Interview On Body Image With Dr. Elayne Daniels - How To Win a Man's Heart

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August 17, 2014

Interview On Body Image With Dr. Elayne Daniels

1. Dr. Elayne, can you explain what body image is and how it affects our self esteem and relationship?

Great question! Body image is the relationship a person has with her body. We all have a body, and we all have a body image. Our body image may be positive or negative, and we will discuss that shortly. Body image includes thoughts and feelings we have about our body, and the associated behaviors we avoid or may engage in excessively as a result of how we think and feel about our body. Body image and self esteem are highly correlated: It is impossible to have high self esteem and poor body image.

Body image affects relationships, especially with dating. Some women may feel like they will attract a man only if they are thin. “When I lose weight, then I will ___________”. How do you fill in the blank? Some women may believe they have to weigh less in order to feel good about themselves, date, be more attractive, or have sex.

Interestingly, research shows that women tend to be more critical of their own body size and shape than men are of women’s body size and shape. Further, women tend to be more critical of one another’s body size than men are of women’s shape. In a classic study that has been frequently replicated, women assume men prefer a thinner female body size than the men themselves report as their preference.

Feeling comfortable and even proud in one’s body is incredibly important for overall functioning. It affects everything. After all, our body is where we live, and we will have a lifelong relationship with our body. Learning how to be in a healthy, happy relationship with our body can be the foundation for satisfaction in all areas of our life, especially when it comes to dating and marriage.

2. How can women who constantly have thoughts about needing to lose more weight or not being happy with the way they look change their negative outlook? For some women, these thoughts may date back to their childhood or teen years and they may have a deep inner relentless critic that constantly reminds them of their perceived inadequacies. What is the first step and how can they take small consistent positive steps to change their thought process?

Is it possible to feel positive about how you look, without losing weight or undergoing cosmetic surgery? Absolutely! By using what I call an ‘inside out’ approach to negative body image, women can actually like how they look, even if their external appearance remains the same. Changing the thought process associated with your appearance often yields benefits that are longer lasting and more durable than attempting to change your appearance.

There are many strategies to address the self talk that goes along with disparaging one’s appearance. This is important because the relentless inner critic’s voice is what perpetuates the bad feelings women have toward their own body. Societal messages add to the problem because of the glorification of thinness in our modern day world. Sociocultural influences on women’s body image are significant and cannot be ignored. (This is a whole other topic, for another post!) For a woman living on a desert island, obsessing about her body size or appearance is unlikely!

For women who are unhappy with their weight or other aspect of their appearance, Cognitive Behavior Therapy (CBT) can help. It includes a set of techniques to identify self talk (also known as thinking, or internal dialogue), evaluate its validity, and generate an accurate reasoned conclusion. This is harder than it may initially seem, because often the self talk is so automatic, perhaps ingrained from earlier in our life, that we may not even be aware of the body image distortions we have.

To identify body image self talk, women are taught how to become more aware of their core beliefs and associated thoughts. We have a tendency to believe what we think, without questioning if it is actually true. For example, if “Brittany” believes her thighs are big, she will likely take that thought as fact. Perhaps she was teased as a child about her thighs by a family member, or by a boy on the playground, and thus internalized the teasing to the point that she believes it 100%.

There are several methods to teach people how to be more aware of their automatic thoughts so that the thoughts are no longer automatic. One includes understanding the relationship between thoughts, feelings, and behaviors and learning ways to recognize underlying beliefs that precede emotion and action.

CBT also incorporates addressing the evidence for and against the core thoughts, and the pros and cons, as well as the advantages and disadvantages, of thoughts. Another aspect of CBT is becoming familiar with the twelve classic types of distortions that most people make at some time.

One example of a common distortion is called dichotomous or polarized thinking. An example of this type of distortion might be of a young woman who wears a size 6 believing, “Since I am not a size 0, I am fat”. Another example is if someone were to say/think, “well, I already blew my diet by eating a cookie I might as well eat the whole box of cookies”. Perfection and imperfection, success and failure, are the only two options when people are engaged in dichotomous thinking. CBT also teaches the person how to generate alternative, more accurate self-talk (ways of thinking) and to incorporate shades of grey in their thinking.

