The way we see ourselves or feel in our skin and our perception of how the rest of the world sees us is called our body image. Body image is closely linked to self-esteem.

As children, we adopt beliefs about how we look based on feedback from family, friends, classmates and culture. Often, discontent starts at a young age, early elementary school even. The opinions we develop become ingrained as we age, and, unfortunately, the messages often are negative. The messages then can grow from a perception of being different from those we see as our norm, whether because of body- or weight-related teasing or comments or because of feeling separate or not good enough.

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The result for many is a negative body image. It can be experienced as a distorted perception of one's shape and a fixation on one's perception of flaws. Those impacted are convinced their body size or shape is a sign of personal failure. "If only I could change (fill in the blank), my life would be better." A person may feel ashamed, uncomfortable, self-conscious, and anxious about their body. This dissatisfaction takes an emotional toll (depression and low self-worth) while also opening the door for self-destructive and health-compromising behaviors (dieting, taking laxative/diet pills, skipping meals, over-exercising, overusing protein powders, taking steroids, etc.) in the hope of changing a body at all costs.

In fact, disliking the body is such a crucial symptom of anorexia nervosa and bulimia that both DSM (Diagnostic Statistical Manual of Mental Disorders) diagnoses include the criteria that a person's self-evaluation is "unduly influenced by body shape and weight."

After 12 years of treating eating disorders as a registered dietitian, my hope is that a person can restore or begin to build a life worth living -- and that includes changing the emphasis from an ideal number or size to a peaceful relationship with one's body with health as a value.

A positive body image is a clear, true perception of your shape. You see the various parts of your body as they really are. You appreciate your natural body shape, and you understand that a person's physical appearance says very little about their character and value as a person. You feel proud and accepting of your unique body and refuse to spend an unreasonable amount of time worrying about food, weight, and calories. You feel comfortable and confident in your body.

No doubt we all have days we feel uncomfortable and awkward in our bodies. The key is recognizing and accepting our true natural shape and becoming aware of how a negative body image impacts the quality of our lives or the quality of life of a loved one.

Kathy Kater, a licensed independent clinical social worker, developed an outstanding resource for people of all ages called "Healthy Bodies: Teaching Kids What They Need to Know." It is an extensive, balanced and well-researched curriculum with the perspective of promoting health as a value vs. size as a goal.

Kater's 10 essential lessons begin with accepting what is not in your control: your body's genetic predisposition, that all bodies change developmentally on their own in ways that can't be affected except by unhealthy means, and that hunger is an internally regulated drive that demands to be satisfied. So do not diet. If you limit what is needed to satiate hunger completely, it will backfire, triggering preoccupation with food and ultimately an overeating or compulsive-eating response.

Kater's lessons focus then on what is within anyone's power to achieve, including satisfying hunger completely with plenty of wholesome, nutrient-rich foods chosen from all food groups (eat well!); limiting sedentary entertainment; understanding that if you eat well and maintain an active lifestyle, over time your best natural weight will be revealed (healthy, well-fed, active bodies are diverse in size and shape); choosing role models who reflect a realistic standard against which you can feel good; maintaining your integrity as a human being; developing a sense of identity based on all the many things you can do, the values you believe in and the person you are deep inside; becoming media savvy (remember, advertisers spend tons of money on strategies specifically designed to make you feel there is something wrong with you); and encouraging friends and coworkers to join you in developing a healthy, realistic body image.

Kirsten Nielsen is a registered dietician who focuses on eating-disorder treatment at the Emily Program in Duluth.