Yes, Body Image Affects Sex

“What has been the role of body image in your life?” I ask Laurie, a lithe athletic, 63-year-old.

“It has been everything, sadly,” she responds. “What a waste of time thinking that I was not beautiful.’”

How is your relationship with your body? Complicated? Mine sure is. In truth, it has all the elements of a good telenovela: Love, longing, fear, petty arguments, mourning, rejection, cruelty, tenderness, and even a case of amnesia, now and then.

Even though our beauty, our value and our dignity stand independent of the external packaging of our bodies, most women I know spend a ridiculous amount of time thinking critically about their bodies. These thoughts contribute to our body image, or how we see ourselves.

Rarely does our mental picture match an actual photo. We seem to possess a remarkable ability to distort reality through our emotional filters. Dorothy, a 56-year-old heterosexual woman, realized the inaccuracy of her body image in her early thirties while dating an artist. She confessed, “I had so many hang-ups about my body. I was just full of stupid flaws. One day he made a sculpture of me. I was like, ‘Is that me?’ and he said, ‘You don’t know what you look like, do you? You don’t see what I see.’ He was the first person who taught me that I was beautiful.”

Even weight, that can be fact checked by numbers, escapes logical perception. Although overweight women generally have a more negative body image than women with a healthy weight,[1] many normal- or low-weight women still feel unsatisfied. Helen, a 52-year-old lesbian, said that she had always felt fat. Even as a tall, rail-thin, younger woman, earning money on the side as a model, she struggled to accept her body. Helen spoke negatively about her body so frequently that in her forties, her partner and her teenage son made her add money to a jar each time she did so, to incentivize her to stop.

Interestingly, weight itself does not affect sexual behavior. One study showed that women who are overweight do not necessarily have less sex nor shy away from certain sexual behaviors, such as receptive oral sex.[2] Our self-evaluation, not our weight, impacts our sex life.

Yes, body image affects our sex life.[3],[4] A poor body image negatively impacts both sexual arousal and sexual pleasure by causing distracting thoughts.[5] ,[6]  Self-conscious worrying about how our body looks takes us away from focusing on the love, adventure and pleasure of sex. For example, a partner’s innocent caress of our belly might trigger a cascade of negative thoughts - self-hatred around belly fat, fear that our partner judges it, and shame that we are not good enough – not exactly a recipe for sexual arousal.

Opal described feeling self-conscious when she got together with her husband at age 46. “I have never liked my body. It is something I’ve struggled with my entire life. It’s uncomfortable for someone to see me naked. I remember the first time I had sex with my husband. I was under the covers, and I waited for him to go to the bathroom after sex so that I could jump up and put my clothes on.”

If you need convincing that how you feel about your body impacts your sex life, check out this study. It found that women, aged 35-55, who perceived themselves as less attractive than in years past, were more likely to report a decline in both sexual desire and sexual frequency. By contrast, the women who thought that they were attractive, reported an increase over time in sexual desire, enjoyment, frequency, and even orgasm.[7] Our body image, how attractive we think we are, truly affects our sex life.

Mary, a 58-year-old heterosexual, expressed well how feeling self-conscious inhibited her behavior in bed. “When I was younger, I had a horrible body image. In high school, I was thin and, quite frankly, hot,” she laughed, “but I was so embarrassed about my body. I think I could have had much better relationships if I had felt as good about myself then as I do now, if I had not been so afraid to explore and have a curiosity about sex.”

Although a negative body image can persist for the entire lifespan, there is some evidence that older women are less vulnerable to the effects of impaired body satisfaction than younger women.[8] Older women may give up trying to look a certain way and resign to accept themselves as they are. As Beth said at age 57, “Somehow, I think I have finally made peace with my body. I don’t judge what I see in the mirror like I used to.”

