Do Body Image Issues Ever Go Away? (An Honest Discussion from a Philadelphia Therapist)

Written by Dr. Colleen Reichmann, owner and clinical director of Wildflower Therapy

If you’ve ever Googled “Do body image issues ever go away?”- first, hi. I’m glad you’re here. I’m a therapist and the owner of Wildflower Therapy, a group practice in Philadelphia that specializes in eating disorder therapy and body image counseling across Pennsylvania. I hear this question a lot, and I want to answer it with the kind of honesty I wish more people offered:

Body image is a relationship, not a finish line.

And like any relationship, it will have seasons-tender ones, complicated ones, stormy ones, calm ones. There will be days you feel at home in your body and days you feel like you just moved into a home that you never got to tour- one that feels weird, with too many rooms. That doesn’t mean you’re failing. It means you’re human.

The Myth of “All Better”

Our culture loves a makeover montage: cue the music, change the wardrobe, and-poof!-all that insecurity evaporates. Real life doesn’t work like that. Even people who have done deep healing, who’ve stepped out of diet culture, or who are years into recovery from an eating disorder, still report fluctuations. You’re not broken if your feelings about your body change during a stressful season, a health diagnosis, a pregnancy, the postpartum months, perimenopause, after an injury, or just because the weather and your jeans are conspiring against you.

This is not bad news. It’s permission. When you stop expecting perfection, you can start practicing gentleness.

Your Body Image Is a Relationship

Imagine your relationship with your body like you would a relationship with a close friend, partner, or family member. You love them. Sometimes they drive you up the wall. Sometimes you misunderstand each other. Sometimes they change and it takes time to catch up. That doesn’t mean you break up-or that you should feel guilty for having feelings. It means you work on the relationship.

We don’t expect our relationships with people to be emotion-free. So let’s stop expecting that from our relationship with our bodies.

Yep- It’s Okay to Feel Angry at Your Body

Let’s legalize something: anger toward your body. Maybe your body has chronic pain, fertility challenges, scars, neurodivergence-related accomodation needs, or a history that feels complicated. Maybe your body holds memories of trauma. Maybe it doesn’t move or look the way you were promised it would if you “did everything right.” Anger can be a signal that something matters to you, that a need isn’t being met, or that an expectation you picked up from the world was unrealistic.

Anger doesn’t make you “anti-recovery.” It makes you honest. The goal isn’t to never feel anger; it’s to stay in relationship with your body while you feel it. To say, “I’m mad, AND I’m not leaving.”

Body Grief Is Real

Grief is a normal response to change. Bodies change. Sometimes we grieve who we were (or who we thought we were “supposed” to be). We might grieve a body before an injury or illness, a body before pregnancy, a body before menopause, a thinner or underweight body that felt safer. Body grief doesn’t mean you don’t accept yourself. It means you’re processing reality with tenderness.

At Wildflower Therapy in Philadelphia, we hold a lot of space for body grief-naming it, legitimizing it, and helping you move with it rather than against it. You can grieve and still choose supportive behaviors. You can ache and also eat lunch. You can cry and also rest. Both/and.

An additional note about body grief: Systemic fat phobia makes body image an everyday endurance test for people in larger bodies- and there is alot of grief around this experiece for many. Anti-fat bias is baked into so many places we move through: doctor’s offices that prescribe weight loss for every complaint, airline seats that don’t fit real bodies, clothing racks that stop at a certain size, fitness spaces that equate “health” with thinness, algorithms that reward “after” photos, and jokes that dehumanize. When the world reflects back constant messages that you’re a “problem” to be fixed, it’s understandable if body image feels raw and grieving (and more specifically grief about what society could look like without fat phobia) feels ongoing. If you’re in a larger body, your struggle is not a personal failing; it’s a logical response to chronic stigma. In therapy, part of the work is building individual skills (self-compassion, boundaries, nervous-system care) and naming the systemic harm so you’re not carrying it alone. We practice advocating for respectful healthcare, curating weight-inclusive spaces, expanding representation in your feed, and connecting with size-affirming community- because your body deserves safety, dignity, and joy right now, not after it changes.

