Body Image

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Who hasn’t met a man who would not like larger biceps, or the woman who would not like longer legs?  So many people are unsatisfied with their looks but woman often report more unhappiness and effects on their self esteem.

Even children have problems with their looks. Children as young as 5 feel bad about themselves if people fail to say that they are attractive. The 2016 Girl Guiding Survey on attitudes about weight and shape show that young people are increasingly insecure about their looks and these trends are accelerating.  Various studies support the view that 5 out of 10 girls age 7 to 21 years of age are content with their looks compared to over 7 in 10 five years formerly. The figures may not be accurate due to small sample sizes and reporter bias.

Girls aged between 7 and 10 say that appearance is the most important thing in their lives and 1 in 4 strive to be perfect.  By 10 years of age, 8 in 10 girls agree that looks are more important than ability and the majority believe that they aren’t attractive and that this will affect their friendships.  Weight is the most important concern they mention. Fat-calling on social media is the most immediate and available insult to offer, whether the recipient is fat or not. Despite our best efforts to make all kinds of body shapes acceptable, this behaviour tracks forward to weight stigma in later life.

The lack of confidence  in the Guiding Study affects the clothes they choose to wear, having their photos taken, whether or not they are willing to participate in sport, and developing life skills such as speaking up in class and socialising.

Adolescent schoolgirls are more likely than boys to deal with poor body image by dieting; but males are rapidly catching up. Body dissatisfaction is very high in college women too and this doesn’t change in adult life even as people become older and wiser. So poor body image can be a lifelong curse which is not actually solved by weight loss cosmetic surgery or reassurance. Poor body image is a constant way of life.

Because we experience life and relationships in the physical body, it makes sense that body opinions of all kinds have an important sway on self-worth.  Low self worth and poor body image underpin eating disorders because we think that eating less food will have the most immediate effect on body size, shape and health.  We also believe that losing weight will make us happier, which it often does before the costs of dieting kick in or the side effects of eating disorders show up. We have strange opinions about our body, we think that it can be moulded by waging war on the it one way or the other and that the body wont fight back. We can indeed do a lot. New developments such as jaw shaving, cosmetic surgery, Botox, fat sculpting, tattooing, womb-renting, egg-freezing buttock and breast implants, placenta injections, photo-shopping; all mean that people feel no longer obliged to settle for the body that they were allotted at birth. We can increasingly “play God” with our bodies because of the vast array of strategies that are available and affordable. We change things because we can. If we can, we should.

Body change used to be seen as the privilege of the wealthy and vain, shame would prevent most people from admitting to a nip and a tuck. Body change is now a survival mechanism in a troubled world where everything else feels out of control.  Breast enhancement and even Botox are now being prescribed for mental health, where in past times only gross physical distortion was an accepted reason for cosmetic change.

According to Susie Orbach in her book “Bodies” (2019), two trends are butting up against each other: the difficulty we have living in the bodies we currently inhabit, together with the happiness we are promised as we move toward futures in which our bodies may become algorithms or artificial. We no longer really own our own bodies; they have become political instruments. In the USA and in the UK, drinking and smoking during pregnancy invites prosecution from the foetus. Parents of wayward children are no longer invited to spank them.  She continues (Guardian 2019 rewritten) the understanding of bodies we inhabit as biological organisms with limits is no longer enough. Capitalism and social media rewrite the terms of engagement and what it means to be seen and valued, in this the body becomes a battleground, pressed into new forms or service display and identity just as at the same time, most of what we think we understand about living (eating, breathing, moving) occurs in the realm of a smartphone or the realm of thought.

What this means  for people striving to live more happily in their bodies has a lot to do with a current epidemic of disturbed mental health among the young and their relationship with food and exercise.

Reality TV (e.g. Love Island) and the rise of social media platforms such as Snapchat, Facebook and Instagram add to the pressure on young people to look perfect.  An emerging tribe of Influencers who attract large media followings via their blogs, vlogs and Instagram posts, is hero worshipped precisely because these people either have natural good looks, or alternatively they photo-shop their images to achieve the look they wish to publicise.  Some influencers go to dangerous lengths to look good but will never admit to the starving, purging, self abuse or photo-shopping that they do routinely. Their tiny waist, enhanced buttocks, or thigh gaps are not natural but the audience assumes that it is.  Why do they do it? The answer must be money, and admiration of course. They are paid large sums of money to promote themselves and their unhealthy and uninformed weight change practices to the  vulnerable young people who follow them.

