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Body Image

In August 2007, our guest expert in Le Club's Ask the Expert segment was Dr. Carla Rice, MEd, PhD.

Dr. Rice is a global consultant on women's body image issues. She has over 20 years experience as a clinician, project director, researcher and media consultant on body image and eating problems.

She is a consultant on the Dove "Campaign for Real Beauty" featuring the "Dove Girls" and the "Dove Real Beauty Photo Exhibit".

She has been quoted on CBC TV and radio, as well as The Globe and Mail, The Toronto Star, and 70 other newspapers and magazines from around the world.

In 1993 she founded the Body Image Project at Women's College Hospital, creating a unique therapeutic approach for women with eating disorder and body image concerns. She is former project director of the National Eating Disorder Information Centre and national organizer of Eating Disorder Awareness Week.

She has worked with the Elementary Teacher's Federation of Ontario to change the curriculum for elementary schools in Canada. While working with girls and young women at the Toronto Board of Education, she developed the Embodying Equity Project, an innovative approach designed to prevent body image problems through changing school cultures. In partnership with the Ontario Ministry of Health, she also authored the popular resource Promoting Healthy Body Image: A Guide for Program Planners. 

Her current research and community work involves using creative, arts-based approaches to explore diverse women's images and narratives of body and identity across their life-spans. For example, through combining narrative with art-making methods, women with disabilities and differences are encouraged to use their creative capacities to envision new meanings of difference and disability.

She received her PhD from York University, winning an award for her thesis, Becoming Women — a collection of narratives of diverse women describing how they came to be in their bodies. This qualitative research project is thought to fill a much needed gap, providing narratives about women's body image and identity formation. Her website is found at www.carlarice.ca.

Here are Dr. Rice’s answers to your questions on Body Image:

Q: How can I tell whether I have a healthy or poor body image? How much "body criticism" is still considered "healthy”?

A: I’ll answer your question by first defining “body image,” then outlining common body image concerns, and finally, considering possible consequences of “body criticism.”

Body image is the inner picture of outer appearance — a person’s perception of his or her body. Called “the view from the inside” this picture often has associated thoughts, feelings and actions. While body image is an inside view, it is shaped by the outside world, by messages about our bodies that we pick up in interactions with others.

Others’ and our own perceptions of our bodies have a powerful impact on how we see ourselves. Body image is shaped over time and in different relationships and places by many things:

  • How we learn to feel about our bodies — through messages from family, friends, and influential others;
  • What happens to our bodies over time — physical changes and how others respond to them;
  • How our culture(s) defines attractiveness and ability — social value placed on our bodies, including our looks, differences and abilities.

Many women (and some men) develop body and self image concerns as a result of these messages. Body image problems range from negative perceptions and dissatisfaction with looks, ability, and/or physical differences, to depression, feelings of isolation and problems with eating.

Some body image concerns are:

  • Negative social perceptions: dealing with looks or questions about our physical appearance or abilities, and the feelings of isolation or “not belonging” that can result from negative perceptions;
  • Conflicted perceptions of bodies: dealing with conflicted perceptions of our bodies or changes in our looks and abilities, and others’ responses to these changes;
  • Body dissatisfaction: not liking our bodies/parts of our bodies, feeling “not good enough” or “less than” because of our looks or abilities;
  • Body harm: hurting our bodies by punishing exercise, bruising or cutting ourselves, numbing ourselves by drinking too much, misusing drugs, bingeing, or not eating, or by neglecting our basic needs (for food and rest).

From your question, you might be experiencing conflicted body perceptions, where you sometimes feel poorly and sometimes positively about your body. You are not alone in this. Most women have conflicted feelings about their bodies. Growing up in an image-oriented culture, we receive a constant stream of messages about our bodies. We form the desire to strive for our culture’s body ideals, yet we also want to be accepted for who and what we are.

The question you pose: “How much ‘body criticism’ is still considered ‘healthy’?” is challenging to answer without further conversation with you. As a way of dialoguing with yourself to discover some answers within, I invite you to consider the history, operations and consequences of “body criticism” in your life.