Why Body Image Ebbs and Flows

A few common reasons you might notice shifts:

Life transitions. Starting college, graduating, new jobs, caregiving, pregnancy/postpartum, divorce, perimenopause, retirement-every transition rewires routines and self-perception.

Stress and coping bandwidth. When systems are overloaded, intrusive body thoughts can get louder.

Health changes. Medication shifts, injury, illness, or hormonal changes can affect energy, appetite, digestion, and weight.

Environment. New gym, new friend group, new social feed. A different mirror or lighting can be surprisingly loud.

Diet culture (everywhere). Billboards, boutique fitness studios, “wellness” trends, even conversations at school pickup-the constant exposure adds up.

Seasonal rhythms. Summer swimsuit messaging, winter layers, holiday talk-all can amplify body thoughts.

Seeing the patterns helps you respond with context instead of self-blame.

So… Do Body Image Issues Ever Go Away?

Here’s the honest, hopeful answer:

You will always be in a relationship with your body, so you will always experience peaks and valleys. But-the noise can get much quieter.

The spikes can become less frequent and less intense.

Your skills can grow so strong that even when tough body image days happen, they don’t run the show.

You can build a life that isn’t on pause until your body meets some imaginary requirement.

In therapy, we’re not chasing “perfect body image.” We’re building resilience-the capacity to feel what you feel and still care for yourself.

What Healing Often Looks Like Over Time

From obsession to noticing. Instead of hours spiraling, it becomes “Oh, a body thought,” and you move on.

From punishment to care. Exercise becomes about mood and mobility; food becomes about nourishment and pleasure.

From isolation to connection. You share, you ask for help, you set boundaries with diet talk.

From control to trust. You learn your body’s signals, explore interoception (your felt sense), and practice responding rather than overriding.

From rigidity to flexibility. There’s room for dessert and veggies, yoga and naps, jeans and sweatpants.

A Gentle Framework for the Tough Days

When body image flares, try this three-part check-in. It’s simple, portable, and compassionate:

Name It. “I’m having a hard body image day.” If you want, add context: “I didn’t sleep well,” “I saw an old photo,” “My jeans are tight.”

Normalize It. “This is a common human experience. Bodies change. Feelings come and go.”

Choose Care. Ask, “What would feel supportive in the next 15 minutes?”- drink water, have a snack, step outside, put on soft clothes, text a friend, schedule therapy, log off the app.

If Anger Shows Up:

Write the unsent letter. “Dear body, I’m furious that ___.” Then add, “Here’s what I’m willing to do for us today anyway: ___.”

Move the feeling, not the shape. A walk, a stretch, punching a pillow, dancing in the kitchen-let anger exit your body safely.

Boundary the noise. Mute, unfollow, or step away from diet-y spaces. Give yourself a media detox for 24 hours.

Co-regulate. Call someone who can listen without fixing. Let another nervous system help yours settle.

If Grief Shows Up:

Name the loss. “I miss how running felt.” “I miss how my clothes fit two years ago.”

Create ritual. Light a candle, press a flower in a journal, take a photo walk. Ritual helps us honor change.

Invite replacement joys. If running is off the table, is there swimming, pilates, or a slow neighborhood loop with a podcast?

Say thank you. Gratitude doesn’t cancel grief, but it can sit beside it: “Thank you, body, for getting me through today.”

Practical Supports You Can Start Today

Body-neutral language. Try “This is my body” instead of “good/bad” labels. Neutral is often more sustainable than forced positivity.

Clothes that fit you. Not the other way around. Tailor something. Donate what digs or pinches. Keep a “soft outfit” at the ready.

Mirror time, on purpose. A two-minute routine where you look with soft eyes and say, “I’m here.” Then move on.

Feed yourself regularly. Body image plummets when you’re under-fueled. Regular meals and snacks stabilize mood and thoughts.

Expand your feed. Follow diverse bodies, disabled creators, older athletes, postpartum voices, non-diet dietitians, local Philly accounts that celebrate community over aesthetics (hello, park dogs and farmers markets).

