Men suffer with their body image much the same as a woman does. There is a media type of perfection that men are influenced by that includes thin, tall, dark men. Most men don't put the same pressure on themselves to reach that perfection or fit in, but men who have “moobs” don't feel masculine or desired by women. Gynecomastia is breast development in males. It can happen at any age, but it is usually due to weight gain with adult males. Fat is deposited over the pectoral muscles, and this can make men appear to have breasts or moobs. There are diseases that can cause this development, so it is important that you go to your doctor if you have pain or other symptoms. With obesity being so common, it is becoming more and more likely you know someone with moobs.

The clothing industry has realized it can make money from peoples' insecurities. They now have shirts made of spandex for men to hold their moobs in. They also have a mature cut with shirts for men with moobs. Clothing industries have always had these clothing sensitivities for women. However, with a high divorce rate and more middle aged men dating, they are becoming more aware that guys, too, suffer with body image. What woman doesn't have a pair of spandex, or transparent line panties, or bras that promote cleavage? Why should it be any different for men? No matter how technical the clothing industry becomes with holding us in or pushing us out, if you are in an intimate relationship, someone eventually has to see your body. Any part of your body that gravity can affect, it will. The latest statistics project that by the year 2015 75% of Americans will be overweight. Can you imagine the moobs and sagging we will see in both men and women?

Here are some tips you can begin today if you feel badly about your weight or if you are growing “moobs” due to obesity:

1. Go to your primary care doctor. This is important because weight gain can be caused by many things. Although weight gain is the primary reason for moobs in adult men, it could be something else.
2. Get engaged in an exercise and nutritional program. Your local Y may be a good place to start. Some physicians have nutritionists on their staff; changing how and why you eat is a great place to begin.
3. Buy clothing to disguise your moobs and stomach. Women have been buying support clothing for a long time. Guys may feel less masculine when purchasing a t-shirt made of spandex, but if you are on the dating scene or just feel bad about your body, a clothing article can help you feel more confident.
4. When you are with your spouse, make it more about the time together than going to a new restaurant. Maybe instead of a full course dinner, you could try appetizers. You will save money, and the time you may have spent eating can be spent going for a walk or talking with your spouse.
5. If you aren't married, engaged or in the dating scene, remember the first thing that impresses people is your appearance. If you lack confidence regarding your body, walk around slumped over, or try to hold back, your first impression will not be favorable. It is much better to stand up straight, look your date in the eyes, and be transparent. Tell her/him you are working on a healthy lifestyle and portray to that person that you are determined to make changes. Women want a “take charge” guy. Taking charge of yourself and being healthy is a turn on. Women would most likely overlook your moobs.

Being judged is never fair, especially when that judgment is primarily made up of visual cues. How a person feels about their flaws may accentuate the flaws. Try to begin a lifestyle that will eliminate the flaw and derive confidence from your ability to follow through. Confidence is visual. Also, most of us have been drawn to people who weren't especially attractive, but their confidence made us want to be with them.

We want our kids to grow up liking themselves, the way they look, and what they contribute to their lives as well as the lives of others. Recently, I was involved in a show on FOX 26 which featured a woman who has the largest breasts in South America. What possessed this woman to keep going to the size of double “Ks,” on her way to “Ms?” She told us she became addicted to the process, that the breasts began to make her feel beautiful, which is something she had never felt as a child growing up and had always wanted. She also told us she was one of thirteen children, a child whose father died when she was seven, and her mom married another man to help with the raising of the children. She also told us that through most of the 30 surgeries she had suffered from bipolar disease and wasn't medicated until recently. Her breasts are infected and she is on constant intravenous pumps to prevent the infection from killing her. The picture is very disturbing, and underneath all of the plastic surgery and media attention is a child who wants to be loved for who she is. Her breast implants are not typical of what usually happens, but when you look at her small frame, and talk to her you understand the implants are not or never were going to give her that inner acceptance that she needs so desperately.