When did “body criticism” begin in your life?

  • What was happening with your body during this time?
  • What messages did you receive about your body and appearance?
  • What did people say about your body?
  • What kinds of non-verbal messages did you receive?

What do you see when looking at yourself today?

  • When do you focus on the physical aspects that you think need to be changed?
  • When do you feel comfortable with what you see? What traits do you like?
  • How do others respond to your appearance now? Does this have an effect on your feelings of body criticism or acceptance?
  • What circumstances, emotions, thoughts or other factors might impact whether you feel positively or poorly about your body in your current daily life?

What kind of impact does “body criticism” have in your life today?

  • To what extent does “body criticism” limit, constrain, hurt or otherwise feel oppressive to you?
  • Does it cause harmful body practices such as over or under-eating, over or under-exercising, etc.?
  • How much time do you spend thinking about your body and appearance in interactions with others? How do you think body criticism affects your interactions with others?

I hope that these questions help you to consider the history and consequences of body criticism in your life. If the effects of “body criticism” in your daily life are relatively minor, you might want to do some additional reading or internet research on creating a positive body image.

If the effects of “body criticism” are more major, for instance by causing you personal pain or limiting your life choices, you might want to seek out a counsellor skilled in the area of body image.


Q: I’ve been naturally thin my whole life and have been able to eat virtually whatever I want and never gain a pound. I have been reasonably active, but have never really needed to exercise to stay slim. I’m turning 40 soon and things are starting to change.

I can handle the odd gray hair and the laugh lines but I’m really startled at how my body shape is changing. I am making a conscious efforts to eat well, I do cardio and weight training every day, I walk frequently but the pounds are slipping on and clothes I bought a year ago don’t fit.

I’m pretty critical of the way the media portrays beauty and have a reasonably good ‘sense of self’ but I have to admit that I’m feeling a little panicked about the path my body seems to be on. Any advice for someone who is trying to balance vanity and health as she approaches middle life?

A: It sounds as though you already are doing a great job trying to resist pressures to conform to cultural images of ‘the body beautiful’! You are eating well, exercising in a healthy way, conscious of media messages and in possession of a good sense of self.

For many women, approaching midlife can be challenging. How our culture values or devalues our aging bodies has a significant impact on our body images and identities.

From early ages we learn that contemporary western society values a certain ideal of the youthful ‘body beautiful’. For many of us, this is reinforced by messages we receive in interpersonal interactions that teach us to aspire to images of perfect bodies.

We may judge ourselves – or be judged by others – on how our appearance and abilities do or do not measure up to body ideals. Yet for many women moving into midlife, images of ‘perfect’ bodies are difficult, if not impossible, to attain. At the same time, positive images of aging or older women are rare. The lack of positive images of aging women can make it difficult for many of us to maintain a positive sense of body and self as we age.

Dealing with others and our own perceptions of our aging bodies can be stressful and challenging. Many midlife women report developing body image concerns associated with society’s negative perceptions of the aging female body. We may adopt a range of body practices to manage bodily changes of aging, as well as others and our own perceptions of those changes.

Studies suggest that some women may be more vulnerable to developing body image dissatisfaction and serious eating disorders during midlife as a direct consequence of internalizing society’s negative perceptions.

In my own research on women’s body image across the life span, I have found that women report two ways of dealing with cultural standards: changing our bodies, which often leads to harmful body image problems, or changing our situations, which can lead to improved self image.

For example, developing positive, supportive relationships, or changing life circumstances where self-worth is based on things other than appearance can inspire a woman to redirect her energy and attitude. In my research, a woman’s capacity to alter and control her environment emerges as key to her ownership of her self-image.

Of course, most of us practice both strategies – we change our bodies and our situations depending on what is possible and consistent with our values. As you so aptly put it, most of us try to ”balance vanity and health” in our relationships with our bodies.

To strike this balance, I often ask women to identify whether they would rate their body perceptions and practices as healthy or not, effective or not,and acceptable or not, within their current daily life. I then invite them to consider situations that increase or decrease their degree of body dissatisfaction. I encourage them to consider changes they could make in their environment to increase their sense of ownership over their image.

