The document discusses the complex relationship between body image and sexual function, emphasizing that negative body image can significantly affect sexual satisfaction, particularly in women. It outlines definitions, prevalence of body dysmorphic disorder (BDD), and cognitive behavioral therapy (CBT) as a treatment option, while also providing practical tips for improving body image. The information highlights the psychological and societal pressures that contribute to body dissatisfaction and its implications for sexual health.

1. Body Image
and Sexual
Function
Dr. Martha Tara Lee, D.H.S.
(Singapore)
The NSpine 2019
London, United Kingdom

2. Dr. Martha Tara Lee
• Doctorate in Human
Sexuality
• Masters in Counselling
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Cert in Sex Therapy
• Cert in Practical Counselling
• Cert in Life Coaching
Relationship Counselor & Clinical
Sexologist

3. AGENDA
• Definition of Body Image
• Different Aspects of Body
Image
• Body image affecting sexuality
• Treatments/ Suggestions

4. BODY IMAGE
1. How a person thinks and feels
about his or her own body.
2. The way we see our body and
the way we think that others see
our body.
3. How you feel your body is
esthetically and how attractive
you perceive yourself.
4. Society's standards may not
always correspond to our
perception of our own body.

5. Body Dysmorphic
Disorder affects 1.7% to
2.4% of the general
population – about 1 in 50
people.
BDD often begins to occur
in adolescents 12-13 years
of age.
Studies show that size
isn’t as important as we
think.
Yarber, W. & Sayad, B. (2013). Human Sexuality: Diversity in
Contemporary America (8th ed)

6. Approximately 80% of individuals with
BDD report past or current suicidal
ideation, and about one quarter have
attempted suicide, which is often
attributed to BDD symptoms
Bjornsson, A. S., Didie, E. R., & Phillips, K. A. (2010). Body dysmorphic disorder. Dialogues in
clinical neuroscience, 12(2), 221–232.
Studies have consistently found that
insight is poorer in BDD than in OCD,
with 27% to 60% of BDD patients having
delusional beliefs versus only 2% of
OCD patients.
About two thirds of BDD patients have
past or current ideas or delusions of
reference, believing that other people
take special notice of them in a negative
way or mock or ridicule them because
of how they look.

7. ALL IN MIND
• The mental representation
we create of what we think
we look like.
• The avg. person receive at
least 14 messages a day
related to attractiveness
from the media.
• Body dissatisfaction and
eating disorders are
common in college females
and adolescents.

8. SEXUAL HEALTH
According to the current working
definition, sexual health is:
“…a state of physical, emotional,
mental and social well-being in
relation to sexuality; it is not merely
the absence of disease, dysfunction or
infirmity. Sexual health requires a
positive and respectful approach to
sexuality and sexual relationships,
as well as the possibility of having
pleasurable and safe sexual
experiences, free of coercion,
discrimination and violence.”

9. BODY IMAGE AFFEECTING SEXUALITY
“In my experience, negative body
image is the no. 1 cause of bad
sex for women,” said Dr. Hilda, a
Clinical Professor of Obstetrics &
Gynecology at Columbia
University Medical Center. “If you
don’t feel good about yourself,
what happens is your brain kind of
leaves your body and you become
spectator.
Jung, A. (2013, February 27). Body image can affect your sex life. Retrieved from
https://statehornet.com/2013/02/body-image-can-affect-your-sex-life/

10. BODY IMAGE AFFEECTING SEXUALITY
Body image becomes a
major issue as females go
through puberty; girls in
mid-adolescence
frequently reported being
dissatisfied with weight ,
fearing further and
preoccupied with weight
loss
Striegel-Moore T.. Franko, J. (2002). How One Perceives Female and the
Media

11. BODY IMAGE AFFEECTING SEXUALITY
A multiple regression
analysis revealed that
sexual satisfaction was
predicted by high body
esteem and low
frequency of
appearance-based
distracting throughts
during sexual activity.
Pujols Y., Meston C. & Seal, B. (2009). Journal of Sexual Medicine Wiley Online
Library. The Association between Sexual Satisfaction and Body Image in Women

12. SOME BODY IMAGE &
SEXUALITY ISSUES 1. Loss of energy/
fatigue
2. Loss of control
3. Isolation
4. Feeling dirty
5. Sexual dysfunction/
distress
6. Fertility
7. Pregnancy
8. Menopause

13. HOW CAN A PHYSICIAN ASSESS AND MANAGE
CHANGES IN BODY IMAGE?
Personality Type Reaction to Medical Illness
Dependent, overdemanding Needs special attention
Orderly, controlled Needs as much information as possible
Dramatizing, emotionally involved,
captivating
Acts with and expects warmth and
personal connection to caregiver
Long-suffering, self-sacrificing Attributes illness to “bad luck”
Guarded, querulous Paranoid, expects the worst
Self-aggrandizing Often insecure when speaking with
anyone other than their own physician
Uninvolved, aloof Often denies their illness
Personality Types and Their Reaction to Medical Illness
Kahana RJ, Bibring GL. Personality types in medical management. In: Zinberg NE, editor. Psychiatry and Medical Practice in a General
Hospital. New York, NY: International Universities Press; 1964. pp. 108–123.

