PERCEPTION OR REALITY?
Granted, some people do have excess body fat that they can appropriately lose to be healthier as a person and lighter as an athlete. They can rightfully feel pleased when they accomplish the goal of attaining a leaner physique that helps them perform better and be healthier. But many active people just think that they have excess fat to lose, and they have distorted body images. For example, a survey of 425 collegiate female athletes reported that most of the women wanted to lose about 5 lbs (3). Did they really have 5 lbs they could appropriately lose? Or did they fail to realize that "fit" looks different from "skinny" (12). A quest to lose 5 lbs also was reported in a survey of the top women runners in the country (5). Despite their accomplishments, these elite women runners reported that they wished they could be leaner. Some, in their desperate efforts to change their physiques, developed unhealthy eating patterns and even eating disorders.
Among 4,463 U.S. teens, about 38% of boys and 51% of girls reported being dissatisfied with their bodies, including 33% of those who were normal weight and 75% who were overweight (1). Dissatisfaction increased with age. This pattern commonly continues into adulthood. As one of my clients confided, "I have struggled for years feeling imperfect, wishing I'd been born with a better body."
Active people with poor body images harshly judge themselves from the outside in, rather than lovingly accept themselves from the inside out. Women complain endlessly about their thighs, abdomen, breasts, and buttocks. Men are dissatisfied with their abdomen, upper body, and balding hair. Sometimes, the problem is imaginary, such as a woman with anorexia who complains about her fat thighs. Sometimes, the problem is real, ranging from a mild complaint about the "spare tire" around the midriff to a major preoccupation with a "jelly belly." Regardless of reality or perception, the end result is often relentless dieting and intense exercise akin to punishment.
ARE YOU REALLY FAT?
Many people who complain about "feeling fat" are not overfat. An informative first step to determining if an active person really does have excess body fat is to measure his or her body composition. Measurements using skinfold calipers can offer a good baseline for repeated measurements over time. Because a margin of error exists when measuring body fat regardless of the method used, the measurer should be sure to explain this to the person being measured. A number is just a number, not a judgment.
Body composition data can be helpful, especially if the person discovers he or she is leaner than expected. Knowing he or she is not as "fat" as he or she feared can help him or her better accept his or her self and body. But sometimes, even when body fat measurements are low, the person may still complain about "feeling fat."
"I feel fat" comments abound among exercisers. An appropriate response to the "I feel fat " complaint is to remind the person that "fat" is not a feeling. That is, a person doesn't feel "blond hair" nor "freckled." She also does not feel "fat." Yes, she may be feeling uncomfortable with her body, but the "fat feeling" generally relates to feeling imperfect, inadequate, insecure, and anxious - or any number of other feelings that get translated into "feeling fat."
People who "feel fat" need to explore those real feelings with the help of a counselor. The counselor can help them figure out where they got the message that something is wrong with their body and then take steps to resolve the issue. The media is a likely source of harmful messages, but other likely sources may include a parent who lovingly said at a tender age "That outfit looks nice, honey, but if only you'd lose a few pounds…" What that child hears is "I'm not good enough." For a perfectionist, this can create a downward spiral of self-esteem. Perfectionistic traits (such as striving for the perfect body) are highly associated with eating disorders (6).
WEIGHT ISSUES ARE SELF-ESTEEM ISSUES
Ideally, what your clients look like on the outside should have little to do with how they feel on the inside. If they struggle with feeling good about themselves, take note: weight issues are often self-esteem issues (10). Your clients may be letting their significant accomplishments, such as success with family, community, and work, get overshadowed by cellulite or love handles (12).
A person's value extends far beyond his or her looks. Appearance is only skin-deep, and real beauty is found in the love, caring, and concern a person offers to her friends, family, and peers. The trick is to figure out how to live a satisfying life at one's genetic weight. Yes, a person can slightly redesign the house that Nature gave, but they can't totally remodel it (at least without paying a high price of obsessive dieting and exhaustive exercising).
For some people, accepting an imperfect body feels like giving up the dream of living a "thin life" and all the fantasies that go along with that. Yet, one's dreams do not have to depend on thinness. The truth is, no number on the scale will ever be good enough to do the enormous job of creating body acceptance and happiness. This story, told to me by an athlete, exemplifies that point:
"I once weighed 124 lbs and was unhappy with that weight. I started exercising and dieting rigidly. I lost to 99 lbs but I still wasn't happy. I ended up binge eating; I gained to 160 lbs, where I was miserable. I sought help from a counselor, stopped eating emotionally, and with time, got my weight back to 124 - and I felt happy there! Why couldn't I have been happy at 124 lbs in the first place?…" Why? Because happiness has little to do with weight.