For some, this might mean surrounding themselves with affirming images of aging women’s bodies; for others, it could involve avoiding or altering situations that increase their body anxiety. You might think about the spaces, people, or activities that fuel your “panic” about your body’s path. There may be ways that you can reduce this panic by changing your environment.


Q: Dr. Rice, after getting out of an abusive relationship, his insults still affect the way I look at myself. What books do you suggest to women struggling with long term self esteem and image issues?

A: Many women who have gotten out of abusive relationships share your experience. In my research and clinical practice, women report that emotional and physical violence can result in numerous lasting adverse consequences for their body and self-image. These range from acute manifestations like eating disorders, self-harm and suicide to more insidious outcomes such as body dissatisfaction, low self-esteem, sexual inhibition, anxiety and depression.

The hidden psychological but serious consequences of violence and abuse often go undetected and unacknowledged by women, their allies, health providers and others. You have made an important connection between your former partner’s abusive comments and your current body and self-image concerns.

Unfortunately, many books on body image and eating problems do not address the connections among violence, body dissatisfaction and harmful body practices such as problem eating or cutting. While not all women with histories of abuse develop body image problems and not all those dealing with harmful body practices have trauma experiences, a significant number do.

In my view, we need more books and treatment programs that better reflect and respond to experiences of women whose body image concerns relate to their past abuse.

I particularly like the following books on body image, notably the book by Becky Thompson, which discusses connections between trauma and body image concerns:

Rita Freedman, Bodylove: Learning to Like Our Looks and Ourselves -- A Practical Guide for Women

Jane R. Hirschmann, When Women Stop Hating Their Bodies: Freeing Yourself from Food and Weight Obsession

Marcia Hutchinson, 200 ways to Love the Body You Have

Marcia Hutchinson, Transforming Body Image: Love the Body You Have

Susan Kano, Making Peace with Food: Freeing Yourself from the Diet/Weight Obsession

Margo Maine, The Body Myth: Adult Women and the Pressure to be Perfect

Becky W. Thompson, Hunger So Wide and So Deep: American Women Speak Out on Eating Problems

Katheryn Zerbe, The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment


Q: I am a 49-year-old woman who has excess body hair (at my bikini line). I hate to use a razor all the time. Is there another way?

A: In western society, women encounter pressures to embody hairless ideals commonplace in pornography and increasingly, in popular media. From puberty onwards, most women in my research report that they begin to perceive body hair as a problem trait. Because hair is seen as “masculine” in our culture, many practice hair removal to fit pervasive images of an “acceptable” female body.

Because a hairless norm has become more mainstream in recent years, some younger women report that men increasingly expect hairlessness in women and think that women are dirty or deviant if they have not removed it.

Motivated by our desire to appear as acceptable or to avoid being seen as different, millions of North American women remove face or body hair using such techniques as shaving, waxing, threading, tweezing, electrolysis and laser treatments. Unwanted hair can become a secret self-esteem issue for those perceived as having “excessive” hair, especially those with facial hair, hair on their chests, or “excessive” underarm, leg, or pubic hair.

According to the American Academy of Dermatology (AAD), most hair removal methods fall into three categories: they give instantaneous, temporary results (shaving, tweezing, waxing); they lead to hair reduction (laser) and they lead to permanent hair removal (electrolysis).

According to many experts, electrolysis remains the only permanent hair removal method available today. For more information about the pros and cons of various methods go to the American Academy of Dermatology's website.


Q: I haven’t been exercising enough lately, eating more junk food and, not surprisingly, have put on a few pounds. I don’t like myself right now…how little discipline I have, and how fat I am starting to look.

I am trying to use this dislike of my current body shape to motivate me to eat healthier and go to the gym. I often wonder if anyone would exercise or eat healthily at all if they did not constantly feel critical about their bodies, or compare themselves to others.

I can’t help thinking that vanity seems like a much stronger motivator than “feeling good” or “being healthy” is, when it comes to getting enough exercise, or eating the right foods. At least, that’s how it seems.