What hope does a vulnerable 13 year old girl have, sitting in her bedroom, wishing that she looked like a skimpy, half-dressed adult with a 14 inch waist who may, for all she knows behind the scenes taking drugs so that she doesn’t have to eat.  Some influences with no nutritional experience at all  glamorise dangerous weight control practices such as squeezing their bodies into extreme corsets,  clean eating or doing a ketogenic diet which insists that you starve a lot of the time. Body change practice is monetised everywhere you look, from the slimming industry to the promotion of gastric band surgery in Romania, for those who cannot afford a properly trained surgeon.

A body  has always been a calling-card about our culture and socio-economic status. But it has all got out of hand. No one knows how fat is too fat and how thin is too thin. Teenage girls and even grown women sculpt their appearance and doctor their photographs on social media to garner likes and approval which people give because they feel obliged. According to research done by Dove, it takes 124 likes to feel “liked enough” but most people get many less than that. So then they conclude that they don’t look good enough. It’s a no-win situation. Life online these days has more meaning for adolescents than real life, our children want to emulate the hunks on Love Island, or celebrities such as Karlie Kloss, more than they want to be fine people.  Trying to look like a celebrity is commonplace and vulnerable minds are prey to all-or-nothing thinking, if you can’t look like them you are ugly and no one will like you.

Social media has also led to the body being fetishised;  You cannot just be on a show, you have to be undressed on a show; female pop stars have to be semi-naked to perform (thanks Madonna). Worse still, many teenagers are forced or manipulated to display the most intimate parts of their bodies, to get approval from people, often unaware until it is too late, that their pictures have ended up as porn fodder for voyeurs, and paedophiles, who manipulate them with shame and threats into doing more of the same.

Obsessive concern about body shape and weight has become so common globally among women of all ages, that it is now the norm. Some cultures are less vulnerable than others. It was assumed that Arab men like their women to be curvy, but weight stigma and eating disorders are known to be rife throughout the Middle East. Being an African American appears to confer some protection. However even among this more confident social group, there is increasing pressure, reflected in rap culture, for women to be bouncy in the right places and skinny elsewhere.  Muscle dysmorphia (not feeling strong enough) is increasingly common among African American males. This is impacting on body image among a group of people hitherto protected against the tyranny of having to be slender.

When women are asked what they want to change about their body they respond without hesitation; when asked what they like about their body their response requires considerably more thought. This is also true for males. Parys Rapper was the son of a handicapped woman who was famous for her willingness to display her body. His suicide in 2019 has been directly attributed to poor body image leading to drug abuse, and he eventually had enough.

In the West, “fat free is beautiful and beautiful is good” belief prevails. Consequently males and females often use weight as a yardstick with which to measure self-worth and attractiveness. It is common for women to enter a room and immediately determine their status by assessing which women are thinner and which are fatter than they are. As a result, being female often means feeling fat and inadequate.

A feminist understanding of negative body image – until the 2000s viewed socio-cultural issues as the reason why so many women loathed their bodies and did harmful things to change their appearance. For example, girls are socialised more than boys to focus on external aspects of themselves, such as their appearance. Learning to do their hair, polish their nails and paint their faces is virtually a rite of passage into womanhood in our culture. Women are expected to have far more control over the body, its function, shape and size, than men. Open discussion and public displays of natural body functions such as sweating, belching and scratching are not as acceptable for women as they are for men. These functions are not only viewed as unfeminine but as evidence of masculinity.

In the 2016 Guiding Survey mentioned above, girl guides expressed the view that women must be neat, polite, attractive and be sexually contained. Only 3 years later these values had changed. Sexual propriety has lost its allure and a free for all with the body as agent has taken its place.

Does this mean that boys are protected from concerns about appearance and weight?  The answer seems to be no. Surveys show that boys as young as 10 fear weight gain too, and many say that their greatest worry – out of a series of options presented to them such as “fear of nuclear war,” – is “putting on weight”. Boys aspire to a body shape which represents strength and power, a strong chest, a six-pack stomach and no body fat. There is a social penalty among males for being too “small”.

Boys are still typically socialised to concentrate on their athletic abilities rather than their looks. In addition, attractiveness is not the prerequisite for masculinity as it is for femininity in our culture. Attractive men are described as handsome. “Handsome” is derived from the Middle English word “handsom” which refers to the ability to manipulate or do. It is first a word about action and only secondarily about appearance. Associated with “handsome” are qualities of achievement and strength. But these days males do not wish to be handsome, they wish to be woke, cool, 6-packed, fit.  You could be forgiven for assuming that many men working out in the gym just want to be healthy, so how do we square that with an epidemic of steroid abuse among a significant number of heavy gym users, especially the young? How do we explain the fact that they will accept without question the strange supplements that are promoted to increase their stamina or their performance.