How do we build up our children so they don't look for surgery to make them feel good enough or beautiful, when that is clearly not the problem (for parents):

1. Try to stay away from critical parenting. Parents, DO NOT focus on your kid's looks. Take interest in what they do, and their gifts instead. When they need reassurance about the way they look, tell them they are beautiful to you in all ways (if they aren't, look deeper).
2. If your child complains that kids make fun of them, help your children think of comebacks. If the child is under the age of seven, talk to the parents or your child's teacher. If your relatives make fun of your child due to some flaw, confront the relative in private and tell them how it is hurting your child. I have a patient who is obese, and her memory of when her weight problem started was in the 5th grade when, in a physical education class, two boys told her she was the fattest girl in the school. The girl was ten pounds overweight, but she did get fatter after hearing that. Children are SENSITIVE TO CRITICISM.
3. Be aware of changes in puberty with your child. This is a time they compare themselves to others, including media. Some kids develop earlier than others, and this can be embarrassing if you have no one to talk to. Make yourself available to talk, and share your feelings and flaws during this time. Your child will appreciate it.
4. Hurtful teasing from parents, cousins, aunts, and teachers all influence how teens feel about themselves (forever).

Tips for improving your body image (for tweens and teens):

You are not born with a body image; you learn it from significant people in your life. Some people think they need to change how they look or act to feel good about themselves. But actually. all you need to do is change the way you see your body and how you think about yourself.

1. The first thing to do is recognize that your body is your own, no matter what shape, size, or color it comes in. If you're very worried about your weight or size, check with your doctor to verify that things are OK. But it's no one's business but your own what your body is like. The only thing you know for sure is that it will change as you go through puberty.
2. Think about which aspects of your appearance you can realistically change and which you can't. Everyone (even the most perfect-seeming celeb) has things about themselves that they can't change and need to accept - like their height, or their parents. Changing how you act is much more powerful than changing how you look.
3. If there are things about yourself that you want to change and can (such as how fit you are, or your skin care), do this by making goals for yourself. For example, if you want to get fit, make a plan to exercise every day and eat nutritious foods. Then keep track of your progress until you reach your goal. If you don't like the pimples on your skin, ask your parents if you can go to the doctor to get appropriate medicine for your skin to be clear. Meeting a challenge you set for yourself is a great way to boost self-esteem!
4. Don't ever talk bad about yourself, and don't let others talk bad about themselves when they are with you. Try building your self-esteem by giving yourself three compliments every day. It can be anything from the way you listened to your friend's problems, your ability to tutor a friend in math, or your keen sense of humor. By focusing on the good things you do and the positive aspects of your life, you can change how you feel about you. Parents are good about telling you not to drink or smoke. Try telling them not to criticize themselves in front of you. Explain to them that when you hear them berating their looks (or someone else's), you have a tendency to think that looks matter a lot to them, and therefore, you will most likely focus on your looks too. Remind them that this begins to happen at the age of three for most children.

Everyone I know has flaws. It is not our visible flaws that cause us misery, but our perception of our flaws that depress or make us feel badly about ourselves. Change what you can with diet, exercise and healthy living. If mom or dad suggests a breast augmentation or a rhinoplasty for your 16th birthday, remind them that putting their money into a college fund for you will give them a better return for their money (also suggest counseling for your parent's issues with looks). You should never undergo cosmetic plastic surgery (unless it is a corrective type for an illness, accident or birth defect) until you are ready to accept the consequences if it doesn't turn out to look the way you had imagined. That's tough to do if you are under the age of eighteen.

I have a friend who constantly looks at herself in any and all mirrors. She is not conceited or even what I would call vain. In fact, this friend is one of my most beautiful friends but she doesn't see that in the mirror. She complains constantly of growing older, getting more saggy skin, and how she would like to have a surgeon give her a body lift and face lift. One day when she was looking at her reflection as we sat down to lunch I hinted that maybe she should quit her obsession with looking at mirrors. I suggested it may be the mirror that was the real culprit to her lack of confidence with her looks. She turned to me with her eyes wide as she took that in. She had never thought about this concept. Apparently she looked to the mirror as a constant valuator of all she detested about her looks. She turned to the mirror to make sure nothing had gotten worse than the last time she checked.