My question: Is some of this vanity (or insecurity) part of our “built in” instinct to protect ourselves from getting too out of shape or leading a lifestyle that is gluttonous, and detrimental to our health? Is some self loathing actually a good thing? Do we need to feel competitive in order to survive?

A: Some people who subscribe to evolutionary psychology believe that our emotions are part of our “built in” instincts for self-protection and survival. I do not endorse this view because it ignores the cultural and historical dimensions as well as the gender dynamics of western women’s concern with our images.

By interpreting body criticism and comparisons as instinctual, this theory naturalizes women’s dissatisfaction with our bodies. It cannot explain why body image concerns affect far more women than men and affect many more people living in economically privileged than impoverished countries.

Studies show that 90 to 95 percent of those with eating problems are women. Currently, 8 percent of women in North America are coping with an eating disorder. Yet the most compelling statistics to support a cultural and historical view are those that capture the extent of the problem among young women.

In a recent survey 27 percent of school girls reported disordered eating attitudes and behaviours (Jones, et al, 2001). In another, 60 percent of girls in grade 7 and 8 were dieting to lose weight (McVey et al, 2002).

Body image problems are rising, in part, because we live in a profoundly visual culture where we learn that image determines our value. Significantly, women’s weight concerns were largely unknown only one hundred years ago, and the word bulimia was only coined in the last thirty years. Body image problems have become prevalent among North American women in particular because women are socially identified with our bodies.

Display of women’s bodies to be “looked at” is a common theme in art, advertising, and popular culture. As you have observed, “vanity” is a stronger motivator for women to exercise and eat right because we are rewarded more for looking than feeling good.

In a final note, there is a risk involved with using body dissatisfaction to improve exercise and eating habits. Body dissatisfaction can contribute to the development of more serious concerns such as an eating disorder. When women relate their stories about this, they often say they began losing weight to improve their body related self-esteem. The link between self-esteem and appearance is strong in a culture that tells women they will be happier, healthier, and more successful if they conform to its narrow definitions of beauty. Women with eating disorders lose weight to gain a positive sense of body, but they also tell of how their positive body esteem eventually is undermined by the growing need to control their bodies.


Hi Dr. Rice. For some reason I seem to be obsessed with mirrors. I cannot get in an elevator or pass a store window without checking myself out. However, it’s not because I love what I see; quite the opposite! I am always startled to see how bad my posture looks, or how there are rolls of fat on my back, or how messy my hair is, or how tired I look. I feel like I am constantly on the lookout for something negative, and am always “checking and correcting” things. Why do I do this? (I also HATE how I look in most photos.)

A: You are not alone in feeling “obsessed with mirrors” and in constantly “checking and correcting” things. Our cultural obsession with the mirror is relatively recent. Mirrors are the oldest image making technologies in our daily lives (photographs and movies are newer technologies). Yet throughout most of western history, mirrors were available only to the very rich.

When reflecting surfaces became a stable of many stores and homes from the late 19th century due to improvements in manufacturing of mirrors and windows, images of their bodies became accessible to millions of people. As a result, the presence of mirrors and reflecting surfaces has had a profound effect on our psychology. By exposing us to a constant stream of images, mirrors have greatly amplified our awareness of our bodies as images. This means that mirrors have made sight, not touch or hearing, a primary sense through which we experience our bodies.

Women in my research talk about how the presence of mirrors has shaped how they perceive their bodies. Some describe how they developed an obsession with the mirror through continually seeking out, checking, and correcting their appearance in much the same way as you describe.

It is difficult to suggest strategies for dealing with mirror obsession without a more in-depth conversation. However, I invite you to think about when you feel the greatest urge to look at your reflection (times of the day, your mood just before looking, etc.) and about how it makes you feel before and afterward.

  • What would happen if you tried to avoid looking in the mirror so often?
  • Is it possible to avert your gaze in an elevator or on the street?
  • Could you remove some mirrors from your own home?
  • What would happen if you tried to live for one day without looking at your image?
  • How would that change your experience of your body?
  • What if you tried looking at those parts of your body that you do like? Or tried gazing at your whole body rather than focusing only on the parts you don't like?
  • How might concentrating on what you like change the way that you look at yourself?


