Body Image

The term body image refers to the view that a person has of his or her own body size and proportion. Body-image distortion occurs when a person's view of their body is significantly different from reality.

Many factors impact the perception of one's body image, including the mass media, peer groups, ethnic groups, and family values. There is no such thing as an "ideal" or "perfect" body, and different cultures have different standards and norms for appropriate body size and shape. Even within a particular culture, societal standards shift periodically. For example, in the United States, the value of being thin has been the predominant stereotype for women since the model Twiggy arrived on the scene in the 1960s. The average fashion model (at the beginning of the twenty-first century) is almost six feet tall and weighs 130 pounds, whereas the average American woman is five feet, four inches tall and weighs 140 pounds. This disparity in height and weight may lead to problems with self-esteem when a woman finds herself not meeting the cultural ideal of body size and shape. The interesting factor is that women tend to feel overweight, not "under height" when comparing themselves to fashion models.

Another example of body-image distortion can be seen among the contestants in the Miss America Beauty Pageant, the Miss Universe Pageant, and the Miss World Pageant. No winner of these pageants has ever been "overweight," and the winners have gotten progressively thinner over the years. Magazines and other media convey the image that being thin equates to being happy and successful, while cases of weight discrimination have been identified and argued in the courts. Fortunately, more emphasis is now being placed on health at any size, and on women becoming more muscular and fit, rather than simply thin. With increases in obesity statistics, however, some people may feel even more pressure to lose weight due to body-image distortion.

There are normal and predictable periods in life when body-image distortion occurs. One of these is puberty, when rapid changes in body size, body shape, and secondary sex characteristics take place. During this time, females tend to gain fat in the breasts, hips, buttocks, and thighs, developing a more pear-shaped body. Adolescent females may view their bodies as being heavier than they actually are, especially when compared to fashion models or celebrities. Adolescent males tend to gain height and muscle mass during puberty, and they may view their bodies as smaller than they actually are when compared to bodybuilders or professional athletes.

Body-image distortion also occurs when eating disorders develop. Most experts agree that the development of eating disorders is multifactorial and includes sociocultural, psychological, hereditary, and brain chemistry effects. Society plays a role in their development since eating disorders occur overweight: weight above the accepted norm based on height, sex, and age obesity: the condition of being overweight, according to established norms based on sex, age, and height puberty: time of onset of sexual maturity psychological: related to thoughts, feelings, and personal experiences

Dissatisfaction with one's body can appear in adolescence and could lead to eating disorders. About 1 percent of teenage girls in the U.S. develop anorexia nervosa and up to 10 percent of those may die as a result. [Photograph by Ariel Skelley. Corbis. Reproduced by permission.]

Dissatisfaction with one's body can appear in adolescence and could lead to eating disorders. About 1 percent of teenage girls in the U.S. develop anorexia nervosa and up to 10 percent of those may die as a result. [Photograph by Ariel Skelley. Corbis. Reproduced by permission.]

incidence: number of new cases reported each year anorexia nervosa: refusal to maintain body weight at or above what is considered normal for height and age bulimia: uncontrolled episodes of eating (bingeing) usually followed by self-induced vomiting (purging)

dysmorphia: the belief that one's body is different (fatter, thinner, etc.) than it really is only in developed nations where food is prevalent and the incidence of these diseases increases with wealth. People diagnosed with eating disorders often see their body accurately only at the end of treatment—or not at all. No matter what their eventual weight is, the females with anorexia or bulimia may see themselves as overweight or fat, and males with muscle dysmor-phia see themselves as underweight and scrawny. In anorexia, even when severe weight loss has occurred, patients may view their emaciated bodies as overweight. The diagnostic criteria for anorexia includes a "disturbance in the way in which one's body weight or shape is experienced; undue influence of body weight or shape on self-evaluation, or denial of the seri-

ousness of current low body weight" (American Psychiatric Association). The diagnostic criteria for bulimia nervosa includes self-evaluation that is "unduly influenced by body shape and weight" (American Psychiatric Association). Body size or shape dissatisfaction appears to be one of the best predictors of dieting behavior. Another characteristic associated with body-image dissatisfaction, dieting, and binge eating is low self-esteem.

The earlier the treatment or intervention in eating disorders occurs, the better the prognosis is. With early diagnosis and treatment, body-image distortion may be minimal and can return to normal. The goals of body-image treatment are to correct distortions in body image and create a more positive body image. The longer the eating disorder has occurred, the more persistent the body-image distortion tends to be. Some female patients may never view their bodies as anything but overweight, and they may even view normal-weight women as fat. In males, the opposite is true: normal-weight men are viewed as scrawny, and only bodybuilders with significantly higher lean body mass than usual are considered ideal. Cognitive-behavioral therapy is commonly used as a major form of treatment for eating disorders and is often provided with a nondiet approach to improve self-esteem as binge-ing or purging behaviors are reduced. see also Dieting; Eating Disorders; Eating Disturbances; Weight Management.

Catherine Christie

Bibliography

American Psychiatric Association (2000). Diagnostic and Statistical Manual, 4th edition. Washington, DC: Author.

Eldredge, K.; Wilson, G. T.; and Whaley, A. (1990). "Failure, Self-Evaluation and Feeling Fat in Women." International Journal of Eating Disorders 9:37-50.

Rosen, J. C.; Gross, J.; and Vara, L. (1987). "Psychological Adjustment of Adolescents Attempting to Lose or Gain Weight." Journal of Consulting and Clinical Psychology 55:742-747.

Rubenstein, S., and Cabellero, B. (2000). "Is Miss America an Undernourished Role Model?" Journal of the American Medical Association 283:1569.

binge: uncontrolled indulgence eating disorder: behavioral disorder involving excess consumption, avoidance of consumption, self-induced vomiting, or other food-related aberrant behavior

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