http://journals.iztacala.unam.mx/index.php/amta/
ARTICLE
‘‘You
have
to
be
slim!’’
Epiphanies:
Body
image
construction
in
middle-aged
women
Verónica
Valdez-Hernández
a,
Ietza
Bojorquez
b,
Luz
de
Lourdes
Eguiluz
Romo
c,
Claudia
Unikel
d,∗aProgramadePosgradoenPsicología,UniversidadNacionalAutónomadeMéxico,CiudaddeMéxico,México
bDepartamentodeEstudiosdePoblación,ElColegiodelaFronteraNorte,Tijuana,BajaCalifornia,México
cProyectodeInvestigaciónenSalud,FamiliayAmbiente,FacultaddeEstudiosSuperioresIztacala,UniversidadNacional
AutónomadeMéxico,Tlalnepantla,EstadodeMéxico,México
dDireccióndeInvestigacionesEpidemiológicasyPsicosociales,InstitutoNacionaldePsiquiatríaRamóndelaFuenteMu˜niz,
CiudaddeMéxico,México
Received4October2016;revised15November2016;accepted13January2017 Availableonline13February2017
KEYWORDS
Bodyimage; Bodydissatisfaction; Epiphanies;
Womenadults; Middle-aged
Abstract Thispaperexplorestheexperiencesthatinfluencedtheconstructionofbodyimage andtheadoption ofbody changestrategiesinMexicanwomenofmiddle-age.A qualitative studywasconductedoneightwomen(35---50yearsold).Thedatawerecollectedthroughan individualsemi-structuredinterview,andothertwomethodologicaltools:thelifelineandthe familytree.Informationwasgatheredduringfourworkingsessionslastingtwohourseachand subsequentlytranscribedverbatim.Theanalysisrevealedexperiencesthatmarkedthewomen’s lives,calledepiphanies.Theseepiphaniesincluded:divorces,separations,commentsregarding theirbodies,parentsconcernedabouttheirweight(eithertheirownortheirdaughters’)and messagespromotingslendernessasameansofachievingbothpersonalandprofessionalsuccess sincechildhood.Thefindings ofthisresearchshowthatbodydissatisfactionnotonlyaffects teenagersandyoungwomen,butalsomiddle-agedwomen.Continuingwiththistypeofresearch willalso makeitpossibletodefine theelementsthatcontributetothepreventionofbody dissatisfactionandriskyeatingbehaviors.
© 2017 Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
∗Correspondingauthor.
E-mailaddress:unikels@imp.edu.mx(C.Unikel). http://dx.doi.org/10.1016/j.rmta.2017.01.003
PALABRASCLAVE
Imagencorporal; Insatisfacción corporal; Epifanías; Mujeresadultas; Medianaedad
«¡Tienesqueestardelgada!»Epifanías:Construccióndelaimagencorporal enmujeresdemedianaedad
Resumen Estetrabajoexploralasexperienciasqueinfluyeronenlaconstruccióndelaimagen corporalylaadopcióndeestrategias decambiocorporalenmujeresmexicanasdemediana edad. Se llevó a cabo un estudio cualitativocon ocho mujeres (35-50 a˜nos de edad). Los datosfueronrecopiladosmedianteunaentrevistasemiestructurada,yotrasdosherramientas metodológicas:lalíneadevidayelárbolgenealógico.Larecopilacióndeinformaciónsellevó acabodurantecuatrosesionesdetrabajodedoshorascadauna,posteriormentesetranscribió la informaciónverbatim. Enelproceso deanálisis, se encontraronvivencias quemarcaron la vida delas mujeres,lascuales se denominan epifanías. Entrelasepifanías encontradas destacan: divorcios, separaciones,comentarioscon relación al cuerpo,padrespreocupados porelpesocorporal(tantodelpropio,comodeldesushijas)ydiscursosenprodeladelgadez como medio para alcanzar tanto el éxito personal como el profesional desde su infancia. Los hallazgosdeestainvestigaciónmuestran quelainsatisfacción corporalnosoloafectaa adolescentesymujeresjóvenes,sinotambiénamujeresdemedianaedad. Elcontinuarcon estetipodeinvestigaciónpermitirádefinirloselementosquecontribuyenalaprevenciónde lainsatisfaccióncorporalylasconductasalimentariasderiesgo.
