Current Physical Ideals
Joan Brumberg, author of The Body Project, notes that the female ideal, and the pressure to achieve it, have become unrelenting. Not only are women encouraged to be thin, they are presented with a physical ideal that is diametrically opposed to the softness and curves more natural to the female body. The flip side of this experience is an ideal based upon exaggeration of male physiology. The authors of The Adonis Complex, state that hyper-muscularity has become increasingly important to men as a symbol of masculinity.
These ideals are not only biologically unattainable for most people, but downright dangerous. Just take a look at Barbie and GI Joe Extreme. If Barbie were life-sized, she'd be at 76% of a healthy body weight - a weight consistent with acute hospitalization. And GI Joe would have biceps almost as big as his waist, and bigger than most competitive body-builders!
Very few women possess the genetics to naturally produce the ultra-long, thin body type so widely promoted, and when they do, it isn't usually accompanied by large breasts. Moreover, there are limits to how little body fat a woman can possess and still have normal hormonal functioning. Below a certain level of body fat and dietary fat, a woman's body cannot produce the estrogen needed for ovulation and menstruation. A woman also develops a higher risk of stress fractures because normal bone breakdown is accelerated in the absence of estrogen, and osteoporosis becomes more likely. (Click here to learn more about amenorrhea.)
The same thing goes for 6-pack abs and the "ripped" look being promoted to men; the ability to have very defined abdominal muscles is genetically endowed, and the hyper-muscled physique of action figures and male fitness models is impossible to achieve without illegal anabolic steroids. UCLA's Student Nutrition Action Committee (SNAC) webpage on Body Image and Eating Disorders puts it very succinctly:
"It's physiologically impossible to gain unlimited pounds of pure, bulging muscle mass while maintaining an ultra-lean, ripped body - even when following the "perfect" training and diet program. Once you reach your maximal muscle mass, any further gains will come from both muscle AND fat. So, men who have greater muscle mass/size tend to have higher body fat percentages as well."
Every day, however, we are told that these unattainable bodies are normal, desirable, and achievable. We compare ourselves to these ideals and feel displeased with our bodies for being so different, and when we fail to make ourselves over in the image of these ideals, we feel even worse because we can't seem to succeed at something so supposedly straightforward. (For further discussion of the realities of weight and health, check out our page on weight concerns.)
Studies at Stanford University and the University of Massachusetts found that 70% of college women say they feel worse about their own looks after reading women's magazines. And a 2006 study published in the journal of Psychology of Men and Masculinity showed that not only did watching prime-time television and music videos appear to make men more uncomfortable with themselves, but that the discomfort led to sexual problems and risky behaviors. "People see the same images over and over and start to believe it's a version of reality," says Deborah Schooler, one of the researchers. "If those bodies are real and that's possible, but you can't attain it, how can you not feel bad about your own body?"
The media is a powerful conduit for transmission and reinforcement of cultural beliefs and values, and while it may not be exclusively responsible for determining the standards for physical attractiveness, it makes escaping frequent exposure to these images and attitudes almost impossible. Advertising, in particular, creates a seductive and toxic mix of messages for men and women. Jean Kilbourne, creator of the award-winning documentary Killing Us Softly, and author of Can't Buy My Love: How Advertising Changes The Way We Think and Feel, says the impact on eating problems and body image may not be absolute, but it is real:
"...these images certainly contribute to the body-hatred...and to some of the resulting eating problems, which range from bulimia to compulsive overeating, to simply being obsessed with controlling one's appetite. Advertising does promote abusive and abnormal attitudes about eating, drinking, and thinness. It thus provides fertile soil for these obsessions to take root in and creates a climate of denial in which these diseases flourish."
Intolerance of body diversity has a lot to do with the meaning of size and shape in our culture. Being thin and/or muscular has become associated with being "hard-working, successful, popular, beautiful, strong, and self-disciplined." Being "fat" is associated with being "lazy, ignorant, hated, ugly, weak, and lacking in will-power." As a result, "fat" isn't a description like tall or redhead - it's an indication of moral character: fat is bad. Size prejudice is absorbed at a very young age; children as young as five have ascribed negative characteristics to silhouettes of fatter children. In part, this is because size prejudice is also widely reinforced; media, friends, family, and even well-respected health professionals can echo the message that fatness is inherently wrong and dangerous, thereby exacerbating the pressure to control our bodies.
Family, Friends, and Lovers
If we grew up surrounded by people who spent a lot of time focused on their bodies (or ours), or who worried a lot about eating and exercise, chances are that we do, too. We learn from other people about the things that are considered important, and if appearance is considered critical, we're going to feel that spending lots of time and energy on image is the right thing to do.
Sometimes the pressure from family isn't about thinness as an aesthetic ideal. Sometimes it's about the struggle to become integrated into a culture from another racial, ethnic, or religious background. Becky Thompson, in her book A Hunger So Wide and So Deep, says, "The culture of thinness in models has been used, erroneously, to dismiss the eating problems among women of color based on the notion that they are not interested in, or affected by a culture that demands thinness." Research indicates that for African-American, Asian-American, and Latina women, increased assimilation into the "white culture" results in higher levels of body dissatisfaction. Anecdotal evidence suggests that the same may be true for men who come to accept being body-focused as the price of succeeding in American society.