My friend regards “looks” like many women I know. Women know too much about the influence of their looks. We know from numerous studies that beauty determines much of our life. We understand that attractive children are more popular with classmates and teachers than unattractive children. We understand that in a court of law the more attractive you are the less guilty you may be found. In all areas of life the more attractive the person the more that same person is thought of as good, intelligent, and popular. We become obsessed with how we look. Women are also much more critical about who is and who is not attractive.
Men are much healthier than women in the assessment of their own attractiveness. Men look in a mirror and judge themselves as better looking than they actually are. Women look in the mirror and see the Ugly Step Mother. In fact, women who look in the mirror excessively are most likely not looking for vanity reasons, but due to insecurity. Where is this coming from, or why is it getting worse? We look to the media to project our blame. The media is no doubt part of the problem. They show thin women who are made up or digitally altered to look so beautiful that we can never match it in real life. Our standards of beauty have become narrower and much less flexible. Whenever you lose the flexibility in what is beautiful, and who is beautiful you create an image that everyone must try to fit into. Pictures of what is accepted as beautiful are on billboards, TV, Internet, and magazines. We see them so much we begin to think of these images as the norm. We, along with our families and friends, don't fit these images so we judge them and ourselves as inferior. We also become susceptible to what the ads are promoting, or commercials are saying in regards to how we can become beautiful. Weight loss ads, skin care commercials, and surgical enhancements are all part of this. The more critical we become regarding our looks the more vulnerable we become to these ads.

In a recent survey, 80% of women who were asked to rate themselves in a mirror did not like what they saw. That is a sobering 8 out of 10 women. Lesbian women and African American women were less harsh with their judgment. These two groups had a more flexible image of what determines beauty. The white Caucasian women were the most inflexible with their judgment. More than any other group, they seemed to have a definite concept of beauty and most of them could not measure up. Their main criticism was aimed at their bodies, especially their stomachs, hips, and thighs. Does this mean we are doomed to continue this cycle to our daughters for generations to come? If not, what can we do today to stop the body hate for the next generation?

 

1. Try to limit looking in the mirror to once or twice a day.
2. Watch your “self talk.” What you say to yourself becomes who you are, and what you say to yourself is what your children hear and will later say to themselves.
3. When you see a reflection of yourself, rather than judge it harshly, remind yourself that you actually look better than what you are thinking (I am borrowing from the men here).
4. Stop all weight loss diets and adopt a lifestyle that involves movement every day.
5. Focus on your relationships rather than your looks.
6. Getting a massage or pampering your body is a way to nurture it and does much more than an expensive face cream ever will.
7. To secure a relationship with your partner, put your focus on enjoying each other with intimacy and sex more than trying to look better (when you are connected with intimacy and sex, how you look becomes less important).
8. Stay away from magazines or websites that promote an inflexible standard of beauty.
9. Stay away from friends that focus on their outer beauty rather than what they can do to benefit other's lives.
10. Be honest with your partner if their behavior or words make you feel judged or unattractive. Most likely, they were insensitive to what they said and how it may have affected you.

 

Aging is difficult for everyone to some extent. Aging is especially difficult for women who have focused most of their attention on their looks rather than their interests. Begin today finding new interests, and ways you can give back and make someone else's life better. The best cure for insecurity with one's looks is having confidence that what you do is valued and needed by others. You don't have to be “HOT” or "ATTRACTIVE" to be a beautiful person.

I read, with interest, the story about Donna Simpson who is already weighing in at 600 pounds and wants to gain to 1,000 pounds to achieve her goal of being the fattest woman in the world for the Guinness World Record (she already holds the title for being the fattest mother after giving birth in 2007). Ms. Simpson is consuming 12,000 calories per day (normal caloric intake for a woman her age is 1,500 to 2,000 calories per day), and taking her toll on taxpayer dollars, as she can only walk 20 feet and has other health issues. How does she make her money? Perhaps this is the sickest part. She has a website where men pay to watch her eat. Ms. Simpson has a boyfriend who encourages this behavior, and he weighs in at a slight 150 pounds. When asked why he does this he reports, “I know where she is and I love to watch her eat.” Her boyfriend suffers from insecurity and control issues among other things.

This story is extreme and it saddens me, but it happens on a smaller scale with overweight patients I counsel about their eating behaviors and lifestyles. Many of my patients report that their weight loss attempts are being sabotaged by their spouses. How could someone who harps at you to lose weight and tells you they don't desire you when you are overweight, be the main contributor to your weight problem? It happens over time, and it happens because even though you are overweight and your partner may not like it, they derive a sense of security with you not changing. There is also a fear that as you lose weight you may become more sexually appealing, and your spouse may worry that you will cheat. Your spouse may not like their own body, and if you change yours they may become threatened that you won't desire them. There are many reasons your spouse may want to cook you dinner with extra butter, or discourage you from going to the gym, and possibly withdraw love if you become too thin. The important aspect of sabotage is to become aware it is happening and not get drawn into it. Sabotage may look like this:

