Body Shame

At 15 I thought my butt was fat.

Body shame is often an underlying contributor to chronic pelvic pain. Body shame is so prevalent that we treat it as a normal part of being a woman. We’re so afraid of looking fat that we obsess about our looks daily. We’re constantly trying to make our body fit an unobtainable and/or unsustainable standard of an acceptable look.

Body Shame Starts Young

Body shame often starts in childhood. In this photo, at 15 years old, I was already worried that my butt was looking fat. I started running to try to make it smaller. I kept running regularly for the next 8 years and even ran competitively. But my butt didn’t get smaller. Several times people accused me of being anorexic.  I couldn’t understand what they were talking about because I thought I ate a lot!

Eating Disorders and Pelvic Pain

It’s not uncommon for women with pelvic pain to also have eating disorders such as anorexia or bulimia in their history. Once the pelvic pain begins to subside, issues with food and body image can come up. Because we don’t want to look fat we unconsciously tense our belly muscles. Our belly (abdominal) muscles also automatically tense when we feel threatened and/or when we unconsciously resist feeling uncomfortable emotions.

This activates the fight, flight or freeze response which the nervous system perceives as danger, kicking in unconscious survival habits. When we stay in this protected/threatened mode everyday it becomes a low level survival response that becomes our new normal. Then we don’t even know what relaxed feels like. We feel stressed much of the time. We don’t sleep well. Low-level stress feels so normal we don’t know anything is amiss until nagging symptoms start. Then we often ignore them and push on until they become chronic and stop us in our tracks when they can no longer be ignored.

Tense Muscles

Body shame triggers chronically tense stomach muscles. Common symptoms from tense abdominals are bladder irritation (frequent urination, interstitial cystitis/IC), vaginal soreness (including vulvodynia), digestive symptoms (gassiness, constipation, loose stools including irritable bowel syndrome/IBS), lower abdominal pain, hip pain, crotch pain, lower back pain and more. These chronic symptoms cause the fight, flight or freeze response (stress response) to ramp up more intensifying fear responses and symptoms. We don’t feel safe in our bodies. We try everything we can to get rid of the pain. This only serves to reinforce distrust of the body and not feeling safe in the body.

Diet Feeds the Stress Response

You believe that if only you can get rid of the belly (or the butt) you would feel better. If only you could lose a few pounds or ten or twenty, then you would be more acceptable, successful, and desirable. You start dieting i.e. restricting food quantities and certain “bad” foods. Having to be hyper vigilant around food in turn feeds the stress response. Not feeling safe in your body or in the world triggers survival habits which can cause adrenal fatigue along with all the other symptoms you already have. All because you’re trying to look like the current acceptable standard for beauty, which idealizes the body shape 20-year-old women. This is a transitory state. It’s not sustainable.

Ditching the Diet

After being so uncomfortable in my body for so long, I ditched the restricted diet I was on for health reasons for over 20 years. It didn’t heal my pain and it was keeping my body and approach to life rigid while feeding my stress response. When I was at an ideal weight at the end of my last restrictive diet I still thought I was fat, especially after a meal.  I was hungry most of the time and that was uncomfortable and triggered my stress response. I was ready for comfort and feeling healthy. The result is I gained weight. Now I feel happy and comfortable, healthy and strong. My body shape and weight are normal for a post-menopausal woman. I feel healthy at my current weight.

Normal Bodies

What helped me to let go of the impossible weight standard of beauty which I perceived as a flat belly was to notice all the stress I had around body image and the pressure for having to maintain a certain weight. I also looked at women my age who are mothers. I saw it was normal for the body to change after pregnancy and as women age. Now I know when I was 15 and my butt was getting bigger my body was just developing normal curves. I know that the weight I am now is healthy for post-menopausal women my age. Now when I start being unhappy with how my body looks, I know it’s just a mind game to distract me from some difficult emotions I need to feel. Once I turn toward feeling emotions, my body image stress releases and I come back to well-being.

I’ve found intuitive eating philosophy and guidelines to be very supportive as I’ve relaxed around my body image and embraced healthy eating. Check out these resources for more support on health at any size:


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