Perfectionism and Eating Disorders
Written by ‘Ai Pono Hawaii Staff Writer
While it may seem harmless - even admirable - to set high standards for yourself and constantly strive for perfection, research shows this type behavior (known as perfectionism) plays a detrimental role in the development and maintenance of eating disorders (ED). Here we dive deeper into perfectionism and eating disorders, uncovering the connection between the two and sharing three practical ways you can reject perfectionism and better support your eating disorder recovery.
What is Perfectionism?
Perfectionism is a personality trait characterized by unrealistically high standards and a constant need to achieve perfection in some or all areas of life. While a small degree of healthy perfectionism may motivate you to reach for your goals, too much perfectionism can quickly turn into a psychological problem with far-reaching consequences. In fact, mental health professionals have gone so far as to give this type of perfectionism a name - clinical or dysfunctional perfectionism. In its clinical form, perfectionism has three defining aspects:
Continuously expecting that you (or others) achieve high standards that other people consider unreasonable or extreme.
Basing your self-worth primarily on your ability to achieve these high standards.
Insisting on aiming for impossibly high standards, in spite of negative consequences.
Other characteristics of clinical perfectionism include avoiding failure and criticism at all costs (this might lead to procrastination, unwillingness to try new things, extreme anxiety about work or academics, etc.), being excessively critical of mistakes, an unwillingness to accept compliments or celebrate successes, and continuously looking to others for validation. Internal pressures such as feelings of unworthiness, low self-esteem, and fear of failure are one of the main sources driving perfectionism.
While these internal pressures may primarily stem from an individual’s personality traits, external influences like negative childhood experiences and social pressures likely play an important role in perfectionism, as well. A Psychology Today article reports that perfectionism is often accompanied by anxiety, depression, obsessive-compulsive disorder, suicidal impulses, and eating disorders.
Perfectionism and Eating Disorders: What’s the Connection?
Perfectionism has long been associated with eating disorders. One of the great pioneers in the eating disorder field, Hilde Bruch, stated in her groundbreaking book, The Golden Cage: The Enigma of Anorexia Nervosa, that patients with eating disorders exhibit “superperfection.” More recent studies on perfectionism confirm individuals with eating disorders demonstrate higher levels of perfectionism compared to those without eating disorders. Perfectionism has also been identified as a predictor of anorexia nervosa and as a risk and maintenance factor for bulimia behaviors. Furthermore, clinical perfectionism is related to higher levels of treatment drop-out in ED patients and is also associated with poorer prognosis among anorexia nervosa patients.
These findings have prompted some eating disorder specialists to make perfectionism (specifically decreasing perfectionism levels) a key focal point in their eating disorder treatment approach. One study found that patients who had fully recovered from an eating disorder no longer had elevated levels of perfectionism, while those who were not yet fully recovered or were still in treatment displayed high levels of perfectionism compared to healthy individuals. The researchers noted that if not addressed during treatment, “elevated perfectionism may increase the risk for relapse or may impede progress toward full recovery.” They go on to state, “from this perspective, interventions and/or experiences that help decrease perfectionism may be key to making full recovery attainable.” In short, perfectionism seems to play a critical role in not only the development of eating disorders, but also their maintenance and subsequent treatment.
What Does Perfectionism Look Like in Individuals with Eating Disorders?
For individuals with eating disorders, perfectionism is primarily focused on the body. This often looks like:
Trying to achieve a “perfect” weight and shape
Basing self-worth on body image, waist size, weight, etc.
Attempting to eat perfectly (e.g. labeling foods as “good” or “bad” and only eating “good” foods)
Tying to exercise perfectly (e.g. never miss a day, workout for a specific time, have perfect form, etc.)
Seeking body validation and praise from others
Obsessing over and being overly critical of “flaws” in one’s appearance
Comparing one’s body, weight, shape, eating habits, exercise routines, etc. to others (especially fitness professionals, celebrities, models, social media influencers, and other people that appear to have the “perfect” body)
While perfectionism in individuals with eating disorders often focuses on the body, it may also appear in other areas of life such as:
Academic and career performance
Athletics
Relationships
Organization and neatness
Time management
Speaking
Writing
Personal hygiene and health
Overcoming Perfectionism During Eating Disorder Recovery
As research shows, letting go of perfectionism is often a key step in recovering from an eating disorder. Not only will it allow you to step away from harmful comparisons and impossibly high body image standards, but it will also bring you one step closer to trusting and accepting your body just the way it is. If you are currently recovering from an eating disorder and struggling with perfectionism, here are three tips to help you let go of perfectionism.
Seek Professional Treatment
One of the best ways to overcome perfectionism is to seek professional help, especially if perfectionism is intertwined with your eating disorder. Cognitive Behavioral Therapy (CBT) is one of the most common treatments for both eating disorders and perfectionism, and has been used to successfully reduce perfectionism in both eating disorder and non eating disorder patients. If you are currently in ED treatment, talk to your treatment team about treating perfectionism alongside your ED, and if you don’t yet have a treatment specialist, search for a therapist in your area or online that uses a CBT approach.
Embrace Imperfections
One of the best ways to overcome perfectionism is to embrace the imperfections of life. To do this, try practicing something called exposure. “Exposure means doing something uncomfortable in the short term in order to get comfortable with doing it in the long run,” writes author and speaker Jenni Schaefer. Schaefer explains that addressing perfectionism through exposure therapy was a critical part of her eating disorder recovery process. “My therapist assigned me to purposefully send emails with typos. This was excruciatingly difficult at first. But, in the end, I stopped over-checking and over-analyzing my messages and I became more efficient at responding.”
Schaefer goes on to say that learning to embrace these little imperfections--sending emails with typos and hanging slightly crooked curtains--taught her that life isn’t meant to be perfect and helped her to let go of perfectionism and embrace the beauty of imperfection. “I was reminded that perfectly imperfect is okay.”
So start challenging your perfectionism in small ways. Maybe it’s as simple as not triple-checking every email you send out (like Schaefer) or inviting a friend over even if your house or apartment isn’t spotless. Whatever it is for you, remember that life will never be perfect, no matter how hard you try. So let go of the impossibly high standards and instead, embrace imperfections, knowing that they’re simply part of being human.
Stop the Comparison Game
The final piece in letting go of perfectionism is to stop comparing yourself to other people. Thanks to social media, it’s easy to spend hours every day comparing your body, clothes, career, friends, house, diet, exercise, and everything else to strangers and friends posing behind a filter. This comparison game can be extremely toxic, especially if you struggle with perfectionism and/or an eating disorder.
So if you find yourself slipping into the comparison game on social media (or any other outlet/social setting) consider deleting the app or unfollowing accounts that prompt you towards comparisons. And always remember, you don’t know the whole story behind a picture, a promotion, an achievement, or a score. There’s always behind-the-scenes information you don’t have. So keep your eyes in your own lane and let go of the need to compare! And if you must compare yourself to anyone, compare yourself to who you were yesterday, last week, or last year (not to some stranger on the internet!). Look back and see how far you’ve come and gain inspiration for the incredible story playing out right in front of you.
If you or someone you love is suffering from an eating disorder, take the first step today and talk to talk to someone about recovery or simply learn more about the eating disorder recovery programs we offer.