 

• Your partner may begin to tell you that you look sick or pale when you lose weight. They may focus on your health and try to make you feel panic or concern.
• They may begin to say in front of you to friends, “My wife or husband has abandoned me.” Or they may say, “My husband/wife won't eat with me anymore, and they have changed since they lost weight.” This is the tactic of love being equal to food and may contribute to the weight problem you are struggling with currently. Love has nothing to do with food. One is fuel, one is an emotion.
• They may make a special meal for you, full of fat and not on your meal plan, and then pout if you don't eat it. This is a control issue, it is best to acknowledge the effort that went into making it, and suggest you take the meal or “special cake” to work for your friends to see what a thoughtful spouse you have.

 

The best way to thwart sabotaging behavior from your spouse is to sit down with them and talk to them openly and honestly before you begin the lifestyle change. Tell them you are unhappy at your current weight, that you are concerned about your health, and with the appearance of your body. Tell them you need their support and help with this transition, because you love them and you want to stay healthy to be a better partner to them. Then have a list of suggestions to give them that will help you stay on track with your lifestyle changes. You may need to reassure them that no matter how you look you will always love them most. Even secure partners need to hear this once in awhile.

Suggestions for the partner of someone trying to lose weight and to change their lifestyle:

 

• Offer to take a walk or go to the gym with your partner. This means a lot. The gym can become the place the two of you go to get away from the kids, and it can become your “date night.”
• If you become frightened with your partner's success, just say it. Tell them you are feeling jealous. They will understand, and most likely it will flatter them, and they will love you more for your honesty.
• When you go to the grocery store do not bring home your partner's trigger foods. Instead, save that money in a jar. Tell your partner that as soon as they lose the weight they want, the two of you will go on a vacation. Tell them the money came from what was usually used on junk food.

Losing weight and making changes with your lifestyle is extremely difficult. It can be made twice as difficult with a sabotaging spouse or twice as easy with a supportive spouse. Make sure you discover which of those you are married to. It is never too late to change.

Body image is a broad term and encompasses these main points:

• How important our physical appearance is to us (the less the woman identifies with her interests and intelligence, the more difficult aging will be for her).
• How we see our “real bodies” as compared to when we look in the mirror, touch ourselves, smell ourselves, exercise ourselves, etc. (Obesity is largely a disease of addiction. Addicts are in denial. Many of my obese patients have never looked at their body from the neck down).
• How we feel others perceive us (the patients that grew up in critical families or suffered abuse are more sensitive to how others judge them).
• How we compare to others' bodies and then how we judge that.

We are not born with a body image. We learn it by the people who surround us. It is also determined by the society we are born into as well as what is valued at the time. Look at the media, magazines, store windows, television, the Internet and commercials. What do you think is the current body image projected for women?

Body image may impact our sexuality in unexpected ways. A study done examining body image and risky sexual practices found that men who had a positive body image took more risks with unhealthy sexual practices, whereas women who had a positive body image took less risks with unhealthy sexual practices.

Beginning in the 1960s, feminists began to educate women more to touch themselves and to satisfy themselves sexually. They were also encouraged to teach their husbands how to touch them and satisfy them. This had a huge impact on women's body images, and the many books that followed also made women feel better and more powerful in regards to their bodies.

The study of body image and sexuality is complicated as many women may be shy and inhibited in public, but not in the privacy of their room. Body image is subjective, and therefore, women may find sex enjoyable once they begin having sex, and feel secure about their ability to orgasm while still saying they “hate” their bodies. Bariatric Times 2007 reported that women who feel obese noted a decline in their sexual libido and also felt embarrassed in regards to their bodies and the way they look while having sex.

A study appearing in the current issue of The Journal of Sex Research, lead by Dr. Patricia Koch, surveyed heterosexual Caucasian women, 21% of whom said they were pre-menopausal, 63% said they were undergoing some menopausal changes (perimenopausal) and 16% were post-menopausal.

The results showed that, regardless of the woman's age or menopausal status, she was more likely to consider herself more attractive when she was 10 years younger. Nearly 21% of the respondents could not think of even one attractive feature, and reported an overall sense of dissatisfaction with their bodies. The survey participants were most dissatisfied with their stomach, hips, thighs and legs - the parts of the body that gain weight with age. The researchers contend that the Western World's infatuation with youthful slender bodies creates anxiety about aging, and pressure for older women to disguise what are otherwise normal changes.

