to self-esteem,” according to Cindy Maynard, MS, RD. “The more negative the perception of our bodies, the more negative we feel about ourselves.”

Body image not only involves our physicality and attractiveness, but it also incorporates our mental perception of our bodies as well as our “thoughts, feelings, judgments, sensations, awareness, and behavior.” We formulate our body image through our relationships with others, and it serves as our mental reality of ourselves. Our body image, then, is our guide to becoming ourselves. When we feel bad about our bodies, we lose confidence in our abilities and develop an unhealthy “sense of self.” This negative effect on our self-esteem, which is a self-evaluation of one’s worth, lessens the opportunity for happiness and can lead to mental disorders.

A negative body image includes a distorted perception of one’s body shape, a view that certain body parts are different from what others see. It’s also the perception that others’ bodies are attractive but hers is not. A person with a negative body image may feel self-conscious about her body or uncomfortable within her body.

People with negative body images have a higher risk of developing eating disorders and experiencing depression, loneliness, and low self-esteem. Those suffering with anorexia oftentimes see themselves as fat even though they weigh less than 85% of what their normal weight should be. This distorted view arises from a negative body image, which in turn feeds a low self-esteem and creates a cyclic effect centered on their eating disorders. “Eating disorders are perpetuated by how a person views his or her image,” says Michelle Wolf.

In addition, a relationship has been drawn between the development of physical and emotional boundaries and body image. These boundaries develop in early childhood as a result of how we are and are not touched. For example, a person deprived of touch may not develop the appropriate sensory information necessary to determine what is inside and outside the body. Boundaries, then, may be ill formed, causing one to inaccurately perceive her shape. Eating may become problematic due to an inability to adequately sense fullness or hunger. Or, if a person was sexually abused during childhood, she may associate her body with the feeling of pain and shame; in turn, she may use food or starvation as physical continuance of childhood trauma. Touch can address the issues of boundaries and body image: Massage can help bring awareness to one’s body image, establishing a more realistic perception of one’s external shape and a more positive relationship with the self.

Massage Can Help

Studies conducted through the Touch Research Institutes prove that massage positively affects imbalances in the body, or diseases, including “asthma, diabetes, anorexia nervosa, insomnia, chronic fatigue syndrome, AIDS and many more,” reports Ben E. Benjamin. Two studies have specifically studied the effects of massage therapy on clients with eating disorders.

The first, conducted in 1998, focused on bulimic patients. The study took twenty-four bulimic female teens and placed them randomly in either a control group or a massage group. Immediately after receiving a massage, study participants showed reductions in anxiety and depression. And after the last day of therapy, the massaged patients exhibited lower cortisol or stress levels, lower depression scores, and higher dopamine levels (a biological association to eating disorders). They also showed improvement on other psychological and behavior measures.

The second study, in 2001, provided anorexia female patients massage twice per week for a five-week period. Control group participants received the standard treatment. Those massaged reported lower stress and anxiety levels, and their cortisol levels were down, directly after therapy. During the five weeks, they tested to have decreased body dissatisfaction on the Eating Disorder Inventory. They also showed higher dopamine and norepinephrine levels. The results of this study supported previous research conducted on the benefits of massage therapy for those with eating disorders.

So then, massage therapy can greatly help those with eating disorders, although more research is needed. A contra-indication for these clients may be cardiovascular weakness; therefore, massage modalities that do not focus on increasing circulation may be more safe for the client, from what is currently known.


Massage therapy directly affects the measurements of eating disorders in research, physically and psychologically. It reduces stress, anxiety, depression, and body dissatisfaction. In addition, it can be concluded that massage provides loving touch to a population suffering from the loss of touch, either early in life or during the course of their disorder.

As eating disorder patients have sought to separate their bodies from others and their bodies from themselves, touch brings the external in congruence with internal and helps to generate a more positive body image. As armoring dissolves, the client’s awareness increases and a more realistic perception of self develops. A more self-caring body image can formulate. In loving one’s body, one grows to love the self. Massage and loving touch can be incredibly helpful tools in eating disorder recovery, as the massage therapist models acceptance and healthy boundaries and healing touch encourages positive feelings for the client’s physical self.



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