© 2017 Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Introduction
Historically, the social value given to women has been inseparablefrom their bodies. Their social role has been identified and expressed through them, for example, by havingchildrenorsatisfyingothers’sexual,emotionaland physicalneeds.When bodysizeandshapeareregardedas essentialbecauseoftheirsocialvalue,womenlearntofocus theirattentionontheirphysicalappearance,whichbecomes arequirementfor obtainingboth internal satisfactionand social success (Brown & Jasper, 1993). In the particular caseof Westernsociety,where slendernessandyouth are equated with the concepts of beauty and health, most women---includingmiddle-agedones---havesomedegreeof dissatisfaction with their bodies. To understand this, we needtoconsidertwoconcepts: bodyimageandbody dis-satisfaction. Body image is defined as‘‘the image of our bodythatweforminourminds,thatis,thewayinwhich ourbodyrepresentsus’’(Schilder,1994,p.15),whilebody dissatisfactionis definedasa person’sdissatisfaction with theirweightandshape,whichtranslatesintoa pathologi-calconcernwiththeirappearance(Cooper,Taylor,Cooper, &Fairburn,1987;Devlin&Zhu,2001).Bodydissatisfaction canariseasaresultoftheinfluenceofone’sculture,family orpeergroup,andmayconstituteariskfactorinthe adop-tionofstrategiestoalterone’sfigureandweight(Midlarsky &Nitzburg,2008)suchasextrememethodsforreducingor controlling body weight(Heinberg, Thompson, & Matzon, 2001)andthustriggeraneatingdisorder(ED).
Several authors have studied middle-aged women, addressing issuessuch asthedevelopment of bodyimage and its possible alterations and consequences (Lev-Ari, Baumgarten-Katz, & Zohar, 2014; Muhlbauer & Chrisler, 2007;Paquette, Leung,& Raine, 2002; Paquette& Raine, 2004;Peat,Peyerl, &Muehlenkamp,2008; Runfolaetal.,
2013; Stokes & Frederick-Recascino, 2003; Whitbourne & Skultety,2002).ReviewssuchasthosebyBrandsma(2007) and Harris and Cumella (2006) state that the transi-tionbetweenchildhoodandadolescence,adolescenceand youth, and youth and adulthood are associated with an increasedriskofdevelopingalterationsinone’sbodyimage orED.Meanwhile,ZerbeandDomnitei(2004)pointoutthat it is essential torecognize the existence of the problem, observethetriggers,andpayattentiontootheraspectsof bodyexperiencebeyondphysical appearance(Tiggemann, 2004).
withthepromotionofgoodhealth.Theseauthorspropose continuing studies on these populations with the aim of designing interventionsfor Mexican ruralwomen that are sensitivetotheirculturalandenvironmentalcontext.
As we can see, there are aspects related to Mexican middle-aged women’s body image that have yet to be addressed,thatiswhythisstudyisinterestedinexploring theexperiencesofthispopulationingreaterdepth,bothto interveneinbodydissatisfaction inthefutureandto pre-ventanyeatingpathologythatcouldgounnoticedsincethis population is not regardedas beingat risk. We therefore asked:What arethe aspectsthathaveinfluenced middle-agedwomenthroughouttheirlivesinconstructingtheirbody imageandthedecisionwhetherornottoadoptbody modi-ficationstrategies?
Since body image construction is a continuous process throughoutaperson’slife,forthisresearch,itwasdecided toidentify‘‘epiphanies’’(Denzin,1989a,1989b),definedas eventsthattransformedwomen’slives,andusethemasa toolthatallowsustounderstandtheparticipants’behavior. Thepurposeofthisstudywasthereforedefinedasthe explo-rationofexperiencesthathaveinfluencedthedevelopment ofmiddle-agedwomen’sbodyimageandtheiradoptionof bodymodificationstrategies.
Method
Participants
The participantswere eightwomenaged between35 and 50 years based in Mexico City, who were receiving psy-chotherapyatanon-profitinstitution.
