See Inside April/May 2007

Through a Glass, Darkly

A distorted body image is symptomatic of nearly all eating disorders. Correcting this mental reflection can help sufferers recover

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They all look the same in front of the mirror--attractive and slim--but one after another, they get up in swimsuits and bemoan their physical faults: fat thighs, shapeless silhouettes, flat chests. These young women are participating in group sessions focused on body image, co-sponsored by the universities of Bochum and Mainz in Germany. Senior therapist Silja Vocks knows she will have a hard time getting through to these girls, who all suffer from eating disorders, but it is her job to help them learn to like themselves again.

Eating disorders are complex psychiatric conditions, instigated by a number of factors both inborn and circumstantial. For most patients, however, significant mental pain stems from having a faulty body image, a term psychologists use to describe an individual's internal picture of his or her exterior form. In truth, this image more accurately reflects self-esteem than physical appearance. It is based not so much on fact as on emotion, and the opinions of family and peers, as well as cultural ideals, can dramatically alter its dimensions.

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