Everyone has a body image—a set of beliefs, perceptions, and feelings related to their body. Surprisingly, body image is not necessarily related to objective measures and does not refer to what you actually look like. Not liking your body makes it difficult to accept yourself and is associated with depression, anxiety and withdrawal. Research shows that many patients experience an improved body image within the first year after weight loss surgery. However, some patients continue to perceive themselves inaccurately and negatively, or change their focus from their body size to sagging skin. It sometimes takes your mind time to “catch up” with your rapid and dramatic body changes.

How to improve your body image

1. How are you talking to yourself? Often, you feel bad about your body because of your thoughts. Try to avoid inaccurate, negative terms like “my disgusting fat hips” or “the elephant skin under my arm.” Rather, use more descriptive and neutral terms (e.g., “round hips” or “the way my underarm skin sags and has wrinkles”). When you feel particularly bad about your body, write down your thoughts and see if you can alter them to be more accurate and neutral. It may help to ask yourself if the thought is helpful or hurtful. If it’s hurtful, then restructuring it to be neutral may make a big difference.

2. Stop avoiding: It is not uncommon for people to avoid activities (e.g., swimming) or certain items of clothing (e.g., sleeveless shirts) when they feel uncomfortable with their bodies. One way to get over these concerns is “exposure therapy”—just do them! What is the worst that could happen? Could you survive even if your worst fear came true (e.g., someone says something to you)? The more you avoid these situations, the more you will feel uncomfortable. If you try them, you might discover that the activity or clothing wasn’t so bad after all.

3. Focus on the function of your body: Our culture focuses on appearance. Instead of thinking about your appearance, try to experience your body. Take a walk. Stretch. Notice your posture. Think about the function of your body. Since surgery, are you able to tie your shoes easier, walk further or cross your legs?

4. Get comfortable with looking in the mirror: People who struggle with their body image sometimes avoid looking in the mirror, or look only from the neck up. Each day, look at yourself in the mirror and make a positive statement about your body. You may feel silly at first, but this will help you accept your body and become more aware of the positive changes that are occurring. Make a list of 10 positive statements about your body (e.g., “My body may not be perfect, but I am still attractive”). Focus on what you like, and remind yourself that it’s okay to like and appreciate what you see.

Me Minutes

Take the time to do nice things for your body. Once a month get a massage, manicure or facial. Get together with a friend and give each other pedicures. Pamper yourself with a bubble bath and candles while listening to your favorite music, or take a long, hot shower. Buy lotion, aftershave, perfume or cologne that helps you feel and smell good.

Kelli E. Friedman, PhD, is an Assistant Professor at Duke University Medical Center working in the weight loss surgery program.

June 2008