If you're reading this in your underwear, do me a favor. Put on some clothes. It's not that you don't look great; you do. But research indicates that a majority of women dislike their bodies, and that when you spend time worrying about the way you look, you're less able to concentrate and enjoy other things. Like magazine articles, for example.

Also sex.

Do I have your attention? It's important because this story is about body image—how satisfied you are with your weight and shape—and if you're a woman who's been awake at all during the past 50 years, there is a high probability that this particular issue affects you in negative ways. Between 1972 and 1997 the percentage of women unhappy with their bodies more than doubled, from 25 percent to 56 percent, says Katharine Phillips, MD, director of the Body Image Program at Butler Hospital in Providence.

This does not bode well for intimacy. As difficult as it is to open up to someone, it's even harder when you feel desperate to hide part of yourself, particularly in the bedroom. Studies show that shame and anxiety about one's body lead to the avoidance of physical closeness and reduced sexual satisfaction. "Women with poor body image don't initiate sex as often, and they're more self-conscious," says Ann Kearney-Cooke, PhD, director of the Cincinnati Psychotherapy Institute. "Sexual intimacy involves the sharing of your innermost essence with another person, and being able to pay attention to yourself as well as to your partner." If you're preoccupied with your body, Kearney-Cooke says—if you're thinking, Is my stomach sticking out? Has he noticed the cellulite on my butt?—you obviously won't be focusing on his desires or yours, or be present in the moment. It's like having a third, unwelcome person in the room: you, your lover, and your cellulite. How intimate is that?

Unfortunately, a poor body image is not so easy to discard because the factors that contribute to it start kicking in at a very young age. One factor, according to Kearney-Cooke, is how we've internalized the way people have responded to our bodies from the time we were small girls—how we're touched or not, criticized or not. Another factor is identification: Kearney-Cooke's research shows that if your mother didn't like what she saw in the mirror, you probably won't either. Projection, that handy psychological trick that allows us to unload onto other people or things (like our bodies) feelings we're having a hard time with, can be a third factor. A woman who hasn't had a thought about her thighs all day, for example, might be struck with the idea that they're huge if on the way to meeting her paramour, she's concerned about how enormously she needs him.

But what if—lucky you—your parents were your devoted admirers, your mother liked her body, and your lover loves yours? Well, then, all you've got to deal with is the rigid and distorted American ideal of the beautiful female. Research indicates that she is 11 percent below normal weight. Fifteen percent below normal weight is considered anorexia. According to a study of Miss America winners, between 1922 and 1999 the ideal became 12 percent lighter. The percentage of real women under 35 who are obese has more than doubled between 1960 and 1994. Also, because the ideal is a light-skinned, blonde, blue-eyed woman in her early twenties-with European features, there is an enormous population of women—most of us, in fact—who don't conform.

The widening gap between what we think we're supposed to look like and what we actually look like is a very fertile place for self-doubt and shame to grow. "We're bombarded with messages suggesting that our bodies and looks not only represent our self-worth but also are fundamentally flawed. Of course that affects our self-esteem," says Liz Dittrich, PhD, a clinical psychologist in Berkeley, California. And so starts a vicious cycle: Shame and insecurity can trigger all kinds of behavior that take a further toll on the body—smoking to control weight, popping lots of diet drugs, having plastic surgery. This behavior also costs money, a point not to be overlooked because it's part of the reason poor body image is so entrenched in our society. As women have gained more power financially, we have become a lucrative target for businesses that profit from our dissatisfaction: The more we hate our bodies, the more we spend to "fix" them. The diet industry alone has grown into a $36 billion– a–year business in the United States.

Next: How to improve your body confidence


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