How to stop fixating on your body in the era of GLP-1s

0:00This message comes from Charles Schwab with their original podcast, Choiceology. Choiceology is a show about the psychology and economics behind people's decisions. Download the latest episode and subscribe at schwab.com slash podcast. Your creative force, your ability to connect, your gifts get a little bit diminished. Like every little bit of energy you're putting into sucking in your nose or your stomach or Or, you know, oh no, I'm distracted by my shiny face. Pulls away energy from you. And what people want is you.

0:41Diana Hill:Hey, it's Mariel Cigarra. You're listening to Life Kit. And that was Diana Hill. She's a clinical psychologist. And this is a topic she's been thinking about a lot. How has this come up in your practice with your clients? Body's dissatisfaction has been around for a long time. And it's actually not the body dissatisfaction that I target in my practice as much as when you are dissatisfied with your body, when you have a negative thought about your arms looking older, or you have a negative thought about the bags under your eyes, how much energy and time are you putting into that negative thought?

1:17Whether it's obsessing about it in the mirror or going on Instagram, trying to find some ways to fix it versus being able to engage in your life and the things that you care about. And in the field of psychology, there's a term called body image flexibility.

1:31Diana Hill:Body image flexibility doesn't require you to love how your body looks or even to get to a neutral place where you don't really care. It's more about what you do when you have negative thoughts about your looks. When those thoughts come up, how well are you able to just notice the thought and engage in what you want to engage in in your life? and how much energy is going into trying to fix that thought or fix your body in some form or another. It's getting less out of this space of either I love my body or I don't love my body, but more in a space of I'm inhabiting this body as it is now, knowing that it's going to change and it continues to change just over the course of a day.

2:12And certainly over the course of a lifetime, it will move from health to not being as healthy and move from ability to disability in different areas. It'll move from closer to beauty standards to further to beauty standards and back. It's just, that's what our body is doing.

2:27Diana Hill:Yeah. Our culture has a shallow understanding of the body and defines it almost as just something to look at. Yeah. But your body is so much more than that. So if you think about even right now in the next few seconds, as I'm talking, you could look at your body from the outside. You could look at your hands or your feet or your belly, but you can also feel your body from the inside. You could bring awareness to sensations in your belly or your back or your neck or behind your eyes, or you could feel the emotions that you're feeling in your body or the urges. So much of our discussion of the body is about this external form that we see.

3:08And many of us are disconnected and increasingly disconnected from the internal experience. But then we're also disconnected from our bodies as something that helps us connect to the world around us. My mouth and my voice right now, that aspect of my body, is what's communicating. My facial expressions, the how am I going to use my hands today to touch something, to hug somebody, to write something. Our bodies are ways of communicating. Our bodies or ways of interacting with the world. And our bodies house a tremendous amount of information about our inner lives and about each other.

3:47Diana Hill:On this episode of Life Kit, we bring you mental exercises rooted in body image flexibility. These can help you stay present in your life and deal with the very real pressure we face to obsess about and alter our appearances.

4:14This message comes from Charles Schwab with their original podcast, Choiceology. Choiceology is a show about the psychology and economics behind people's decisions. Download the latest episode and subscribe at schwab.com slash podcast. This message comes from ADT. One second, you're enjoying your day off. The next, Your phone buzzes. A window's been broken at home. You're miles away. In one second, everything can change. That's why ADT's security systems can monitor your home 24-7. They're backed by the most company-operated monitoring centers in the industry, so you're always supported during an emergency.

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5:47Diana Hill:Let's talk about strategies, particularly ones that focus on body flexibility. Often people have a particular gripe about their body or multiple gripes. It's, I don't like my stomach or my nose or these wrinkles on my face. And I don't want to look in the mirror because I feel like it's not perfect. What strategies would you give to a patient who's experiencing this? Well, the first strategy that's part of body image flexibility is flexible attention. So in all those examples, what you're highlighting is someone that's paying attention to one body part or one area. And people notice this. They'll go in the mirror and they'll be like, all I can see is my crow's feet.

