Columbus, OH, USA. Women's appreciation of their bodies is only indirectly connected to their body mass index (BMI), a common health measure of weight relative to height.

According to recent research on the acceptance model of intuitive eating, the most powerful influence on women's appreciation of their bodies is their belief in how they are viewed by other people they consider important.


On the flip side, the more women are able to focus on the inner workings of their body — or how their bodies function and feel — rather than how they appear to others, the more they will appreciate their own bodies. And the more a woman appreciates her body, the more likely she is to eat intuitively — responding to physical feelings of hunger and fullness rather than emotions or the mere presence of food.

A comparison of women in emerging adulthood, early adulthood, and middle adulthood

Tracy Tylka is associate professor of psychology at Ohio State University and the senior author of the study.

"Women who focus more on how their bodies function and less on how they appear to others are going to have a healthier, more positive body image and a tendency to eat according to their bodies' needs rather than according to what society dictates."

Tylka performed the research with former Ohio State doctoral student Casey Augustus-Horvath, who is now at the Laureate Psychiatric Clinic and Hospital in Tulsa, Okla.

Their findings appear in the Journal of Counseling PsychologyOther studies have suggested that about 50 percent of women appreciate their bodies. This work is geared toward examining how they arrive at their satisfaction with their bodies, and how they avoid any pitfalls that might interfere with their positive thinking.

Ultimately, the researchers say, it boils down to respect. If women are going to treat their bodies well — through nourishment, health screenings and exercise, for example — they first have to like their bodies.

"And it turns out we look to whether others accept our bodies to determine whether we appreciate them ourselves," Tylka said. "It's not our weight, but instead whether others in our social network appreciate us. That implies that people should be convinced to be less judgmental and to focus less on weight."

Tylka has created what she calls an acceptance model, which serves as a guideline to other researchers and clinicians about the factors that influence whether women appreciate their bodies and engage in intuitive eating. She first constructed the model with input from college-age women, and expanded it in this study after surveying women between the ages of 18 and 65.

The women she surveyed were separated into three groups: emerging adult women age 18-25, early adult women age 26 to 39, and middle adult women age 40 to 65. A total of 801 women participated in the survey.

The researchers asked the women about their perceived social support from a variety of different relationships; whether they believed their bodies were accepted by people close to them as well as by society and the media; whether they focus more on how their bodies function and less on their appearance; how they felt about their own bodies; and whether they engaged in intuitive eating.

For the most part, the pathways to body appreciation and intuitive eating are the same among all adult age groups. Women who perceive that they have strong social support in turn believe that others accept their bodies. This perception empowers them to be less concerned about their physical appearance and more concerned about how their bodies function, which encourages appreciation of their own bodies and a healthful approach to eating.

But some differences also emerged in this study, especially with the addition of BMI as an influence. BMI alone was not directly associated with how women felt about their bodies. "It was a cool finding, that BMI's association with body appreciation is mediated by how we view others' acceptance of our bodies," Tylka said.

The Role of Criticism

"So if women are heavy, they can have a good body image if they don't perceive that important others are trying to change their body shape or weight and instead accept them as who they are."

"If women have a low BMI, they might have a poor body image if they perceive that influential people don't accept their appearance, but not because of their weight.

"One clinical implication is to educate partners, family, friends and the media on the importance of accepting others' bodies and to stop criticizing people about their bodies and appearance."BMI did affect eating patterns in the two older groups of women. For women age 26-65, those with a higher BMI were less likely to eat according to physical hunger and fullness cues. For the younger women, there was no relationship between BMI and intuitive eating.

"This could mean that people who are heavier feel pressure by others to lose weight so they go on a diet, taking them away from paying attention to those internal cues," Tylka said. "Perhaps, over time, women who are heavier start to mistrust their bodies, including when they are truly hungry and full."

The women in the two older age groups also were more likely to think that others didn't accept their bodies if they weighed more. Tylka said that finding suggests that the weight gain that often accompanies aging for women causes women to perceive that others do not accept their body, whether it is accurate or not.

Women age 26 to 39 were most likely to achieve body appreciation by focusing more on how their bodies function rather than how they physically appear. "Our thinking here is that women in early adulthood are in their childbearing years, and if they take that perspective of look at what my body can do with regard to having children, they're more likely to appreciate their body for more than just its appearance. But when they get past childbearing age and into middle adulthood, that appreciation is less strong," Tylka said.

Efforts by friends and family to encourage a person to lose weight often backfire, Tylka noted, because they tend to place the focus on eating according to arbitrary calorie counts and portion sizes — external cues — rather than on what the body really needs — actual internal hunger and satiety cues.

"If you're disconnected from hunger and fullness cues and someone makes you feel bad about yourself, you'll be more emotional. And if you tend to eat for emotional reasons, voilà, you're going to eat and likely gain weight," she said.

Tylka added, however, that, "We are in charge of our attitudes, ultimately. We don't want to send a message that the only thing that matters is that others accept our bodies. But others' opinions do have an impact. And we need as a society to stop judging people based on their appearance and weight."

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