We're in the midst of a #CelebrateMySize, #HonorMyCurves body-image revolution. But the words in this article—real words from real women—are not about how their size or curves make them feel. In a first-of-its-kind investigation, Women's Health reveals the psychological fallout from physical "flaws" that haven't a thing to do with weight—and how a new way of thinking could save every woman's self-esteem.
The first time Adrienne Jones showed her knees in public, she was 37 years old. She'd covered her legs for decades, obsessed with hiding the remnants of a childhood car accident: raised, red scars that crisscrossed her knees. By the time she reached adulthood, the marks had all but disappeared, yet… "when I looked in the mirror," says Adrienne, "they were all I could see—all I was sure anyone would see." Feeling ugly and ashamed, she withdrew from friends, sliding into depression.
Adrienne's story sounds dramatic, but it's far from rare. Nearly 70 percent of women are traumatized by what they perceive as imperfect physical traits; they're haunted by everything from thinning hair to spider veins to wonky ear shape, per an exclusive new WH poll. Yet their struggles go largely overlooked—even, ironically, in the midst of a powerful "Love Your Body" cultural moment.
The problem: "The body-image discussion is now centered on weight," explains Heidi Williamson, Ph.D., a psychologist at the Centre for Appearance Research in Bristol, England. Mostly because it's so relatable (89 percent of women are unhappy with their size, says a recent survey). And ubiquitous: Fashion and beauty companies have run weight-related body-positive campaigns; celebs like Kate Winslet reject retouching; plus-size models (finally) walk the runways.
Such progress is encouraging, yes. But the singular focus excludes millions of women who, like Adrienne, grapple with other types of physical issues. And something as seemingly innocuous as a birthmark or crooked nose can be just as detrimental, healthwise, as feeling fat—in many cases, more so, partly because there's no message "normalizing" it. The results can be devastating: untold mental suffering and raised risks for chronic disease.
Fits and Starts
Ã¢â‚¬Â¨In some cases, a major life event (a bad breakup, a serious injury) can dismantle a previously healthy body image. But for most women, it's a slow burn—one that starts younger than you might imagine. "Even preschoolers compare themselves to others and internalize differences," says Canice Crerand, Ph.D., a clinical psychologist at Nationwide Children's Hospital in Columbus, Ohio. And it's no surprise that, on top of playground put-downs, social media and—we're owning our part here—the actual media continue to shape self-perception en route to (and during) adulthood.
The breadth or location of any "flaws" you might find matter less than how you see them. If a woman repeatedly zeroes in on, say, her stretch marks day after day, the problem can become amplified in her mind, says psychologist Leslie Heinberg, Ph.D., director of behavioral services at the Cleveland Clinic. "What might be nearly invisible to a stranger can still feel devastating."
When a perceived imperfection is visible, stares and insults can aggravate nose-diving body image. Even well-meaning questions or advice (e.g., "I know of a great concealer for that scar") can, says Williamson, "confirm a person's secret fear: that something about her is noticeably different."
What Lies BeneathÃ¢â‚¬Â¨
The fallout reaches far beyond feelings of unattractiveness. Research shows women with any type of poor body image are less likely to exercise and more likely to smoke and overeat (after all, why take care of something you despise?). Consequently, they're more prone to high blood pressure and heart disease. Per our WH survey, those with a negative body perception are less inclined to date, hang out with friends, or meet new people—bad news, since studies show social isolation can hammer immune function and boost inflammation, which may lead to arthritis, diabetes, and Alzheimer's disease.
Scientists are just now looking at the specific, additional health impacts of non-weight-based hang-ups. People who have low self-worth due to psoriasis, for example, can be sexually inhibited. Scoliosis patients are at increased risk for depression and suicidal thoughts. And women with vitiligo can experience stress that leads to alcohol and substance abuse.
Even smaller, nonmedical fixations (like Adrienne's knees) "can drive you into depression just as fast as a major health problem," says Michelle Fingeret, Ph.D., a psychologist at the MD Anderson Cancer Center in Houston.
Ã¢â‚¬Â¨Let's be real: Not every woman will love every part of her body—and she doesn't need to. The commandment that we embrace each inch of ourselves can feel like just another unrealistic ideal. A better goal, say experts, is to work on separating your physical form from your self-worth.
The first step, says Heinberg, is awareness. Most women—82 percent, per our survey—already admit that the way they view themselves may not match how others see them. Problem is, body bashing has become a staple way for women to bond (see: the mirror scene in Mean Girls..."Oh my god, my hips are huge!" "Please. I hate my calves!"). That makes it easy to disparage body parts in public, but difficult to sincerely open up about legitimate concerns.
If you suspect a body-image woe is taking over your life, try seeking out a therapist. Heinberg, for one, prompts clients to focus on what their bodies can do—run a 5-K, cradle a baby—rather than what they look like. Fingeret advises devising a proactive game plan for handling unwanted comments; sometimes having comebacks at the ready (And you're saying this because...?) can defuse a situation before it piles onto your internal angst.
In the end, recognizing that your body—or any of its parts—doesn't define who you are is key to body positivity. It's a lesson that, after 30-plus years of anxiety, Adrienne Jones accepted while out shopping one day. She spied a cute pair of shorts and became overwhelmed by how sick she was of obsessing over her knees. Four years later, Adrienne, now 41, still owns just one pair. But she'll wear them when it's really hot and, as she says, "One is better than none, right?"
This article was originally published in the January/February issue of Women's Health, on newstands now.