Does Self-Esteem Overlap with an Eating Disorder?

For people with positive self-esteem, these shifts in feelings only temporarily impact how they feel about themselves. These feelings are transitory and do not inform an overall self-image. The feelings are related only to the actual events rather than being connected to a perception of being “bad.” In 1969, Nathanel Brandon defined self-esteem as “the experience of being competent to cope with the basic challenges of life and being worthy of happiness.”

The Mayo Clinic defines self-esteem as: shaped by your thoughts, relationships, and experiences that creates your overall opinion of yourself. When you have healthy self-esteem, you feel good about yourself and believe you deserve respect of others. When you have poor self-esteem, you put little value on your opinions and ideas.

Psychologist Abraham Maslow included two types of self-esteem in his hierarchy of needs: the need for respect from others, and the need for self-respect, or inner self-esteem. Furthermore, Maslow believed that without the fulfillment of the self-esteem need, individuals are unable to grow and obtain self-actualization.

Poor vs. Healthy Self-Esteem

Healthy self-esteem includes the ability to assess oneself in relation to others while accepting one’s inherent, individual traits as valuable. This includes setting personal standards of success while realizing long term plans are required for knowledge or improved skills. A person with healthy self-esteem can reflect on strengths and weaknesses, ask for help in order to gain more knowledge in a highly valued area, all while protecting individuality and character.

Individuals with poor self-esteem, however, often require considerable feedback from others in order to understand how to think and feel about themselves. They may require continual validation from family, friends or group experiences in order to combat negative thoughts that dominate their thoughts. As such, the positive feelings related to being congratulated on a job well done are, usually, interpreted as superficial and often temporary in nature.

How Do We Get Self-Esteem

Setting the stage for positive self-esteem starts early in a child’s life. Although this writer never plays the blame game with parents, here are some things parents, coaches, educators, mentors, family members, health practitioners, and religious figures can do to foster positive self-esteem:

  • Individual strengths noticed amongst siblings
  • Positive feedback
  • Making time to listen
  • Modeling respectful communication
  • Affection in form of verbalization and hugs
  • Weaknesses acknowledged without being made fun of
  • Being appreciated for all their strengths
  • Appropriate physical, emotional and sexual boundaries

Communication that may foster poor self-esteem:

  • Being singled out when not perfect
  • Ridiculed for short comings
  • Being ignored if parent is actively using substances
  • Expected to be an adult too soon
  • Asked to participate in physical or sexual abuse
  • Told they are less than their sibling(s)
  • Not being appreciated

Individuals with negative self-esteem take feedback personally and often interpret it as criticism of their self-worth, morals and integrity. And it is common that a person with low self-esteem reports they hear a “critical voice in their head” that leads them to feeling anxious about where they “will surely fail next.”

According to Jose Vincent Bonet, lack of self-esteem is a kind of “self-rejection” where his research identified the following characteristics:

  • Heavy self-criticism and dissatisfaction
  • Hypersensitivity to criticism with resentment against critics
  • Feelings of being attacked
  • Chronic indecision and an exaggerated fear of mistakes
  • Excessive will to please • Perfectionism
  • Neurotic guilt
  • Dwelling on and/or exaggerating the magnitude of past mistakes
  • Floating hostility and general defensiveness and irritability
  • Pessimism and a general negative outlook
  • Envy or general resentment
  • Sees temporary setbacks as permanent, intolerable conditions

Overlapping Issues

The above list is also similar to the issues seen in individuals who struggle with an eating disorder. Could it be that these characteristics laid the ground on which the eating disorder sits? An eating disorder is a bio-psycho-social-spiritual crisis where an individualized treatment is specific to each person.

Professionals who are trained in Cognitive Behavioral Therapy are well equipped with tools that teach individuals how to verify cues from others, validate successes and learn healthy responses. The ultimate goal for individuals with low self-esteem is to learn how to have healthy relationships with others and to tolerate the normal ups and downs of life.

The team approach is important. While these and other clinical issues are being addressed, the medical, psychiatric and dietary team members are simultaneously addressing each of their own specializations.

And although self-esteem is only one part of the eating disorder puzzle, we, as professionals, can support individuals to learn skills to change a harsh inner critique, to gain empathy for themselves and others, to validate emotions, to ask for help and believe in their own humanness.

About the Author

Libby Neal, MA, LPC, is in private practice on the western slope of Colorado. Specializing in eating disorders and trauma, Libby utilizes psychodynamic therapy, evidence-based practices, equine assisted therapy and art therapy. Libby has fifteen years of experience with eating disorders working as a clinician, administrator and educator.

Maslow, A. H. (1987). Motivation and Personality (Third ed.). New York: Harper & Row.
Mayo Clinic On Line Medical Support:
Nathaniel Branden. Cómo mejorar su autoestima. 1987. Versión traducida: 1990. 1ª edición en formato electrónico: enero de 2010. Ediciones Paidós Ibérica.
Vicente Bonet. Sé amigo de ti mismo: manual de autoestima. 1997. Ed. Sal Terrae. Maliaño (Cantabria, España).

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