Anchor in values. Make a list of body-independent values (friendship, creativity, humor, justice, curiosity) and choose one tiny action each day.

When Body Image Tangles with an Eating Disorder

If body image distress has you restricting, bingeing, purging, over-exercising, abusing substances, or avoiding social life, it might be more than a “rough patch.” Eating disorder therapy can help you untangle the deeper patterns. At Wildflower Therapy in Philadelphia, we often collaborate with local non-diet dietitians and medical providers to create a team around you.

How Therapy Helps (What We Do at Wildflower Therapy)

We help you to make space for the whole story. Not just symptoms, but identity, culture, family narratives, trauma history, Philadelphia’s particular flavor of comparison culture (we see you, Center City studio mirrors and UPenn culture of glorification of under-nourshing), and your dreams outside of body talk. We also help you shore up those coping skills-Distress tolerance, body image flexibility, nervous system regulation, and compassion practices that actually fit real schedules. Then we work to rescript your inner voice. We help you notice and name the diet culture narrator- and build a kinder, sturdier narrator rooted in your values. We also practice in-sessions. (From mirror exposure that respects your consent to trying on new language, we move at your pace.) And finally, we plan for the waves. We expect ebb and flow. Together, we create a personalized “hard day” plan so you know what to do when the tide rises.

Common Questions We Hear (and how we answer them)

“I can’t accept my body. Is neutrality enough?”

Yes. Body neutrality is a valid, compassionate destination. Many clients find neutrality far more sustainable than relentless positivity.

“What if my body keeps changing?”

It will. Bodies change across a lifetime. Therapy helps you build rituals and skills that flex with those changes, so you’re not starting from zero each time.

“I’m pregnant/postpartum/in menopause. Why is this so hard?”

Hormones, sleep, identity shifts, and a tidal wave of cultural commentary-of course it’s hard. Your struggle makes sense. There are targeted strategies we can use for these seasons.

“I’m angry at my body. Does that mean I’m ‘doing recovery wrong’?”

Absolutely not. Anger can be a doorway to deeper care. We’ll help you walk through it safely.

“Do I need eating disorder therapy or just body image counseling?”

We’ll talk it through. If your behaviors are interfering with health or life, we’ll recommend a team approach. If it’s primarily distress and negative self-talk, targeted body image counseling may be a great fit.

A Note on Comparison and Community:

It’s so. SO easy to compare: fitness challenges at the office, group runs, campus culture, the never-ending stream of “before/after” posts. One antidote is community that refuses to bond over body criticism. In session, we practice how to redirect diet talk, ask for support, and build friendships that center shared values instead of shared macros.

A Tiny Script for the Next Time You’re Stuck

Try this aloud, even if it feels corny:

“I’m allowed to be mad at my body today. I’m also allowed to take care of us. I choose food, water, softness, and one thing that brings me back to myself.”

Then do one small action that matches those words.

So, Do Body Image Issues Ever Go Away?

Sometimes the sharp edges soften so much that you rarely think about your body. Sometimes the feelings still visit, but they don’t unpack their suitcase. Either way, you can build a life where your worth isn’t on the line every time you look in a mirror. That’s what we do together in body image counseling and eating disorder therapy- right here in Philadelphia, and virtually throughout PA, VA, VT, FL, NJ, DE, MA, OH, and SC.

If You’re Ready:

At Wildflower Therapy, we offer compassionate, evidence-informed eating disorder therapy and body image counseling in Philadelphia and across Pennsylvania. We work with teens, college students, adults, parents, LGBTQ+ folks, athletes, new moms-humans with bodies at every size and stage. You don’t have to earn help by “getting worse.” If you’re wondering if you deserve support, that’s your sign.

Reach out to Wildflower Therapy (Philadelphia, PA) to schedule a consultation, ask questions about the process, and get matched with a therapist who feels like a good fit. If we’re not the right place, we’ll help you find one that is. Your body image will ebb and flow—but you DO NOT have to ride those waves alone.