Body image in later life

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How comfortable are adults with their bodies in later life?

Concerns about body image and appearance, while often associated with younger people, are not exclusive to youth. Though our appearance and our relationship with our bodies change as we age, we do not stop valuing our bodies, and body image concerns can still remain.  

People in later life report feeling dissatisfied with their bodies and having misconceptions of their body size and shape (73,74), although estimates of the degree of body dissatisfaction among people in later life vary widely in the literature (73). Estimates from the 2013 British Social Attitudes Survey found that, among those adults over 65, 69% were satisfied with their appearance, compared to 67% of adults aged 18–34 (6).  

In our survey, around one in five adults aged 55+ felt anxious (20%) or depressed (23%) specifically because of their body image, demonstrating that body image continues to affect our mental health into later life. 


What affects body image in later life?

Body image in people in later life is informed by a lifetime of experiences throughout childhood, young adulthood and middle age. As such, the factors discussed in previous sections will all have played a role in shaping how people in later life understand and experience their bodies. 

Ageing 

One review of the research comparing how younger and older adults experience their bodies found that, in terms of body image, older adults tend to place a greater importance on how their bodies function compared to younger people (73). This is echoed in a qualitative study of older women’s experiences of their bodies, which found that women’s perception of what body image is evolves with age, often focusing more on overall health and functionality with time (75,76). For some, there may be a tension between this increase in focus on health and functionality, and a desire to maintain appearance (73,76). 

As in both childhood and adulthood, the degree to which individuals compare to an ‘ideal’ body type or appearance may also play a role in body image concerns in older adults (77). In Western cultures, this ideal is commonly associated with youth (e.g. smooth skin) and older adults tend to be underrepresented in the media (74). Ageing can therefore highlight differences between actual and ‘ideal’ appearance. 

This may particularly be the case for women, who tend to express greater body image concerns than older men (73,74). One study of how women speak about weight and age found that among older women, conversations about the physical signs of ageing that reinforce the idea that youth is the ideal standard of beauty (referred to as ‘old talk’) were associated with anxiety around ageing and increased body image disturbance (78). In some cases, women may feel disconnected from their bodies as they age, as their external appearance no longer matches their perceptions of themselves, such that they do not feel ‘old’ but are identified by other people as ‘old’ because of how they look (76). Women with poorer body image were also less likely to be socially engaged and more likely to report depressive symptoms (79). Age-based discrimination can be a significant source of psychological distress among older adults, and experiences of ageism have been associated with poorer body image and psychological wellbeing among older women (80).  

Transition points in later life 

People in later life navigate many transition points, including retirement, changing family structures, bereavement and loss, downsizing and moving into later-life housing. Such major transitions can present profound changes to the routine, roles and responsibilities of people in later life, and can result in mental health challenges to older adults (81). Indeed, a study that looked at mental wellbeing scores across three age cohorts found that the oldest-age cohort experienced a slight decline in score, which was still significant after factoring in demographic information, physical ailments, chronic conditions and mental health problems (82).  

For many women, age brings significant transition in the form of menopause. The experience of menopause can contribute to changes in body image; however, its effect on body image is a uniquely individual experience and may vary among women with different cultural attitudes and backgrounds (83). One review of the research found that women with higher self-esteem and positive attitudes toward menopause experienced fewer negative symptoms, whereas women with negative attitudes toward menopause experienced higher levels of shame about their bodies, and lower bodily esteem (84).  


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References

6. Government Equalities Office. Body confidence: Findings from the British Social Attitudes Survey October 2014. [Internet]. London; 2014. Available from: https://www.gov.uk/government/publications/body-confidence-a-rapid-evidence-assessment-of-the-literature 
73. Roy M, Payette H. The body image construct among Western seniors: A systematic review of the literature. Archives of Gerontology and Geriatrics. 2012;55(1):505–21.  
74. Peat CM, Peyerl NL, Muehlenkamp JJ. Body image and eating disorders in Older adults: A review. J Gen Psychol. 2008 Oct;135(4):343–58.  
75. Liechty T, Yarnal C. The Role of Body Image in Older Women’s Leisure. J Leis Res. 2010;42(3):443–67 
76. Cameron E, Ward P, Mandville-Anstey SA, Coombs A. The female aging body: A systematic review of female perspectives on aging, health, and body image. J Women Aging. 2019 Jan 2;31(1):3–17.  
77. Slevec JH, Tiggemann M. Predictors of body dissatisfaction and disordered eating in middle-aged women. Clin Psychol Rev. 2011 Jun;31(4):515–24.  
78. Becker CB, Diedrichs PC, Jankowski G, Werchan C. I’m not just fat, I’m old: Has the study of body image overlooked “old talk”? J Eat Disord. 2013 Dec 21;1(1):6 
79. Sabik NJ. Is social engagement linked to body image and depression among aging women? J Women Aging. 2017 Sep 3;29(5):405–16.  
80. Sabik NJ. Ageism and body esteem: Associations with psychological well-being among late middle-aged African American and European American Women. Journals Gerontol - Ser B Psychol Sci Soc Sci. 2015 Mar 1;70(2):189–99.  
81. Vrkljan B, Montpetit A, Naglie G, Rapoport M, Mazer B. Interventions that support major life transitions in older adulthood: a systematic review. International Psychogeriatrics. 2018 Mar 11;1–23.  
82. Snowden M, Dhingra SS, Keyes CLM, Anderson LA. Changes in mental well-being in the transition to late life: Findings from MIDUSI and II. Am J Public Health. 2010 Dec;100(12):2385–8.  
83. Kilpela LS, Becker CB, Wesley N, Stewart T. Body image in adult women: moving beyond the younger years. Adv Eat Disord. 2015 May 4;3(2):144–64.  
84. Pearce G, Thøgersen-Ntoumani C, Duda J. Body image during the menopausal transition: a systematic scoping review. Health Psychol Rev. 2014 Oct 2;8(4):473–89.