Most interestingly, the more a woman perceived herself as less attractive, the more likely she was to report a decline in sexual desire or activity. Nearly 70% of the women reported one or more changes in their sexual response, usually desiring sex less and engaging in sex less often. Encouragingly, despite these changes in desire, the women reported that when they did have sex, there was a high level of enjoyment.

Below are some common feelings reported to me during counseling, by women who feel bad about their bodies, in regard for their desire to have sex.

• “I feel fat. I feel like my tummy sticks out and it isn't attractive. My husband tells me he loves me anyway, but I don't love me.”
• “If my legs were thinner, I would feel sexier. My legs use to be long and slender. Now I notice edema in the evenings. No one else can notice it, but I know it is there.”
• One patient told me, “My husband has never seen me naked.” I asked, “Never? How long have you been married?” She replied, “22 years.”
• “My skin is so dried out. It doesn't look the same. When I am lying on my back it is better, so I refuse other positions because I know how it looks when it sags.”
• “I haven't looked at myself naked in over 12 years.”

Tips to help women enjoy their sexuality as they age:

1. Viagra vs. women's libido medication. What comes first, the chicken or the egg? If the relationship is part of the problem, this could be medicating the perfect storm. Maybe, instead of hormones, we should consider addressing body image, insecurity and the lack of confidence.
2. Women should be encouraged to go naked in the privacy of their homes. The more women are comfortable with their nude bodies, looking at them, and touching them, the more they will begin to “normalize” unrealistic expectations.
3. Encourage celebrities, by making a conscious effort to write to the editors, to look more real. Celebrities, such as Jamie Lee Curtis and Oprah, have helped inspire what women look like in their 50s and beyond. Dove commercials are attempting to show what “normal bodies” look like.
4. Try yoga and other sports. The more women engage in sports, the more body awareness they experience. This translates into more confidence in their bodies.
5. Women should talk about their relationships. Do they feel comfortable with their partner? Do they feel free to be who they want to be? More than 40% of obese women have been sexually abused. This is a huge libido killer and destroys their body image.
6. Women should understand the importance of masturbation and self- touching. It is impossible to communicate with your partner what you like if you don't know what you like. There is nothing shameful in masturbating, and if women hear their health care provider encourage it, many times this helps give them permission.
7. Infidelity kills body image, self-esteem, and confidence (especially in mid-life). Just as body image was taught to you as a child, it can be re-taught, practiced and learned as an adult.
8. Experiment with your sex life. Different rooms, different lotions, sex toys, and talking to your partner about spicing up your sex life.
9. Many issues with body image and sexuality can be solved between couples. Talk to your mate for 15 minutes of total “tech free” time in regards to your relationship.

I work at the Methodist Weight Management program. It is not uncommon for women to tell me they became morbidly obese after they got married. In fact many women will recite that they were thin until the birth of their first baby. They are frustrated and do not understand what happened. Many of these women feel guilty because they believe it is the way they eat or not enough exercise. Certainly behavior changes do contribute to weight gain, but maybe it has more to do with the couple and what they are doing together that leads to weight gain for the wife?

Annette J. Dobson, a professor of biostatistics at the University of Queensland in Australia reported that adjusting for other variables on average a woman who weighs 140 pounds who has a partner whether she lives with him or is married to him gains up to 20lbs in ten years if she has a baby, 15 pounds if there is no baby and no partner she gains only 11 pounds.  The number of women with a baby but no partner was too small of a sample size to draw statistically significant conclusions (link to the NY Times Article).

Scientists cannot come up with a reason to believe that having a partner would cause metabolic changes so they are lead to believe that the weight gain among the childless women with partners must be caused by behavioral changes. The weight gain seemed to be steady during the whole 10 year study so whatever behaviors they were changing just kept getting more constant.

This study was done with 6,000 Australian women over a ten year period which ended in 2006. It was difficult studying such a large group over that period of time. By the end of the study more than half of the women had college degrees and about three quarters had partners and half had had at least one baby. Almost all the weight gain happened with the first baby, while subsequent births had little effect. Also by the end of the study there were fewer smokers and risky drinkers than at the beginning. There were fewer women exercising and less of them were working outside the home. But even after adjusting for all of these factors and more, the difference in weight gain among women with and without babies and among women with and without partners remained. This study included only women but the researchers cited one earlier study that showed an increase in obesity among men who had children, adding evidence that behavior changes occur to both partners. Healthy and unhealthy lifestyles affect both men and women.