Methodologicalapproach
The biographical method (Bertaux, 1993) was used. This perspective makes it possible to study and compile per-sonal documents, which involves examining people’s lives throughtheirexperiences,simultaneouslydirectingustoan innerworldofthoughtandan outsideworldoftheevents surrounding them (Denzin, 1989a). This method provides methodologicalstrategiesofconversationandnarrationas well asa documentaryreview of autobiographies, biogra-phies,personal narratives,letters,diaries andpictures.It combines oral sources with documentary ones, with the twofoldpurposeoffirst,identifyingthemechanisms under-lying the processesused by individuals togive sense and meaning to their own lives, and second, of providing a descriptive, interpretive and necessarily systematic and criticalanalysisoflifedocuments(Sanz,2005).
Inordertoobtainabiographicalaccountofeach respon-dent,severalmethodologicaltoolswereusedthatmakeit possible to understand the chain from the history of the grouptowhichtheybelongtofamilyhistory,andfromthis historytotheshapingoftheirownidentity.Inthisregard, workonthelifehistoryisamethodthatattemptstolocate theevolutionofsocialrelationsthroughindividualstories, sinceparticipantsareencouragedtousethisknowledgeto betterunderstandthesignificancetheygivetheirbodieson thebasisoftheirexperiences.
This research used the tools proposed by Vincent de Gaulejac (cited in Salda˜na, 2009), who suggests a com-bination of techniques involving verbal and nonverbal exploration(drawings,dramatizations,roleplaying,family tree, lifeline, masks, etc.) that make it possible to gain accesstoexpression forms not linkedtospoken language rulesinwhichonetendstorationalize.
Methodologicaldevices
Semi-structured individual interview. An interview guide wasconstructed onthebasis ofthemaintopicsidentified intheresearchreviewedthat haveaddressed bodyimage issues(Barthalow, Kernoff, Thurau, & Carey,2005; Harris & Cumella, 2006; Johnston, Reilly, & Kremer, 2004; Kally &Cumella,2008;Paquetteetal.,2002;Paquette&Raine, 2004;Patrick& Stahl,2009;Peatetal.,2008).Theguide covered the following topics: the experience of being a woman,thebody,beingthetargetofcriticism,bodyimage, bodydissatisfaction,naturalbodychanges,losses(deaths, separations, divorces, job losses), body weight history, health problems, strategiesand attempts to controlbody weight(dietand/orexercise,etc.),interpersonal relation-ships,sexualexperiencesandpregnancy(seeAppendixA).
Lifeline.Thistoolinvolveddrawingthreehorizontallines ona sheet of bond paper. On the top line, called social events, each respondent wrote down the macro events thatweresignificantinhercountryor theworld,in other words,eventssuchasanearthquakeorastrike.Onthe sec-ondline,calledbiography, theydescribed everythingthey consideredsignificant from themomentof birth untilthe present,bothindividuallyandintheirfamilies(school,birth of siblings, marriages, major diseases, parental divorce, losses,achievements, meetings, jobs, etc.). On the third line,calledmembershipgroups,theywereaskedtoinclude the groups to which they had belonged in their lifetime, animportantpersonwhohadhadaninfluenceonthem,and themessagesaboutbeingawoman,theirbodiesandbeauty theyhadexperiencedateachlife-stage.
Family tree. Graphic representation of at least three generations of relatives. In addition, they had toinclude critical events in the family history, social mandates regardingthebody,beautyandthegenderstereotypes fol-lowedin their families;important people, and comments about the body. They were also asked to mention fam-ily members who had implemented a strategy to change theirbodyshape,fromfrequentpersonalgroomingthrough restricteddietstosurgeries.
Analyticalframework
epiphany: a situationthat touchesa person’slife tosuch anextent thatheisnolongerthesameperson; onetalks ofa beforeandafter theevent; (2)Cumulative epiphany orrepresentativeevent:thisisasuddenreaction,resulting froma seriesof events that have been taking placeover along periodof time;(3)Minor or illuminatingepiphany: thisisaproblematicmomentinarelationshiporaperson’s life. These epiphanies highlight the underlying tensions orproblems in asituationor relationship; and(4)Relived epiphany:inthistypeofepiphanies,apersonexperiences asituationthattriggersthememoryandfeelings ofother similar experiences, due to the occurrence of an event. Thesesituationscantriggerthefeelingsandthoughtsthat surroundedpreviousevents.
Procedure
Permissionwasrequestedfromthedirectorsofthe institu-tiontoallowitspopulationtoparticipateintheproject.The therapists identified possible participants who were con-tacted to explainthem about the goal and the dynamics ofparticipatingintheproject.Theinclusioncriteriawere: beingwithintheestablishedagerange,agreeingto partici-pateandbeingMexican.
