The Issue of “Body Image”

A recent news story on a popular television news network reported on July 5, the “epidemic” of childhood obesity.  Another news story some months ago reported on the “obesity epidemic in America.”  In this particular story, a local pediatrician reported that nearly 25 – 30% of her child-patients were considered obese.  Over the past several years, other stories have been offered in virtually all of the major news media, magazines, and popular books, relating to obesity and health. 

Yet, there are also stories about a drastic swing in the other direction; namely, anorexia nervosa and bulimia nervosa.  The dynamics involved in these “diseases” are quite complex.  Essentially, the person with anorexia, or bulimia, uses certain behaviors to control their weight.

Anorexia involves immense control on the part of the person who decides to eat very little.  In severe cases, the person literally starves to death.  Bulimia is when a person uses “purging behaviors” to control their weight.  One type of purging behavior uses the body’s gag reflex to rid stomach of its contents.  Other forms of purging are misuse of laxatives, diuretics, and enemas, in an effort not to gain weight.  A person in the bulimia dilemma, sometimes eats a lot, or “binges” and then vomits this food soon after enjoying the taste and feeling of eating.  Another purging behavior is where the person uses excessive exercise (and sometimes vomiting as well) to counteract the effects of the eating binges on the body.

Another dilemma that might fit in this category is the dilemma of “overeating.”  This is where a person cannot seem to stop eating a certain type or types of foods.  These foods are sometimes referred to as “binge” foods or “trigger” foods.  The idea is that the person who engages in overeating behaviors struggles with a love/hate relationship with their food.

Why would a person engage in these extreme behaviors, especially considering the negative health consequences?  There is more to these behaviors than simply being “all in one’s head.”  There are numerous and complex reasons that people engage in these behaviors.  Some thoughts about the genesis, or etiology of the issues are listed below:

• A biological issue.  This area has many controversial and sometimes opposing views from different “authorities” concerning a person’s body type.  Several medical and scientific studies have suggested that there is some validity to the idea that certain persons are genetically predisposed to carry more “fat tissue.”  There are also the health and fitness trainers that acknowledge or believe in the three body somatotypes: the ectomorph, mesomorph, and endomorph.  In their experience, these body types develop and maintain muscle and fat tissue in unique ways.  Additionally, these body types are reported to respond to exercise and nutrition differently.
• A psychological issue.  This can be a controversial subject.  However, Anorexia and Bulimia are listed in the Diagnostic and Statistical Manuel IV – TR (DSM-IV-TR).  These dilemmas are treated as recognized mental illnesses with specific treatment plans. 
• bergen A sociological issue.  Consider the time, money, and effort that the American media invests in marketing “pretty people.”  These models are usually quite thin, and some are thin with a degree of muscularity.  It is also anecdotally reported that the “camera” adds ten pounds to the actor’s appearance; therefore, if this is true, the models/actors are very thin.  The media is a very powerful influence upon the majority of people living in America.  Consequently, this influence is dynamically influencing people on the conscious and sub-conscious levels.  It is also interesting that the media seems to focus almost exclusively on the very young, with the age being somewhere between eighteen (probably younger) and twenty-something, for their models that appear in the magazines, television commercials, and the like.
• A spiritual issue.  This area is included because it is possible that many persons struggling with the above-mentioned dangerous behaviors may lack something in, or a piece or part of, the whole person.  Many healing theories in use today acknowledge or include treatment, or attention to the “whole person.”  Whatever way one chooses to label or identify this theory, it is becoming more useful to address additional areas or needs than simply the “presenting problem.”

It seems important and useful for any person who is actively seeking to lead a healthy lifestyle to become, at the very least, familiar with this information.  It is probable that all persons living experience a degree of each of these issues to a lesser or greater extent simply by being human and experiencing human feelings. 

There is the popular notion of “comfort foods.”  Implied in the term itself is the idea that a person who is experiencing some form of discomfort might use food to make them feel better.  A typical example is chocolate for women, candy for children, or a huge steak for a man.  While these are stereotypically presented, the idea is that most, if not all persons, have used or abused food at some level, in some way, at some time.  The importance is to identify this dynamic and label it for what it is.