6:28I'm brushing my teeth, but I couldn't even tell you what my teeth look like, but I could tell you what my crow's feet look like, right? So there's two ways that I would practice flexible attention. One way is can you turn your attention to inside your body how it's feeling, what we call interoceptive awareness. And interoceptive awareness is associated with all sorts of beneficial things, like better ability to pay attention to your hunger and fullness and stop when you're full and start when you're hungry, but also better empathy and interpersonal awareness. So paying attention to what's happening inside when you notice that you're fixated on one part on the outside.

7:06Diana Hill:Takeaway one, practice flexible attention. When you look in the mirror and all you can see is your nose or your belly or your acne or your wrinkles, turn your attention to what's happening inside your body instead. Are you hungry or full? Does your stomach feel tense or relaxed? Are you feeling nervous, excited, happy, calm? Think about all the things your internal organs are doing right now. Your heart beating steadily. But then there are also people who are dealing with chronic illness or chronic pain. And so going inside their body might feel really bad too. One of the primary treatments for chronic pain is acceptance commitment therapy.

7:49And part of that work is to do this type of flexibility of attention, but also flexibility with feeling states. So something like pain, often pain isn't just the pain itself. It's the story that we're adding on to the pain of like, I can't handle this. This is going to keep on going forever. and a really helpful flexible way of responding to pain is actually to go to the pain in your body

8:19Diana Hill:and explore it allow it to be there notice the edge of it if it were colored in with like a sharpie what would the color be where is it most intense now pain can get to a point where it's so intense that all you can do is be in the present moment with it but usually pain is moving and changing everything is impermanent including your pain and there's gonna be periods when it peaks and periods when it gets a little bit less then you can also notice wow I can put my attention on my pain but I could also find another part of my body that actually doesn't experience any pain at all it feels free it feels either numb for some of us or neutral or even positive and could I bring my attention to pain and bring my attention to another part of my body that doesn't have an intense pain to it.

9:11And now I'm in this whole realm of a body that has many different experiences happening in it. The idea here is not to get stuck in one spot, whether it's get stuck on fixing or stuck on a thought or even stuck on a sensation.

9:27Diana Hill:Diana says when you're doing this exercise, you can also turn your attention to what's outside of your body. What's around you? What's going on? What's in your life? How are you going going to use this body and how are you using it in this moment? So right now I'm sitting on the floor. I have a window outside of me. There's a tree. My eyes are seeing a tree. My eyes may not always be able to see a tree the way I can see a tree now, right? So I can appreciate that tree and I'm listening to sounds. My ears are receiving sounds. My body is breathing in air. I'm in a conversation with you. These are ways in which my body is connecting me to this world.

10:03And the more and more you practice paying attention to your thinning hair or whatever it is you're paying attention to, the stronger that neuronal connection will get. And where do you really want your stronger neuronal connections to get? You want to have better awareness of the inside of your body, what it's telling you, and also how it's functioning and connecting you to what matters to you in this world. When I work with clients that are highly fixated on the body as a form, one of the things that happens is they actually are more disconnected from people. Because if you're in a conversation with someone and you are so focused on your nose or so focused on the wrinkles of your neck, maybe you're being intimate with someone and you're so focused on whether or not your belly is sticking out, then you are not engaging in the connection with another human being, which we know is so important for our wellbeing and our mental health and our feeling of satisfaction and even our physical health.

11:02Diana Hill:If you want to do this kind of work, what are some questions you can ask or ways you can approach it? Like, let's just say you are always sucking in your stomach and you're so like uncomfortable with your stomach. Well, I think the first thing is that you've already had to develop the awareness that you're always sucking in your stomach and start to notice, are there times when you're doing that more and times when you're doing that less. I don't know if you're always stuck in your stomach. There may be times where you let it go a little bit because maybe you feel a bit safer. Maybe you're alone.