The study was conducted onthe premises of the civil association,withtheexceptionoftwosessions,whichwere held at another institution providing psychological care under the same conditions, in other words, a large, pri-vatespace.Thefirstauthorwasresponsibleforperforming the field work. The participants’ informed consent was obtainedinaccordancewiththeEthicalprinciplesfor medi-calresearchinhumanbeingsoftheHelsinkiDeclarationand theprotocol thatinformedthisresearchwasapprovedby thetutors’committeeoftheMastersandDoctoralProgram oftheNationalAutonomousUniversityofMexicoPsychology Faculty.The informedconsentformguaranteedthe confi-dentialityandanonymityoftheinformation(synonymswere used),andrespondentswereaskedtoauthorizetheaudio recordingofthesessions.Theirparticipationwascompletely voluntaryandtherewasnofinancial orany other typeof compensation.Information wasgathered infour two-hour meetings.Thefirstmeetingconsistedofasemi-structured interview,withindividualsessionsforeachparticipant.For thenextthreemeetings,groupsoftwowereformedwhose memberswerechosen randomlyandthelifelinesandthe familytreesweredrawn.Thisdynamicwaschosenbecause thesearethemost productivemethodologicaldevicesfor smallgroups.
Dataanalysis
Theanalysisinvolvedcategorizingtheinformationinthree stages(Monje,2011):(a)verbatimtranscriptoftheaudio formats;(b)categorization,whichinvolvesidentifyingkey topicsinthe transcripts,retrievingtextual datasegments that share a common code; and (c) the identification of recurrentanddivergentissues.Eachtranscribeddocument wasindependentlyreviewedinordertoidentifythetopics that arose. The first author classified the corresponding fragments in order to subsequently draw up a list of categories per participant and identify what they had in common.
Results
Theresultsareshownasfollows.Firstthedemographic pro-fileoftheparticipants,showingthepopulationstudiedand the bodymodification usedbyeach participant(Table 1). Thisisfollowedbythedissatisfactionwithaparticularpart of the body which they mentioned, and the modification methods used.Lastly,theepiphaniesfound inthe partici-pants’accountsarepresented.
Participants’profile
The participants’ age range is 35---50. Five of the partici-pants receive low, sporadic financial remuneration,three ofthemworkinfamilybusinesses,onehastemporaryjobs, andanotherisengagedinformalemployment,forwhichshe earnsalowwageandpaymentscanbedelayedbyuptoa month.Threeoftheremainingwomenhavepermanentjobs, oneasasalesmanager,anotheratagovernmentagency,and anotherasamortgagebroker,apositionshesecuredthrough oneofhersisters,sinceshehadbeenunabletofindworkon herown.Table1showstheparticipants’demographicdata. Thestudyfoundthat87.5%oftheparticipantshad imple-mented a strategy tomodify their bodiesand engaged in REB,mainly involving restricteddiets. They alsoreported otherweightcontrolstrategies,suchasengaginginphysical activity (running, walking,jogging); having injections and takingburn fatcapsules,andsupportfromnutritionistsor other alternative practitioners (acupuncturists) that offer optionsfor weightcontrol.Moreover,some ofthe partici-pantsreportedthatthereweresomepartsoftheirbodies theydisliked,whichisclassifiedasdissatisfactionwiththeir bodies. This dissatisfaction is associated with their skin, face, height and in one case, breast size. It is important tonote that, in thelatter case, the participantsaid that thisdissatisfaction is duetothefactthat thispartof the body is attractive tomen, a situation that has made her feeluncomfortablethroughoutherlife.
Analysisofthestories
On the basis of the reading of the material produced by the participants, the analysis focused on the epiphanies thathaveinfluencedthedevelopmentofthewomen’sbody image.
Majorepiphanies
Throughouttheaccounts,fivemajorepiphanieswere identi-fied,whichconstitutedsituationsthatsignificantlychanged the participants’ lives. In four of the five accounts, the common factor was the presence of a male figure (the participant’s father or partner). The period when these situations emerge variedfrom childhoodand adolescence tomiddleage.
Table1 Participants’demographicprofile.
