How Rheumatoid Arthritis Affects Body Image

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If the physical effects of RA have led you to develop a negative body image, there are a number of ways to improve how you feel.

Mindfulness

A shift toward mindfulness — paying attention to the present moment, nonjudgmentally — may help increase body satisfaction when it’s practiced with kindness and self-compassion.

“Mindfulness is really about acceptance. That does not mean you have to love your body,” Albers says. “It means learning to accept it as it is, especially in this moment. It is a shift away from constantly evaluating how your body looks and toward noticing what your body does for you.”

“That might be noticing your breath, the ability to move in a way that feels okay, or even small moments of comfort,” she says. “This approach can take some of the pressure off. You are not trying to force positive feelings. You are simply creating space to relate to your body in a more neutral and compassionate way.”

Albers also suggests focusing on sensory experiences. “The feeling of soft clothing, a warm shower, or even stepping outside and noticing a breeze,” she says. “These moments may seem simple, but they help rebuild a positive connection with the body.”

Movement

Making the effort to move your body in ways that feel good can evoke a positive body image; that is, appreciating your body for what it can do. According to research, exercise can decrease body dissatisfaction, and frequent movement is linked to a more positive body image.

But exercise can be hard with RA-related physical changes. “Movement that once boosted mood or helped someone feel energized can start to feel painful or draining,” says Albers. “Instead of being a source of relief, it can feel like something to avoid.”

“Over time, some people cope by emotionally checking out from their body altogether. They may try to numb or ignore what they are feeling because it is overwhelming,” she says. “But when you disconnect in that way, it does not just dull the discomfort. It can also dull positive sensations.”

Albers says that finding ways to move that work with your body as it is right now is key. If cardio is too much, you might try yoga, tai chi, or stretching. Research has shown that yoga and mindfulness-based exercise programs can also improve mood in people with RA.

 And participating in shared tai chi sessions was found to provide an increased awareness of the links between mind and body, a reduction in anxiety and depression, and improvements in self-esteem and motivation in people with RA.

Optimizing Your Treatment Plan

It may also help to be proactive about fine-tuning your treatment regimen, to reduce the impact of side effects and improve your ability to function as much as possible. “At the same time, it is important to acknowledge that this is not always a perfect tradeoff,” says Albers.

“Sometimes the most effective treatments do come with side effects, and people may still have mixed feelings. You can feel grateful for relief and frustrated by the changes at the same time.”

It is important for people with RA patients to optimize their disease-modifying medications so they have good control of disease activity and less unpredictable disease flares. This will improve swelling, pain, and possibly any visible abnormalities. Adjunctive (complementary) treatments can also help such as “physical therapy, local injections, topical pain relievers, nonsteroidal anti-inflammatory agents,” Fields says. They can temporarily relieve pain and swelling while disease modifying medications are optimized. Complementary practices, like adequate nutrition and gentle exercise techniques, may also help mitigate side effects of medications.

Psychotherapy

Research has shown that several types of psychotherapy can support efforts to improve your body image, including acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and cognitive behavioral therapy (CBT).

“Acceptance and commitment therapy, or ACT, is especially powerful here,” Albers says. “Instead of trying to fight or eliminate difficult thoughts or feelings, ACT helps people make space for them while still engaging in what matters most to them.”

She also says that DBT can be beneficial. “[It] can help with emotional regulation. It gives people tools to manage intense feelings like frustration, anger, or shame, without turning to unhelpful coping strategies.”

CBT works by helping people become aware of — and learn how to change — unhelpful thought patterns. “For example, if someone is thinking, ‘My body is broken’ or ‘I look terrible,’ CBT helps reframe those thoughts into something more balanced and less harsh,” Albers says.

She points out that mindfulness is core to all three types of therapy. “Mindfulness helps people reconnect with their body in a gentler, more neutral way.”



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