Thinking negatively about your appearance didn’t happen overnight, and learning to feel happy about your appearance will not happen overnight either. It requires deliberate effort and consistent practice. Women who practice the techniques described report it is well worth the effort!

3. Can you talk about the difference between the end purpose of a goal in terms of achieving it because I want to do it versus doing it because I want to feel more acceptable and desirable in the eyes of others? For example a woman who is looking to lose weight because she wants to be healthy and fit versus a woman looking to lose weight because summer is approaching and she wants to feel comfortable wearing a bikini or be more attractive to men. Does the “why” matter?

Yes, the why matters. When it comes to successfully achieving a goal, there are lots of effective strategies that psychology has to offer. People tend to have more success with accomplishing their goals if the goal has intrinsic value to them. Without this relevance to people’s life, the goal may end up requiring too much commitment or effort and lead to putting off the necessary steps to make the goal a reality.  For the goal, and the reasons behind it, to be aligned with a person’s value system is important.  Otherwise, resentment that interferes with accomplishing the goal can prevail.

If the goal of weight loss, for example, is motivated by a desire to be healthier and more fit, the motivation is more likely to be sustained than if the goal is motivated by external reasons, like ‘looking good” (however that is defined!) in a bathing suit. In this example, the more helpful reason for the goal is self improvement, not adherence to an externally defined social standard of beauty.

Losing weight for fitness and health reasons can be achieved in a systematic way, in which measures of success can be defined by a variety of important and relevant variables. These indices may include criteria that are much more motivating than those that rely on the vague opinion of anonymous others. It is helpful to actually see the progress week to week. For example, specific fitness goals could be assessed each week, such as distance walked/run. How awesome to see that for the same 30 minutes, more distance was covered each day in week two than in week one.  Or, how inherently motivating it is for a woman to notice week to week how much more flexible she is, how much more weight she can lift, or changes in some other measurable goal due to practice. However, if the goal of weight loss is to look hot in a bikini or attractive to a potential mate, there is a greater chance for derailment. There is less opportunity for achieving the goal if there is no systematic way to measure the progress. Using the number on the tempermental scale as the sole criteria, or even relying on others’ compliments, to assess weight loss or ‘improved appearance’ is unreliable.

To assess the motivation behind the reason for weight loss goals, I encourage my patients to honestly assess why the goal is important and valuable to them. I ask them to say out loud the reasons, and to hear what they are saying. If they say their weight loss goal is due to wanting to look ‘better’, I ask them to define very clearly what ‘better’ means. I ask them to explain how looking ‘better’ will help in their life. Often what happens during this conversation is the person’s realization that she wants to feel more comfortable with herself and more proud of her body. She has a far better likelihood of achieving this goal if she approaches it via the health and fitness route.

During the conversation, I also remind my patients of the dangers and pitfalls of dieting. Simply put, diets don’t work. The only exception is for 1% of those who embark on a diet and successfully lose weight and keep it off. Those odds are not favorable! Why not stack the deck in one’s favor? Focus on fitness and health, which for most people are highly valued. Feeling fit and healthy is associated with improved self esteem and social ease.

4. You talked about “dichotomous or polarized thinking” and gave a great example “Well, I already blew my diet by eating a cookie I might as well eat the whole box of cookies”.  This is something so many of us experience especially as we are looking to lose weight. But this line of thinking also harms relationships reinforcing negative beliefs and affecting one’s self-esteem and confidence. Is the solution to treat ourselves less harshly and not allow ourselves to be dictated by the minor setbacks that come in the way of achieving our goals?

Yes, although this is certainly easier said than done! People tend to erroneously believe that if they speak to themselves harshly, they will motivate themselves and be successful. This assumption is simply not true. Instead what tends to happen is demoralization and derailment. A person ends up feeling bad about herself and not following the steps she identified to meet her goals.

For example, let’s say “Sue” were to tell herself that because she ate a few cookies she might as well eat the whole package. She is likely to continue this thinking with some serious self deprecation. For example, she might then call herself  a gluttonous pig with no self control, and convince herself that she should keep eating cookies because she will never eat cookies ever again, starting tomorrow. Or, she may tell herself that she must eat all the cookies so that they are all gone and she won’t have to worry about them.

