Just How Important Is Body Image?

What happens when you become ill, so seriously ill that part of your treatment involves body-changing surgery?

Ever walked past a mirror and copped a sneaky glance... just to make sure you look ok? I certainly have and usually regret doing so. This time of year I always seem to have a white and spiteful look about me. The combination of office work, freezing weather and limited sunlight makes it difficult to achieve that tanned look deemed so appealing. But why do we do the mirror thing? I’m sure the media has something to do with it. Everywhere we are confronted by images of beautiful people. There’s always something to aspire to, whether it be an ideal weight, body shape, complexion or ‘look’.

The fashion industry is now worth an estimated £26 billion to the British economy. Cosmetic surgery, once the preserve of Hollywood film stars is now commonplace. So too, is body piercing. Ten years ago a study in the British Medical Journal reported that one in 10 people (and nearly half of all young women) had a body piercing other than an earlobe. A measure of just how popular this sort of body ‘enhancement’ has become is the burden it has placed on the NHS - sorting out botched jobs. Tattoos are also, once again, in vogue. According to an article by Tessa Dunlop in History Today, the number of tattoo parlours in Britain increased by over 500% between 2000 and 2012. Then there are all the gyms and spas… society, it seems, is obsessed. And, far from being a modern, media-driven phenomenon, I would argue that this has always been the case. The British Museum’s recent exhibition of artifacts from ancient Pompeii and Herculaneum revealed an enduring fascination with how we look. Like it or not, how you feel about your body and the way you look, is important. It has implications for how you behave, your chances of getting a job, your chances of finding a partner, mental well-being, the list is endless.

So what happens when you become ill, so seriously ill that part of your treatment involves body-changing surgery? This is the case with people (ostomates) who have undergone stoma surgery. Used in the treatment of diseases such as bowel cancer, it involves making an opening in the abdomen (known as a stoma) through which bodily waste is diverted and then collected in a bag. Although to others the condition may be ‘invisible’, the impact on the person concerned can be devastating. Perceptions of being unattractive can rapidly lead to social isolation and have a frightening effect on intimate relationships and sexual function. In Colostomy UK’s lifestyle survey (2016) almost two thirds of respondents said they felt that their body image was worse following surgery. Even more concerning, was the handful of people who admitted to having felt suicidal. These findings resonate with a study published in the British Journal of Nursing in 2015. This suggested that after stoma surgery many people go through the grieving process of loss, denial and anger, as they mourn the ‘death’ of their old self.

Studies show that good pre-op preparation followed afterwards by ongoing professional and lay support (such as that offered by patient associations and charities), along with access to quality information play a vital role helping ostomates come to terms with their altered body image. But, from my own involvement in supporting patients post-op, I know that small things can make a huge difference too. One example of this is knickers and, I should add, knickers on prescription. I don’t mean ‘national health’ knickers either, like the old ‘national health’ glasses, but knickers which, as well as performing a medical function, make the wearer feel just a little bit better about themselves.

When I say this, people quite often raise their eyebrows. Silently, they’re thinking: ‘whatever next’? If this is you, then have a read of a recent blog by Rachel Jury called ‘Body Confidence With a Stoma’. In what can only be described as a piece from the heart, the author talks candidly about the effect stoma surgery has had on her life. It’s powerful stuff. It also includes testimony from other ostomates. The one that sticks most in my mind is from a lady who, as a result of developing a parastomal hernia after surgery, now has to wear maternity clothing. This is something she struggles with because, amongst other things, it constantly reminds her that she can no longer have children. If you were this lady’s GP and she came to you in the hope of getting a prescription for some support underwear, and had the audacity to expect something a little pretty into the bargain, would you deny her?