Q: Hello Dr. Rice. I have always wondered something. Why do so many women go on crash diets before a major social event, such as their weddings, or class reunions? What purpose does this serve? I know of several women who almost starved themselves for months so that they could squeeze into a smaller dress and look “good” in their wedding photos.

Did they not meet their mates when they were heavier? Did their partners not fall in love with them for who they are? Are they doing this so that there will be a permanent record (photos) of a time when they were “perfect” for a day? Or is it a defence mechanism; are they afraid to stand up in front of everyone, under scrutiny? Is it a competition? Why do people do this?

A: I think that you have some generated interesting ideas about why women go on crash diets before a major social event such as weddings or class reunions.

There is fascinating research on the ways that the wedding industry promotes weight obsession in women. Industry insiders have told me that wedding dresses tend to be sized small, which serves to increase body anxiety of brides-to-be. You can imagine the shot of anxiety that a size 10 woman might feel if she found that she only fit a size 14 gown. She might be motivated to lose weight in the hope that she could squeeze into a smaller dress for her wedding day.

Aside from sizing pressures, I am aware that there are special diets and exercise programs marketed to brides-to-be, which further fuel women’s body dissatisfaction and adoption of practices such as crash dieting.

Many women create an internal picture of our ideal ‘look’ prior important social events. Like you, I think that anticipation of a permanent photographic record combined with public scrutiny often causes us to aspire to our image of perfection for these events.


My boyfriend and I seem to have a delicate balance when it comes to weight and body image issues. I know he really likes how “skinny” girls look (he has told me this many times), and I know he would be happier if I weighed less. He never comes right out and says that (always tells me I look “fine”), but I suspect that is how he really feels. Sometimes I want to throw that back in his face, as he is not the “ideal” body type either, if you know what I mean. Any advice for me?

A: Our partners’ body preferences and prejudices can have a significant impact on our body images. Whether spoken or unspoken, the messages that we receive from intimate others can shape our sense of attractiveness and desirability. From your question, it sounds as though your boyfriend may be sending you a mixed message: he really likes skinny girls yet he also tells you that you look fine as you are.

I wonder whether you feel safe enough to talk with him about your feelings. If you can open up a conversation, you might think in advance about the specific ways that he can support your positive body image. Would it be helpful for him to stop making comments about skinny girls? To give you unsolicited positive feedback about your weight and looks?

In conversations with men about the impact of their body preferences and prejudices on girls and women, I often ask them to consider the following: what is your ideal woman? In what ways do you communicate this to your partner/daughter/sister/friend? Challenge your own biases by practicing affirmation of your partner/daughter/sister/friend’s looks and size.


Q: My husband has put on a lot of weight recently. I hate to admit this, but I find him less attractive now. I don’t think it’s his looks so much as the feeling that he has given up on himself and doesn’t care anymore. He eats crap, doesn’t exercise and complains all the time that he hates the way he looks and feels. That is what I find to be the biggest turnoff. But maybe I am kidding myself? Maybe I am just shallow, and I don’t want to be with a “fat guy”? Does this make me a bad person?

A: I take from your explanation that your feelings about your husband primarily relate not to his body size but to his negative attitude and image. I pick up from your question that you doubt your ability to tease out whether you are responding negatively to his actual body size or to his attitude, energy, and behaviour.

Yet you also clearly state twice that you don’t think your reaction is based on his looks as much as his expressions of defeat, self-denigration, and self-disgust. I do not think you are a bad or shallow person. It is easy to collapse a person’s image with their identity in a culture that sees our bodies as outward expressions of our innermost selves.

I wonder: is your husband down or depressed about something? If you suspect he might be, you might be able to help him best by refocusing your energy on his mental health. Taking his, and your own, focus off fat and unto what might be bothering him.


Q: Why are so many of us fascinated by women who are painfully thin? We whisper and wonder if they are anorexic, if they have some sort of illness, or if they are just built that way. When we see them in a restaurant, we always look at what they are eating (or not eating). It’s almost like they are famous. Is this over-attention and speculation part of the problem? Is this one reason why people strive to be thin in the first place, so everyone will notice them?

