I’m a Body Image Therapist Who’s Gotten Botox Since 2021: Does That Make Me a Hypocrite?

Unpopular opinion: The shift that came with a global pandemic was not destabilizing for me. Perhaps a common sentiment among other easily-overstimulated-introverts. Prior to 2020, I had just begun building my private practice, and was still healing from the burnout and vicarious trauma of working in frontline social work & psychotherapy. The forced isolation of COVID-19 was the opposite of disruptive for me— it felt like I was given permission to slow down, it gave me relief in not feeling pressure to do more. 

I have had my head buried in eating disorder & body image research for as long as I can remember. This passion was built from experiencing the pressures of being a woman, and seeing the drive for control that impacts every single one of us. I have immersed myself in learning, teaching, understanding, and advocating. I felt this need in my bones— to have people with these struggles feel seen, to guide them through self-compassion work, and to support them in their journey of finding their way back Home. 

What was once an anomaly became the new standard in 2020— therapy moved online. I was never trained for virtual relationships— I never expected to manage both emotions & wifi connection at the same time. This felt like new territory, but the relief of working from home kept me motivated. I could have never anticipated what I saw; from almost the moment our world shut down, I witnessed an increase in eating disorder behaviour that felt unexplainable. A systematic review completed in 2025 concluded that eating disorder diagnoses in women increased by almost 45% throughout the pandemic. Stop and let that sink in— an increase of almost double from the year prior. Another review in 2022 concluded that eating disorder-related hospital visits rose by 48% during this same time. Fast forward to 2026— we have seen a 93% increase in eating disorder-related medical visits in youth in the last year alone. Anorexia rates in girls have increased by 60%, since 2020— almost quadruple the stats we saw prior.

Eating disorders are one of the most complicated & destructive mental illnesses. It remains the number one risk for mental-illness related death, simply due to the interception of psychological (suicidality) & physical (malnutrition/organ failure) factors. The demographic most at risk of developing an eating disorder is women— at puberty, and again at menopause. Bulimia & Binge Eating Disorders are notably common with women in midlife— about a 30% increased risk around the time of menopause. This speaks volumes. What this means is: Women are affected most when their bodies start to age. Women are taught their value exists only in youthfulness— young girls aren’t excluded. Not only is body fat unacceptable, so are any body changes that show any sign of development. It’s no coincidence we’ve seen a massive increase in kids obsessing over skincare— long before their first wrinkle. The global teen skincare market was valued at ~$11.8 billion in 2024 and is projected to nearly double by 2033— largely driven by body awareness & anti-aging ideologies. Women aren’t just taught to shrink, we’re taught to stay immortal. 

One in four teenagers between 13 and 17 report wanting, and planning, plastic surgery. 37% of parents agree that vanity procedures will help their child’s self-esteem and overall mental health. This has nothing— and everything— to do with eating disorders. These concepts don’t exist independently. Time and time again, it’s the responsibility of women to control their desirability, to stop the terrifying train of aging. 

The conclusions I can draw in the aftermath of a pandemic are pretty straightforward— people struggled in isolation. People went inwards, they focused on “fixing” their flaws, they wanted to feel a sense of control. Capitalism ate that up. Since 2020, advertising for weight loss-related pursuits has increased by 54%— the fastest increase in weight loss advertising ever documented in history. Kids are digesting weight loss ads, they are regurgitating diet culture principles, and they are dissecting their bodies like never before. 

As I enter my mid-thirties, something is shifting. I can’t exactly explain it fully. I still care very deeply for this work, even more now than ever. But I also can’t ignore the other, sister-like part, of what this work is at it’s core. I don’t just see the impact of bodies shrinking, I see the desire to stop the process of aging entirely. Everyone wants to be frozen in time— to be the skinniest, youngest version of themselves— for eternity. Anti-aging is not revolutionary— but the mass advertising, production, and cultural shift towards pursuing it is. This shift has forced me into my own introspection, around the female experience of aging. As I explore this topic, I’m learning that the pipeline between eating disorders & cosmetic surgeries is extremely apparent. Between 1 in 3 of all cosmetic surgeries are sought out by women with eating disorders. The overlap is unmistakable. 

I’d be lying if I said I’ve never considered Rhinoplasty. I’ve been told many times throughout my life that my nose was “too big”. In the pursuit of empowerment, I’ve spent hours researching doctors and imagining this was my path forward. Most women can relate to this, unfortunately. It is no coincidence that 2021 was also the year I first tried Botox. After months of staring at my own face in Zoom calls, I did what most women do— I sought control— to freeze my face into timelessness. I have actively used Botox, every four months, since my first visit. When the nurse asks how frozen I want my face, I say make it unmovable. My smile lines, my forehead wrinkles— the part of me that shows emotion— stunted in time. I never thought twice about the double standard. Take care of your body, I’d say, as I actively numbed mine. It’s harmless, I’d repeat— it’s certainly not as bad as starving my body. Perhaps true, but this sentiment lacks a deeper awareness. 

The unexplainable shift for me has been seeing the work I do as building collective, rather than healing an individual eating disorder. It’s seeing this work as a global issue, a push to keep women obedient, numb, and young. The shift for me has been in identity— my values around self and community have broadened. 

I woke up this morning and cancelled my upcoming Botox appointment. I’m as prepared as I’ll ever be, to see my face with wrinkles. I want you to see my brow furrow when you say something I don’t like. I want you to see my crows feet when I smile. I want to exist in a world where my wrinkles are a sign of wisdom, not worthlessness. I’m not naive, I’m aware we’re far from this reality— but the shift I’m choosing is personal, and it is satisfying to my deepest core. I’ve been taught to fear aging, to fear menopause, to fear change— but what’s important here is that those values were learned, they aren’t inherent. I have no judgement towards an individual who chooses cosmetic procedures & surgeries— I am no different than you. We exist in the same suffocating space of womanhood. What’s important for me to admit though, is that I’ve changed my mind. I don’t want to pursue a life where anti-aging is valuable, where I’m competing to “win”. I’ve changed my mind— because I think we’re all collectively losing, and actively becoming more disembodied. 

I believe in body image work, because I’ve lived in a body that I’ve hated, and I’ve grown into a body that I appreciate. Body acceptance & aging go hand in hand. My path forward is chosen— by me, for me. My commitment is to practicing the values that I preach— even if the world never ceases to measure me.