Participant Age Scholarship Occupation
Mapi 38 BAinAccounting Housewife(occasionaldataentryclerk)
Zapatita 38 BAinAdministration Mortgagebroker
Denisse 41 BAinJournalism Clerkingovernmentagency
Mariana 39 CompletedBAinPsychology, exceptforthesis
Makesbags(familybusiness)
Mary 41 CompletedBAinBusiness
Administration,exceptfor thesis
Independentsalesdirector(cosmeticsfirm)
Natacha 39 BAinCommunicationsScience Housewife(helpsrunfather’sbusiness)
Coco 50 BAinLaw Housewife
Ana 45 BAinGraphicDesign
(incomplete)
Administrativepost(temporary)
‘‘WhenIwasgirl,Iwasstillat elementaryschool...my dadtook me toadoctor...(myfather) told himtoput meonadiet,buthe(thedoctor)refusedbecauseIwas beginningtodevelopandum...hecouldn’tputmeona diet’’.(Mapi,38yearsold)
This eventisrememberedasthefirstinherlifewhere shewastoldthatoverweightissomethingthatshouldnot bepresent,andshouldbetreatedasadiseasetobecured. Inthesecondmajorepiphany,herfathermadea momen-tousdecisionfortheparticipant’slifewhenhedecidedto move her from a public to a private school. In this new context,shebegantofeeldifferentfromtheotherstudents:
‘‘...theymovedmetothesouthtoaprivateschoolthat wasfullofpreppygirlsandboys.IdidnotfeelIwason thesamelevelasthem.Theyallhadnicehouses,decent dads, withgood degrees,nicefamilies,everythingwas nice...Ididnotwanttointroducethemtomydad,who wasacabbie’’.(Zapatita,38yearsold)
This wasthefirsttimethatZapatitahadplaced impor-tance on the appearance required to belong to her new social groupandthus establish interpersonal relationships thatwouldfacilitateherinclusion.
The third epiphanyis linked to the previous one, and occurred at the time of a surgical operation that would initiallyimproveherhealth,butalsohadestheticbenefits.
‘‘Ihadanosejob,thatwasabeforeandafter.Itwasas thoughIhadbeenbornagain.Assureasmyname’sZ...I usedtohavealarge,hookednoseandthatmademefeel verybad’’.(Zapatita,38yearsold)
Thefourthepiphanyoccurredwiththedivorceofoneof theparticipants.Thissituationresultedinthewomanhaving mainlynegativethoughtsandfeelingsaboutherappearance andherself-conceptingeneral.
‘‘...I was a real mess, I felt ugly and bad. I felt like afailureandhadaneconomic, professional,emotional slumpallatthesametime’’.(Mary,41yearsold)
Thelastepiphanyoccurredasaresultofthecomments of the partner of one of the participants about her body weight.Thisoccurredduringherhighschoolstudies.Inher
ownwords,itwasthefirsttimesomeonehadpointedout herbuildandmadeherengageinweightlossstrategies.
‘‘My firstboyfriendkeptsayingthat Iwasveryfatand thatmyclothesdidn’tfitright...thatIwasfat...Ifeltfat at the timebecausethetrend ofbeing tooskinny was startingbutIwasnotfat.IhadcurvesbutnotbecauseI wasfatbutbecauseIhadawomanlyfigure’’.(Zapatita, 38yearsold)
Inadditiontothecommentsthatcanbemadebythose closetoaperson,whichhaveconsequencesontheirhabits orself-perception,wecanseetheinfluencethattheideal ofbeautycanhaveonthesewomen’sself-appraisal.
Cumulativeepiphanies
Thecentralfeatureofthistypeofepiphaniesisthatafter thepresenceofeventsofthesamekindthathave accumu-latedoveran indefiniteperiodof time,a suddenreaction occurs,adecisionistakenandasaresult,thereisa signifi-cantchangeinpeople’slives.
Sixcumulativeepiphanieswerefoundinthisstudy.The commonfactor wasconcern and pressureregarding one’s weight. The pressure, comments and insinuations about theparticipants’bodyweightwere madebythe women’s mothers,grandmothersorsisters,whichledtothemhaving agreatinterestinkeepingthin.Itisimportanttorecallthat cumulative epiphanies are a chain of events that gather duringpeople’slivesandattheendofeach chainthereis one last epiphanythat triggers a sudden reaction tothis series of accumulated experiences. For this analysis, we only reportthe last epiphany in the chain, which left an importantmarkontheparticipants’lives.