A: Yours’ is a fascinating question. I too have noticed the proliferation of images of painfully thin women. It seems that every time I go to the grocery store checkout I am confronted with headlines such as “Battle of the Bones” and “Celebrity Weight Wars.” While famous women perceived as “too fat” often are subject to public scrutiny and criticism, I have traced the emerging trend of subjecting bodies of “too thin” celebrities to intense speculation and over-attention. On the surface, such coverage appears to raise public consciousness about the eating disorders epidemic in young Hollywood.

Yet I think something far more interesting – and disturbing – is happening. Many tabloids print pictures of emaciated stars on their front covers. Because editors choose front covers that sell magazines, I must conclude that these images are popular with consumers. I suspect that our collective fascination with emaciated bodies reveals that we are both attracted to, and repulsed by, the anorexic body.

These images are meant to shock and to seduce the viewer. Unquestionably, they encourage and reinforce body size comparison and competition among women.


Q: When I was in high school, I was naturally very thin. People used to comment on how “skinny” I was, and I thought they were repulsed. As a result, I was very self-conscious, and used to hide behind big sweaters. When I think back though, I realise they were probably actually speaking with envy rather than revulsion. (Sometimes these things sound almost the same!)

It makes me sad that I could not enjoy who I was then because of what I perceived to be negative comments. Nowadays, I am not so thin, and wish I could go back in time. The fact that I had a 23-inch waist and didn’t even appreciate it drives me crazy to think about.

And, I wonder, will I never be happy with who I am right now?

A: Like you, women in my research remember acquiring consciousness of appearance and difference through the many cultural mirrors in their daily lives. As young children, they developed attitudes about appearance when they internalized cultural criteria used by adults to judge attractiveness.

Entering peer groups, most recall feeling keenly the social consequences of physical appearances, when discovering which differences were distinguished and devalued in interpersonal interactions.

Significantly, some came to see themselves as too tall or too short, but rarely quite right. Others came to perceive their bodies as too fat or too thin, but never quite right.

To varying degrees, all acquired consciousness of their perceived difference and hoped for cultural acceptance. As their and your stories illustrate, body-based comments, comparisons and criticisms frequently become the most memorable sources of cultural information about our bodies.

It is possible to be happy with who you are right now. Because as children we have limited access to alternative images and meanings, we are especially susceptible to incorporating others’ attributions into our developing body images. This is not the case when we gain greater resources and freedoms of adulthood.

My research and clinical practice has taught me that a woman's capacity to change her environment is key to her ownership and improvement of her self-image. As I outlined earlier, developing positive, supportive relationships and changing life circumstances where self-worth is based on things other than appearance can inspire women to redirect our energy and attitude.

We also can shift our images by surrounding ourselves with representations that reflect us – such as affirming artwork or photographs, for example. Wearing comfortable clothing, avoiding over-attention to the mirror, and finding ways to appreciate our bodies through senses other than sight can help us create a better body view.

If you are interested in exploring your body history further, try answering the following questions about body formation and transformation.


  • Body image is the inner picture of outer appearance — it is a person’s perception of her body.
  • Body image includes how you feel about your body; messages you have received from others; and the social value placed on your looks and abilities.
  • Body image is not static but develops in interactions and changes throughout our lives.

Questions about body image formation:

  1. What kinds of messages did you receive about your appearance and abilities as a young child, as an adolescent, as a young woman, etc.?
  2. What did others say? What kind of non-verbal messages did you receive? (Think about sign messages from family, friends, peers, doctors, popular culture; think about images and interactions.)
  3. How do you think things that happened to you impacted on body perceptions? (Things that happened at school, in the medical system, in communities, neighbourhoods, in families, in friendship groups.)
  4. In each time period, was your body seen as an asset? A problem? Something that was admired? Desired? Something that needed to be fixed? Something that was acceptable or unacceptable, fit or unfit, normal or other than the norm?

