I sit at the edge of her bed and talk about nutrition, hydration, and the recent eating problems she’s been having. She’s a wisp of a woman who I could easily lift out of bed. Her clothes hang askew in a way that shows recent weight loss. Her cheeks have a wrinkled, sunken look and she’s more bone than muscle, with not even a trace of fat. As we talk about her progress, the “limited intake”(speech therapy code for “not eating”), she opens up and admits that it feels good being thin. She doesn’t want to get fat again. When I mention she could easily gain 5 pounds and notice no difference, her eyes widen in disbelief. Maybe fear. She tells me that she used to be “big”—at least adding 50 pounds to her current slight frame. There are no pictures in her room to confirm this, but I read the truth in her eyes. And I find myself telling her, “I used to be chubby, too. When I was a teenager.” Her eyes widen further and she shakes her head in disbelief. But when I describe what I think she’s feeling, she sees truth in my eyes. Suddenly there aren’t 45 years between us. We could easily be girlfriends talking late into the night.

We talk openly about how difficult it is to get past those old perceptions of ourselves. I assure her I am not trying to make her gain weight—that I just want her to be healthy—and her posture relaxes. She smiles. She’ll work with me on this “food” thing. She’ll try.

What kind of broken world do we live in when an 85-year-old woman has issues with body image? What kind of dark path has society walked that a clearly malnourished elderly woman finds worth in being thin? Yet, we pretend that these are the problems of youth. If a young woman in her teens or 20s struggles with body issues, we figure she’ll grow out of it. Severe cases might warrant therapy, but we otherwise adopt an attitude that these problems will somehow disappear over the years. What do we assume is the cure? Marriage? Parenthood? I don’t see how women are supposed to break free of this when body image is so ingrained in our culture.

I can walk into any grocery store on any given day and see “fitness” magazines full of images of thinness that are not realistically achievable by most women. And even if they are, what values are being driven out to achieve them? Physical beauty is something we’re born into. Or we’re not. The preferred body type of the decade is something we’re genetically predisposed to. Or we’re not.

How do we combat this? I wish I had more answers. I am filled with a general angst and frustration with the value placed on the physical beauty of women. We’re all a bit guilty, and we all buy into the lies in one way or another. We all want to believe in a better world where we see people for inner beauty. In the movie Shallow Hal, the main character is brainwashed into seeing people for their inner beauty—or ugliness. The results are irreverent, silly, and strangely heartwarming. As light as the movie is, I’ve often found myself wishing I could go through life being brainwashed like this, whether I’m looking at others, or looking in the mirror.

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