Males with eating disorders used to aspire to the body shape of professional athletes such as cyclists or footballers. Now we learn that some of these icons have taken dangerous drugs in order to enhance their performance, to win at all costs, often with the guidance of their professional helpers. None of these professionals have reached down to the young people they have influenced to confess to their actions, the costs of their actions, and their abhorrent reasons for doing as they did.

Boys as well as girls now die from taking drugs, weight loss pills and illegal metabolism-burning tablets often obtained online to reduce body fat.

Even age no longer protects against poor body image as it once did. The quest for eternal youth has overtaken the quest for wisdom and self-acceptance. Celebrities aged 80 are portrayed as cougars chasing virile young studs. 50 year old trumpet their ability to look as if they were 25. The menopause is viewed as an inconvenience, or as an illness not as a marker of passing from one stage of life to the other. We may now delay the menopause, condemning women to menstruation or worse, into geriatric childbirth ad-infinitum. Testosterone injections spice up the life of ageing men, condemning their wives to bad sexual performance or even persuading these enhanced men to ditch their wives for younger models.

Girls have it harder because of how their physiology works. At puberty females typically gain body fat which leads to menstruation. Males have a growth spurt accompanied by loss of body fat and muscle increase.  This natural physical change affects women negatively. Males who experience puberty early  feel good about themselves;  conversely, early puberty in females is often associated with shame, depression and low self esteem.

In their book “Hunger Strike,” now outdated, Susie Orbach and Louise Eichenbaum claim that body insecurity in women may be associated with how girls and boys are treated in early life. Mothers, they write,  respond less readily to girl children than to boys, feeding them for less time and taking longer to respond to their cries of distress.  Girls who stick up for themselves or who demand attention are told off. Boys are given a get-out-of-jail-free card for being mannish. Mothers, it seems, feel that they need to train their daughters to respond to the needs of other people. A girl child becomes guilty about wishing to satisfy her own needs,including the needs which arise in her body for meeting her hunger. They say that this translates to poor body image and eating difficulty in adult life.

There is a more complex psychological literature about the development of poor body image. The Attachment explanation is based on the work of Allan Score and his colleagues. They suggest that early adverse relational experiences cause feelings of alarm in the body which cannot be dampened down with a useful apparatus for self soothing. The body becomes an object of distress and may cause a person to experience the physical body as “just too much”.

Some psychologists view poor body image in girls as an expression of rebellion at being too closely identified with the “mother figure.”  As part of normal psychological development, a boy “identifies” with male figures at an early age and “separates” from his mother, to resolve the oedipal complex of wishing to possess her. This early separation from the mother does not happen in girls. When they progress into adolescence they are more likely to rebel by rejecting the maternal rounded female form.

Body Shaming leads to very poor body image as is associated with binge eating in adult life.  Teasing and weight comments at home, or among peers, or even seeing other people being fat-shamed is always traumatic, even if not meant unkindly. Nowadays we are mindful of fat stigma and try to prevent it, yet  fat-calling is the most immediately available insult from one young person to the other even if the recipient is thin.  Fat-shaming is too common in social media as a power-play and has been associated with both male and female suicides as the outcome of social media bullying and harassment.

Traumatic events, like sexual abuse have a negative impact on body image but the impact is worse if the person feel responsible for what has happened to them. The link between abuse and poor body image is complex.

Many other things can have an affect on body image. The list of factors we know affect body image include parental dieting practices, how parents feel about their own bodies, how good you are at sport,  and whether there were physical problems in childhood. The number of NUMBER of negative body experiences appears significant in deciding how you think about your body and how you try to deal with it.

Two factors are known to have a protective effect against poor body image. The first is having good emotional resilience, being able to know what you feel including bad feelings, and being able to manage your feelings effectively. Unhelpful dieting practices and general self care are much less likely in people who are good with their emotions.
The second protective factor is good self esteem. People who generally like themselves may have poor body image, but it doesnt seem to matter very much. They tolerate their imperfections better. They compare themselves less to other people.

When we treat poor body image, we must be mindful of these issues.

Different cultures have different body ideas; by and large these affect women more than males. Perhaps because of women’s dependent status, their appearance has often served as a reflection of the abilities of their male “protectors”. Women who have successful protectors will have the resources, the time and the means, of pursuing the ideal physical physique. Thus, the ideal shape tends to be whatsoever is hardest to attain during a given time period. If everyone else is thin due to starvation, it is good to show up as plump.  If too many women are able to meet the ideal, standards would have to change for the ideal to retain its extraordinary nature. When images of beauty change, female bodies are expected to change. Women have always been objects.

