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Body Image Distortion

By Cynthia K. Buffington, PhD


Body image dissatisfaction is relatively common among those who struggle with excess weight. It is especially common for individuals who have experienced obesity for what seems like or actually has been a lifetime.


Such disparagement of body image is greater for females than for males and more prevalent among Caucasians than African Americans or Hispanics.


Body image dissatisfaction has a number of deleterious consequences that increase one’s risk for obesity. A poor body image is associated with a high risk for binge eating, bulimia, yo-yo dieting, psychological distress, low self-esteem, poor social interactions, and reduced life quality.


Studies even find body image disturbances among overweight children as young as 5 years of age. Factors contributing to such disturbances include criticism of body size by parents and other adults, jeering and unkind remarks by peers, and the concept of the ‘ideal’ man or woman portrayed in movies and other facets of the media.

A poor body image in childhood may not only impair psychosocial development and lead to eating abnormalities but may also distort one’s perception of body size. A Columbia University study found that individuals obese since childhood are far more likely to have a distorted body image following weight loss than are those who become obese as adults.


Another study found that normalization of body weight following weight loss surgery resolves body image distortion and disparagement among patients with adult onset obesity but not among those with childhood onset obesity. Studies at one bariatric program found that 3 out of 4 bariatric surgical patients have been obese since childhood. Such a high incidence of childhood onset obesity may explain why, upon reaching goal weight or ideal body weight, so many bariatric surgical patients still feel as though they are obese.  Distortion of body image, if left uncorrected, could jeopardize long term maximal weight loss success and overall psychosocial well-being. 


What to Do: How then is it possible for someone who has been obese nearly all of their life to improve his/her concept of body image? One way is through ‘before’ and ‘after’ photos and videos. Other techniques for improved body image include cognitive-behavioral therapy and a newer technique known as virtual reality multidimensional therapy.

If you feel you need support with improving body image satisfaction, contact your psychologist for a consultation.