WHAT TO DO
So what should you do when you have a client who is dissatisfied with his or her body? You might think that the solution is to encourage him or her to lose weight by going on a restrictive diet (that deprives the body of carbohydrates, protein, iron, zinc, calcium, and a myriad of other health-protective and performance-enhancing nutrients). You might also encourage him or her to redesign his or her body by pumping iron, training for a triathlon, or doing thousands of sit-ups. Cosmetic surgery is another enticing option. Unfortunately, this "outside" approach to correcting body dissatisfaction tends to be incomplete and inadequate. The better approach is to build self-esteem and focus on what the body can "do" versus how it looks. Perhaps it can lift heavy weights, run a marathon, enjoy a walk, or create a healthy baby. Encourage your clients to accept their bodies for what they are and love themselves from the inside out (13). And even if they are overfat, despite being fit and healthy, they can still be good people who can be proud of who they are - loving, caring, and beautiful humans (2). A person is not defined by a number on the scale nor a percentage of body fat, but rather by his or her family life, community work, and the friendships he or she nurtures.
To help your clients stop the struggles with their "imperfect" bodies, Dr. Thomas Cash recommends that they first need to identify where they got the message that something is wrong with their bodies. Perhaps it was a parent who (years ago) lovingly remarked "You look good, dear, but you'd look even better if you'd lose a few pounds." Or the siblings who teased about their "thunder thighs." Next, they need to take steps to find peace with their bodies, redefine their goals, and accept themselves as being good people. These steps may include -
* Rename the disliked body part. For example, "round stomach" is a more loving name than "repulsive gut."
* Identify the parts of their bodies that they do like and give themselves credit for their good parts with positive body talk. Perhaps they have beautiful hair, a gorgeous smile, and a cute nose.
* Focus on loving all the good things their bodies do for them. Those strong legs (formerly fat thighs) let them be active, fit, and strong (4).
Nutrition therapist Karin Katrina, Ph.D., R.D., of Gainesville, FL, encourages her clients to pretend that they live on an island where their bodies are "good enough" the way they are. (Few people will ever have a "perfect" body, so the second-best option is to enjoy a body that is "good enough.") If they leave their imaginary island and start comparing themselves to their peers, they'll undoubtedly notice they soon end up "feeling fat." As the saying goes, "To compare is to despair!"
Katrina suggests that a person with a poor body image refers to herself or himself as a gorgeous goddess or a handsome hunk whenever she or he looks in a mirror. With time, he or she can start to believe that perhaps he or she is indeed good enough the way he or she is.
A person's body has been and will continue to be his or her house throughout his or her lifetime. It likely has been good enough for his or her family, friends, and coworkers. And although it may seem not perfect enough for him or her, perhaps now is the time for him or her to make it his or her home. This body acceptance can contribute greatly to a higher quality of life (8).
ADDITIONAL READING AND RESOURCES
Changing the way a person feels about his or her body is a complex process. The following Web sites can help active people in this journey to find peace with their bodies:
* www.nourishingconnections.com (free e-newsletter by Karen Katrina, Ph.D., R.D.)
* www.findingbalance.com (includes videos about resolving weight issues)
* www.adiosBarbie.com (offers resources and insights into the media)
For a plethora of body image books, visit the online bookshelf at www.gurze.com.
Some favorites include:
* Andersen A, Cohn L, Holbrook T. Making Weight: Healing Men's Conflicts With Food, Weight, Shape and Appearance. Carlsbad (CA): Gurze Books; 2001.
* Cash T. The Body Image Workbook: An 8-Step Program for Learning to Like Your Looks. Oakland (CA): New Harbinger Publications; 2008.
* Freedman R. Bodylove: Learning to Like Our Looks and Ourselves. Carlsbad (CA): Gurze Books; 2002.
* Johnson C. Self-Esteem Comes in All Sizes. Carlsbad (CA): Gurze Books; 2001.
* Maine M, Kelly J. The Body Myth: Adult Women and the Pressure to Be Perfect. New York: Wiley; 2005.
* Wachter A, Marcus M. The Don't Diet, Live It Workbook. Carlsbad (CA): Gurze Books; 1999.
CONDENSED VERSION AND BOTTOM LINE
Body-image issues plague many active people, especially those who strive to attain a "perfect" body. Yet, few humans are born with "perfect" bodies. By accepting their bodies for what they are, loving themselves from the inside out, appreciating all that their bodies do for them on a daily basis, and honoring genetic differences in body size and shape, active people can start to resolve their body-image issues and enjoy better quality of life.
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Keywords:© 2010 American College of Sports Medicine
Body Weight; Body Fat; Self-Esteem; Weight Reduction; Physique