How to prevent or minimize weight gain as a couple:

1. Get into an exercise program and do it every day (consistency is the key). Don’t focus on the amount of time; try to take mini intense workouts. Walking very fast for 10 minutes is better than walking slow for 20. No time to exercise? Fit walking in whenever you can.
2. When you go out to eat, watch portions. If your husband weighs 200 pounds and is 6 feet and you are 5 feet 2 inches and weigh 140 you should not be eating the same amount of food he does. Cut down half of the portion the restaurant brings you.
3. As much as possible do not eat after 7 p.m. in the evening.
4. Have sex frequently. I don’t know why it works, but it does for burning calories. It also will help with your body image which will help you control your appetite.
5. Pamper yourself with things other than food. Most of what I do at my job is to teach people alternative behaviors to relieve stress that don’t include food.

As couples become comfortable in a relationship they may develop the attitude that they don’t need to stay slim anymore. This is not only untrue but it is dangerous. Most diseases are worsened or precipitated by weight gain. Instead of using food as a measure of comfort couples would be wise to use a new measure such as hugs, snuggling, or massages. In the New Year make it a goal to find a new activity you can do as a couple that doesn’t involve eating.

I use to believe as many people do that an obese woman is over-weight because she eats too much. It was simple thinking and reflected my own ignorance as well as my inability to look deeper. Michael Myers MD does research on eating disorders and sexuality and he estimates that 40 percent of obese females have experienced sexual abuse. I work in a weight loss clinic and I too have seen this trend. Obesity protects a person from their sexuality since (in Western cultures) obesity is frowned upon and not thought of as attractive. How did we miss this? Why didn't more of us in the health profession notice it?

Much of ignorance has to do with our own taboos around the issues of incest and sexual abuse. We don't want to ask the patients about it because we don't want to offend them. We also don't ask because we have no idea what to say when they begin to cry and tell us their history of abuse.

The connection between sexual abuse and developing a weight problem has to do with the emotions of guilt, shame, self-punishment, self-comfort, and protection. The body image of a sexually abused woman (or man) is forever distorted. Sexual abuse violates boundaries and, therefore, what may be feelings of fatigue or hunger get confused. The patient no longer understands what they feel and they begin to comfort with food as a way of not feeling. Many of these patients try to starve themselves as way of maintaining control after being sexually violated. They try to control whatever they can so they won't feel vulnerable and so food becomes one of the few things they can control.

Reports from bariatric clinics show that 20 to 40% of patients seeking weight loss surgery have histories of sexual abuse. A study in 2001 for patients with binge eating disorder found that out of 145 patients being treated for binging, 83% reported some sort of abuse in their past (59% were emotionally abused, 36% reported sexual abuse, 69% reported emotional neglect and 49%reported physical neglect).

Suggesting to an obese woman that she should go on a diet or begin an exercise program is analogous to telling a three day a week jogger to run the Boston Marathon. It is overwhelming, discouraging and missing the point. The jogger has to be motivated and be confident that they could actually complete a marathon and, more importantly, that it would be worthwhile. If you have been abused and are obese you feel so bad about yourself, why would you want to diet or exercise? What would be the point if you thought yourself a failure so many times in the past? We have to begin to see this problem in a much different light. Some of it is the environment, some of it is genetics, but those things can be modified if the person has not been traumatized with abuse. If we miss this important aspect of obesity then no matter what kind of surgery or treatment we provide, the patient will not be successful.

Suggestions for healing past sexual trauma:

1. Get a therapist on your team who deals with abuse issues. Make sure that as a patient you trust this person and can rely on this person to be on your team.

2. Get at the bottom of your obesity issues (preferably before weight loss surgery). One good way to begin this is to write down every "tape" in your head. Try to remember who said it and in what situation you heard that tape. When do you repeat it now to yourself?

3. You need to get the experience out of your head and onto paper and then verbalize it to a trained therapist. This will help you look at it as an adult and will help your therapist guide you with letting go of the past.

4. Learn ways to calm yourself other than food. Support groups are good at helping patients feel connected with each other and also helps patients understand they are not alone in their suffering. A support group also offers "new skills" in dealing with stress that patients learn vicariously from each other's life experiences.

