Many people, including myself, have had days where they stand in front of the mirror and aren't satisfied with their reflection. Perhaps they think their pores are too big, their waist is too large, and their muscles aren’t defined—they just don't like their bodies. When seeking support, many will turn to the advice of therapists, life coaches, and influencers and hear phrases such as, “You may not love the way your body looks, and that is OK—at least it is healthy!" and, “Honour your body because she keeps you functioning and does amazing things for you." or, "As long as you are healthy, you’ll eventually like what you see in the mirror; it just takes time." While most people can find encouragement in these mantras, what such phrases fail to account for are the perspectives of those with chronic conditions. What about the people whose bodies are failing or fighting them on a daily basis? Can they say those mantras when, to them, such perspectives just aren't true?

From experience, I can tell you these affirmations don't always work. If anything, they can sometimes make things worse and leave me more frustrated with my body. My body is not healthy, and I deal with multiple chronic illnesses every day. I am just one of many who cannot repeat positive mantras in the mirror when dealing with chronic illnesses, and I've learned that that's ok. However, it has motivated me to explore current research and see what others who share my perspective are doing to cope.

People with serious health conditions form a sizable demographic in the United Kingdom (UK). In 2019, approximately 18.8 million people over the age of 16 self-reported as having at least one long-term health condition. Among the younger populace, one quarter of 11–15 year-olds reported having a disability or chronic illness, while among 10–24 year-olds, one in ten felt that disabilities impacted their everyday activities. As for older members of society, it is estimated that by 2035, two thirds of adults over 65 are likely to have multi-morbidities. If you take a step back, that is about one in every four people in the UK who have something going on, visible or hidden, that seriously impacts their health. So, how do we—as people dealing with chronic illness(es)— try to address issues of body image? Am I the only one getting frustrated with my body, and tired of hearing, “oh well, at least your body is healthy”?

While the verdict is still out on body-positivity mantras, there is research available that explores the relationship between body image and chronic illness. Now, I want to be clear that just because someone has a chronic illness, or indeed illnesses, doesn’t mean they cannot love their body. I cannot speak for all, but I know that for many people in the chronic illness community it can feel harder to achieve body acceptance when they cannot rely on ‘at least’ being healthy. The World Health Organization found that the self-image and ego development of adolescents with chronic health conditions can be negatively affected, especially for those who score highly in verbal intelligence tests and have more severe diseases. Furthermore, the demands of chronic illnesses or disabilities, such as using body braces or managing medication, can negatively impact self-image. Virginia Quick builds on these findings by highlighting how chronic illness can place people at a greater risk of negative body image compared to their healthy peers, especially with illnesses that lead to weight fluctuation.

Although research on body image often focuses on young people, those of all ages can experience negative views of themselves. Young adults with bowel conditions recall being teased about their bodies, a possible contributor to their depression and anxiety. For people over 65, chronic illness can lead to a redefinition of self-concept that “involves the negotiation of identity trade-off as individuals confront their physical losses, [and] change their future goals.” This process plays out for people on medications, such as corticosteroids or insulin, that can alter the body and consequently affect body image. This was the case for me when I was going on and off various medications that caused visible puffiness and weight fluctuations; I definitely found myself looking at my body differently in the mirror. When such medications are needed to keep a patient stable, even if they try their hardest, those that take them may still find it hard to meet conventional standards of beauty. The appearance of research on body image and chronic illness is encouraging and I am hopeful that there will be more to come.

I know I’m not the only person in England feeling distressed about my body image. Research aside, I wanted to see what others are doing to soothe their feelings and I stumbled upon the body neutrality movement. I learned that body neutrality can be a great asset in helping those with a negative body image, including those whose negative self-view intertwines with their chronic illness. Unlike the body positivity movement, which promotes the idea that everyone is beautiful in their own way, body neutrality focuses on accepting your body for how it currently is. Crystal Raypole describes it as “taking a neutral perspective towards your body … [and] moving away from the idea that you have to cultivate a love for your body or make an effort to love it every day.” This mindset can be especially useful for people living with chronic illnesses—sometimes you may not love your body and you shouldn’t feel shame about that. Raypole goes on to say that body neutrality is about respecting your body even if you don’t love it, and practising mindfulness as a response to how your body is feeling. Although the idea of body neutrality has been around for a long time, it’s something that I’ve only recently introduced to help combat the self-image issues related to my chronic illnesses. I’ve started to create my own mantras and see body image through a different lens. Plus, I’ve come to understand that whilst it might not feel like it sometimes, many people, chronically ill or not, struggle with body image. Overcoming this struggle is an effort that needs to be taken one day at a time.