Different body shapes have been “in” for women during different eras. Let us consider Chinese foot binding, African lip stretching and the 19th century corsets which squeezed a woman’s internal organs out of shape. Only one century ago, the ideal female body was the opposite of what it is today.

Dimpled flesh, today’s cellulite, was beautiful in the times of Rubens. Fatness was viewed as a sign of energy and health. The thin silhouette was considered sickly and a poor bet for a bride who was less likely to conceive. Around the turn of the century, slenderness became more fashionable although it would still be considered too fat for today’s standards. By the 1920s the Victorian hourglass gave way to the thin flapper who bound her breasts to achieve the washboard profile that suited the Charleston. Just as the girdle achieved its technological maturity, the voluptuous Marilyn Monroe in the 1950s set a new standard for women. Now they needed to rebuild the curves they had tried to stave, bind and restrain.

In the 1960s Twiggy set a new trend, weighing in at a shapeless 91 lbs. There are few women in their 60s today who cannot recall trying to fit a female body into jeans designed for a prepubescent boy. The 1980s beauty ideal remained slim but required a more toned and fit look. Women could no longer just “diet” into the correct size; there was a new pressure to add exercise to achieve the right look. Today the ideal combines such opposite traits as erotic sophistication with naive innocence and delicate grace with muscularity, maturity with youth.

The 1990s body ideal was very slim and large breasted; an almost impossible combination for most women. Jane Fonda and Cher monetised their aerobic videos. Pressures to fulfil conflicting demands and keep up with the images in the ideal body are stressful and have resulted in the majority of Western women suffering with negative body image.

The symptoms of poor body image in terms of behaviour include all the eating disorders, self abuse, cutting, avoiding certain situations, over-exercising, and much more. Poor body image is carried around like a curse, wherever you are and affecting whatever you are doing. People with poor body image avoid seeing other people,  avoid relationships, buying nice clothes or treating themselves to a hairdo.

There are three aspects to poor body image: Feelings & thoughts which include salience or importance of the body, consequent behaviours, & thirdly size perception.  Example of negative body image thoughts include:

I am fat and disgusting – we call this labelling

My thighs are so big I can’t wear a bathing suit we call this awfulising

I look so fat next to Jane I can’t go out with her we call this comparing 

Everyone notices my flat chest we call this mind-reading

I can’t stop thinking about my weight we call this obsessive thinking

Poor body image may lead to depression and anxiety, causing additional injury to self esteem. In really severe cases, we refer to this as Body Dysmorphic Disorder.  It is no use telling someone that they do not look as bad as they think they do. The effects of negative body image on size perception is clearly evident an individual’s tendency to over or under-estimate the size of their disliked body parts – even in the face of objective data which confirms the opposite. A person might say yes I know weigh 90 lbs but I am still really really fat.

Exercise is both a cause and effect of poor body image. Males who exercise regularly are more likely to do so to build body mass and improve cardiovascular fitness. Women on the other hand, are more likely to exercise to lose weight and change their shape in an effort to increase their attractiveness. Unhappily, this implies that exercise will lose its enjoyable quality for many women and become an additional source of stress.

The emphasis on any person’s outward appearance makes it very difficult for them to appreciate their qualities and strengths. When a person’s attention toward their body is narrowed and over focused, they become unable to devote much energy to other aspects of their lives.

Whether male or female, attempts to meet the ideal are often ineffective in the long run and can lead to physical, psychological and behavioural problems, obsessions about food, odd diets, exercise obsession and eating disorders. Other psychological effects of the pursuit of a perfect body include low self-esteem, feelings of failure and inferiority, irritability, loss of libido and memory problems. Body dissatisfaction is also associated with depression, anxiety, relationship problems, self-contempt, and social introversion. Body image can affect QOL to a considerable degree. We have lost sight of the high price we pay for being at war with their bodies.

Because body image problems play a central role in dieting and in the development and maintenance of eating disorders, we cannot ignore the need to treat body dysmorphia however mild. Even people who do manage to achieve an ideal size or weight can feel anxious, insecure and riddled with self-dislike.

It is hard to get the message across that the ideal shape does not confer happiness and mental well-being, while at the same, time body hatred does have a profound effect on quality of life. Even so, overweight people who sustain weight loss do feel happier and more effective overall. Successful weight loss surgery patients describe weight change as transforming.

Interestingly, recent research with women who have had a mastectomy for breast cancer suggests they feel more body satisfaction than women who have not had breast surgery or disease. Despite not meeting the societal ideal, the women with the mastectomy report they become more appreciative of their body and less likely to treat it as an object to torture into a particular shape.