5. Learn how to mediate, pray and breathe. Nothing calms the body as much as deep breathing. This is an integral aspect of healing from abuse.

Our culture doesn't understand the depth of obesity. We find it easier to judge or label than to seek and understand. The next time you see an obese woman instead of judging her as lazy you may want to step back and question your own need to put her in a category. If she is forced to fit in a category, will we feel better about our self—and, if so, then why?

MJo

The government and every advertiser understand that we are all afraid. You know this because you watch TV and I read the newspaper; most of the stories and commercials are centered on our fears. Our fears are growing old, losing our children to drugs or alcohol, losing our job, or maybe being sick and having no medical coverage. Our fears of getting obese and losing our sense of esteem. So many fears and all of us, every single one of us are being affected. I see my own, I see yours, and so I write this as a reminder to myself and you that we DO NOT have to be controlled by our fears.

Most of what we fear never happens. When it does, it is the "tape" we tell ourselves that scares us most. We say "If that ever happened I would kill myself or shoot someone". This is "crazy talk" and although we don't mean it, we say it, and it scares us. A lot of my work is teaching patients how to "re-tape" their own fears. Below are some examples to get you started. You can chose any topic and walk yourself through a plan. The best way to overcome fear is to have a plan or a tape that you can recite. This is my personal tape and it works well if you can recite it frequently: "No matter what happens, I will deal with it".

Sample Fears

• Being without a man. This sounds trivial but many women fear this. They tell themselves that they will never have a husband and children and will grow old with no one to care for them. They know it is not rational but they are still terrified.

Overcoming this fear:

First write down exactly what you are afraid of (eating alone, shopping alone, sleeping alone, etc...). Now begin to focus on doing those things you have said you are afraid of. Go shopping alone and enjoy it (add whatever you need to in order to make it fun). Eat alone (go to a fancy restaurant and enjoy each bite, look great when you go). The idea is to practice these things you are afraid of and overcome them. Not all at once.

Next begin to re-think being single. What have you told yourself about being single? If you made it negative, begin to look at the positive aspects (no abuse, no divorce, watching what you want) and always think of how you can get your fears conquered in a healthy way. If you don't like to eat alone, invite someone to go with you. Or have a party. If you want children, baby sit for your friends; make someone happy by reading at a school or volunteer for a boys and girls club.

• Gaining weight

Overcome this fear:

Write down exactly what you are afraid of (your eating is out of control, you will not be able to date, you won't be able to walk, you will be teased). Now begin to focus on doing the things you are afraid of. When you eat, take more control by having smaller plates, eating at home instead of fast foods, plan what you are going to eat. Have "cheat food" (carrots and celery) available at all times. Begin to go out on evenings. Put yourself out there—join on line dating, go dancing. Begin to walk and WALK EVERY DAY. What do you notice when you walk? Think of "come backs" when/if people do tease you. Write them down. Practice with delivery. Be assured that you are taking care of yourself. You are being your own advocate.

Next, begin to re-think what you have told yourself about being overweight. What words have you called yourself or heard people say to overweight people? What did your parents say to you when you were overweight? Write them down and get them out of your head and on to paper. Don't lose weight for others, lose weight for yourself. Don't focus on a size, but on an activity you want to be able to participate in once you lose weight. How can you help yourself or others going through the same struggle or fear? Participate in support groups, volunteer for a Children's Obese Camp, join or organize a "walkers group". Get active.

The key is to write the fear down and then come up with at least 5 things you can do for each of those fears to alleviate them in a healthy way (this usually means serving/helping others with the management of your fear).

Fear thrives on inactivity and talking about your fear. It cannot thrive on writing down elements of the fear nor can it thrive if you become active. Chose a fear, and begin to act on it today!

MJo

I was reading an article about Barbie. A recent study out of Canada resulted in the finding that 99% of girls (age 3 to 10 years old) had a Barbie doll. That is not really remarkable except for the fact that these young girls want to look like their Barbie. It isn’t the same as boys wanting to be like GI Joe. Little boys think if they have a dart gun or fatigues they look like GI Joe. If they are screaming and shooting a toy gun they become him. Little girls really want to be Barbie to the extent that it is frightening. They want the hair, the shoes, the tops, but mostly they want the body. Barbies’ proportions, for example, found that her back would be too weak to support the weight of her upper body and her lower body would be too narrow to contain more then half a liver and only a few centimeters of bowel. A real woman who was built that way would suffer from chronic diarrhea and eventually die. Eating disorders affect almost half of all teenage girls in some capacity. Who is responsible—media, TV, girlfriends, boyfriends, genetics, web sites, parents? It’s all of us. We all have ways of judging people and in this society we usually judge what we see first.

