Body Image Issues

Since the fitness boom of the 1970s, women have been bombarded with social messages that ‘exercise is good for you’ and ‘the more the better’, prompting many of us to engage in regular, and sometimes vigorous, exercise regimes, often alongside restricted diets. In the magazines in the check-out isle at the supermarket, or as soon as we switch on the television, we are exposed to ideas about what is a ‘good’, ‘disciplined’ and ‘healthy’ body, and alternatively what is a ‘bad’, ‘unhealthy’ body. We see others comment positively about ‘good’ bodies, and we also see the ways society ridicules and marginalizes those bodies that do not conform. We also absorb many ideas about ‘good’ or ‘naughty’ foods from many different sources (e.g. parents, peer group, teachers, television, magazines, books).

With so much information proliferating in our society about ‘good’ and ‘bad’ bodies, it is not surprising that many girls and women (and boys and men too) internalize these messages and start ‘disciplining’ their own bodies through highly regimented exercise practices, by paying close attention to their diets, and/or by more radical measures. Many do so with the understanding that such practices are ‘good for our health’. But, as should be clear on this website, this message is overly simple and ignores the potential risks to long-term health from excessive exercise with insufficient nutrition. While obesity continues to be a major concern for many individuals, families, and health organisations, this does not mean we should completely overlook the experiences of those who appear a ‘healthy’ weight or doing all the ‘right’ things (e.g., going to the gym, retrictive food consumption), but whose exercise and dieting practices may also be compromising current and future health and well-being.

Magazines Display

Worried that they do not measure up to the images seen in the magazines, many girls and women experience body image concerns. American sports sociologist Margaret Carlisle Duncan (1994) analysed an array of glossy women’s fitness magazines, which she describes as replete with stories of dieting and exercise successes combined with pictures of slender and glamorous models. She argued that these magazines “encourage women to survey, with degrees of distress, their own bodies for signs of abnormality against an unrealistic body image”. According to Professor Duncan, these magazines promote weight control and dieting as disciplinary practices. While the overt function of these practices is the production of an attractive, recognisably feminine body, their covert function is women’s disempowerment, as women find themselves ceaselessly striving to correct a body that is always defined as deficient. How much time, energy and money do women invest in seeking to achieve a largely unrealistic ‘feminine ideal’ celebrated in these magazines? Rather than recognizing these images as celebrating an unrealistic body image, many women feel a sense of failure or guilt when they are unable to achieve this particular type of body.

In the high performance sports world, many coaches, teammates and fellow competitors comment on the appearance of female athletes bodies at events, in training or even in the media: ‘Wow, look at her, she’s in great shape!’, ‘I think she could lose a few kg’s’, ‘She’s carrying a bit of weight around her middle, that will slow her down’. Such comments may seem innocent enough, and often they are spoken without the intent to harm, or even for anyone to take them personally. However, when some girls and women (over)hear such comments, it can prompt them  to internalize these social messages (e.g., ‘thinner is better for performance’, ‘my coach will be pleased if I lose some weight’) and thus begin to carefully discipline their own bodies through exercise and food. Interestingly, many retired female athletes who suffered from disordered eating or exercise addictions during their competitive years have spoken about the significance of a comment from a coach or a team-mate in triggering unhealthy relationships with their bodies, food and training.

In an article titled ‘Making weight: Lightweight rowing, technologies of power, and technologies of self’, Dr Chapman offers fascinating insights into the culture of women’s high performance sport. She explains how lightweight rowers embarked on a regimen of rigid control of food consumption, exceptional levels of physical activity, and constant self-monitoring through which they produced the thin, tanned, and toned bodies culturally defined as attractive, healthy and feminine. According to Chapman, female rowers body surveillance was primarily experienced as an internalized, self-directed gaze rather than emanating from an obvious external source of power (e.g. coach). In other words, when Chapman interviewed the athletes, they explained that they were engaging in these practices out of their own choice and will. However, looking at the broader sporting culture, and analyzing trends across the interviews, Chapman revealed the significance of the coach-athlete relationships, and also the dynamics between teammates in terms of supporting and encouraging unhealthy body management practices.

In both the high performance sports world, and in everyday society, body image concerns are being experienced by many girls and women, and boys and men. Next we briefly discuss a particular type of body image concern facing many female athletes and exercising women, and the growing issue of exercise addiction.

Exercise and Self-Esteem

Self-esteem is the degree to which an individual likes or approves of him or herself. Self-esteem is multidimensional: there are different sources of self-esteem including knowledge, physical, sport, religious, family, and work self-esteem. Self-esteem is a product of learning, especially through social interactions with others, and a culmination of personal experiences (i.e., success and failures). Research has shown that enhanced self-esteem has significance for mental health because it provides a feeling of value or worth; symptoms of anxiety and depression are often associated with low self esteem.

