It takes continuous practice to maintain a positive body image. Think of it as a skill that needs attention and sharpening.

And that’s a great thing. It means that you can lift a low body image at any time. While it’s not easy, there are practical, concrete ways you can improve how you see your body — and yourself.

Below, Joyce Marter, LCPC, a psychotherapist and owner of Urban Balance, LLC, a multi-site counseling practice in the greater Chicago area, offers five ideas to do just that.

I live in a town where eating disorder treatment is almost nonexistent. Feeling in danger of a relapse, I decided it was time to see a therapist. She was a licensed psychologist specializing in eating disorders and women’s issues. I went voluntarily, not expecting what I received.

Everything was booked and set via email. My choice. I hate calling people. She mailed me all the paperwork from her office to bring with me on my first visit. What I loved when I first met her was that she didn’t even want to look at the filled-out documents during session; she was eager to get down to talking. I was nervous being there, naturally, it’s sensitive material being shared with a stranger. I remember which chair I sat in and how she sat on the couch.

Eager. Ready.

There is a strong correlation between trauma and eating disorders. A number of studies have shown that people who struggle with eating disorders have a higher incidence of neglect and physical, emotional and sexual abuse. In particular, binge eating disorder is associated with emotional abuse while sexual abuse has been linked to eating disorders in males.

So what constitutes trauma?

Trauma comes in many forms, including childhood abuse or neglect, growing up in an alcoholic or dysfunctional home, environmental catastrophes such as Hurricane Katrina, a serious accident, loss of a loved one, and violent attacks such as rape and sexual assault. What all of these experiences have in common is that they leave the individual feeling helpless and out of control.

Trauma isn’t the same as having post-traumatic stress disorder (PTSD). PTSD is a specific diagnosis with distinct criteria, involving a serious or life-threatening experience that results in nightmares, flashbacks, attempts to avoid situations similar to those that led to the trauma and a hyperactive startle response, among other symptoms.

Recently I had the chance to ask Margarita Tartakovsky, an associate editor at Psych Central, a few questions about eating behavior.  She blogs regularly about eating and self-image issues on her blog Weightless.

Q. Why doesn’t the current model of treating obesity — only telling people what and how much to eat — work for most people?

A. Great question, because the current model definitely doesn’t work. I can’t remember who said it, but there’s a saying that if you want to gain weight, go on a diet. Diets have a failure rate of about 95 percent. People may lose weight initially but then they usually gain it back and then some.

So this model doesn’t work for many reasons. For one thing, genetics plays a prominent role in our weight. This is why you can have two people who eat the same foods in the same quantities look very different. One may be thin; the other may be considered “overweight.” Our bodies are more complicated than the “calories in, calories out” equation assumes.

Integrative medicine can be defined as “a healing-oriented discipline that takes into account the whole person — body, mind and spirit — including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of both conventional and alternative therapies.”

Complementary and alternative therapies used in integrative medicine can include acupuncture, chiropractic, herbal medicine, dietary supplements and others that give the clinician a wide array of treatments for difficult conditions. This is particularly true in the integrative medicine approach to eating disorders.

Eating disorders have been documented in adolescents and adults for many years. More recently, there is evidence that these disorders can also affect young children.

The cornerstones of an integrative medicine model for eating disorders includes some components that are found in every approach to the treatment of eating disorders, but may be used in a unique manner. Others are more specific to the use of complementary and alternative medicine (CAM) therapies. The most important difference in this model when compared to other treatment strategies is the philosophical underpinning of integrative medicine — that is, the belief in the self-healing nature of body, mind and spirit.

Are you a moderator or an abstainer?

In honor of many people’s New Year’s resolutions — “Eat more healthfully,” “Cut out sweets,” “Lose weight,” and the like — I’m re-posting this quiz, to help you determine whether you’re a moderator or an abstainer. When I figured out that I’m an “abstainer,” it helped me tremendously in terms of eating better.

Often, we know we’d have more long-term happiness if we gave up something that gives us a rush of satisfaction in the short-term. That morning doughnut, that late-night ice cream.

A piece of advice I often see is, “Be moderate. Don’t have dessert every night, but if you try to deny yourself altogether, you’ll fall off the wagon. Allow yourself to have the occasional treat, it will help you stick to your plan.”

I’ve come to believe that this is good advice for some people: the moderators. They do better when they try to make moderate changes, when they avoid absolutes and bright lines.

Food likes and dislikes are often thought to play a huge role in eating behaviors.  The pleasure we derive from food may be one of the most — if not the most — important factors contributing to food intake (Eertmans, et al., 2001; Rozin & Zellner, 1985; Rozin, 1990). 