Questions about body image transformation:

  1. When in your life have you felt best about your body? Try to remember a time when you felt good about your body. (Recent and/or distant past, in childhood, adolescence, adulthood, in particular relationships, jobs, or social situations.)
  2. How do you maintain or revisit that feeling? How can you get that feeling back? (Think about specific situations, relationships, spaces or activities when you revisit your positive feelings.)
  3. What values, qualities, purposes, commitments, connections, desires, and/or aspirations do you hold that help you maintain a sense of body and/or move toward your preferred body image? (For example, I am determined to make a change – I show determination in my actions).
  4. What actions can you take to move in the direction that you want to go? What are you already doing to make this happen? What have you learned?
  5. How would the people in your life support you in reaching your goal of a positive body image? How would people in your life acknowledge the qualities or values that you possess to help you reach your objective? How would they acknowledge these?


Q:  Is eating too much, or eating nothing but junk food, considered an eating disorder? How do we balance talk of the “obesity epidemic” and risk of illnesses such as diabetes, with society’s obsession with thinness, and the obvious risks of eating disorders and poor self image? Neither is healthy, but avoiding one extreme can lead to the other. How do we find a balance?

A: This is a great question. In the popular and health professional press, there is much talk of rising rates in obesity – especially among children and youth. At the same time, there is discussion of high rates of body image and eating problems. This leaves many of us – parents, health professionals, and physical education teachers – wondering just what we should be doing: tackling the obesity epidemic or the epidemic of dieting and body image problems?

How do we find our way past this confusion? In my clinical work, most women speak of how society’s negative perceptions of overweight significantly instilled and fuelled their food and weight struggles. In other words, they report developing bingeing or compulsive eating behaviour as a direct response to the trauma and emotional suffering caused by others’ negative perceptions of their fatness.

This is important because it challenges conventional wisdom, which assumes that people become fat because they eat too much. Instead, these women are saying that the reverse is true: others’ negative perceptions of their overweight and imposition of punitive dieting routines (especially in childhood) lead them to adopt binge eating behaviour.

This view is supported by research I conducted on women’s experiences of being seen as a “fat” girl. According to study participants, others’ anti-fat attitudes contributed directly to their problem eating and inactivity. For example, when teachers and students saw their bodies as unfit or unable, women stopped exercising to avoid hurtful comments, harassment and humiliation. Ironically, others’ perceptions and practices that framed women’s fat as unfit helped to produce the very behaviours and bodies they were attempting to prevent!

With a renewed focus on ‘fatness prevention’ through fitness promotion, I am deeply concerned that efforts to stem today’s obesity epidemic likewise may be leading a new cohort of large kids to adopt problem eating and exercise, possibility contributing to their overweight.

Morally-laden weight messages throughout society interpret fat bodies as unfit. Yet the science of obesity itself acknowledges that there are many causes of fat – from the genetic and hormonal to the behavioural and environmental. My research further suggests that the cultural and social – our negative attitudes about fat – also contribute to the obesity epidemic. Taken together, this evidence calls into question mechanistic and moralistic claims that faulty genes or bad habits cause fat.

In my view, health policy might more successfully serve kids and adults by shifting focus from changing bodies, to altering social worlds that impede our options for eating and activity.

For example, a “body equity” approach in schools, that advocated acceptance of diverse bodies, would expand options for enjoyable physical activities and increase kids’ capacities to make good food choices.

The primary objectives here would be to stop size stereotyping and stigma, and to give kids opportunities to explore the abilities and possibilities unique to their bodies.

Look for: Carla Rice (2007). Becoming the fat girl: Acquisition of an unfit identity. Women’s Studies International Forum, 30(2), 158-174.

The following books take a critical approach to our cultural obsession with fat and the obesity epidemic”:

Campos, Paul (2004). The obesity myth. New York: Gotham Books.

Gard, Michael and Wright, Jan (2005), Obesity epidemic: science, morality and ideology. New York: Taylor & Francis.


Q: It looks to me as if lesbian women often seem less concerned about body image, and are more comfortable with themselves than straight women are. Do you think this is actually true, and if so, why?

