The beauty industry spends billions of dollars a year convincing women that they need to look thinner, younger and sexier. 51 Magazine asked Tamara Anderson — a professor in 51’s Rosemead School of Psychology — about the high toll the media takes on women’s body image.

How many women struggle with an unhealthy body image?

The majority of women will say they are dissatisfied with their bodies, but, on the flip side, many of them can also tell you what they like, such as their eyes or hair. This is healthy because it shows they can assess themselves. So having a healthy body image is not about thinking, “I feel good about myself in all these areas,” because having areas for improvement is just the state of being human. But if a woman feels so bad about how she looks that she doesn’t leave her house or hang out with friends, or doesn’t put herself in a community where she might develop a romantic attachment, then it’s affecting her life. And, according to the current literature, one in four women in Western culture will have an eating disorder — anorexia or bulimia — in their lifetimes.

Do more women in Western culture have an unhealthy body image than in other cultures?

Eating disorders are seen around the world in every industrialized country. But in Western culture, media has a huge influence on women’s body image, and we definitely see higher rates of eating disorders in the West. The California subculture — home to the entertainment industry and so many beaches — is particularly a problem. In California culture, men are much more concerned about how their bodies look than in other places, with what’s pushed out here as being the ideal body. But it still does not equal what women deal with.

How does the media contribute to an unhealthy body image?

The whole beauty industry is built on, “You’re not OK the way you are. We’ll make you better.” It would seem bizarre to us today, but 50 years ago, when television was brand new, there were commercials that would say, “Gain 10 pounds in a week, guaranteed.” Women bought these products until wafer thin was considered the best body to have. Then, for a while, Cindy Crawford brought in a new kind of image of models who looked healthier. Also, in advertisements a woman is often treated as a body or a collection of body parts and not a whole. For example, often you’ll see a part of a woman’s body — maybe her head isn’t showing and her knees and below aren’t showing, but the rest of her body is. That’s a clear objectification of a woman.

Do celebrities struggle with body image issues?

Yes, they’re also victims of the media. I’ve worked with models whose names you’d know based on how popular they are, and they’ve had to lie in bed for 20 minutes in the morning repeating to themselves, “I am worthy to get up” because they think they’re ugly and they’re depressed and suicidal. Other people look at them and say, “Wow, they must have a good life,” but they have no idea what these women deal with everyday.

Does the rise in plastic surgeries influence body image?

Yes, this has been very disturbing to me. I just heard a radio ad for breast implants for $299.95. You could get your full body redone for something like $6,000. It sounded like a paint job for a car. The mentality is, “If you’re unhappy with something about your body, then get it fixed.” I just heard of a case from a colleague who is working with a client whose parents gave her breast implants for her 16th birthday. That’s outrageous. The problem with plastic surgeries is that — even if one area of the body gets “fixed” —  there’s always something else to be upset about. If somebody has true body image issues, then 20 plastic surgeries won’t fix what’s broken on the inside. Of course, some people do have very simple concerns. For example, they feel they have an unusually large nose as defined by their culture. If they basically feel good about themselves otherwise, then getting a nose job can make them feel good because that’s all they were concerned about. But the availability of plastic surgery to the general public is clouding the issue of body image.

Besides the media, are there other factors that contribute to an unhealthy body image?

Family messages are very powerful. I’ve worked with girls who are 9 years old who exhibit eating disorder symptoms, partly because they’ve been told by their families, “You’re fat. You don’t want to be fat.” So, they start to see themselves as unworthy based on body size. If body image is elevated above other things in girls’ minds, that can create a problem.

What does current research into body image reveal?

The more refined research is showing the impact of women’s perceived body image — their ideas of what other people think of them — rather than what other people really think of them. There’s a subtle difference there, like, for instance, with a husband and wife. The husband will say, “I think you’re fine,” but if the woman’s perception is that he really doesn’t mean that, then that takes a toll on her. He can be saying until he’s blue in the face, “I don’t have any trouble with how you’re shaped and what you look like,” but her perception is what is the most powerful.

What steps should be taken if someone suffers from an unhealthy body image?

With clinical eating disorders, interventions will vary woman to woman. I’ve worked with clients who I’ve told not to read fashion magazines. That may seem like a small thing, but it’s not small for somebody who is already distressed about her body because fashion magazines depress every woman. Many of my patients have spent a lot of money on them, and they also often surround themselves with people who reinforce the message that they’re overweight. These are the girls with boyfriends who tell them, “You need to lose some weight.” So, women can choose to be in relationships with men who don’t talk that way to them. And Christian women can learn to see themselves as God sees them. That can be a wonderful healing thing, knowing “I’m one of God’s creatures. He created me. I’m beautiful to Him.”

How can families help young girls develop a healthy body image?

I have a 6-year-old daughter who loves to put on outfits and match them. I’ll say, “Oh, you look beautiful. What a smart girl you are to be able to be so creative with your clothes.” So, I’m always throwing in what a smart girl she is with how beautiful she looks. However, you don’t want to go too far the other direction and deny telling girls they’re beautiful. Families must also realize that moms set the tone a lot of the times. If mom is continually obsessing about her weight and continually dieting — always saying, “Oh my goodness, how many calories are in that?” — that sends a very strong message to young girls as to what they should be concerned about and what’s most important in the world.