WOMEN'S HEALTH
May 3, 2012

Body Weight vs. Body Image

Losing weight is not a cure-all for self esteem issues.

It’s easy to think that losing weight will solve all the body image and self-esteem issues that one grapples with. But that’s not the case, as many people know from experience. Now, a new study shows that formerly obese young women may continue to have self-esteem issues, even after the weight is lost.

In the study, 2,000 Caucasian and African-American girls were followed for 10 years, beginning when they were between nine and 10 years old. Based on body mass index (BMI), they were placed in to one of three groups: normal weight, transitioning from obesity to normal weight, and chronically obese. The participants filled out questionnaires about their self-image every other year during the study period.

The next steps in Mustillo’s work will be to pinpoint the periods during youth when people are more or less susceptible to the “stigma of obesity.”

African-American girls started out with lower self-esteem if they were overweight, but those who lost weight gained more self-esteem over time than Caucasian girls did. The self-esteem of Caucasian girls who were initially obese was also lower than normal weight girls, but it stayed fairly constant over time, even after they lost weight. In other words, it did not “rebound” as it did for African-American girls. The study did not get into why self-esteem didn’t change in Caucasian girls: It is tempting to think that it stayed the same because they continued to view themselves as heavy, but this is not clear from the study.

In a university news release, lead author Sarah A. Mustillo suggested it is, however, quite possible that the overweight self-image may have stuck with the young girls: “Studies show that children internalize stereotypes and negative perceptions of obese people before they ever become obese themselves, so when they do enter that stigmatized state, it affects their sense of self-worth."

The idea that negative self-images can outlast weight loss is not new. At its most extreme, it is seen in anorexics who see themselves as fat even when they are dangerously underweight. Mustillo urges mental health practitioners to pay particular attention to identity and body image issues, since addressing these could help weight loss efforts be more successful, and boost the overall well being of the person who is struggling with his or her weight.

The next steps in Mustillo’s work will be to pinpoint the periods during youth when people are more or less susceptible to the “stigma of obesity.”

Mustillo’s data came from the National Heart, Lung and Blood Institute Growth and Health Study; she is faculty at Purdue University and published her study in the Journal of Health and Social Behavior.

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