Contributor: Carolyn Karoll, LCSW-C is the Clinical Supervisor at The Renfrew Center of Baltimore.

There has been a great deal of research on body image in midlife over the past decade.

The majority of this research focuses on how midlife women struggle with body image concerns.

This is no surprise as we live in a youth obsessed culture with a standard of beauty that includes concepts such as “the thin ideal” and “ageless skin.”

It is hard to find a woman who not only accepts but has positive feelings towards her body. This is evidenced by a study published online, Oct. 11, 2013, by the Journal of Women and Aging that found only 12.2 percent of women ages 50 and older were content with their body size.

Even among these women, a significant number remained dissatisfied with other aspects of their appearance, such as their stomach, face and skin.

The Surge of Women in Midlife Needing Treatment

What we are seeing in treatment programs is a surge of women between the ages of 35-65 affected by eating disorders. They are struggling with discontent in aging and are taking drastic measures to achieve thin, “perfect” bodies or are binge eating to avoid/numb the shame and guilt.

While not all middle-aged women who are dissatisfied with their bodies develop an eating disorder, they are more susceptible to:

Depression
Isolation
Anxiety
Shame
Low self-esteem

They are more likely to be sexually promiscuous and remain in unhealthy relationships. In contrast, midlife women who have a positive regard for their bodies are typically more engaged in life, have more self-confidence and are in better physical and emotional health than their counterparts.

Identifying Factors that Impair Body Image

This article will provide suggestions for ways to develop or maintain positive body image in midlife. To begin, it is helpful to identify factors that impair a woman’s body image in midlife.

It is often found that looking at how a problem is maintained can help guide interventions to elicit change.

What is Body Image?

Body image is the way you see yourself and imagine how you look. Body image is not inborn, it is learned. It is influenced by many things from birth to midlife including biology (personality and temperament), peer norms, media and life experiences.

What Impacts Body Image in Midlife

Factors that are especially salient in midlife include the value contemporary Western culture puts on women’s bodies and appearance above other attributes. The unattainable media images, which are typically altered by technology, are internalized.

While research findings suggest body dissatisfaction remains stable across the life span even if a woman is not technically “overweight”, in midlife, the pressure to be thin is also compounded by the pressure to stay young.

Just type in the word “wrinkles” or “gray hair” into your browser and you will be inundated with articles, ads, and videos on “How to Reverse the Aging Process.”

From creams to cosmetic procedures, the midlife woman is often the target for interventions that seem to promise not only youth but also happiness, confidence, romance and desirability.

When the “Ideal” Is No Longer Attainable

The reality is women’s bodies undergo natural changes over time, which results in wrinkles, tooth discoloration, graying hair, and weight gain. Women gain, on average, 5-10 pounds per decade of life as body fat increases with each developmental milestone (puberty, pregnancy, and menopause).

Consequently, the thin ideal becomes less and less attainable. While weight loss is often seen as a sign of disciple and receives positive attention, weight gain is associated with laziness, and often leaves midlife women feeling shunned if not invisible.

Other Factors for Poor Body Image

Other factors that are related to a midlife woman’s body image include a culture that maintains patriarchal stereotypes of “middle aged” women as over-reactive, emotional, irrational, dependent, and subordinate in political and business skills.

These stereotypes dismiss and devalue midlife women.

Women who reject these stereotypes are often seen as “manly” or “bossy”. While women do have more opportunities in education and in the business world than in the past, the expectation is to be a kind of “superwoman.”

This may include being the primary breadwinner in a family while still being expected to pick up the kids at school, have dinner on the table for her husband and children, and keep the house clean.

This can leave women feeling inadequate. On the other hand, a lack of an identity beyond the role of mother and wife often leaves midlife women feeling disconnected from their true selves.

Since body image is based on a subjective feeling, when a midlife woman feels inadequate, this is often transferred to how she feels about her body.

Tips to Develop and/or Maintain Positive Body Image in Midlife

Although there is no formula, the themes of acceptance and “bigger picture” thinking appear to help women develop positive body image in midlife.

Identify and adopt realistic role models

Look at media images with a critical eye. Make a conscious choice to look for women over 50 who have attributes such as strength, wisdom and courage to be your role models. Think about the attributes you admire in women in your life – it is amazing how rare it is to identify attributes such as body shape or size.