Scientists call this thinking the “Abstinence Violation Effect (AVE)”, and it is often the cause of weight GAIN. The AVE  is the inevitable outcome of a dieting mentality. People ultimately eat  a lot more calories as a result of “I already blew it so I might as well”, or AVE, thinking.

Another effect of this kind of thinking is low self esteem and demoralization. AVE thinking causes a sense of personal ineffectiveness and the “why even bother” feeling.

This raises another important point. The way we speak to ourselves is often very different from how we would speak to a loved one, or even to someone we don’t particularly like! The tendency is to speak much more negatively, harshly, and hurtfully to ourselves than we do to anyone.

Would you call your friend or even a stranger who ate several cookies a gluttonous pig with no self control? Probably not.

All of us have an internal dialogue that is often so automatic and embedded that we are not even aware of it, and especially of its automaticity and pervasiveness. If “Sue” starts thinking along the lines of the Abstinence Violation Effect every time she eats something she deems ‘bad’, she will continue to stay stuck in a cycle of feeling like a failure and of gaining weight.

A key take home message here: It is important that we not believe everything we think, especially about ourselves! Our minds produce thoughts, and thoughts are not necessarily facts. For example, is it a fact that when someone eats several cookies she must eat the entire box? Is there a label to that effect on the box of cookies? No, of course not, but in the heat of the moment and due to the strength and repetition of the thought, the person thinking it believes it wholeheartedly.

Believing everything we think can be dangerous! Many of our thoughts are fears, not facts. Some are antiquated methods of solving a problem, or of justifying a behavior (in this case, overeating).

Learning how to talk back to our maladaptive thoughts is key to improved self esteem and successful and sustained weight loss. I encourage my patients to aim for neutral thoughts, not even necessarily positive ones. In the case of Sue, an example of a restructured thought that is neutral would be something like, “I ate 8 cookies. I must have been craving sugar, or coping with feelings by eating. What can I do differently next time so that I don’t repeat this situation?” She can then decide how to proceed. She may go for a walk, talk with a friend, write in her journal, and just go on with her day, rather than to allow herself to spiral downward into a dangerous emotional and physical trap.

5. You mentioned “It is impossible to have high self esteem and poor body image.” So for someone having a poor body image, can they work towards achieving a higher self-esteem on other areas of life such as career, sports etc. and eventually work on improving their body image or is it more easier to achieve higher self-esteem and find success in other areas of life once you work on improving your body image? 

Another great question.

Think about it: We all enter this world with and in a body. Our body image is our first sense of our self, of who we are. We relate to ourselves and to others through our body, especially as infants. We suck on our toes, yearn for touch, and cry if we are too hot or cold. The sense of self is first and foremost a body self.

As we age, our relationship with our body remains intertwined with our sense of who we are, but so many other influences are also at play. Society tells us how we ‘should’ look, media models portray the culturally prescribed ideal body, and we learn to blame our body when something in our life goes wrong. Our body may become a source or target of anger or disgust for a variety of reasons. This is especially true among those who have been sexually abused or in other ways harmed or emotionally wounded (e.g. teased). As adults, our relationship with our body can become objectified so that we just think of our body antagonistically, as some ‘thing’ to change in size or shape. Our relationship with our body can become so desensitized that we lose touch with when we are hungry, full, lonely, tired and the like. Mind/body therapies like yoga can improve our relationship with our body by teaching us to do what we were born knowing how to do but become out of practice doing. We can relearn how to attune  to our body and respond to the cues and signals it automatically provides.

When women improve their relationship with their body (aka body image), the effects generalize to other important areas of their life, including dating and their sex life. The benefits to their life as a whole often come as a surprise to women – a very pleasant surprise!

When the sequence is improving self esteem first via career, sports, or other means, body image does not necessarily improve. In fact, women report that they are ‘successful’ in every area of their life except for their weight and shape. This discontent with their weight and shape makes it hard for them to truly feel happy about their successes in their career, family, education, and other important areas of life.