Peers and friends strengthen the development of body image through what researchers call "appearance training." Conversations about clothes, looks, and attractiveness provide a context for paying attention to and interpreting appearance-related information. Friendships are particularly important in body image development because of the sheer amount of time involved, the value placed on friendships, and the ways in which friends create shared norms and expectations about appearance.
And when the group "vibe" about body image trends towards the negative, it's difficult not to get dragged down. People report widely that their dining halls, bathrooms, locker-rooms and dorm rooms are filled with "bad body talk": "I've got to get rid of this gut." "Ugh, I hate the cellulite on my thighs." "I feel fat." Listening to so many of these conversations tends to reinforce the need to focus on appearance and make comparisons between ours and other's bodies. It also increases the likelihood that we will find our appearance lacking.
Then there's the issue of romance. Media messages, particularly those from advertising, strongly emphasize the role of appearance in romantic success. "Getting" the guy or the girl is reduced to possessing a stereotypical set of physical attributes, with no appreciation for personality, background, values, or beliefs. But studies suggest that people's perceptions may not accurately reflect the body type preferred by a potential partner. Among heterosexuals, research using silhouettes of the opposite sex revealed a large gap between the perception and reality of attractiveness for both men and women. The body ideal that men THOUGHT women preferred was actually 15-20 lbs. more muscular than the one female respondents actually preferred. And the female silhouette that most men idealized was significantly bigger than the one the women expected them to prefer.
Research studies on body image issues in LGBTQ populations reflect the diversity and complexity of this community:
One study of 263 lesbian women found that although they were generally more critical of social norms concerning the roles of women, they were not so critical of expectations about women's weight and appearance. 48% of the participants had dieted in the past 3 months, almost half were dissatisfied with their weight, and low self-esteem was strongly linked to body dissatisfaction.
One study found that gay men diet more, are more fearful of becoming fat, and are more dissatisfied with their bodies in general as well as with their degree of muscularity than heterosexual men. Gay men were also more likely than heterosexual men to hold distorted cognitions about the importance of having an ideal physique. (It is important to note, however, that body image experts like Dr. Roberto Olivardia, co-author of The Adonis Complex, feel that gay men, because they have already confronted perceptions of not being masculine, may simply be more be more likely than heterosexual men to acknowledge and get support around struggles with body dissatisfaction.)
Researchers speculate that trans* individuals may be particularly at risk for body dissatisfaction and eating disorders, due to issues around estrangement from the body, the gender assigned at birth, and managing the physiological aspects of surgery and hormone shots.
Medical Standards and Medical Professionals
Unfortunately, the healthcare setting is another place where we can struggle to maintain a positive relationship with our bodies. In 1998, the National Heart, Lung and Blood Institute released their Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Body Mass Index was promoted as an important factor in the new system for formally classifying weight status, and since then primary care providers have been widely encouraged to apply these classifications in their routine evaluations of patients. Some insurance companies are even providing fiscal incentives to clinicians for every BMI calculated. Aggressive approaches to the obesity "epidemic" are being heavily marketed to clinicians by insurers, pharmaceutical companies, the weight loss industry and some researchers, so it isn't surprising that both patients and providers are feeling the pressure to focus on weight.
This is particularly unfortunate, because there is a growing body of research which suggests that it may be more helpful to encourage people to focus on changes in eating and activity without reference to weight or size. Canada's public health campaign VITALITY encourages Canadians to enjoy eating, being active and feeling good about themselves, rather than focusing on weight reduction and ideal body shapes.
A similar approach was piloted as part of a California study. The study compared changes in weight, labwork, eating behavior, eating attitudes, and psychology (self-esteem, depression, body image) between two groups of women receiving 6 months of weekly group education. The first group received behavior-based weight loss education which included nutrition information, moderate calorie and fat restriction, keeping a food diary, and monitoring weight. The second group used a Health At Every Size (HAES) approach which focused on body acceptance, decreasing restrictive eating, increasing attendance to internal cues for hunger and satiety, nutrition information, and addressing barriers to enjoyable physical activity.
The results were pretty striking. At the two-year follow-up point, the HAES group showed sustained and significant improvements in total cholesterol, LDL, blood pressure, moderate physical activity, restricted eating, susceptibility to hunger, body dissatisfaction, and self-esteem. The diet group did not sustain positive changes in any of these areas, and in fact, self-esteem was shown to be significantly worse at the two-year follow-up point. Fifty-three per cent of the diet participants expressed feelings of failure, compared with 0% of the HAES group.
It's important to remember, too, that medical providers are not protected from the influence of the wider culture by virtue of their training or education. They are inundated with the same images, messages, and societal pressures, which can and do travel with them into patient-care interactions, further influenced by medical provider's feelings about their own relationship with size, shape, food, and exercise. So if we experience weight prejudice in a medical setting, it's important to remember that there are very powerful forces at work, and that we have a right to receive respectful and supportive medical care - not the least of which is balanced, accurate information about the relationship between weight and health.