It is also possible that many persons have used exercise to lose a few pounds quickly, in addition to the “strict diet” that is engaged in for a discreet period, until the desired amount of weight is lost.  This would seem to be somewhat akin to bulimia, by virtue of the exercise “purging behaviors,” though not significant enough to be labeled as such by a psychologist.

Many persons have engaged in a period of acute or severe dieting.  This seems to be a behavior that resembles anorexia, save that the severe diet is only for a discreet period of time until the desired amount of weight is lost.

It seems that the common element in the above behaviors is that these changes in exercise and eating patterns are engaged in for a short period of time.  Upon obtainment of the desired weight goal, the person tends to return to the previous way of living and eating.  The cycle is then inevitably repeated.  Recent research is indicating that this type of “yo-yo” dieting can actually reduce lean muscle mass and increase body fat.  This is the opposite of what most people desire.  This kind of moving back and forth between dieting and non-dieting can actually be harmful to one’s health.

This begs the question, “What is the driving force behind such behaviors?”  It seems probable that the person is struggling with a body image issue.

Body image issues play a key role in the minds of persons who struggle with anorexic and bulimic behaviors, as well as, overeating behaviors.  Helpers who work with persons struggling with these issues work heavily with body image in their treatment processes.  Entire books, audio-visual presentations, and treatment groups are devoted to the dynamics of body image. 

Essentially, each person has a particular way in which they view their own bodies.  Many people have a body image that is consistent with how other people see them.  However, it seems that all people can struggle with how they perceive their bodies.  On some days, a person can look in the mirror and see themselves as pleasant looking, and on other days, the same person can view themselves in a less positive way.  In extreme cases, a person with anorexia may see themselves as “pudgy” even though their rib and pelvic bones are clearly defined beneath the skin. 

These “image distortions” seem to be difficult enough to deal with by themselves.  Add to the mix of these natural and normal vacillations of “distortions” the continuous bombardment of our psyches with ultra-thin, very young models through the television and print media, and there is the recipe for “image disaster.”  These dynamics can and do drive many people to different levels of discomfort that may lead to rather significant or, in some cases, extreme behaviors related to exercise, nutrition, and health.  In some cases, the continual presentation and focus upon ultra-thin people in these media can lead to a paradoxical effect whereby a person may simply believe they will never achieve this look.  Therefore, they reason, why not eat, drink, and be merry.

Health and fitness is not a discreet event that is undertaken at special times of the year.  Nor is it something that need be dull and dreary.  Instead, the safest, healthiest, and most sustainable method of maintaining good health and fitness is to make it a lifestyle.  This saying has become cliché during the past few years.  However, it seems to be a reasonable and responsible approach to healthy living. 

Find the proper exercise routines, the proper nutrition, and a positive balance in all areas of life.  This is the most effective way in which to maintain good health.  Exercise routines should include aerobic and anaerobic work, and the routines should be varied every four to six weeks.  Nutrition is a critical component.  Just “eating healthier foods” does not work.  Calories, grams of protein, carbohydrates, and essential fats, should all be factored into the right amounts for the particular needs of the person.  Eating all of the fruits and bread products currently being recommended may not be helpful to the person who wishes to become more lean.  While it may seem overwhelming at first to try to count calories and account for grams of different foods, etc., it really is quite simple once learned. 

Persons who wish to lose weight in a medically sound fashion should take the attitude of settling in for the “long haul.”  Persons who wish to become more fit should also consider starting low and going slow. 

We Americans tend to want things “yesterday.”  When undertaking a serious program of health and fitness, a person does not simply lose large amounts of scale weight overnight, nor do they become race winning marathon runners in two weeks time.  It may also be that a person needs time to become more aware of their own feelings about their body image.

When looking in the mirror, a person may initially wish to spend a short time evaluating their appearance, possibly for only seconds at first.  As they do, it may be helpful to take notice of at least three things that they like about their appearance.  It is sometimes beneficial to say those things they like about their appearance out loud.  What is not helpful is to compare their bodies with others, or worse yet, with commercial models, television, or movie personalities.