‘‘I started to be really affected by...the remarks I heard from my uncle and my dad... the news-papers they brought home nearly always had a girl on the front...and whenever they got to that page...theyalmost fainted.Wow!They wouldmake comments...mostlyaboutherphysiqueandhow beau-tifulshewas...itmademefeelthatIwasnevergoing toachievethat.’’
2. Commentsaboutherappearance(Natacha,39yearsold) In another story, the respondent mentions having heardpositivecommentsaboutslendernesssince child-hood, becauseshealwayshad abigger buildthanthat of her classmates. Although she did not regard them as important at the timeof receipt, she now realizes thattheyrecurredthroughoutherlife,becomingmore important when she went to live at New York. Her partner’s comments were usually summarized in the followingphrases:
‘‘You have to be slim, you have to look good, you havetobepretty’’.
‘‘You’re fatanduglyand Idon’tfindyou attractive anymore,Idon’tfancyyouanymore’’.
After having received all these negative comments, she made a sudden decision on his birthday, which constitutedacumulativeepiphany.
‘‘...andthenIlookedforinformationandstartedto diet,afteraboutsixmonthsIsaid’’.
‘‘Idonotwanttobefat,becauseIdidn’tfeelgood ...Isaid:I’vehadit’’.
3. Commentsreceivedthroughoutherlifeaboutthevalue ofslimwomen(Coco,50yearsold)
Throughoutherlife,Chasreceivedcomments, empha-sizing the importance of thinness as a prerequisite in people’sworth.Althoughsheisawarethatthismessage had todowithher mother,thishasnot preventedher from feelingdissatisfiedwith herbody image todate. Her younger sister has also been influenced by these stereotypes, whichstillpersecuteC. Thissisterisvery interestedinmaintaininganimageofyouthandthinness, whichreinforcestheparticipant’sdesiretobethin:
‘‘How is that possible? Where do you put all that food?Humanshavetoeattolive,notlivetoeat.Just lookatyourself!’’.(Sister)
C has obviously received constant violent remarks aboutherimageandnotonlyfromherfamilyoforigin, butalsoherpartner:
‘‘...heisalwaystellingmethatI’mfat,thatI’mnot smart and he also always tells me: ‘Your face has gonelikethatnow’,inotherwords,itsags...because he is a misogynist, yes, he just criticizes me and doesn’tseehowhehasaged’’.
Previous experiences have contributed to C’s body image, resulting in insecurity, dissatisfaction and the rejection of her body as well as the adoption of
strategies throughout herlife, ranging fromrestrictive dietstoovereating.
4. Comments about keeping slim and emphasizing the importanceofappearance(Ana,45yearsold)
Themaincharacterinthiscumulativeepiphanyisthe mother,who strove toensure that the family wasnot overweight, but focused onAna, perhaps because she wastheonlygirl.
‘‘...mymomwasalwaysvery,verycarefulaboutour weightandcontrollingourdiet.Weneverhaddessert at home...or chocolate, or mayo...so I was always veryslim,Iwasalwaystherightweight,Ialwayshad agoodfigure’’.
She constantly received comments about her appearance, which made her dissatisfied with her-self. Ana nearly always lived under the care of her mother,evenduringhermarriage.
‘‘Mymomtoldme,‘Youhaveanuglynoseandspotson yourface’...shemademefeeluglyformanyyears’’.
Wecanseefromthispairoftestimonialstheideathat Ana’s mother introjected into her, that slenderness is perfection.At thesame time,herhusbandcontinually madecommentsaboutheroverweight:
‘‘HesaysI’mveryfatandthathe’llleave...because ofme, hehadanaffair withasecretary,it’sallmy fault,thefactthatI’mfatismyfault,thefactthat Idon’tsticktomydietisallmyfault’’.
5. Thepowerofthebody(Denisse,41yearsold)
Unlike the previous cases, one of the participants experiencedapositive cumulativeepiphany,which she referstoasthe powerof thebody. Atthe endof high school,whenshehademergedfrompuberty,therewere some facts that meant she hada positive relationship withherbody.Wespecificallydiscussedtheeventsthat had made her feel she was an attractive woman. She remarkedthatwhenhermothermeasuredhertomake her a skirt in high school, she breathed in so that it wouldbetighterandshewouldlookmoreattractive:
‘‘Iremember that mymummade me a skirtand it lookedlikeatube,andIfeltverysexyinmyskirt’’.