11:34Maybe you're on a hike. Maybe you're in bed. So what are the contexts? Are there thoughts that you believe to be true that you're holding onto about sucking? If I stuck in my stomach, then finish that sentence. If I don't suck in my stomach, then finish that sentence. What is the biggest feared experience? for you. Is there something about messaging around your stomach that you received or you saw or continue to see from culture and society? Is that messaging you want to believe and let guide your life? And then how is it impacting you in your day? Are you less comfortable in your clothes? Are you distracted?

12:15Are you hiding behind a desk? You're not standing up and speaking in front of a group. There's a whole slew of things that's happening at the biological level, at the psychological level, at the social level, when we are just automatically shutting off a part of our body.

12:34Diana Hill:Takeaway two, become aware of how your attention to your body image is stealing your energy. Notice when you hide parts of your body where you feel especially self-conscious about them. Ask yourself what you think will happen if you don't hide that part. And think about what you could do if you weren't held back by your body image. What else might you spend that time on? And what could you do more easily? Give a big presentation at work? Go swimming? Laugh and smile freely? After the break, we talk about social media and also weight loss medications and cosmetic procedures.

13:23This message comes from Charles Schwab with their original podcast, Choiceology, hosted by Katie Milkman, an award-winning behavioral scientist and author of the best-selling book, How to Change. Choiceology is a show about the psychology and economics behind people's decisions. Hear true stories from Nobel laureates, historians, authors, athletes, and more about why people do the things they do. Download the latest episode and subscribe at schwab.com slash podcast or wherever you listen.

13:52Diana Hill:I just want to say it can be really hard to focus on anything else when we are bombarded with these images of people who just lost a ton of weight on a GLP or who have no forehead wrinkles because they do Botox. And then if you're looking at this kind of content on social media, then you just get served more of it. Yeah, we're being served up things that are very captivating. And not only are they captivating, they're hitting us right in our sore spot. and they have the ability to figure out what your sore spot is because they're tracking how long you're paying attention to it. You know, get out of your phone into your life is probably the best thing that you can do.

14:30But if you want to feel better about your body, be in your body. There's so much to explore about the body. Everything from if you have the ability to hear, you can explore sounds. Bird watching is a big thing right now, right? So exploring bird sound, That's a way to relate to your body differently. Exploring foods and the taste of foods, exploring touch and the many different ways in which our body loves to be touched. The five senses, those are all great things that when we're in our phones, we're not doing. Another practice that I like to do with clients is a little bit of an energy audit.

15:06This is an exercise where you start to look at how your energy is actually getting drained when it comes to your body. So how much energy are you putting into comparing your body during the day? When do you feel energy drain in terms of your time? How much time you're maybe looking for products or on Instagram, looking for likes and seeing those as like sucking down of your life force. And then what actually fuels your energy in relationship to your body? Maybe it's being outside. Maybe it's doing movement that you enjoy. Maybe it's playing with your dog on the floor. But having that energy audit for yourself where you actually get honest about how much time and effort is going into your body and where it's taking energy from in your life.

16:03Diana Hill:Yeah. I've been trying to get to this place and I feel like it's working with my phone and with Instagram specifically, like when I have the impulse to look at it, I just go like, there's nothing for me there. Yeah. I mean, I think the ways to look at it is like, this is a false refuge. This is a place where I'm trying to seek out refuge. It's easy, it's quick, but it's away from my values. And what actually are my true refuges? What is it that when I engage in it, it has a deeper, more satisfying, longer-term experience. In psychology, we're looking at sort of two things that drive behavior, and both of them have a good amount of research into them.

16:46The first one is being driven by avoidance, and we call it experiential avoidance. So I'm feeling uncomfortable. I'm feeling stressed. I just grab my phone. It's a quick escape. And when I feel uncomfortable, I feel stressed, and I grab my phone, often what happens is the phone is actually serving something up to me that's going to make me feel more uncomfortable and stressed. But then there's this other part of what drives our behavior, which is called experiential attachment. And this is what's dangerous. It's our drive for status to be seen, our drive for control, our drive to be in power. It's basically our ego drive.