A: Studies suggest that lesbians and queer women are less likely to be concerned about their body image, and tend to be more comfortable with themselves than straight women. I think that one reason for this is found in “looking relations” that get established from puberty onwards when women and men form their sexual identities.

To explain the concept of looking relations, I draw on feminist theory. Simone de Beauvoir once wrote that one is not “born a woman; one becomes a woman.”

She argued that women’s bodies are central to this process: through media, schools, medical systems and the beauty business we are taught how to fashion our bodies to “create” our gender.

Feminists have long argued that popular images play a key role in teaching us how to become women: images show us how to look and act to “construct” and convey our gender. Importantly, they also teach us about looking relations, by communicating who does the looking and who receives the looks. We know that “to be looked at” has been coded as female and “to do the looking” as male throughout our cultural history.

Thus when girls look at images, they quickly come to see that they are ‘objects’ of men’s gaze. Boys likewise observe that they are supposed to do the looking (not so for gay men, but that is another story).

Of course, these gendered looking relations are not only inequitable but they also are evaluative. The power that our culture gives men “to look” and to assess what they see makes women particularly vulnerable to their gaze. This is what makes straight women more susceptible to developing body anxieties and issues. For straight women especially, body dissatisfaction can arise and increase between ages nine to 16, when they form their sexual identities and encounter strong social pressure to appear and feel desirable.

Obviously, lesbians and queer women are not immune to gendered looking relations simply because of their gender or sexual orientation; nor are they protected from developing body image problems because of their gender or sexual identity.

Through my research and clinical practice, I have found that queer and lesbian women can develop body image problems as a result of gender, sexual and homophobic harassment. Thus, a young lesbian who is harassed at school or rejected by her family for being queer may develop problems with eating or self harm to deal with the trauma. A young ‘butch’ woman whose peers assault her because she is “too masculine” may develop similar coping strategies. Finally, ‘femme’ lesbian women may be as vulnerable as straight women to getting caught in gendered looking relations and to developing body image problems because they may be mistaken as straight.

You may be interested in my research on lesbians and bulimia, published in the following journal: Carla Rice (1991). Pandora's box and cultural paradox: (Hetero)sexuality, lesbianism and bulimia. Resources for Feminist Research, 19(3&4).


Q: In many societies, elders are respected and revered – and larger bodies equal wealth and prosperity. Why is our society so obsessed with youth and thinness? And, even worse, why do I buy into it?

A: You are not alone in “buying into” our social values about thinness, youth and beauty.

As an aging 44 –year-old, not-so-thin woman, I combat these values as well, despite my longstanding work in this area and passion for these issues.

I believe that one reason we buy into them is because we live in a profoundly visual culture. More than ever, we are surrounded by thin, youthful, idealized images that constantly remind us how we don’t “measure up.” These messages are powerfully designed to sell us products and services.

As an example, I was blissfully unaware of my “yellow teeth” until I was subjected to an onslaught of television shows and commercials, drug stores shelf displays, and magazine articles about products for whitening “yellow, stained, and aging” teeth. Significantly, I never saw my teeth that way before I encountered these messages. In another example, I am flabbergasted with the recent proliferation of advertisements for cosmetic surgeries and chemical injections to stave off the bodily signs of aging.

Of course, the messages women receive about beauty don’t come only from the obvious “culprits” like the media, but also from the people around us over the course of a lifetime.

It is important not to underestimate the significance of others’ attitudes on shaping our self images. Childhood teasing, family and friends’ attitudes, and messages around us can be mutually reinforcing. These work together to tell a woman that she must look a certain way to be beautiful – or increasingly, to be acceptable. It makes me both sad and angry when I see the damage this does.

I often wonder where our extreme emphasis on appearance and body improvement is taking us as a society. I know that whenever I go to Los Angeles, arguably the epicentre of our image-obsessed culture, I am amazed with the numbers of cosmetic surgery ads along side ads for combating depression that I see in local newspapers. It makes me think that we are headed to becoming a population of pretty, yet profoundly unhappy people. I hope that we each do what we can to prevent that from happening.

For more information about my work or to downward selected publications, please visit to my website at www.carlarice.ca.


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