Female Body Image and ‘normative discontent’
It’s time for me to tackle the issue of female body image, healthy weight management, overweight and obesity. If you turn up in my clinic with no other concern than wanting to lose a few pounds I am listening to your concerns. I understand your frustrations at the conflicting information and diet tribes. I will help and support you to lose weight for no other reason that that you want to feel more confident.
As a Nutritional Therapist you might imagine that this is straightforward conversation for me to have with you but that is not the case.
Body weight is measured as a clinical abstract, with linear categorisation of BMI into Underweight, Normal, Overweight and Obese. The scientific research shows us that BMI greater than 25 (Overweight) is directly correlated with risk factors for chronic disease (diabetes, cardiovascular disease and cancer). Worthy cause for concern indeed.
As practitioner and client alike, we are conditioned to downplay the context of weight gain and body image, ashamed to admit how those extra pounds make us feel, instead we adopt the loftier ambitions of weight loss for optimal health. We dance around our distress at gradual pounds gained and goals of weight loss for the aesthetic, choosing instead to treat our gains as a clinical symptom of ill health. I think this is detrimental to our long term health.
A client might come to me and say something like:
“of course, losing a couple of pounds would be a bonus, (we both laugh – we don’t want to seem shallow and vain), but I am really only concerned with improving my health.”
When I look more closely at the scientific literature, I see that we are entirely deluding ourselves. Let me explain why.
Body Image is measured using a Figure Rating Scale (FRS). It’s actually quite a simple concept.
In one study, 6000 women, between the ages of 25 and 75 were asked to look at silhouettes of 10 different body images (ranging from very small to small, through to average, large and very large).
The respondents were then asked to select two from the ten images, (A), the schematic which best represents their current silhouette and (B) the silhouette which best represents their perceived ideal body shape.
The researchers then do a quick calculation to work out the difference; (A minus B = Body Image discrepancy).
Their study demonstrated that 90% of female respondents perceived as ideal a body silhouette smaller than their current silhouette. (That’s nearly 5400 / 6000 women unhappy with their body).
This discrepancy is referred to as Body Dissatisfaction and is negatively correlated with social anxiety, reduced quality of life, low self-esteem and depressive symptoms.
So, we see that 90% of the adult female population are unhappy with their body weight and feeling anxious and depressed as a result of it. Anxiety and depression feed into the cycle of excess stress and blood sugar mismanagement making it harder to lose weight. This in turn leads to further health issues down the line, yes, but also, how are 90% living lives unhappy with the way we look? That SUCKS!
For this reason, I am determined to enable Body Image and Weight Gain to be a positive conversation in my clinic.
‘Normative discontent’ is a term coined by Rodin et al. in 1984. Basically translated, it means that women, unhappy with their weight, have accepted it as normal to feel this way. Is this why the food industry gets away with sluicing our supermarket shelves with such poison I wonder? Have we have given up fighting against the convenience of high fat high sugar foods that disrupt our hormones and metabolic control? Have we resigned ourselves to view discontent as the acceptable relationship with our body?
Are we too afraid to ask for help in reversing the often-marginal discrepancies between how we perceive ourselves currently and our right to achieve our ideal weight? We must not be afraid to ask for help in achieving our goals. We must not be afraid to stand up love our bodies. Your ideal may be different from my ideal and someone else’s ideal, but I want to live my ideal. I do not accept normative discontent as my set point for living.
The argument for our health is strong and unequivocal.
Scientific evidence shows us that overweight and obesity is a leading determinant of chronic disease; Being overweight is not good for our health.
According to the World Health Organisation, 1.6 billion people were classified as overweight (2016) and 650 million were obese. The prevalence of obesity has almost tripled since 1975. Overweight and diabetes have been leading risk factors for mortality from Covid-19.
But if you turn up in my clinic with no other concern than wanting to lose a few pounds I am listening to your concerns. I understand your frustrations at the conflicting information and diet tribes. I will help and support you to lose weight for no other reason that that you will feel more confident. And if as a bonus you find that you have more energy, that you are sleeping better, your cholesterol is reduced and your blood pressure normalised, well that is just a happy by-product.
We should not feel ashamed of aspiring to our perceived ideals.