Body Image

August 1, 2011

Cultural perception of the perfect female shape has varied over time from a full-figured fertility goddess and rounded Rubenesque figure to the pencil thin Twiggy and Ally McBeal. In Third World countries, women who are heavier are associated with high social status and having money to buy food, while the Western world worships thinness. Many women attribute to their bodies the power to define their lives. Physical and emotional health suffers when extreme obesity or anorexia occurs driven by a dictatorial body image. A negative body image can lower one’s mood, self-esteem, and confidence. Social influences on body image begin early. Children and adolescents who are teased about being fat begin to “hate” the way they look and fear ostracism and isolation from peers. Even elementary aged girls now talk of diet, but severe pressure occurs at puberty when the natural process of rounding is counter to the desired image. In fact, girls who have a negative body image are more likely to have eating disorders and depression and are likely to consider suicide. Lower socioeconomic status, less education, and lower paying jobs are known associates of obesity and feeling ashamed of appearance.

A mother’s body image has a significant impact on her daughter even without words. Is the mother happy with her body image; are diets continual; is she always worried she looks fat; or does the daughter perceive poor treatment of her mother and vows never to look the same? A feminist approach would urge each woman to formulate a cognitive image of physical and mental health. Rather than being “tyrannized” by society or caught in the male/mind, female/body dichotomy, women can begin to celebrate their unique bodies. Selfcaring, not self-contempt, can encourage true improvement both inside and outside. Healthy nutrition and exercise habits can allow flexibility of what is seen as good. Each woman must decide what is most beneficial for her health. As a group older women are less concerned about weight and body image than middle-aged women, but the very old also tend to be thinner. Likewise ethnic minorities may be more accepting of their weight and body image than whites in this country. Peers and colleagues at school or work, income level, education, occupation, household size, marital status, activity level, parenthood, residential density, and region impact on weight and therefore indirectly on body image.

For centuries men’s opinions about features that visually attracted them to females molded how women perceived themselves. Women have believed that if men found them attractive, they would be protected from violence. This offers little satisfaction to several million women each year who are victims of violent crime, most often at the hands of someone with whom they are intimate. Nonetheless, to appear more beautiful than others, women listen to weight loss and cosmetic industries and are forever seeking to appear youthful and thin. Many will select an “easy” quick and more dramatic attempt to achieve the perfect body with surgery.

In the recent past the media has made it impossible to escape reminders of how the attractive, healthy woman should look. Although humans performed nasal reconstruction for other reasons in ancient times, not until the 1950s did beauty surgery grow in popularity. Nose, ear, eye area, and lid surgeries increased as well as removal of blemishes. Many women feel they must aspire shapes displayed on television, magazines, or billboards. Albeit some women have breast reductions for health or athletic reasons, others request this procedure to appear thinner. The frequency of liposuction of thighs and tummy tucks (abdominoplasty) dramatically escalated in the 1990s as well as breast implants for those wishing to be more attractive to men. Rhinoplasty (nose), rhytidectomy (facelift), cheek and chin augmentation, brow lifts, ear and eye area surgery, and chemical peels are all designed to improve the facial image.

Society judges women by their appearance more often than men, particularly with respect to weight and body shape. “Stigmatization” and feelings of inadequacy encourage women to utilize technology available to make the body more attractive, which may vary from culture to culture. For example, in the Philippines reshaping skin lateral to the eyes to appear more European is the most popular plastic surgery procedure. There is little available data using standardized testing to discern how much body image may improve from procedures such as liposuction, laser eye surgery, or Botox injections, but it is likely there is some. Between 1992 and 2001, the incidence of breast augmentation in healthy patients increased by 533% according to the American Society of Plastic Surgeons. A recent study by Banbury reports 96% of women who have breast augmentation felt that surgery had a positive impact on their body image and 80% said they would have the surgery again.

Other body image concerns follow malignant illness and surgical procedures. Losing one’s hair after chemotherapy is particularly common in women who face cancer treatment. Vulvectomy, mastectomy, and ileostomy (surgical procedures that remove portions of external genitalia, breasts, or bowel) are devastating blows, leaving some to describe they no longer feel like a woman. A woman may have been praised for her beautiful hair or told by her husband how he loved her breasts and now may find it harder to trust that she will
still be valued as much as she was prior to the physical loss. Certainly many women with cancer have benefited greatly from multiple “image-boosters.” Support groups and counselors recommend women consider possibilities from makeup classes and wigs to breast and vaginal reconstruction.

Although weight loss and exercise can improve body image for many, “phantom fat,” the continued selfperception of being overweight and recollection of adverse consequences of being fat can limit improvement for others. Cognitive-behavioral therapy that reshapes body image and provides alternative interpretations can be quite helpful. With this therapy, individuals describe their ideals, learn relaxation techniques, participate in psychoeducational sessions, attack old distortions, develop positive activities, and explore interpersonal relationships. Feedback from other participants and practicing strategies to change negative mental schema and unhealthy behaviors support new efforts of an individual working to improve body image. There is no single correct treatment any more than a single correct body. Each woman must objectively reflect on her own health physically, mentally, and spiritually to guide her decisions.

SEE ALSO: Anorexia nervosa, Bulimia nervosa, Depression, Eating disorders

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