Reengage in self-care practices

Role demands can lead to neglect of healthcare practices and reduce body-directed self-care (McLean, Paxton).

Use practices that can teach you to value your body, reconnect with it and respond to your physical needs. This can range from putting lotion on your body and going to doctor appointments to exercise, mediation and yoga.

Avoid making disparaging remarks at your body

Practice looking in the mirror and simply noticing and describing your body in neutral terms.

List reasons you appreciate your body

Once you are able to talk about your body in neutral terms, think of how your body has served you in positive ways. Practice acknowledging these things aloud and/or write them down and refer to them when you begin to engage in negative self-talk.

Write an apology letter to your body

Identify ways you may have abused or neglected your body and ask it for reconciliation to allow you to feel connected to it.

Increase self-compassion

Stop blaming your body for the natural process of aging. Talk to your body like you would talk to a dear friend.

Get accurate information about sex and aging

For example, weight gain in midlife is the result of normal hormonal and metabolic shifts; maintaining a healthy sex life in midlife may mean addressing changes in hormone levels through supplemental hormone therapy and/or use of lubricants.

Since certain medications (i.e. antidepressants and blood pressure medications) can affect sexuality. Medication changes may be indicated as well as counseling to address issues of self-image and other issues that may impact one’s sex life.

Try a holistic mind/body approach

This can help integrate mind and body by helping women reconnect with their bodies and challenge self-criticism though guided imagery, mindfulness meditation, mirror work, and cognitive-behavioral therapy.

Focus on spirituality and exploration of existential issues

This may enable some midlife women to shift focus to fundamental values and personal transcendence rather than on appearance.

Treatment

While not everyone in midlife who struggles with impaired body image develops an eating disorder, we do know that body image dissatisfaction is the primary precursor for the development of eating disorders.

More and more women in midlife are recognizing their body image worries have turned into obsessions and are seeking help. If you think your or a loved one’s dissatisfaction with body image may be negatively impacting self-esteem, interpersonal relationships, and/or daily functioning, help is available.

Help may include individual therapy, a support group, and/or working with a dietitian. It also may mean a treatment program like The Renfrew Center, the country’s first residential eating disorder treatment facility, which offers a full continuum of care, including individual and group therapy and nutrition support, to help those who are struggling with body image disturbance.

It is not too late for women in midlife and older to learn to make peace with their bodies. Support is available to help reduce self-criticism and promote self-acceptance, so women can not only tolerate their bodies but eventually accept and appreciate them.

About the Author:

Carolyn Karoll, LCSW-C is the Clinical Supervisor at The Renfrew Center of Baltimore. Carolyn earned a Master of Social Work degree at the University of Maryland School of Social Work in May 2003 with a specialization in clinical mental health and completed her undergraduate studies at Towson University in 1994 where she earned a bachelor’s degree in Women’s Studies.

She has worked in the field of eating disorders since 2008 and has past experience working on an inpatient and partial hospitalization eating disorder unit, focusing primarily on family therapy and group work. She also has experience working with incarcerated populations, victims of domestic violence, teen mothers, and general psych.

At Renfrew, Carolyn provides clinical leadership and works with individuals, families, and groups in the Day Treatment and the Intensive Outpatient levels of care and is also a part of a Renfrew workgroup that is researching ways to adapt family therapy models for the treatment of eating disorders program-wide. Carolyn has presented on several topics in the community to include Body Image and Eating Disorders in Midlife Women.

Journal Reference:

McLean, Sian A.; Paxton, Susan J.; Wertheim, Eleanor H.
A Body Image and Disordered Eating Intervention for Women in Midlife: A Randomized Controlled Trial. Journal of Consulting & Clinical Psychology, 2011; 79(6), 751-758 Journal of Consulting and Clinical Psychology, v79 n6 p751-758 Dec 2011
Cristin D. Runfola, Ann Von Holle, Christine M. Peat, Danielle A. Gagne, Kimberly A. Brownley, Sara M. Hofmeier, Cynthia M. Bulik. Characteristics of Women with Body Size Satisfaction at Midlife: Results of the Gender and Body Image (GABI) Study. Journal of Women & Aging, 2013; 25 (4): 287

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.