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

It can be difficult to love how your body looks, or even like it. But what if you could expand the way you think about your body? This episode, psychologist Diana Hill shares how to practice body image flexibility and appreciate all of the ways your body allows you to experience the world. She gives mental exercises that help you fixate less on your appearance in an image-obsessed culture. Follow us on Instagram: @nprlifekit https://www.instagram.com/nprlifekit/?hl=en Sign up for our newsletter here. https://www.npr.org/newsletter/life-kit Have an episode idea or feedback you want to share? Email us at [email protected] mailto:[email protected] Support public media with NPR+ and enjoy perks for over 25 podcasts like this one. This show’s perks include sponsor-free listening and convenient playlists of popular help topics like personal finance, getting healthy, and more. Learn more at plus.npr.org http://plus.npr.org/. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:01Speaker 00

  This week on Up First, the midterms, less than 15 days away. President Trump, Vice President J.D. Vance, and former President Obama, all crisscrossing the country, rallying voters in key races from Michigan to Georgia to North Carolina. Join us every morning as we guide you through the home stretch of this election season, Up First, on the NPR app or wherever you get your podcasts.

• 0:24Speaker 01

  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 your, you know, "Oh, no, I'm distracted by my shiny face," pulls away energy from you. And what people want is you.

• 0:50Marielle Segarra?

  Hey, it's Marielle Segarra. 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?

• 1:03Speaker 01

  Body 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, whether 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.

• 1:40Marielle Segarra?

  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.

• 1:54Speaker 01

  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, and certainly over a 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 again. It's just, that's what our body is doing.

• 2:36Marielle Segarra?

  Yeah. Our culture has a shallow understanding of the body and defines it almost as just something to look at.

• 2:44Speaker 01

  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. And many of us are disconnected and increasingly disconnected from the internal experience. But then we're also disconnected from our bodies as something

• 3:27Speaker 01

  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 are ways of interacting with the world. And our bodies house a tremendous amount of information about our inner lives and about each other.

• 3:56Marielle Segarra?

  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.

• 4:23Speaker 03

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• 4:27Speaker 04

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• 5:47Marielle Segarra?

  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?

• 6:11Speaker 01

  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. I'm brushing my teeth, but I don't even, I couldn't even tell you what my teeth looked 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 interceptive awareness. And interceptive 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

• 6:56Speaker 01

  interpersonal awareness. So paying attention to what's happening inside, when you notice that you're fixated on one part on the outside.

• 7:05Marielle Segarra?

  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.

• 7:35Marielle Segarra?

  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.

• 7:45Speaker 01

  One of the primary treatments for chronic pain is acceptance commitment therapy. And part of that work is to do this type of flexibility of attention, but also flexibility with feeling states. So with 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 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

• 8:27Speaker 01

  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 going to be periods when it peaks and periods when it gets a little bit less.

• 8:47Speaker 01

  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? And now I'm in this, 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.

• 9:27Marielle Segarra?

  Diana says when you're doing this exercise, you can also turn your attention to what's outside of your body.

• 9:32Speaker 01

  What's around you? What's going on? What's in your life? How are you 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. And 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? Do you want to have a better awareness of the inside of your body,

• 10:17Speaker 01

  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.

• 11:02Marielle Segarra?

  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 uncomfortable with your stomach.

• 11:15Speaker 01

  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 sucking 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. Maybe 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 on to about sucking? If I stuck in my stomach, then, like, finish that sentence. If I don't suck in my stomach, then, finish that sentence. What is the biggest fear or experience for you? Is there something about messaging around your stomach

• 12:00Speaker 01

  that you received, or you saw, or continue to see from culture and society? Is that messaging you want to believe and guide your life? And then, like, how is it impacting you and your day? Are you less comfortable in your clothes? Are you distracted? Are you hiding behind a desk? Are you 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.

• 12:34Marielle Segarra?

  Takeaway two. Become aware of how your attention to your body image is stealing your energy. Notice when you hide parts of your body, or 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.

• 13:23Speaker 04

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• 13:58Speaker 03

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• 14:14Marielle Segarra?

  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.

• 14:33Speaker 01

  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. But 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.

• 15:16Speaker 01

  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. This 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 drained 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?

• 15:58Speaker 01

  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?

• 16:25Marielle Segarra?

  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.

• 16:37Speaker 01

  Yeah. I mean, I think 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. The 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.

• 17:19Speaker 01

  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. And 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. You know, like the experience on Instagram

• 18:03Speaker 01

  where you're kind of going down like, who made a comment on my post? Oh, they made, I'm going to go look at them and see if, 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? Or am I chasing after something that is going to, in the long run, actually not give me the satisfaction that I'm hungry for?

• 18:39Marielle Segarra?

  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.

• 19:14Marielle Segarra?

  How do you counsel patients who have a negative view of their bodies? And who are also considering weight loss medication or cosmetic procedures?

• 19:26Speaker 01

  I 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?

• 20:10Speaker 01

  So 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?

• 20:32Marielle Segarra?

  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? Also, think about the time and money that you'll put in and whether that's worth it to you.

• 20:55Marielle Segarra?

  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.

• 21:07Speaker 01

  Absolutely.

• 21:08Marielle Segarra?

  And if I change this thing, then my experience in the world will be better.

• 21:13Speaker 01

  Yeah, there'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? And 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.

• 21:57Speaker 01

  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.

• 22:08Marielle Segarra?

  Diana, thank you so much for this.

• 22:10Speaker 01

  Thank you for having me.

• 22:14Marielle Segarra?

  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. Takeaway four, when you're considering body alterations, know your why. What will these changes offer you?

• 22:58Marielle Segarra?

  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.

• 23:11Marielle Segarra?

  All right, that's our show. If you love Life Kit and want even more, follow us on Instagram, @nprlifekit. 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 DM'd me to say that my face matches my voice, which was nice to hear. Follow us @nprlifekit. This episode of Life Kit was produced by Margaret Serino. Our digital editor is Malika Gharib, and our visuals editor is CJ Ricolon. Megan Cain is our senior supervising editor, and Lauren Gonzalez is our executive producer. Our production team also includes Andy Tagel, Claire Marie Schneider, and Sylvie Douglas.

• 23:55Marielle Segarra?

  Engineering support comes from Kwasi Lee. Fact checking by Tyler Jones. I'm Marielle Segarra. Thanks for listening.

• 24:14Speaker 03

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