No one enters the world hating his or her body. Imagine the creativity and energy that we as women would have if we were able to eradicate body shame and truly celebrate our body!

6. What advice would you have for women who are looking to change their negative body image especially when they are dealing with people who are used to passing remarks on their body. Often our readers say that these comments are made by their friends and family, sometimes just for fun with no intent to hurt them. However every time they hear that, it’s a dent to their confidence and self esteem. For the most part, they try to laugh it off or use self deprecating humor but inside they are suffering. Do they need to set up boundaries and start discussing openly and honestly on what is acceptable vs what is not acceptable and talk about how their remarks are affecting them?

“With that little pouch of a belly you look four months pregnant”, her aunt said to Katie (not her real name). Katie, a 20 year old of average weight, immediately felt ashamed and sucked in her stomach even more than usual. Her aunt, chuckling, said “I am only kidding, Honey”. Katie did not take it that way, though, especially since an acquaintance recently said “ too bad you (Katie) can’t take some of your (her) belly fat and move it up to your (her) boobs to be better proportioned”.

Certainly, Katie’s aunt and friend did not intend to hurt Katie’s feelings. Katie knew that but it did not console her.

There are many factors that made Katie vulnerable to others’ comments, especially to remarks that are negative.

Katie, like many men and women—and teenagers especially–tend to view themselves externally, ie ‘from the outside’, or as they think other people view them This makes Katie vulnerable to the impressions and comments of others. External standards of beauty and body image are the basis of her self perception, and she judges herself by these standards. [i]Further, Katie does what we all tend to do; she has a tendency to compare herself with others. Her age also puts her at greater risk for taking body related negative feedback to heart. Experiences of younger children relate to the development of body dissatisfaction, but adolescents and young adults are most significantly affected by their body image. It is a large part of their self esteem.

The fact that Katie is female is relevant; girls are more likely to develop body dissatisfaction than boys.[ii] Girls are also more likely to internalize external standards and feel pressure to conform to an idealized body image.

In her therapy session with me, Katie talked about her feelings. While Katie intellectually knew she is not fat or pregnant looking, she still ‘felt fat’. We identified that fat is not really a feeling. It is code for feeling disgusting and gross, shame and worthlessness. Eventually we talked about how she could have responded to her aunt. Here are Katie’s ideas: She could use humor. For example, she could say something like ‘ Actually, I am 6, not 4, months pregnant!” or “No, that is my third chakra, my power center!” She could also speak from her heart and tell her aunt how hurtful her remark was; “Aunt Jan, your comment really hurt my feelings and is not funny.” Another option is to set limits, such as saying ‘talking about my body negatively is not ok with me.’ What are other responses Katie could have had?

In general, my suggestions are to think about what I call “witty remarks to weighty comments” ahead of time, so that if anyone makes a body image comment there is already some thought put into how to respond. I also recommend that the person making the remark be reminded that body image is not something to joke about. Another recommendation is to discuss the parameters around talking about weight and body image. For example, some people create a ‘no diet talk’ zone, or a ‘body positive only’ rule. That means they specifically request that conversations be about topics other than diets and disparaging body comments. One of the responses I also suggest is to think of every situation where passing negative remarks are made re someone else’s body as an opportunity for a Public Service Announcement (PSA). Here is an example, and hopefully an idea that you will consider too. “Talking about other women’s bodies contributes to the problem. Be more like Gandhi: ‘Be the change you want to see in the world!”

Body empowerment has to start somewhere. Why not with you?

[i] Eleanor H. Wertheim, Susan J. Paxton & Simone Blaney, Op cit.

[ii] Eleanor H. Wertheim, Susan J. Paxton & Simone Blaney, Op cit.

7.To continue with the previous question, how do you suggest someone deal with negative remarks or comments from people outside the family and friends. These may be coming from people who either just don’t care or purposefully do it just like a bully?

When teased in elementary school about her ‘thunder thighs’ by kids she did not know, Emma was devastated. Twenty years later she remains extremely self conscious about her entire body, and her thighs in particular. She refuses to wear shorts or a bathing suit, won’t let her boyfriend see her naked body, and blames her thighs for her low self esteem. Whenever something does not go right in her life, she feels even worse about her thighs and becomes more self critical overall.