Men are more visual and I use to think if we change men’s thinking or educated them about the importance of the way they talk to women and about women we could turn this body image epidemic around. Although men could be educated more in regards to women’ bodies and what they experience in relation to hormones and body fat, they are not really the problem. Most men marry a woman that is average height 5’4’’, and weight twenty to forty pounds over their desired weight. Men talk about beautiful women, but they go deeper than our look when they are talking about love or marriage (how deep is up to negotiation). I think women are the real problem. We hold ourselves up to impossible standards. Men are sick of hearing about our thighs, our wrinkles, and our hair.

It is women who have to make the change. We have to understand that the concept of beauty is driven by an advertisement industry. This industry is all about making money. We women fall for it hook, line and sinker. We buy products to boost us up, hold us in, cover our age spots, and define our waists. We don’t only judge ourselves, but we judge our daughters and we judge our daughters’ friends. We make foolish mistakes by trying to make our daughters the most beautiful in the class so they (or is it us?) can be popular. How do we get out of this mess?

1. Before you buy anything look at it carefully. What is the advertiser trying to convince you of? If they are trying to sell you something that is going to make you more beautiful do you really believe this is going to change your life? Wouldn’t everyone buy it if it were so powerful?

2. If your man really wanted a “Barbie Doll” could he get one? If he could why is he with you? If you aren’t sure, maybe you should ask him.

3. What would improve in your life if you were as thin as Barbie? Would you have more confidence? Would you feel more accomplished? Maybe your looks are not the problem. Maybe it is deeper and the fact that you have a flaw (a little overweight) makes it easier to not deal with the real issue.

4. When your daughter does something special reward her with your time, not by buying her something that “will make her look more beautiful”. She is beautiful enough and so are you.

MJo

       I am involved with counseling in the Weight Management Center at Methodist Hospital. One of the main issues I deal with is body image for women undergoing obesity treatment. I cannot stress enough how a woman's body image dramatically affects her ability to be sexual and to enjoy her sexuality. Women who are overweight feel embarrassed about their bodies and unworthy of having someone love them or desire them.

      For the most part every woman struggles with her body image from time to time. Our bodies fluctuate more than men due to hormonal imbalances. As women, we also retain more fluid and fat in our bodies than men. This is to insure our ability to get pregnant and also is what makes us women. Our skin is softer, we have more curves, and we are more emotional when compared to men. Women are judged harshly by society-particularly where weight is an issue. Studies done in the 60's and 80's revealed that small children would rather play with someone in a wheelchair or missing body parts than someone who was obese. The depth of the problem begins at a young age and gets more severe as we grow older.

       Many of the women I counsel go to extremes to hide their weight from their husbands. One patient told me her husband has never seen her naked. How sad as the biggest "turn on" for most men is to see their partner naked. Another patient told me when she takes a shower she lines the glass walls with towels so her husband cannot see her. Women don't go to these extremes without feelings of shame and guilt. The media makes it clear about the body types women "should" have. Women who cannot achieve this body type (99% of all women) tend to tell themselves that there is something wrong with their body and, therefore, try to hide it with clothes, towels, or etc. Sometimes obesity covers that body and is used as a defense to keep others away. The underlying motivation is the same: your body must be punished for not fitting in with other more attractive bodies.

Suggestions for re-discovery and loving your body:

1. Write down who taught you that your body wasn't okay. Who were these people (if it was a magazine or article) and who gave them authority over you?

2. Find pictures of bodies that look more like yours. Begin to look at these bodies. Evaluate them. What do you like about them, what don't you like about them (it is easier to evaluate fairly when it isn't your body).

3. Begin to explore your own body. What parts of your body respond to touch? What parts of your body bring back bad memories when you touch them?

4. If you are married or have a boyfriend/girlfriend ask this person what they like about your body. Write down what they say and post it somewhere you will see it frequently throughout the day. Re-read it and say these positive messages aloud. Create "new tapes".

5. Remember...everyone no matter their size, race, or creed has a right to enjoy the pleasures of their body. Before you begin to change your bodies through surgery to achieve a "more perfect one" consider changing your thoughts!