ARTIGOS

 

The meaning of eating and body perception of women that sought the na medida multidisciplinary program

 

 

Nayara Tiemi Naves; Alessandra Elisa Gromowski; Cristiane Vercesi; Silvia Nogueira Cordeiro

Universidade Estadual de Londrina, Londrina, PR, Brasil

Mailing address

 

 

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ABSTRACT

The subjective experience socially lived and the body image developed in the early childhood are aspects that contribute to the own body perception. The act of eating goes beyond its historical and cultural meaning and suffers unconscious processes. It is aimed at knowing the meaning of eating and the body perception of 27 women who were interested in participating of the multidisciplinary program Na Medida, residents in the north of Paraná State (Brazil). It was used a semi structured questionnaire for data collection, that were analyzed from the thematic-categorical context by the psychoanalysis reference, considering the social context. The results demonstrated that eating, besides meaning the species' preservation; is associated to the unconscious processes in search of satisfaction. The women have felt unsatisfied by their own body and it was checked the attempt to supply the fault by investing in the body, (re)framing it and trying to create an idealized image under the Other's gaze.

Keywords: Body image, perception, feeding, psichoanalysis.

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"In addition to the biological body and physiological hunger, there exists a body that demands, but is not satisfied"
(Seixas, 2009).

 

Perception of Body Image and of the Ideal Body

Body image can be considered a set of images or how a person represents their own body to him/herself and is a concept of multiple construction. Perceptual and social subjective experiences collaborate in the construction of the body image (Sousa, 2007). In other words, it can be defined by how the person sees, feels and experiences his/her body within their culture and society, linked to the emotional and physiological factors, personal experiences, beliefs and behaviors and also covering the relationship with others (Leal, Catrib, Amorim, & Montagner, 2010; Secchi, Camargo, & Bertoldo, 2009; Stenzel, 2006).

The appearance that the body maintains is of great importance in contemporary society, however, the subjective aspect presents a psychosocial force of greater influence (Stenzel, 2006; i.e., individuals are expected to present themselves in a certain way and the perception of their own image generates great concern).

Thus, one can talk about the perception of body image, considering that self-perception covers self-image, as it constitutes part of the impressions regarding the person's own body and how he/she is concerned with it in relation to concerns with the outside world (Sousa, 2007).

The ideal body sought by women is tall and thin, below the body mass index considered normal by the World Health Organization (Kakeshita & Almeida, 2006; Martins et al., 2012; Secchi et al., 2009), which influences the manner and quality of life of these women, as they end up being subject to dietary restrictions, exercise and medication, among others. Such procedures can cause psychological distress and often damage to the body itself, including dissatisfaction with body image or even body image disorders (Kakeshita & Almeida, 2006).

The reinforcement given by the media to show attractive bodies is of great importance in the construction of the body image. The media is a disseminator of values, information and behaviors that are reinforced in everyday relationships with colleagues and family, and generally emphasize the characteristics of the successful body, therefore generating expec-tations and desire in consumers (Cash, 2005). The body industry, through the media, is responsible for creating desires and enhancing images, with standardizations therefore emerging. People who find themselves outside this standard feel pressured and dissatisfied.

Studies on body dissatisfaction among women and female adolescents show that exposure to media content related to beauty standards, the comparison between the person's own body and that shown, as well as frustration in achieving the ideal body, cause low self-esteem and dissatisfaction with the body image (Alves, Pinto, Alves, Mota, & Leirós, 2009; Martins, Pelegrini, Matheus, & Petroski, 2010; Posavac, Posavac, & Weigel, 2010).

The body can today be associated with the idea of consumption. In many instances, this is the object of exaggerated valorization of goods and services for the "maintenance of this body". As stated by Fernandes (2003), "The body is great! Great price, great production, great investment... Great frustration" (p. 13).

Body inadequacy generates a "hatred of fat" and leads people to adopt aggressive practices with themselves, such as excessive control of eating to make themselves fit the current standards of the society (Freire & Andrada, 2012; Sibilia, 2006). Sibilia (2006) gives examples of practices, such as prolonged fasting, sunlight-only diet and diet restricted to seeds and grains, to illustrate the idea of bodily purification, the body must be clean and detoxified by hunger strategies, because the flesh is unclean.

To achieve beauty, it is believed that very little should be eaten, although the medical recommendation stipulates a balance. The notion of "eating like a bird" carries a historical heritage arising from the Middle Ages to the present day (Asfora, 2012). Food is associated with health in all cultures due to the question of human survival and the medical discourse regarding types of diet (Carneiro, 2005).

The image of the fat person carries a social stigma that people seek to avoid, that is, having the stereotype of being kind and friendly, while simultaneously, suffering judgment and disgust from others for being fat. Fat people are seen as people who cannot manage their own bodies and their limits, as people who do not try to control their size (Novaes & Vilhena, 2003).

Thus, the diet or the act of eating, in addition to its function of providing energy and nutrition for the body, carries a strong sense within a historical, cultural and social context, encompassing rites of passage, social relationships, the construction of bonds and the production of both individual and collective identities (Carvalho, Luz, & Prado, 2011).

Eating Throughout history

The history of food refers to a society that is expressed through eating habits, with their meanings being continuously modified.