It is hard to say whether there is any such thing as a natural body, our bodies are shaped by cultural messages almost from the moment we are born. Orbach notes that from early ages, marking our children with circumcisions, genital mutilations, blue for boys and pink for girls, facial markings, piercings, and food practices shapes us socially and economically. It is also true that we are trying to move away from the limitations imposed on us by genitals and culture but this is not making us more accepting of either our bodies or the sensations and emotions which bodies produce. This may be because globalisation promotes the illusion of belonging by persuading us to have the right kind of look.

In the first part of the 21st century we confront weight stigma, but at the same time we normalise various forms of starving the human body. We promote diets which advise us to starve all day and binge eat for an hour in the evening;  and other intermittent forms of fasting (1 day eating, 3 days fasting). We avoid meat and eat food we do not like because we think it is good for us. We convince ourselves that these odd eating plans promise health, wellbeing, freedom from disease and longevity.

70-year olds are now expected to look like 30-year olds. It is no longer deemed responsible to attend to other things which lead to the meaningful, moderate & flourishing way of life. We fetishise the body in penance perhaps to atone for the fact that we are able to eat while at the same time millions of people starve to death as the result of war or famine.

Susie Orbach – a well-known psychotherapist, argues that this may be the last generation to inhabit bodies that are familiar to us now. Robotics, genetic modification, biosynthesis and change techniques like body part exchanges may change our bodies, much as we change our clothes. I believe that we have to accept this change and work with it since bodies continually evolve according to the culture, weather, food practices, transports and even the bacteria which form the greatest part of our structure.

It is not easy to change anyone’s opinions about their body. People fiercely resist thinking differently about their appearance.

A psychologist is trained to manage body image with different strategies and does not expect instant change. This therapy is not a quick fix.  We can do three things,

We can adjust the way someone thinks about their body or parts of it.

We can help someone to behave as if they felt OK about their body. To act more kindly toward him or her self.

We can make it matter less.

A therapist must be trained to work with body image, using many different therapies. The best tested include; CBT, Compassionate Mind Training, Neurolinguistic Programming,  the use of visualisations and EFT (Tapping).  We also teach media literacy and, how to look in mirrors without getting angry and despairing.

The feminist approach to dealing with negative body image is based on  consciousness raising and education. We discuss the changes in the body ideal over time, as well as the influence of media, magazines, fitness media and social media. We help women and men also to reconsider their negative feelings and unhelpful attitudes. Rather than blaming their discomfort exclusively on their (perceived) ugly bodies, people learn to see the bigger picture. There may also be discussion of cross-cultural views of appearance and role of social class and race.

Another component of therapy involves challenging myths about looks and dieting and addressing the ways in which society’s promotion of unrealistic ideals limits them in power. Discussing these issues in a group setting can be particularly helpful. We need to begin this in school as part of mental health literacy, personal and social health education.  Above all, we need to train parents into modelling helpful actions, to stop commenting on their own bodies / weight or modelling unhelpful eating actions.

If body image is associated with negative events such as teasing, trauma or abuse, therapy may incorporate dealing with these issues as well.  We may have to use trauma based therapy to help someone deal with abuse, and move on.

The single, most effective thing that predicts a better relationship with your  body is  improved self worth, together with expanding the domains of self worth. In other words, many other things will define whether you are at peace with yourself.  Positive Psychology and CBT are useful therapies to improve self worth.

Conclusion

Feeling at home in our bodies is essential to our well-being. As people examine the source of their body image dissatisfaction, they may view their discontent less as individual pathology and more as part of a larger system that thwarts difference and distorts reality.

Eliminating body standards is unrealistic. However, a more diverse view of attractiveness is necessary to save people from additional physical and psychological tolls. To be productive, happy members of society, bodies must be well nourished and have mental energy to channel to other pursuits. This is not possible with obsessively counting calories, restricting their intake, daydreaming about food and weight, and futilely whipping their bodies into an unattainable shape.

It is essential for everyone from an early age to consider the effects that the pursuit of the perfect body has on their lives and to challenge their beliefs about weight and appearance. With awareness of the cultural context and socio-cultural issues, and with the support of a properly trained therapist to help people to think and behave differently,  we can learn to behave more compassionately toward ourselves. This will allow us to live life more fully and meaningfully.

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Allen P., Katzman, M. and Wooley, S. – Feminist Perspectives on Eating Disorders 1994 – New York Guildford Press.

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Freidman, R., – Body Love- learning to Like our Looks and Ourselves – 1988 New York, Harper and Rowe.

Sara Grogan. Body Image, Routledge Press. This is our favourite

Orbach S. Bodies 2009 republished 2019.

Seligman M. 2011 Flourish.