Rheumatoid Arthritis and Body Image

By Beth Axtell

It’s hard to feel good about yourself when you feel like your body has betrayed you. You may face physical limits, chronic pain and changing plans for the future. These challenges force you to reevaluate your body and your relationship with it.

“Body image is how we think and feel about our bodies. But it is just one component of our self-concept,” explains Gerald Goodman, PhD, professor emeritus of clinical psychology at UCLA. “Body acceptance fits into a larger framework of self-esteem.”

Many studies show that women with rheumatoid arthritis (RA) have lower self-esteem, poorer body image, and are more dissatisfied with their bodies than healthy women. “Many people with RA experience swelling, changes in the shape of their hands and feet, weight gain or loss, and difficulty walking. These body changes can affect how a person views herself and her body,” says Helen L. Coons, PhD, associate professor, department of psychiatry, University of Colorado School of Medicine, Aurora.

People with early-stage RA are often as concerned about their looks as those with longstanding disease, even though the disease hasn’t had any outward impacts. A study published in Arthritis Care and Research found this to be the case. Louise Sharpe, PhD, lead study author and professor of psychology at University of Sydney in Australia explained, “Participants in the recently diagnosed group had few, if any, observable disfigurements, but had rates of concerns similar to those with chronic RA.”

According to Coons, any shift in your body and self-perception can be emotionally distressing. Adults who are physically challenged may feel unsupported by others, become self-conscious in public, are critical of their bodies and sometimes isolate themselves, she says.

This distress can progress to depression and anxiety. Studies have linked depression with social anxiety, social avoidance, physical disability and concerns about appearance.

If your disease, pain and body frustration triggers distress, anxiety or depression, Coons urges you to seek help. Your rheumatologist or insurance company can refer you to a psychologist, counselor or social worker with expertise in adults with chronic disease.

Goodman, Coons and Sharpe share tips for nurturing a positive self-image.

• Appreciate yourself as a whole person. Don’t be defined by your illness.
• Focus on and develop abilities to feel good about things you can do.
• Don’t over-generalize. If RA keeps you from doing one thing, don’t think you’re an overall failure.
• Work toward being accepting of your body.
• Commit to your body in positive ways. Manage weight; be physically active; do activities that promote a positive attitude.
• Distract yourself from RA-related challenges. Read, watch a movie, enjoy hobbies or volunteer. 
• Surround yourself with people who support, respect and encourage you. Explore body image issues with those you trust.
• Advocate for yourself and for people with disabilities. Join the Arthritis Foundation Advocacy network.