Patrice Werner grew up believing her body was never good enough.
In her twenties, when she wore size 0 clothes, she wished she were smaller.
“I was critical of my thighs or other body parts that I thought weren’t small enough,” says Werner, who’s now 69 and is a retired college professor living in San Marcos, Texas. “When I saw another woman who had what I considered to be a thinner, better body, I’d obsess over it and try to figure out how I could look that way, even if that person was a completely different body type.”
Werner says she believed she needed to be thin in order to attract friends and boyfriends.
At 31, Werner became a mother just as she was finishing her doctoral dissertation. “When I didn’t automatically lose the ‘baby weight’ while breastfeeding, I was incensed,” she says.
She joined an at-work weight loss program and lost even more weight than she’d gained during pregnancy, and did the same thing after her second child was born four years later.
“I wasn’t worried about boyfriends anymore, but I thought being thin and attractive was necessary to be recognized by the male college administrators and considered cool by my students,” she says.
It’s Normal to Have Body Image Ups and Downs Throughout Life
The combination of the physical changes that come with menopause, like weight gain and changing body shape, along with societal pressures and expectations women face around beauty and youthfulness, can significantly impact a woman's body image and self-esteem, says Sarah Allen, PhD, a therapist in Chicago.
One large study suggests that body image tends to improve with age. Using survey data from 15,265 adults in New Zealand, researchers found that, on average, body image was better at age 74 (the oldest group in the analysis) than at 19.
For men, who on average have better body image throughout life than women, body image seems to dip slightly in young adulthood, then improve gradually starting in the thirties. For women, body image increases slowly throughout adulthood, with the biggest increases happening after age 60.
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Menopause: ‘I Still Felt Judged for Being Overweight’
In her forties, Werner was busy with work and parenting. “It was during these years that I noticed a ‘thickening’ of my body — that’s the best word I can think of,” she says. She had very little free time, and let go of some of her obsession with size.
But when she realized she had to buy larger clothes, she beat herself up. She even tried a few extreme weight loss plans, but they weren’t sustainable, and the weight never stayed off. “The shame of those ‘failures’ was overwhelming,” she says.
When menopause began, in her fifties, Werner was settling into an empty nest and a career shift into a more sedentary, more stressful role. She experienced significant weight gain, and she hated herself for it, she says.
This led to years of weight cycling. She would feel so ashamed of her body that she’d try a new diet, lose about 30 pounds, be ecstatic, hit a plateau, and gradually regain more weight than she’d lost, she says. Then, the cycle would start over again.
“That weight-shame cycling continued well into my sixties,” Werner says. “I no longer believed I had to be thin to have friends or be successful professionally, but I still felt judged for being overweight.”
Even though a woman’s body image tends to improve overall in older adulthood, menopause can bring significant challenges. One review found that changes in body size, shape, and appearance, as well as bodily function changes like sleep disruption and heavy unpredictable bleeding during menopause, can significantly change the way a woman thinks about her body, according to the 15 studies included in the analysis. But the relationship between body image and menopause is complex and varies between women.
Another study looked at data from 113 women ages 25 to 60 and found that body satisfaction was significantly higher among post-menopausal women than among premenopausal or menopausal women.
Experts say that body acceptance is what drives this increased body satisfaction. Kathryn Felicetta, LCSW, a licensed clinical social worker with Empower Your Mind Therapy in New York City, says that during menopause, women often go through the process of mourning the (oppressive) societal body ideals they realize they’re no longer able to achieve (if they ever were).
“During menopause, people reestablish themselves,” Felicetta says. “A lot of women accept their body, and its importance goes down.”
But this is not the case for everyone. And even for those who do get to that place of acceptance, the journey isn’t always an easy one.
Learning the Science of Weight Loss and Gain — and Therapy — ‘Was Freeing’
In preparation for her 65th birthday, Werner went on what would be her last diet and lost 35 pounds with the help of a prescription weight loss medication. “I was thrilled at the quick weight loss and all the attention I got for it. But I developed terrible vertigo that I still struggle with,” she says. Her weight plateaued, and she soon regained all the lost weight, feeling totally out of control of her own body.
Things started to shift about a year after she made that last weight loss attempt. “I finally changed doctors because the one who’d prescribed the weight loss medicine insisted I stay on it ‘for my health,’ despite horrific side effects,” Werner says. “She even shamed me when I hit that plateau and gained two pounds.”
Werner opened up to her new doctor about her binge eating and dieting history, and the doctor recommended she seek therapy.
Werner took her advice. She read Health at Every Size and Intuitive Eating — both recommended by her new therapist.
“My mind was officially blown,” she says. “Learning about how the body reacts to dieting by shifting hunger and satiety hormones to stave off starvation was freeing.” It also helped her to finally accept that she doesn’t need to be thin to be healthy or worthy.
Learning to Practice Self-Compassion
While Werner’s body image is much better now than it’s ever been, she considers it a work in progress. Through therapy, she’s learning to practice self-compassion, and to talk back to her inner critic when body-shaming thoughts pop up. She also has a better understanding of the binge-eating cycle and her own triggers, so she’s able to nourish her body without bingeing or restricting.
Werner considers self-compassion an essential tool, because even though she’s worked hard to overcome her body image struggles, she still has challenging moments.
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Felicetta says that showing yourself compassion is critical to a healthy body image — and to healing from an unhealthy one.
“Nothing changes overnight,” she says. “A strong body image isn’t easy to obtain, but we can make progress.” She encourages clients to work toward body neutrality, not body positivity.
“There’s a toxicity that comes with body positivity, as if you must love your whole body and you're not allowed to want to change something,” she says. “You don't have to like everything about yourself to have body appreciation, and body neutrality takes the pressure off.”
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Ultimately, Werner was able to start improving her body image in her mid-sixties by accepting that she doesn’t have total control over how her body looks and changes. Dr. Allen does similar work with her clients, helping them identify their negative self-talk, such as “I am not as pretty as I used to be,” or, “my partner isn't going to find me as attractive.” “We then challenge the negative thoughts and replace them with more reasonable ones, including self-compassion.” She recommends looking for the positives as well, like practicing gratitude for how much your body has carried you through over the course of life.
Does Werner love her 69-year-old body unconditionally? No — she still finds herself wishing it were smaller sometimes. But she feels much closer to body acceptance now than ever before. “I’m very privileged to have the financial resources and the time, now that I’m retired, to get help and heal,” she says. “I’m immensely grateful for my supportive husband and all the intuitive eating [and body acceptance] professionals on Instagram that help me stay on track.”