17:28And our phone does that too. So we can feel like we're left out or we can feel we're not getting the attention that we want to get. And then we can go to our phone and go to our likes. Like the experience on Instagram where you're kind of going down like, who made a comment on my post? Oh, I'm going to go look at them and see if they, oh, who are they? And it's this ego chasing aspect as well. So experiential avoidance and experiential attachment are a lot of what's driving our behavior in the phone space. And we need to catch ourselves. Like, am I trying to avoid something that's uncomfortable and how could I actually really meet my true need here?

18:04Or am I chasing after something that is going to, in the long run, actually not give me the satisfaction that I'm hungry for.

18:18Diana Hill:Takeaway three, get out of your phone and into your life. Recognize how you feel about your body after you browse your social media feeds and swap some of the time you spend scrolling for an activity that's right in front of you. Look up, listen to the sound of birds in the park, pet your cat, taste a sweet, juicy blackberry, put on some music and dance. Your body is glorious and capable of so much. And when you treat it as a meat suit and judge it based on its appearances, you diminish it. How do you counsel patients who have a negative view of their bodies and who are also considering weight loss medication or cosmetic procedures?

19:04I actually don't take a moral stance on GLPs. I don't take a moral stance on cosmetic procedures. I take a functional stance on it. And that's because something like a GLP, for one person, a GLP may open them up to be able to go hiking with their grandkids. So what's the function of taking that medication or what's the function of the cosmetic surgery? Does it open up your life? Does it help you live more aligned with your values? Or is it one of those other two things that I talked about earlier? Is it avoidance and trying to control something and fear-based or chasing after something that you may never actually get to?

19:48So I'm really just curious about what's driving it for people. Will this open up your life more? Is this aligned with your values? How much energy is going to go into doing this thing? Is it where you want to spend your time and energy and money, given our limited time and energy and money on this planet? And what do you think it's going to offer you?

20:10Diana Hill:Takeaway four. When you're considering body alterations through procedures or weight loss medications, just make sure you know why. What will these changes offer you? Will you be able to function better, to move more easily, breathe better? Or will you feel more open to life? life also think about the time and money that you'll put in and whether that's worth it to you there are people who rightfully will say like the way i look some feature of how i look whether it's like my height or my weight or my facial features has caused me to be discriminated against absolutely and if i change this thing then my experience in the world will be better Yeah.

20:52There's ways in which we dress to be accepted. There's not only body features and body parts, but also abilities, physical abilities. And some physical abilities are more visible than others. And is that up to you to change you? Or is that really not up to you in a much bigger cultural systemic issue than yours? And that's where I find that having groups of support and friends and even on your curating your social media, being protective, you can to some degree decide who you're following and why. You can find groups of people that are resisting that belief system. And the more that you align yourself with that, the stronger you may start to feel and being okay with not going with the trend of trying to make yourself the same.

21:46Diana, thank you so much for this. Thank you for having me.

21:53Diana Hill:All right, time for a recap. Takeaway one, practice flexible attention. when you look in the mirror and all you can see is your nose or your belly or your acne or your wrinkles turn your attention to what's happening inside or outside of your body instead takeaway two consider how your attention to your body image is draining your energy and what specific activities you might try if you weren't thinking about how you looked takeaway three get out of your phone and into your life and swap some of the time you spend scrolling for an activity that's right in front of you and stimulates your senses.

22:30Diana Hill:Takeaway four, when you're considering body alterations, know your why. What will these changes offer you? Weight loss medications and cosmetic procedures are not morally good or bad. They're tools you can use if they align with your values and make sense for your life and your budget.

22:49Diana Hill:All right, that's our show. If you love Life Kit and want even more, follow us on Instagram at NPR Life Kit. We post video snippets of interviews, plus comics on things like the three types of financial guilt and how to cope. Also, if you're curious what I look like, here's your chance to find out. One listener DMed me to say that my face matches my voice, which was nice to hear. Follow us at NPR Life Kit. This episode of Life Kit was produced by Margaret Serino. Our digital editor is Malika Garib, and our visuals editor is CJ Ricalon. Megan Cain is our senior supervising editor, and Lauren Gonzalez is our executive producer.