Exercise psychologists have studied the relationship between exercise and self-esteem. According to Buckworth & Dishman (2002): “Positive associations between exercise and self-esteem have been found, but effects are stronger for individuals initially lower in self-esteem” (p. 168). Continuing, they state: “Exercise has more potent effect on physical self-concept and self-esteem than on general self-perceptions” (p. 168)

Researchers have also shown that the relationship between exercise and body/physique self-esteem is particularly strong among women. Research has also shown that changes in self-esteem with exercise more likely in children than adults. This is most likely because adults self-esteem is more multidimensional (e.g., career, adult roles and responsibilities). Because self-esteem is relatively enduring or stable, changes are more likely to be seen after prolonged involvement in exercise. However, exercise participation is not a simple solution to low self esteem. As you will read below, low self esteem can negatively affect women’s body image, and affect the ways they engage in sport and/or exercise, and their relationships with food.

Social Physique Anxiety

Social physique anxiety (SPA) is the anxiety that people feel when others are evaluating their physique or body. Researchers found that individuals with higher levels of SPA may be less likely to participate in activities where their bodies can be negatively evaluated by others. Not only do they avoid situations where their body may be evaluated, they are also more likely to become distressed when in such situations. Individuals with high levels of SPA are more likely to attempt to improve their physique in ways that may be harmful (e.g. fasting, crash dieting). Those with high levels of SPA also tend to demonstrate higher levels of appearance-related exercise motivation. There are many other socio-psychological body image disorders (e.g., Body Dysmorphic Disorder) that cause stress and anxiety for many women and men promoting them to undergo extreme measures such as dieting, excessive exercise and even surgery in an attempt to obtain their desired physique. Appropriate medical treatment and support for women and men with SPA is imperative.

Disordered Eating

Anorexia nervosa and bulimia are the two most common eating disorders. Anorexia nervosa includes the following characteristics:

  • Weight loss leading to body weight maintained at least 15% below expected norms
  • Intense fear of gaining weight or becoming fat, despite being underweight
  • Disturbance in how one’s body weight, size or shape is experienced (I.e., feeling fat even when obviously underweight)
  • In females, the absence of at least 3 consecutive menstrual cycles otherwise expected to occur

The diagnostic criteria for bulimia include:

  • Recurrent episodes of binge eating
  • A sense of lacking control over eating behavior during the binges
  • Engaging in regular self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain
  • An average minimum of 2 binge-eating episodes a week for at least 3 months
  • Persistent concern with body shape and weight

 According to the US National Eating Disorder Association, between 5–10% of all women have some form of eating disorder. Recent research conducted in the United States suggests that 19–30% of female university students could be diagnosed with an eating disorder.

Disordered eating in sport

Research repeatedly shows that athletes appear to have a greater occurrence of eating-related problems than does the general population. A study conducted by Norwegian researchers, Sungot-Borgen and Torstveit, for example, showed that 20% of elite female athletes meet the criteria for an eating disorder in comparison to 9% of the general population. It is also important to keep in mind that not all disordered eating practices are so severe that they meet the diagnostic criteria. A significant percentage of athletes engage in pathogenic eating or weight-loss behaviors (e.g., binge eating, rigorous dieting, fasting, vomiting, use of diuretics) and these are important to examine even though they are sub-clinical in intensity.

Eating disorders among athletes and their use of pathogenic weight-loss techniques tend to have a sport-specific prevalence (e.g., they occur more among gymnasts and figure skaters than in archers and basketball players.

Some predisposing factors for disordered eating and other pathogenic weight-loss techniques in sport:

Weight restrictions and standards: sports such as rowing, weightlifting and boxing commonly use weight classifications to subdivide competitors. Often athletes try to ‘make weight’ so they can compete at a lower weight classification. Fasting, fluid restriction, and the use of diuretics, laxatives, and purging are all methods used to achieve rapid weight loss. Coaches and trainers should discourage these weight-loss methods, even those that are embedded in the sport culture

Coach and peer pressure: Many female athletes recovering or recovered from disordered eating discuss the significance of a coach’s comment earlier in their careers in initiating their body image concerns.

Performance demands: the correlation between a low % body fat and high level of performance has led many coaches and athletes to focus on weight control

Judging criteria: in some sports (e.g., figure skating, gymnastics) judges and coaches tend to be biased toward certain body types. Research by Sundgot-Borgen (1994) and Torstveit (2004) found that female athletes competing in aesthetic sports show higher rates of eating disorder symptoms (42%) than are observed in endurance sports (24%), technical sports (17%), or ball game sports (16%)

If you are a coach, teacher, athletic trainer, or exercise leader, and you identify someone who demonstrates symptoms, you’ll need to solicit help from a specialist familiar with eating disorders. It is also important to remember, some people exhibit some of these signs without having a disorder. Others are afflicted, and it would be a serious mistake to think the problem will correct itself. As we explain on the coaches page, ignorance is negligence when it comes to the thinking about the longer term health of female (and male) athletes. Here is a link to a great resource for coaches and trainers of female athletes wanting to know more about disordered eating in sport and some appropriate strategies to support and develop a healthy body image culture among female athletes. Also see various other great resources on the ‘links’ page.

