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Body Image & Substance Use Connection
Understanding the entanglement between a negative body image, eating disorders, and substance use is crucial in addressing these issues during treatment. That’s because body image issues can cause or contribute to a perceived need for self-medication, which can, in turn, worsen overall mental health. This is true for all individuals, but thanks to the many development changes adolescents are experiencing, they tend to be especially vulnerable.
From Insecurity to Self-Medication
Insecurity about one’s body image can lead to an individual’s decision to self-medicate with drugs or alcohol due to a variety of factors, including:
- Negative emotions — Those with poor body image often experience intense feelings of shame, anxiety, depression, and low self-esteem, all of which are associated with an increased risk of substance use.
- Need for coping mechanisms — Substances are often used as a means of numbing oneself or escaping reality, including negative and painful feelings.
- Desire for temporary relief — Substances provide a brief respite from stress and emotional turmoil, leading to a false sense of confidence.
- Social pressure — Insecurity about one’s appearance can make social situations challenging, and substance use can reduce feelings of self-consciousness and reserve. For example, alcohol is sometimes referred to as “liquid courage.”
- Underlying issues — Other issues that adolescents experience, such as physical impairments, childhood trauma, family dysfunction, eating disorders, and a need for control, can all be intertwined with both body image insecurities and substance use.
Ultimately, self-medication is not a permanent solution and doesn’t address the root causes of poor body image and other mental health issues. Instead, it tends to exacerbate these problems and lead to addiction and further health conditions.
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High-Risk Substances & Behaviors
While the types of substances preferred by teens vary greatly, especially based on availability, research has found that those used by people who struggle with body dysmorphic disorder (BDD) commonly include:2- Alcohol — Often used as a means to cope with social anxiety and body image issues, alcohol temporarily reduces inhibitions and self-consciousness. It also increases feel-good brain chemicals, leading to a sense of well-being. Alcohol is a common substance of misuse found among those with eating disorders.
- Cannabis — Like alcohol, marijuana can temporarily alleviate the anxiety and distress associated with BDD, as it can induce feelings of relaxation and overall well-being.
- Illicit stimulants — Those who are preoccupied with weight or muscle mass may find that certain illicit stimulants—often those with a high potential for addiction like methamphetamine and cocaine—simultaneously boost energy, suppress appetite, and instill a sense of euphoria and confidence.
- Anabolic steroids — Individuals who struggle with muscle dysmorphia (sometimes referred to as “bigorexia”) may turn to anabolic steroids for help, which can have a dramatic effect on mental and physical health.
- Restrictive dieting, or severely limiting food intake (e.g., anorexia nervosa)3
- Binge eating, or consuming large amounts of food in a short period (e.g., bulimia nervosa)4
- Purging, which includes self-induced vomiting, laxative overuse, or excessive exercise (e.g., bulimia nervosa)
Weight Control & Drug Use
In addition to illicit stimulants such as cocaine and amphetamines, teens seeking to reduce or control their weight may misuse other prescription or over-the-counter (OTC) medications. These often include:- Amphetamines (Adderall, Dexedrine) — Prescription medications most often used to treat ADD/ADHD but can boost energy and act as an appetite suppressant among those without the condition.
- Phentermine (Adipex-P) — Phentermine is an atypical amphetamine and prescription-only appetite suppressant meant to treat obesity. It’s only to be used as part of an overall regimen that also includes diet and exercise.
- Laxatives — Laxatives of various mechanisms of action that stimulate bowel movements can be obtained OTC or by prescription. But they are not meant to be used for weight loss and can cause digestive issues and rapid dependence.
- Diuretics — These medications, which can be obtained via prescription or OTC, increase urination and reduce fluid retention. But they’re not intended for weight control and can cause dehydration and electrolyte imbalances.
Social Media Impact on a Teen’s Self-Image
Social media can have a profound negative impact on a teen’s self-image in many ways, but one of the most damaging is through unrealistic comparisons to others. Teens who engage with social media are regularly exposed to photoshopped or filtered images of people living fabulous lives, which can lead to feelings of inadequacy and low self-esteem. Current beauty standards and the pressure to put forth an “ideal” image can also contribute to body dissatisfaction. Social media often promotes certain body types or features as desirable, leading to pressure to conform and harmful behaviors such as extreme dieting, excessive exercise, or seeking out cosmetic surgery. Cyberbullying is another way adolescents can be affected by social media. Disparaging comments and online harassment can damage a teen’s self-worth and confidence, and in extreme cases, it has even led to suicidal thoughts and behaviors.Digital Pressure & Substances
Digital pressure is a term that refers to the expectations and stress that come with navigating social media. This pressure can impact body image, self-esteem, and social connections. In some cases, it can also contribute to substance use. For example, unrealistic comparisons or cyberbullying can lead some teens to turn to drugs or alcohol as a means of escape. Similarly, digital pressure can worsen underlying mental health issues such as anxiety and depression, and substances may be used as a form of self-medication to relieve these symptoms. Online platforms may also make it easier for teens to access substances and connect with others who can provide them.Prevention & Support
Parents can proactively address the impact of social media on their teen’s body image through media literacy education, open communication, and the adoption of healthy habits. Moreover, teens should be taught to critically analyze social media content and recognize that it often presents an idealized and unrealistic version of reality. It’s important to create a safe space for them to talk about their social media experiences and the pressure they may feel and to encourage them to share concerns and questions without fear of judgment. Finally, healthy habits such as eating a balanced diet, getting regular exercise, and employing self-care practices can prompt overall well-being and a positive body image./p> When offering support, consider the following:
- Validate their feelings about body image and digital pressure and let me know they are not alone in their struggles.
- Help them identify their strengths and uniqueness, foster a sense of self-worth aside from appearance, and encourage them to challenge negative thoughts and replace them with positive affirmations.
- Encourage them to connect with positive role models and follow social media accounts that promote body positivity, diversity, and a healthy lifestyle.
- Seek professional assistance from a therapist, counselor, or treatment center such as Guardian Recovery to help them improve their body image and recover from substance use.
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Taking the first step toward mental wellness and recovery from substance use can feel challenging, but your teen—or your family—doesn’t have to face it alone. Using a holistic approach, our compassionate team provides expert guidance and care to promote lasting sobriety and well-being. Recovery is an ongoing journey, which is why we plan for your teen’s next steps from day one, adjusting our strategies to meet their evolving needs long after formal treatment concludes.
Is your teen ready to start their journey to a brighter future? Our admissions process is simple and has been designed to be as stress-free as possible. Contact us today for a free, no-obligation consultation. Our treatment advisors will answer your questions about treatment options, insurance coverage, and self-pay options. We’re here to help you and your teen find the right path to recovery.
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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.
- Nieri, T., Kulis, S., Keith, V. M., & Hurdle, D. (2005). Body image, acculturation, and substance abuse among boys and girls in the Southwest. The American journal of drug and alcohol abuse, 31(4), 617–639. https://doi.org/10.1081/ada-200068418.
- Mayo Clinic. (2024). Body dysmorphic disorder – symptoms and causes.
- Mayo Clinic. (2024). Anorexia nervosa – symptoms and causes.
- Mayo Clinic. (2024). Bulimia nervosa – symptoms and causes.