Body image and sexual function

Dr Larisse Badenhorst explains the correlation between body image and sexual function.

Body image is the confluence of your perception of your physical self and the thoughts and feelings that result from that perception. It involves how you see yourself compared to the standards that have been set by society.

It is evident that body image is highly subjective, whereas body mass index (BMI) is more objective. Your BMI is the measure of your weight compared to your height. Using this calculation, you are classified into categories (either underweight, healthy weight, overweight or obese).

Your perception of your physical self can be either positive or negative (body satisfaction versus dissatisfaction). This is not necessarily dependent on body habitus, but on how you perceive yourself.

How is body image formed?

The evaluation of your appearance is shaped and developed in a socio-cultural contact where cultural messages convey standards, valued physical characteristics, and gender-based expectations to certain physical attributes.

The media is often claimed to be the most influential source of presenting the ideal body. It is believed that body image is well-established by the age of 16. For both genders, an exercised and slender body symbolises values that are highly-regarded in our society, such as will power, control and success.

The difference between men and women

Body image as a construct is not gender-specific, but literature on it correlates overwhelmingly focus on women’s experiences. Many women’s self-worth is tied in with their perceptions of their attractiveness. Women are socialised to believe that if they fail to attain the cultural ideals of thinness and beauty, men will not see them as attractive.

Although there is pressure on men to fulfil the male body ideals, men are socialised to believe that other characteristics are also important when women evaluate their attractiveness.

Women’s bodies are regarded more as objects of observation. Particularly by men, in a way that is sexually satisfying for men. Thinness rather than health has been described as the most valued physical attribute in women.

Self-objectification, body dissatisfaction and the desire to change one’s body to more closely meet the ‘thin cultural ideals’ are normative among women in the western culture. Consequently, many young women may view their sexual desirability as synonymous with thinness.

Effects on sexual relations

Situations where body-related concerns are more prominent and the body is at focus is during sexual intercourse. Body dissatisfaction may result in avoidance of exposing the body in sexual encounters. This in turn may inhibit sexual desire, pleasure and performance.

Negative body image has been found to be a predictor for lower intercourse frequency or sexual avoidance; being distracted during sexual intercourse; and inhibited sexual arousal, pleasure and satisfaction, especially in women.

Given that messages around women’s bodies are fractured and contradictory, being dependent on intrapersonal and cultural-level ideas around fat and shape, may leave women at the whim of things out of their control.

Mental health factors, such as anxiety, depression or eating disturbances directly or indirectly through BMI and body image, may influence sexual satisfaction. People who experience body-related anxiety may also be experiencing sexuality-related concerns.

Accepting your body

Size acceptance has the goal of decreasing negative bodily regard and increasing acceptance of your body as it currently is. Rather than focusing on weight loss.

A woman resisting self-objectification may have a different perception of her appearance to others and a different reaction to a partner’s attraction to her and may experience a more integrated and satisfying sexually healthy self.

Sexual satisfaction, specifically in women, stems from the need to feel accepted and emotional closeness with their partner, as well as commitment and love in their relationships. This shows that a person’s perception of intimacy with his or her partner is important for sexual satisfaction.

However, negative body image is often associated with feeling sexually insecure and dissatisfied. This may in turn have consequences for the perception of intimacy with your partner. If the body becomes too much of an object and does not feel emotionally intimate with the partner, this is likely to result in reduced sexual satisfaction.

In studies done, the relationship between body image and sexual satisfaction disappeared when relationship satisfaction was introduced in the model. The most important predictors of high sexual satisfaction were perceived intimacy with a partner, followed by body image. Sexual satisfaction is likely to stem from feeling acceptance and emotional intimacy with the partner, in both men and women.


Dr Larisse Badenhorst is a medical doctor. She joined the My Sexual Health team, in Bryanston, Gauteng, during May 2019 as general practitioner with a special interest in sexual health and HIV.

Header image by FreePik

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