Recent research suggests that disordered eating practices are increasingly associated with compulsive or addictive exercise practices.

Exercise Dependence

Exercise dependence has been defined as a craving for leisure-time physical activity, resulting in uncontrollable excessive exercise that manifests in physiological (e.g. withdrawal) and/or psychological (e.g. anxiety/depression) symptoms. Other common terms include “obligatory exercise”, “excessive exercise”, “exercise addiction”, and “exercise bulimia”. Some of the reported ‘withdrawal symptoms’ for those with ‘exercise dependence’ include: Mood changes, restlessness, irritability, lack of appetite, insomnia, and/or feelings of guilt if a 24-36 hour duration passes without vigorous physical activity. Exercise dependence has mainly been studied in runners, but is increasingly being observed by fitness professionals working in many gyms and fitness centers across the Western world.

Given the so-called ‘obesity epidemic’, some argue that exercise addictions should be the least of our concern. In contrast, those who have observed the damaging effects on the lives of exercise addicts and their families may argue otherwise. So, is compulsive exercise behaviour helpful or harmful? Recent research reveals there is truth in both sides of this argument. There are two types of exercise addition:

‘Positive addiction’ is when a person’s exercise compulsion is beneficial to his/her health and psychological well-being. The individual still enjoys exercising, and does not cause damage to their bodies through their participation (e.g., taking the time to recover fully from an injury).

‘Negative addiction’ is when an individuals’ exercise regime comes at the expense of other daily regimes (e.g., work, family life) and is no-longer good for their health (e.g. continuing to exercise with an injury or refusing to take time out to recover from an illness). The key distinction is that the individual perceives exercise as work and no longer enjoys the pleasure it once provided. They may feel controlled by their exercise practices, but feel ‘out-of-control’ when they aren’t able to exercise which can cause anxiety or stress.

Compulsive exercisers may demonstrate some or all of the following:

  • Dissatisfaction with their bodies or themselves
  • Exercise to have control but become controlled by the activity
  • Do not enjoy having free time
  • Become dependent on the euphoric and calming effects of exercise
  • Are likely to be avid goal setters
  • Become socially withdrawn
  • Energy Availability, Amenorrhea, and Mood

    In the world of high performance sport, many coaches encourage their female athletes to maintain a body weight deemed to be ideal for successful performance. In doing so, coaches are focusing on the physiological or biomechanical functioning of the athlete. While most attention is focused on developing the athletes physical and physiological conditioning, the athletes psychology is also integral to success. Research has shown that amenorrheic athletes may have a compromised mood profile, which can impinge upon performance in some sports.

    Coaches are in a position of power over their athletes, and many young female athletes often trust their advice such that some will go to great lengths to obtain this suggested body weight. For some (not all) women, achieving such body weights might mean going into an amenorrheic state for a short or long period of time. In many high performance sport contexts, coaches and female athletes seem to have accepted the idea that amenorrhea is just a ‘natural’ part of elite competition and training. While menstruation is an important marker of good health for pre-menopausal women, for many female athletes and their coaches it is often inconsistent with ideas about conditioning for successful performance.

    Research has shown that female athletes who are in an amenorrheic state may be compromising the psychological dimensions of performances. In a research article titled ‘Mood, mileage and the menstrual cycle’, researchers from the University of Birmingham (UK) revealed significant differences in the mood profiles of amenorrhoeic athletes, non-amenorrhoeic athletes and inactive women. Focusing on elite female runners, the study revealled that amenorrhoeic athletes demonstrate a negative ‘Profile of Mood States’ which they suggest could be counter-productive for optimal performance. In this study, amenorrhoeic athletes experienced higher tension, depression, anger, fatigue and confusion, and less vigor (or energy), than non-amenorrhoeic athletes. In comparison to the non-active group, they also experienced higher levels of depression, anger, fatigue and confusion. However, further clarification on this theory is required as in other studies  amenorrheic female endurance athletes have also reported the iceberg profile and positive mood states similar to those reported by their eumenorrheic counterparts.

    The key point, however, is that this study should prompt coaches and athletes to keep in mind that performance is the result of physical conditioning and physiology, as well as psychological and social components. Coaches should try to adopt a holistic approach toward their female athletes, and question misguided assumptions that obtaining the ‘ideal’ body weight, whatever the consequences (e.g., amenorrhea, body image concerns, disordered eating), will enhance performance. Of course, while the physiological and  biomechanical aspects of performance are important, at the elite level, it is often the psychological dimensions that  distinguish the winners from those in second, third or last place.

    Amenorrhoeic female exercisers might also consider how their moods might be being affected by their exercise and/or dieting practices, and also how their mood profile might be affecting their everyday functioning and relationships with friends, family, and/or workmates.

    Click here to see relevant research