Moreover, the participant expressed acceptance of herbodyanddoesnotlinktheconceptofattractiveness tothinness.Lateroninherlife,theideaofpowerthat a woman can have over men as a result of her body, wasconfirmedbytheexperiencesofoneofherfriends. When she had these experiences, the participant had thefollowingreflectionsshowingthatshehadapositive relationshipwithherbody:
‘‘...it depends on you, you determine whether you lookniceandattractive’’.
6. Recoveringafteradivorce(Mary,41yearsold)
asan attractive woman, a situation that restored her confidenceinherappearanceandherself.
‘‘...Imetalotofpeople...Ialsogottoknowmyself better...this stage helped me to recover, and get myself back. I felt ugly, I felt bad, a failure, and I had a hard time financially, professionally and emotionally,allinonego’’.
‘‘...I realized I was an interesting woman that I was an attractive woman and that men liked my figure...which helped me recover and regain my self-esteem’’.
Minorepiphanies
Lastly,therearetheminorepiphanies.Thisisaproblematic momentin aperson’slife. These epiphanieshighlight the latent tensions or problems in a situationor relationship. Thisoneoccurredatthetimeofaseparation,causedbythe unfaithfulness ofthe respondent’shusband. The epiphany triggeredtheideathatshewasnotavaluablepersonand couldonly acquirevalue by beingslim. When he leftand I realizedthat he hadgone off withsomeone else, I felt traumatizedandsaidtomyself:
‘‘Youputonweight’andsoIstarteddoingexerciseand triedtogetslim’’.(Mariana,39yearsold)
Discussion
Theaimofthispaperwastoexploretheexperiencesthat haveinfluencedthedevelopmentofmiddle-agedwomen’s body image. The main findings of this research were the ways in which messages about slenderness reached each of theparticipants and howtheyare linkedtosignificant life events (epiphanies). For most of these women, the epiphaniesrelated tothe perception of their bodyimage andthedesiretomodifytheirbodieswereassociatedwith momentswhentheirrelationship withotherswasaltered, andmessages about slendernessbecameimportant in the contextofthischangedrelationship.
Thereisstrongevidencethatbothpeersandfamilycan influence the onset of disordered eating or ED, through commentsona person’sweightor appearance( Neumark-Sztainer et al., 2010; Quiles, Quiles, Pamies, Botella, & Treasure, 2013), and most participants have received messagesaboutslendernessbeingameansofachievingboth personal and professional success since their childhood. Research has shown that dissatisfaction with weight and body shape can be transmitted from one generation to another (Quiles et al., 2013), as borne out by several of the accounts in our sample. This influence may be more significant whenit occursin conjunction withlifeevents. As in our study, other authors have noted that concerns about the body begin at significant times of transition throughoutlife(Anderson-Fye,2004;Berge,Loth,Hanson, Croll, & Neumark-Sztainer, 2012; Brandsma, 2007; Carter &McGoldrick,1989;Harris&Cumella,2006;Keel,Leon,& Fulkerson,2001;Zerbe&Domnitei, 2004).Transitions can bestressfulperiods,whichmaytrigger negativesymptoms in physical andmental health.The way peoplecopewith themdependspartlyonthesocialsupportavailable,since
itrequires an enormous capacitytoadapt tosuccessfully advancethroughthecriticalmomentsoflife.
For most of the participants, the events associated with body modification strategies in adult life were the physical changes that occurred after childbirth, including saggingabdominalskin,cellulite,excessbodyweightanda largerstomach.Eventhosewhohadnothadchildrensofar declaredthatastheyreachedmiddleage,overweightand itsconsequencescausedthemtofeelextremelydissatisfied withtheirbodies.Inbothcases,theyhaveresortedtobody modification strategies, ranging from walks, restrictive diets(most participantsarefamiliar witha widerangeof options)and exercise, through capsulesand injections to burnfat.Somehavealreadygonetoclinicstoloseweight orseenendocrinologistsordieticiansyethavealwaysbeen dissatisfiedwiththesemethods andgivenupaftera short time.Anotherimportantaspectforthesewomenweretheir partners’commentsabouttheirbodies,criticizingthemfor being overweight. These experiences have affected their body image, eliciting great concern and sadness, which ledthemtoemploystrategiestomodify theirbodies.Itis strikingthatthesekindsofcommentsarealmostregarded asnormal.
