Chapter 1
Body Image Concerns Throughout the Lifespan
Jacalyn J. Robert-McComb, PhD, FACSM
Texas Tech University
Learning Objectives
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The difference between normal body image concerns,
body dissatisfaction, and the pre-occupation with
body image concerns, or a pathological concern for
thinness;
Mediating factors that contribute to body image
dissatisfaction in females;
Pre-pubertal, adolescent, young adult, midlife and
older adult body image concerns;
Clinical assessment tools for the evaluation of body
image; and
Effective body image education and management
programs referenced in the scientific literature
Introduction
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Body image is a multidimensional
construct
“Body image”, according to
Thompson, is the internal
representation of your own outer
appearance
Concerns about body image
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desire to look attractive
body dissatisfaction
concern with thinness or perfection
Introduction cont.
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Medical issues arise form body dissatisfaction
ranging from anorexia nervosa to obesity.
Assessment, prevention, and treatment of body image
concerns associated with medical disease, is termed
the “single most neglected area in the study of body
image
Clinicians need to be aware of the development of
body image disturbances, knowledge of body image
assessment techniques, and prevention and
management programs to be able to educate and
guide their patients.
The Difference Between Normal Body Image Concerns,
Body Dissatisfaction, and the Pre-Occupation with
Body Image Concerns, or Body Image Disturbances
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Body image is individualized
Factors that shape individuals body image:
1.
Current/proximal
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2.
Everyday experiences, how they are interpreted, and
their effects on mood and behavior
Historical/developmental
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Socio-demographic factors
Peer and familial influences
Internalization of cultural ideal
Personality attributes
Body Image
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Defined by numerous terms:
Body dissatisfaction
 Negative body image
 Body dysphoria
 Body image distortion
 Body esteem
 Body image disturbance
 Body image concerns
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Body Image Cont’
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Dissatisfaction
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Common problem in many Westernized women
The negative subjective evaluation of one’s physical body
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Weight, figure, stomach and hips
Distortion
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Typically denotes a clinical problem
Most recognized with body image disturbances in eating
disorders and body dymorphic disorders
Mediating Factors that Contribute to
Body Image concerns in Females
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Media
Culture
Difference in athletic
and social setting
Family and Social class
Media
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Enormous impact on the issue regarding body
dissatisfaction
Portrays how women “should” look
Effect of fashion magazines and the internet on
females
Consumer portrays media differently
depending on one’s own culture
Culture
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“Metacommunion system”
Characteristics of culture
The medium of personhood and social
relationships
 Consciousness
 An extension of biological capabilities
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Difference in athletic and social setting
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Society tells women to have a small, toned
body, but athletes are to have large and
muscular bodies
An athlete’s body is not accepted in the social
setting, but accepted in the athletic setting
Positive and negative effects concerning
athletes bodies are setting dependent
Family and Social class
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Disorders can arise from overprotective
parenting
Socio-economically advantaged women are
more concerned with their body
Pre-pubertal, Adolescent, Young Adult, Midlife
and Older Adult Body Image Concerns
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Children
Adolescence
Adult women
Pregnant women
Children
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Concerns with body image are starting at a
younger age
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children at the age of five are having concerns
about their body image
Use of diet and exercise to lose weight
Fear of becoming fat
Adolescence
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Body image concerns have been shown to
increase with age
Greatest risk in development of body image and
weight concerns
Issues that impact teens:
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Peer pressure
Teasing
Adult Women
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Research has shown that adult women express
unnecessary dissatisfaction about their body
Women with higher education and class are more
likely to be dissatisfied with their body
Pregnant Women
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Concern about weight and shape decrease
during pregnancy and early postpartum period
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A woman’s focus goes toward the well-being of
their child
Clinical Assessment Tools for Body Image
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Cognitive Behavioral Approach
Identifying factors that precipitate and maintain
body image concerns
 Primary goals:
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Contextualize body image concerns in way that will
increase patient awareness of precipitating and
maintaining factors
 Provide guide for treatment goals and planning
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Primary goals Cont’
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Current/proximal factors are:
Impact of body image concerns
 Patient’s investment in appearance
 Activating events/triggers
 Cognitive and emotional processing
 Behavioral strategies/self-regulatory behaviors; and
 Goals and obstacles to treatment
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Primary Goals Cont’
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Historical/developmental factors:
Socio-demographic factors
 Cultural/socialization factors
 Physical characteristics of attribute
 Personality attributes
 History of treatment attempts; and
 Co-morbidity
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Cognitive Behavioral Model
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Self-monitoring integral part in assessment
Patient record any situation that triggers experiences
related to body image, appearance-related beliefs and
thoughts, and their effects on mood and behavior
 Allows assessment of treatment progress and
outcomes
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Commonly used Body Image
Assessment Scales and Questionnaires
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Table 1.1 (in book)
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Lists some common scales that have been reported
in research literature that have internal consistency
rating and test-retest reliability rating of at least 0.70
Caution recommended in adopting scales
without psychometric properties
Judgment must be used in generalizing the
standardized sample to your target sample
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Effective Body Image Education and
Management Programs Referenced in the
Scientific Literature
Body Image Education
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Positive impact on women’s body image
Program based on Social Cognitive Theory
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goal is to promote women’s acceptance of their
bodies
Management of Body Disturbances
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Two primary approaches:
Cognitive-behavioral
 Feminist approach
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Both treatment option for wide variety of
clinical population
The Cognitive-Behavioral Strategy
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8 Components
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7.
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Comprehensive body image assessment
Body image education
Body image exposure and desensitization
Identifying and challenging appearance assumptions and
problems
Clients dispute negative appearance assumptions
Targets avoidant behaviors and compulsive patterns by
self-defeating body image behaviors
Development of body image enhancement activities
Clients evaluate their progress, set future goals, and
strategies
Feminist Approach
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1.
2.
3.
Differs form cognitive behavioral approach in 3
primary ways:
Criticizes approaches that focus on treating body
image problems by changing a woman’s appearance
Egalitarian relationship characterized by therapist
self-disclosure, greater informality and nurturance,
and patient advocacy
Different etiological factors that play a role in the
development of body image disturbance.
Conclusion
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Growing appreciation of complexities in body
image
Concerns about body image range form normal
desire to look attractive, to pathological concern
with thinness or perfection
Ideas of beauty vary across ethnic groups,
gender, sexual orientation, age, and culture