Like it or not, most of us are aware of how we look. We have all had a bad hair day, or worried whether we are wearing the right clothes for a particular event.
The traditional stereotype is that young women are more concerned about their appearance than young men. Societal pressures, media images, and doting relatives saying how pretty a female child looks all have an impact.
But how serious an impact can it have on our wellbeing and our mental health? And just how much does our body image trouble us as we get older?
Statistics by the charity the Mental Health Foundation (MHF), show that poor body self-image can affect all ages, not just younger people, and the reactions it can trigger range from anxiety and self-disgust to suicidal thoughts.
The figures, revealed to coincide with the body image theme of national Mental Health Awareness Week, follow a YouGov poll of 4,505 UK adults. It found that 57% of 18- to 24-year-olds surveyed admit to having felt anxious because of their body image, compared with 30% of 45- to 54-year-olds and 20% of over 55s.
Some 10% of women have deliberately hurt themselves because of their body image compared with 4% of men. At the same time, 13% of adults admit to having experienced suicidal thoughts or feelings because of their body image.
And, although the sample of people from the LGBT+ community was small, 39% of those who experienced these thoughts identified as bisexual, and 23% identified as gay or lesbian.
While puberty is notoriously stressful, there are other times in our lives when we might worry about our image, such as during pregnancy or the menopause – or when our hairline starts to recede or we need to use a walking stick.
Phillippa Diedrichs, professor of psychology at the University of the West of England (UWE) and an expert on body image, says even at primary school age, girls are more aware than boys of their appearance.
“They have been very much valued in terms of their image. That’s the way they have currency in society; most research has focused on young women,” she says. “But there are key transitional points in people’s lives, such as reaching 65, when people still feel it’s important how they present themselves. It’s difficult to say for sure how these concerns affect people over time, because we’ve no longitudinal research.”
Having concerns about how you look is not, in itself, a mental illness, according to the MHF. “However, it can be a risk factor for mental health problems,” its spokesperson says.
“Research suggests that higher body dissatisfaction is associated with poorer quality of life, psychological distress and risk of unhealthy eating behaviours and eating disorders.”
For Hannah Lewis, policy officer at Rethink Mental Illness, how we see ourselves is also a public health issue: “People with poor body image are at risk of self harm and of potentially harmful sexual behaviour,” she says. And poor body image can further undermine the wellbeing of people who already have a mental illness. Some medications can cause weight gain. “That’s really important to a person’s body image,” says Lewis. But can concerns about how you look directly lead to an eating disorder?
Separate research from the LGBT+ equality charity Stonewall last year showed that 12% of LGBT+ people had experienced an eating disorder. Stonewall policy manager Josh Bradlow acknowledges the potential damage insecurities about body image may cause: “Stereotypical assumptions and beliefs about masculinity and femininity can be deeply damaging for how anyone – especially LGBT people – see themselves and their bodies.”
And Tom Quinn, director of external affairs at eating disorder charity Beat, says people who are dissatisfied with their body image are at higher risk of developing an eating disorder. “This is only one of many factors that can lead to the development of these serious mental illnesses,” he says. So how can we start to tackle an issue that is so ingrained in our society?
Diedrichs has been working with the beauty product manufacturer Dove on a self-esteem project in schools that encourages pupils to discuss the impact of advertising on body image. Diedrichs also counsels against “fat talk” and “old talk”.
“Telling someone ‘you look good, have you been on a diet’ or ‘you don’t look that old, tell me your secret’ only reinforces our obsession with body image,” she says.
She also suggests complaining if you do not like body images you see in the media, particularly where the photo has been retouched. “And don’t just talk about looks when you meet a friend. Instead, ask them how they’ve been,” she says.
In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.
Experience: ‘Body image is constantly under discussion, everywhere’
Alexia Harrison was hospitalised for anorexia as an adolescent. She shares the toll it took on her mental health, and how she recovered. Interview by Rossalyn Warren
Alexia Harrison did not stay in one place for very long during her childhood. Her family often moved from country to country due to her father’s work, so she attended many different schools, making it difficult to keep hold of long-term friendships.
Then, at the age of 11, she returned to live in the UK. At school, she felt she had missed out and was out of touch with the latest trends her friends gossiped about.
The constant travelling had put Harrison’s life in a state of upheaval. She felt isolated, and her mental health deteriorated. She began to show signs of a troubling relationship with eating. At the same time her mother also grappled with a disorder, and often spoke about dieting and body image.
Then, when Harrison was aged around 13, she began to develop anorexia. By the time she reached her GCSEs her anorexia had become so severe she was admitted to hospital. “At the time, there wasn’t as much information about anorexia as there is today,” says Harrison. “Looking back, they didn’t know what to do with us. They tried to feed us, but I ended up losing more weight while on the ward.”
She describes that period of her life as “desperately unhappy.” But today she is in a far better place. Now aged 41, she lives in Leeds with her husband and two children, and is surrounded by close friends.
She is also using her experience to shape the lives of others who face similar challenges.
As a counsellor and psychotherapist, she works closely with young people who have anorexia and bulimia, and volunteers with Beat, the UK’s leading charity for eating disorders.
While the causes for eating disorders are complex and many factors are involved, being surrounded by images of “perfect” bodies can distort how a person sees themselves.
And celebrity culture and social media strongly contribute to and exacerbate the issue, she says.
“The society I grew up in is very different to what girls face today,” she says. “There is social media and unrealistic models on Instagram, and it’s all contributing to the pressure on young people and their mental health, and how they see their bodies.
“The trouble is that people’s body image is constantly being discussed everywhere – on television, screens, magazines. And if you’re somebody who’s vulnerable, it’s really easy to snap into a very low mood and think dieting may be the answer.”
Medical care is not always there, or easily accessible either, she says, despite eating disorders being serious mental illnesses that require professional support.
Harrison has a starker view about herself in relation to the pressures young people face today.
“If I grew up in this culture today, with the intense influence from social media and celebrities, I’m not sure I would have made it through,” she says.
Still, she thinks her coping mechanisms in her childhood years still serve as valuable guidance for herself and others today.
“What kept me going is that I’ve always liked nature,” says Harrison. “I would always feel better when I’d get away from it all – from everybody, from the pressures, and from technology,” she says.
“I still do this today with my husband. We take off and get lost, and go to lakes. I am always better when I’m outside.”
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