Anotherkeymomentwaswhencouplesseparated,since womenimmediatelyblamedtheirbodiesfortheseparation, andmostofthemtriedtoaltertheminordertoembarkona newrelationship.Thiswasthecaseofoneparticipant,who usedanose lifterwhen shewent outwitha newpartner afterherdivorce,eventhoughitwasextremelypainful.
Something we found in these women’s stories is their constantfearofgainingweight,growingoldandnolonger findingwaystofeelgoodaboutthemselves.Researchingthis typeofproblemingreaterdepthcouldprovideknowledge thatwouldenableustointerveneearlierinthemiddle-aged Mexican female population, as well as those already at thisstage, by working withtheir stories toimprove their qualityoflife.Inparticular,theburdentheyplaceontheir bodiesand the difficulties womenexperience at times of transition, point to the importance of providing tools to addresstheseissues.
Amongthelimitations ofthisstudy isthefactthatthe information provided by the respondents was not totally confidential,sinceitwassharedwiththeirtherapists.The topics addressed may vary by socioeconomic group and amongpopulationsthatdoordonotseektreatment, edu-cational attainment or type of family, which would be interestingtostudyinthefuture.Lastly,thecodingwasonly performedbythefirstauthor.Itwouldbeusefulforfuture researchtoincludetwoormoreresearcherstoimprovethe reliabilityoftheanalysis.
Attempts to please and be accepted by others do not disappearwithage.Onthecontrary,mostofthesewomen have been perfecting their ways to maintain a low body weight;andsomeofthem,despitetheirfailuretoachieve this,continue withthisidealizationofbeautythatsociety demandstoday,whichhasbeenrequiredofthemfromthe timethey were small.The findingsof this researchshow that body dissatisfaction not only affects teenagers and youngwomen,butalsomiddle-agedwomen.
possible to identify ED symptoms in this population, and thereforestop thetransmissionof thistypeof dissatisfac-tionfromgenerationtogeneration ashappenedtothem, becausealthough itisawell-knownfactthatthisisa key factorfortheoccurrenceofthistypeofdiseasesinyoung women,literatureonthesubjectisstillscarce.
Ethical
disclosures
Protection of human and animal subjects.The authors declarethat the proceduresfollowed were in accordance withtheregulationsoftherelevantclinicalresearchethics committeeandwiththoseoftheCodeofEthicsoftheWorld MedicalAssociation(DeclarationofHelsinki).
Confidentialityofdata.Theauthorsdeclarethatnopatient dataappearinthisarticle.
Right to privacy and informed consent.The authors declarethatnopatientdataappearinthisarticle.
Conflict
of
interest
Theauthorsdeclarenoconflictofinterest.
Sponsors
Theresearchwasfinancedbyascholarship(No.229174)to thefirstauthorbyConsejoNacionaldeCienciayTecnología.
Acknowledgements
This research was supported by the ‘‘Cenyeliztli A.C.’’ donee institution which provided support for the use of methodologicaltools withthepeopleinitsfacilities. This studywasconductedaspart ofthe firstauthor’sdoctoral dissertationonthePh.D.PsychologyProgramofthe Univer-sidadNacionalAutónomadeMéxico.
Appendix
A.
Interview
guide
1. Welcome.
2. Purposeoftheresearchandtheinterview.
3. Whatwerethewaysyouweretaughtorhowdidyoulearn aboutbeingawoman?Messages,games,sayings,songs, body,religion,treatment.
4. Tellmeaboutyourbody.
Thoughts,perceptions,desiresandbehaviors. 5. Whathavepeoplesaidaboutyourbody?
Rules,roles,genderstereotypes,etc.,relatedtothe body.
Social mandates (comments, explicit and implicit messages).
Referencegroups. 6. Themiddle-agedbody.
Expectations.
Physicalchangesinthebody. Pregnancy,menopause,illness.
7. Whatdopeoplesayaboutbeauty,slenderness,youth? Parents.
Friends,peers.
8. Bodymodificationstrategies. Family,friends,group. Wishtobedifferent. Wishtobetransformed. Desireforresistance. 9. Endofinterview.
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