Body Image:
Ghost in the Machine
How counselors help clients see through unrealistic messages that lead to body image issues.
By Mike Hovancsek, M.Ed, P.C.
Imagine what it would be like if someone invented a talking machine. Every day, you would sit in front of your machine for a couple of hours while it told you that you are too skinny or too tall or that your nose isn’t the proper shape or that your breasts aren’t big enough or that nobody will ever love you because you just aren’t good enough. How much would you pay for a machine like that?
There’s a very high probability that you already own a couple of machines like this. Do you own a television? A computer? A radio? Have you ever thought about the messages that these appliances bring into your home? According to the National Eating Disorders Association (NEDA), a study of 4,294 network TV commercials revealed that one out of every 3.8 commercials sends some sort of “attractiveness message,” telling viewers what is, or is not, attractive. These researchers estimate that the average adolescent sees more than 5,260 attractiveness messages per year.
The average American spends four to eight hours per day listening to and watching these machines. Even if we throw away our televisions, radios and computers, however, we still won’t be free from the message. The same message emerges from newspapers, magazines, store windows and waiting rooms, on billboards and the sides of busses and virtually everywhere else that we look.
Perhaps we can extend the “machine” metaphor to include all forms of mass media. What messages do we receive from print media? Most newspapers and magazines are loaded with photographs of fashion models, both in their article illustrations and their advertisements. According to NEDA, the average American woman is 5 feet 4 inches tall and weighs 140 pounds. The average American model measures 5 feet 11 inches and weighs 117 pounds. Furthermore, most fashion models are thinner than 98 percent of American women.
According to Sut Jhally in his 1997 documentary “Advertising and the End of the World”, the average American is bombarded with 3,600 ads every day. There are fewer and fewer places that are free from advertising. The content of films and TV shows is strewn with product placements and product-related plot developments. As a result of these trends, many forms of entertainment have become little more than long commercials. The major corporations are even “sponsoring” schools. They provide funding in exchange for things such as Coca-Cola appreciation days, school bus ads and other product placements in the schools. We are awash in these messages from the cradle to the grave.
Of course, we are far too intelligent to let these messages change our behaviors. We are critical thinkers able to decide for ourselves how we should look and feel about ourselves. This is a nice thought. Unfortunately, research suggests otherwise. Consider these facts:
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- A 2023 article published by the American Psychological Association concludes that reducing social media use has a significant positive effect on body image among teens and young adults.
- According to a 2024 article published by the National Library of Medicine, “Several cross-sectional studies have reported a positive association between exposure to beauty and fashion magazines and an increased level of weight concerns or eating disorder symptoms in girls.”
- A 2019 study by the National Institutes of Health concluded that “Out of 816 completed questionnaires, 48.5 percent reported being influenced by social media to consider undergoing cosmetic procedures.”
The media bases its very existence on the principle that human behavior can be influenced in fairly specific ways. After all, it is a medium that earns its money through advertising. If ads weren’t hugely effective, the mass media would have died off decades ago.
Look at the clothes you are wearing, the car you drive and the music you listen to. Ask yourself why you chose these items. How did you even know they existed? How many of them were purchased because they were familiar to you? Is it possible that the mass media shapes at least some of your behaviors? If so, how much of your opinion of your own body is influence by these messages?
The message is clear: We aren’t attractive enough and we won’t be attractive enough until we buy all the right products and pay for all the right treatments. Of course, once we buy all the right products and pay for all the right treatments, we find that we still aren’t good enough. We are then encouraged to buy more. This message is hurting us — even killing us.
Poor body image contributes to eating disorders, overzealous plastic surgeries, suicides, self-mutilation, promiscuity and a host of other dangerous behaviors. As the statistics quoted in this article suggest, these trends are growing more out of control every year.
In the United States, conservative estimates suggest that after puberty, 5 million to 10 million girls and women and 1 million boys struggle with eating disorders such as anorexia, bulimia, binge eating disorder or borderline conditions. According to the National Eating Disorders Association, anorexia nervosa is one of the most common psychiatric diagnoses in young women, and according to a 2006 National Institute of Mental Health report, “About 0.5 percent of those with anorexia die each year as a result of their illness, making it one of the top psychiatric illnesses that lead to death.”
What counselors can do
Clearly, body image issues affect a large percentage of our clients in a wide variety of ways. As a result, it is our responsibility as counselors to advocate for them in every way we can. This includes speaking out publicly, writing books and articles, proposing and supporting the passage of legislation and developing therapeutic programming.
In addition to advocacy, counselors can address body image issues with clients in many ways through individual, group, couples and family counseling.
Psychoeducation
Become aware of the startling statistics about unrealistic body image messages in our society. Teach clients and their families the history and extent of the problem so they won’t be as willing to embrace unhealthy ideas that are offered to them through different media.
Encourage clients to use health as a guideline for their diet and exercise rather than unrealistic body ideals. Help them to understand that diet and exercise are only appropriate when they are done with healthy intentions and limitations.
Cognitive therapy
Teach clients to identify unhealthy messages in their own thinking and in the world around them. Encourage them to challenge these ideas and to replace them with sensible, healthy alternatives.
Behavioral therapy
Educate clients on the importance of healthy diet and exercise routines. Refer them to professionals who can help them develop a routine that is appropriate for their age, health and lifestyle.
Behavioral techniques are good for confounding unhealthy habits. For example, it is a good idea not to go grocery shopping when one is hungry, it is hard to snack when no snack foods are available in one’s living spaces and a busy person is less likely to engage in unhealthy eating behaviors than a person who has a lot of idle time. At the same time, individuals who have a history of overexercising or over-restricting their food intake can put together a schedule that places limitations on these behaviors.
Collaborate with medical professionals
As mentioned earlier, eating disorders are one of the leading causes of death among people with psychiatric problems. If you have a client who has an eating disorder, refer him or her to a doctor and get a release so you and that doctor can provide good continuity of care.
Creative modalities
Clients can express and explore their attitudes toward body image in a variety of ways. These can include:
- Journaling about the process as they learn to question and replace unhealthy ideas
- Making a collage of unhealthy messages from magazines
- Drawing an outline of their body and filling it with positive messages
- Inventorying their good qualities
- Looking at pictures of normal body types and recognizing the beauty in them
- Writing poetry that challenges the unhealthy messages from society
It is extremely important for all of us to be critical thinkers as we face this issue. Counselors and their clients have to learn to question the unhealthy body image messages that the media are offering us, to spread the word to others and speak out against the media outlets that are getting rich from our insecurities and to live according to our own standards, not those of the media. It won’t be easy. Then again, very few important changes that have occurred in society were easy.
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