Guest Article

Body Image As We Age: From Dissatisfaction to Acceptance

Kim Scott, LMFT

In the height of summer, aka bathing suit season, it seemed like a perfect time to delve into the subject of body image. The idea came to me when I invited a friend over to swim and lounge by the pool. Her response was a hard no. She said, “I would not subject anyone to seeing my old, fat body in a swimsuit!” This made me curious about how our feelings about our bodies change (or stay the same) as we age.  While we often associate body image issues with teens, these concerns can resurface as we age, significantly impacting mental health, quality of life, and even physical health.

In this article, we will explore the research on aging and body image, examine the unique factors contributing to body image issues in later life, and discuss the psychological, social, and physical challenges associated with poor body image. Additionally, we will offer strategies for therapists to assist clients in moving towards body acceptance—or at least body neutrality.

The Reality of Aging and Body Image

A study published in the International Journal of Eating Disorders by Dr. Sara M. Hofmeier and colleagues analyzed responses from 1,849 women over the age of 50 to understand their feelings and thoughts about their bodies as they aged. The average age of participants was 59. The findings were striking: 79% reported that their weight or shape affected their self-perception, and 62% indicated that their weight or shape negatively impacted their lives. Moreover, 70% were actively trying to lose weight.

Although body image concerns affect both men and women, men generally report higher levels of body satisfaction compared to women.

A Glimmer of Hope

Other studies offer a more hopeful perspective, suggesting that body satisfaction remains relatively stable over a lifetime and may even improve slightly with age. However, given the pervasive negative self-perception that many women hold about their bodies, the notion of stability doesn't equate to significant improvement.

Factors that Contribute to Body Dissatisfaction with Aging

Let's dive into some of the key factors contributing to body dissatisfaction as we age. One of the primary culprits is our society’s obsession with youth and thinness. When being young and slim is held up as the ideal, the natural signs of aging—wrinkles, age spots, sagging skin, and changes in weight—can make us feel unattractive and ashamed.  Ashamed that we let this (aging) happen to ourselves.

Menopause can also cause weight gain and body composition changes due to the decrease in hormones. Even women who have never had body image issues can suddenly face challenges during this time of life. In addition to the physical changes that begin in peri-menopause and continue into menopause, emotions can become heightened, sex drive can decrease, and societal messages about a woman’s decreased attractiveness in this new phase of life can contribute to plummeting self-esteem.

A 2014 study conducted by Kathryn L. Jackson and colleagues suggested that poor body image in menopause adds additional risk to mental health and increases the episodes of depression.

Body dissatisfaction can also be exacerbated by changes in mobility and physical functioning, health issues, chronic pain, and medication side effects. These changes can leave us feeling disconnected from the bodies we once knew so well, leading to feelings of frustration, betrayal, and again, shame.

By acknowledging these factors, we can better understand the challenges faced by our aging clients and help them work towards fostering a more compassionate and accepting view of their bodies.

Psychological Impacts

Poor body image can lead to numerous psychological issues, including depression, anxiety, low self-esteem, and a decrease in sex drive. As people age, these issues can become intertwined with other life stressors, such as retirement, health problems, and changes in social roles. The death of a spouse can also impact body dissatisfaction and insecurities as the individual considers dating again.

Social and Physical Challenges

Socially, poor body image can lead to isolation and avoidance of activities that might highlight physical appearance or eating. Sadly, I have seen this many times in my practice where clients forgo participating in social events because they are embarrassed about their weight or appearance.

Physically, it can also result in unhealthy behaviors such as extreme dieting or excessive exercise, which can further harm overall health. It can also make the individual avoid seeing their doctor for fear of getting on the scale or learning that they have other physical ailments.

Moving Towards Acceptance

Below are some strategies to help clients move towards body acceptance:

1. Acceptance and Commitment Therapy (ACT): This can help clients acknowledge and accept the physical realities of aging, mindfully observe rather than fight their negative cognitions, explore their values and how they fit with or contradict their negative body image, and identify action steps to feel better and more comfortable in their body as it changes.

2. Cognitive-Behavioral Therapy (CBT): This can help clients identify, challenge, and change negative thought patterns about their bodies. This can be extremely helpful because often negative cognitions about our bodies and aging are deeply engrained and steeped in unconscious societal biases.

3. Mindfulness and Self-Compassion: Encouraging practices that promote self-kindness and present-moment awareness can reduce the harsh self-criticism often associated with poor body image.

4. Promoting Healthy Lifestyle Choices: Focusing on health rather than weight can help clients develop a more positive relationship with their bodies.

5. Community and Support Groups: Connecting clients with others who share similar experiences can provide much-needed support and reduce feelings of isolation.

Conclusion

Body image issues do not simply fade away with age. They can resurface and bring with them significant challenges. However, with appropriate strategies and support, it is possible to foster a more accepting and compassionate view of one's body, enhancing both mental and physical well-being.

Kim Scott, LMFT is a licensed marriage, family and child therapist. She has a private practice in Granada Hills where she works with couples and individuals, in-person and via Telehealth. Kim has been licensed for 30 years and has expertise in working with older adults and women issues. To learn more about Kim's practice and to read more of her articles visit her website: www.kimscottmft.com