14. 5 RESEARCH-BASED TIPS FOR IMPROVING
BODY IMAGE
1. Harm reduction - Reduce your
exposure to media imagery of
idealized, unrealistic bodies
and compare yourself to normal
healthy people, not to unrealistic
media ideals.
2. Social - Think about whom you’re
“hanging” with and whether they’re
healthy for your body image. Avoid or
distance from “lookist” people and
groups that are overly focused on
physical appearance and achieving
unrealistic physical standards.
Cultivate relationships with people
and groups with healthy body images
and practices. Retrieved from https://www.psychologytoday.com/us/blog/presence-
mind/201501/five-research-based-tips-improving-your-body-image

15. 5 RESEARCH-BASED TIPS FOR IMPROVING
BODY IMAGE
3. Self compassion - Write a letter to a
hypothetical younger woman or man, or a
young daughter or son that outlines the
costs of pursuing the idealized body and
the benefits of a healthy body.
4. Affirmations - Identify and challenge
any irrational absolutist thoughts that feed
your body image dissatisfaction. Make this
your practice until you’ve truly banished
these damaging little devils from your
head.
5. Do what you can - Switch from thinking
of your body, diet, and exercise in terms of
how it will make you look to thinking of
your body, diet, and exercise in terms of
how it will benefit your health.
Five Research Based Tips Improving Your Body Image. 2019 June
23 Retrieved from
https://www.psychologytoday.com/us/blog/presence-
mind/201501/five-research-based-tips-improving-your-body-
image

16. TIPS FOR BETTER
BODY IMAGE
1. Say something positive
about your body every
day
2. Aim to get healthier
rather than lose weight
3. Focus on yourself as a
person not just how
you look
4. Stop making unkind
comments about other
bodies
5. Choose media that
make you feel better,
not worse
Body Image (infographic). (2017, June 13). Retrieved from
https://www.thefyi.org/body-image-infographic/

17. GROUP/ SELF MIRROR EXERCISE
1. Each part body - Name and talk about your
thoughts/ feelings about each part of your
body as you look into a mirror (can be
clothed or unclothed).
2. Reflection questions
• Did you have more areas you liked vs disliked
in your body? Why do you think that is?
• Do you tend to focus on what you like or
dislike in your body?
• If in a group: When others in the group talked
about their body in negative ways, did you go
“What is he/ she talking about?” Could we be
too hard on ourselves?
• If we can be gracious/ not notice flaws in
other people’s bodies, is there a possibility
others aren’t noticing those areas you focus
on?
• What could we do more/ less of moving
forward?

18. COGNITIVE BEHAVIORAL THERAPY AND BODY
IMAGE
• Cognitive behavioral therapy (CBT) is a form of psychotherapy that
focuses on changing patterns of thinking or behavior in order to
change an emotion.
• CBT is used to treat a wide range of challenges including anxiety,
substance abuse, depression, and more.
• This problem-solving technique teaches the skills necessary to
overcome negative and destructive patterns of thinking.
• Cognitive behavioral therapy helps to identify which factors are
playing a role in maintaining a negative body image and works to
address each one by teaching the skills necessary to allow healing to
occur.
Cognitive Behavioral Therapy and Body Image. (2015, July 5). Retrieved from https://www.eatingdisorderhope.com/treatment-for-eating-
disorders/types-of-treatments/cognitive-behavioral-therapy-cbt/cognitive-behavioral-therapy-and-body-image

20. REFERENCES
1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC.
2. Bjornsson, A. S., Didie, E. R., & Phillips, K. A. (2010). Body dysmorphic disorder. Dialogues in clinical neuroscience, 12(2), 221–232.
3. British Association of Sexual & RelationshipTherapy.020854432707 www.basrt.org.uk
4. Body Image (infographic). (2017, June 13). Retrieved from https://www.thefyi.org/body-image-infographic/
5. Cognitive Behavioral Therapy and Body Image. (2015, July 5). Retrieved from https://www.eatingdisorderhope.com/treatment-for-
eating-disorders/types-of-treatments/cognitive-behavioral-therapy-cbt/cognitive-behavioral-therapy-and-body-image
6. Five Research Based Tips Improving Your Body Image. 2019 June 23 Retrieved from https://www.psychologytoday.com/us/blog/presence-
mind/201501/five-research-based-tips-improving-your-body-image
7. Jung, A. 2013 February 27). Body image can affect your sex life. Retrieved from https://statehornet.com/2013/02/body-image-can-
affect-your-sex-life/
8. Lee,J,M (1970) Emotional reactions to trauma.Nursing Clinics of North America.Vol 5 pp 577-587`
9. Kahana RJ, Bibring GL. Personality types in medical management. In: Zinberg NE, editor. Psychiatry and Medical Practice in a
General Hospital. New York, NY: International Universities Press; 1964. pp. 108–123.
10. Price,B (1990) A model for body image care. Journal of Advanced Nursing Vol 15 pp 585 – 593
11. Pujols Y., Meston C. & Seal, B. (2009). Journal of Sexual Medicine Wiley Online Library. The Association between Sexual Satisfaction
and Body Image in Women
12. Striegel-Moore T.. Franko, J. (2002). How One Perceives Female and the Media
13. Tomlinson,J (2000) ABC of sexual health: Taking a sexual history. London: BMJ
14. Van de Velde,C,D ( 1985) Body images of ones’ self & others. Development & clinical significance. American Journal of Psychiatry.
Vol. 142 pp 527 – 537
15. Yarber, W. & Sayad, B. (2013). Human Sexuality: Diversity in Contemporary America (8th ed)

21. Dr. Martha Tara Lee,
D.H.S.
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email:
drmarthalee@eroscoaching.com