Another example is of Taylor, who was out with her friends at a bar one night. She overheard an acquaintance, Isabel, comment on her weight. Isabel said, “I don’t know why David likes Taylor. She is fat!” Even though Taylor knew that Isabel was being mean because she was jealous of David’s interest in Taylor, the comment still hurt.

Negative remarks from strangers or peers can have a major impact on a person’s relationship with her own body. Decades later, the memories of hurtful body related comments may remain strong.

In our culture, emphasis on appearance is at an all-time high. With this focus on looks, there is the potential for a significant increase in negative body image. Researchers have documented a vicious cycle in which the more a person focuses on her own body, the worse she feels about how she looks.

How a person feels about her looks is intertwined with how she feels about herself and how she interacts with the world. Negative body image often involves shame and anxiety and can interfere dramatically with every aspect of a person’s life.

What can we do about this? What are some strategies to use if we are the recipient of negative comments about our body?

1. Remember: Hurt people hurt people. If someone is making hurtful remarks, it says more about that person than about you.

2. The remarks are hurtful only if the words are allowed to penetrate. Imagine yourself coated in Teflon, with the words just sliding down and not staying around long enough to enter your mind.

3. Body size and shape are largely genetically determined. Learn to appreciate your link to others in your family tree! Ongoing attempts to change body size or shape is akin to trying to change one’s foot size or eye color. What a waste of our glorious energy!

4. Spend time with people who feel neutral or positive about their own body, and around whom you feel neutral or positive about yours. Being with others who have a healthy and happy relationship with food, weight, exercise, and their body can be contagious!

5. Find ways to enjoy your body, NOW, not when you lose 5 pounds. Celebrate your ability to dance, run, walk, swim. Find ways to nurture yourself.

6. Imagine what life would be like if you did feel at peace with your body. As an experiment, for one day act as if you and your body have a positive relationship. What is that like?

7. Celebrate diversity, including your own! Clones can be boring. Maybe the aspect of your body that you don’t like is part of what makes you unique?

8. Own your own power. Allowing a bully to take our power away from us empowers the bully and adds to the bully’s ammunition and the potential to continue to bully us and others.

9. What other qualities of yours do you value? Is your worth based exclusively on your looks? Consider your other attributes and nurture them.

10. Consider keeping a gratitude journal. Research suggests it is a useful way to feel happier in our everyday life.

Emma and Isabel found that the strategies listed above were very helpful. For Emma, keeping a gratitude journal helped her to realize all of the wonderful aspects of her life that she was ignoring because of the intense focus on her thighs. Isabel found that owning her power was especially helpful as a strategy. She noticed that it helped her to feel more confident and to take things less personally.

Try these strategies and discover which ones work for you!

8. Do you have any books or resources that you would recommend for women who are interested in knowing more about body image and how they can learn to love the body they have?

Here are some resources:




Body Outlaws: Rewriting the Rules of Beauty and Body Image (Live Girls) By Ophira Edut 

Body Drama: Real Girls, Real Bodies, Real Issues, Real Answers By Nancy Amanda Redd

The Good Body By Eve Ensler

Survival of the Prettiest: The Science of Beauty By Nancy L. Etcoff

Locker Room Diaries: The Naked Truth about Women, Body Image, and Re-imagining the “Perfect” Body By Leslie Goldman

Cinderella Ate My Daughter: Dispatches from the Front Lines of the New Girlie-Girl Culture By Peggy Orenstein

Transforming Body Image: Love the Body You Have By Marcia Germaine Hutchinson

Body Love (Rita Freedman)

Beauty Bound (Rita Freedman)

Feed Me!: Writers Dish About Food, Eating, Weight, and Body Image By Harriet Brown

Any book by Thomas Cash, PhD

About Dr. Elayne Daniels

Dr. Elayne Daniels

Dr. Elayne Daniels is a psychologist located in Canton, Massachusetts. She provides assessment and treatment of psychological disorders and programming for improved physical and psychological well being.

Visit her website to learn more about eating, weight and body image issues, mood and anxiety problems and yoga integrated psychotherapy.