Our partners can affect our self-image. Ursula, a 67-year-old, petite woman said, “I have always been down on myself for my stomach; I have never had a flat stomach. Never. Not even as a kid. And that has been probably the biggest shaming aspect of my life. I still look at my profile in the mirror and look at my stomach. And now I say, ‘You're 67 years old, get over it,’ but I still have a body image in my mind.” Ursula’s husband reinforced her fear of not being good enough. He had serial affairs during their 30-year marriage. She said, “I once asked him, ‘What would you do if I got fat?’ We were in the hot tub, and he said, ‘I would divorce you.’ Then, I asked, ‘What would you do if I had an affair?’ And, he said, ‘We'd work through that.’”

Evelyn, a 62-year-old, Native American heterosexual woman from the Midwest, told me, “My weight has always tended to yo-yo. And, I am less amorous when I gain weight because I feel self-conscious. But [my husband] doesn’t care whether my weight is up or down.” Evelyn is aware of the impact of her body image on her sex life, but the acceptance of her husband helps to mitigate her own negative thoughts.

Some women shrugged off my question about body image, giving responses like, “I’ve always felt attractive,” or, “Oh yeah, I don’t have any issues with that.” Samantha, a survivor of incest, had more to say. “I like my body. There have been times when I have liked my body more, when I felt like I was in better physical shape and all of my muscles were popping and stuff, but I still like my body. I look at myself in the mirror, and I say, ‘Hey this is you. 63. Not so shabby.’ If somebody wanted to have sex with me, and I wanted to have sex with them, I'm still okay with leaving the lights on,” she laughed.

I relay these women’s stories in hopes that it encourages you to think about the impact of body image on your own sex life. How has your evaluation of your body affected your behavior sexually? If you have negative feelings and judgements about your body, I invite you to imagine that your body is stunning, whatever that ideal is for you. If you could eliminate feeling self-conscious, how would that affect your sexual behavior? Now imagine being with your partner or on a date with a potential partner. Can you imagine any ways that your behavior might be different, more free, more uninhibited? 

[1] Kilpela, L.S., Verzijl, C. L., & Becker, C. B. (2019) Body image in older women: a mediator of BMI and wellness behaviors, Journal of Women & Aging, DOI: 10.1080/08952841.2019.1692629

[2] Satinsky, S. (2014) Body Size and Sexual Behavior in a Community-Based Sample of Women, International Journal of Sexual Health, 26:2, 129-135, DOI: 10.1080/19317611.2013.834859

[3] Kilpela, L.S., Verzijl, C. L., & Becker, C. B. (2019) Body image in older women: a mediator of BMI and wellness behaviors, Journal of Women & Aging, DOI: 10.1080/08952841.2019.1692629

[4] Holt A & Lyness KP (2007) Body Image and Sexual Satisfaction, Journal of Couple & Relationship Therapy, 6:3, 45-68, DOI: 10.1300/J398v06n03_03

[5] Sanchez, D.T., Kiefer, A.K. (2007). Body Concerns In and Out of the Bedroom: Implications for sexual pleasure and problems. Arch Sex Behav, 36, 808–820. DOI:10.1007/s10508-007-9205-0

[6] Pujols, Y., Meston, C. M., & Seal, B. N. (2010). The Association Between Sexual Satisfaction and Body Image in Women. The Journal of Sexual Medicine, (7) 2,2, 905-916. DOI: 10.1111/j.1743-6109.2009.01604.x

[7] Koch, B. P., Mansfield, K. P., Thurau, D., & Carey, M. (2005). “Feeling Frumpy”: The relationships between body image and sexual response changes in midlife women, The Journal of Sex Research, 42(3), 215-223, DOI: 10.1080/00224490509552276

[8] Træen, B., Carvalheira, A., Kvalem, L. I., et al. (2017) Sexuality in Older Adults (65+)—An overview of the recent literature, part 2: body image and sexual satisfaction, International Journal of Sexual Health, 29, (1), 11-21, DOI: 10.1080/19317611.2016.1227012