Interviews with customers in supermarkets and restaurants have shown that people consider the sensory properties of food as an important value influencing their choice of food purchased (Furst, et al., 1996).  If food is not perceived as appealing in terms of appearance, smell, taste, and texture it probably will not be eaten (Hetherington & Rolls, 1996). 

Although food preferences are by no means the only influences on eating behavior, likes and dislikes are very important factors. This article will briefly discuss the influence food preferences have on eating behavior.  

It has been suggested that we are often unaware of external factors that influence eating behavior (Wansink, 2006; Vartaninan et al., 2008).  There is a substantial body of research that shows external factors have a robust influence on eating behavior (Epstein et al., 2009; Remick et al., 2009; Rozin et al., 2003). 

These external factors include things such as portion size, labeling, variety of food we eat, and how much attention we pay when we’re eating (or whether we’re distracted by socializing, for instance). Even the plate size can affect how we eat.

Now, some researchers have suggested that external factors may play a larger role in eating behavior than internal factors, such as hunger, satiety, flavor, macro-nutrient content, and so on (Wansink et al., 2007; Levitsky, 2005; Wansink, et al., 2005). 

What’s behind these external or environmental factors and their role in how we eat?

There’s a lucrative cottage industry in the U.S. for the residential treatment of almost anything you can imagine. Everything from “Internet addiction” and drug and alcohol problems, to eating and mood disorders. If you can treat it in an outpatient setting, the thinking goes, why not treat it in a “residential” setting for 30 or more days where you control every aspect of the patient’s life?

The “residential” treatment approach has long been available for eating disorders, since the treatment of these disorders tends to be long and complicated. Andrew Pollack writing for the New York Times notes how these kinds of programs have now become the focus of insurance companies looking to cut back on treatment options.

It’s no surprise, really. With the rollout of mental health parity — requiring that insurance companies can no longer discriminate against people with mental disorders for their treatment options — those companies are looking for other places they can cut costs. Residential treatment for eating disorders appears to be one obvious area.

So is residential treatment a legitimate modality for helping people with eating disorders? Should insurance companies cover the costs of such care?

This guest article from YourTango was written by Mary Jo Rapini.

The recent statistics from the CDC (Center for Disease Control and Prevention) has reported that about one-third (33.8%) of U.S. adults are obese. That number rises every day, and keeping up with it is more difficult than keeping up with your stocks. I work with the finest bariatric surgeons in the U.S. They are dedicated to helping their patients lose weight in an effort to thwart diseases, and minimize current disease progression. I also run several 12-step food addiction groups in the city of Houston and online in many cities.

I talk to morbidly obese patients everyday. I teach them, counsel them, eat with them, and spend endless hours reading their journals. These patients have a story to tell, but we aren’t listening and we continue asking the wrong questions.

6:05 am: You lie awake in your tiny bed, underneath the salmon covers, your neck sore from sleeping on one pillow (you asked for another but you’ll need a doctor’s order to have more than one.) Your sleep medicine has worn off and you are now once again a prisoner to your insomnia.

All there is to do now is listen to your roommate snore and mutter to herself in her sleep and the sounds of the nurses talking and phones ringing at the nurses station. You remember a Seroquel-induced nightmare you had previously in the night in which you were trapped in a house that was filling with water, drowning and gasping for air. You make a mental note to mention the dream to your doctor later on.

7:00 am: Morning checks. A tech bangs on your door just as you have started to drift off into a sweet sleep again and informs you that you must be up for breakfast in thirty minutes. You incoherently moan something that resembles an “OK,” roll over and close your eyes again.

Take a minute and answer this question: Is anyone really normal today?

I mean, even those who claim they are normal may, in fact, be the most neurotic among us, swimming with a nice pair of scuba fins down the river of Denial. Having my psychiatric file published online and in print for public viewing, I get to hear my share of dirty secrets—weird obsessions, family dysfunction, or disguised addiction—that are kept concealed from everyone but a self-professed neurotic and maybe a shrink.

“Why are there so many disorders today?” Those seven words, or a variation of them, surface a few times a week. And my take on this query is so complex that, to avoid sounding like my grad school professors making an erudite case that fails to communicate anything to average folks like me, I often shrug my shoulders and move on to a conversation about dessert. Now that I can talk about all day.

Here’s the abridged edition of my guess as to why we mark up more pages of the DSM-IV today than, say, a century ago (even though the DSM-IV had yet to be born).