In a brief historical retrospective, Flandrin and Montanari (1998) concluded that, in Greece, the main aspect of food was the importance given to the banquet, due to its close connection with the process of reproduction of the social body, as it defined the human condition and differentiated the Greeks from the other societies. Like the Greeks, the ancient Egyptians associated the preservation of health with the quantity of food ingested.

Following the trend of the times, Mazzini (2000) adds that in the Middle Ages these requirements came to define the social classes to which each person belonged, as the Christian society helped in the proliferation of dietary guidelines and their social impact when food was linked to the sin of gluttony.

Flandrin and Montanari (1998) state that it was in the seventeenth and eighteenth centuries that the elites allowed an easing in food rules, favoring the entry of new foods on the menu and also seeking taste satisfaction at the expense of good health, associating a strange value to the taste of food (i.e., a figurative meaning to distinguish the edible from the inedible).

In the passage from the eighteenth century to the nineteenth century, there was population growth, the development of cities and industrialization, the expansion of markets and the conquest of new lands. These facts gave rise, in the figure of the ascendant bourgeoisie, to fat as a symbol of wealth and social distinction (Flandrin & Montanari, 1998).

As the eating habits of the Brazilian and the meaning of food have been modified in recent decades, so that the increasing consumption of fast and practical food is currently seen, with solitary, industrialized meals that have little nutritional value and favor overeating, obesity and its comorbidities (Bleil, 1998).

Obesity, considered a disease, is becoming a worldwide epidemic, resulting from the association of inadequate eating habits, from a nutritional point of view, and physical inactivity, and appears in all ages and social classes (Ministério da Saúde, 2006).

Nevertheless, hunger has not stopped being a social problem, as the new mode of production creates inequalities.

The process of globalization of the contemporary capitalist society has homogenized the ways of life of the population in general and modified eating habits. The calendar is no longer regulated by the time of harvest and religious festivities, but by useful working days, weekends and holidays. In the same way, foods are no longer restricted to a particular region or time, they are sold in supermarkets that integrate relations, trade, people and activities (Hernández, 2005).

The media and advertising, by focusing on the importance of healthy food, create a new consumer market, such as diet and light foods, which promote a balance of nutrition, taste and practicality, even with the food being industrial (Marins, Araújo, & Jacob, 2011). At the same time, but still within the market process, traditions of cooking and the kitchen are revived by gourmets and the local and cultural identity is valued by some market sectors (Hernández, 2005).

Drive and Body Image: Eating Beyond Hunger

Varela (2006) asked what makes humans continue eating when their physiological need, hunger is already satisfied. She suggested, then, that the food would be a driven object linked to the history, desire and fantasies of the person. That is, eating is driven, a form of expression that does not occur through language, but through the filling of the body.

In medicine, addiction is associated with the body that deregulates itself, is changed by a certain pathology. The psychoanalytical perspective proposes addiction as the compulsion due to the demand for the object, characterizing overeating as a symptom, as an action mediated by the unconscious (Campos, Ferreira, Cunha, & Braun, 2012; Rocha, Vilhena, & Vilhena Novaes, 2003; Seixas, 2009).

The drive, according to Freud (1905/2006b), would be the boundary between the physical and the psychic. He distinguished two types of human drives: self-preservation and sexual. The first has the specific goal of survival and cannot be delayed for very long. The second contains the drive of self-preservation plus a quantity of libido that eroticizes the relationship with the object. The body is both a constant source of this drive and its purpose. The goal of the drive is satisfaction, even partial, and objects, such as food, are used as means to achieve this goal.

When the person is born, he/she is in a state of helplessness permeated by these drives and excitements. Such drives are satisfied in the body, in erogenous zones. First in the mouth, associated with sucking milk and overcoming hunger: then using parts of the body, such as the finger, hand or foot, characterizing autoeroticism. Maternal care to fulfill the needs of the baby, along with the sensory experiences and reactions of the human circle, provide the first mirror for the child, which will constitute itself from what is reflected. The maternal figure acquires its importance as the Other that invests in this person with her presence and her gaze (Anzieu, 1989; Freud, 1905/2006b).

Therefore, the baby, at first, experiences its body as separated parts. The first place of satisfaction is the mouth, because hunger is the first need to be fulfilled by the mother and the suction is based on a somatic function, later to be directed to other objects, such as the baby's own finger (Freud, 1905/2006b). According to Freitas, Moreira, Freitas and Lamounier (2006) the mother needs to know the different needs of the child (hunger, affection, diaper change), as to give food every time the child cries, may be teaching an abnormal relationship with food.

The feelings of comfort or discomfort are felt in bodily regions, without connection between them. So that these sensations are integrated and the body can be experienced as one, the constitution of a body image is required, which is organized through the gaze of the Other, the mother (Cabas, 1982; Lacan, 1949/1998; Winnicott, 1967).

Therefore, it is from experiences that the baby establishes with its mother, to be petted or held, to be recognized by her as the subject and to receive a place as such, that the baby is helped to differentiate between self and non-self and to constitute its subjectivity (Jerusalinsky, 2006).

The eyes have the function of capturing the outside world, but not only this. They also serve to perceive the delights of the objects that are chosen as objects of love. This is due to the drives using the same organs and body systems that are used in survival, so that the act of seeing is made up of both conscious and unconscious processes (Freud, 1910/1996a).

The function of seeing is a drive that Freud (1915/1996b) called the scopic drive and involves both seeing and being seen. First there is the vision of external objects, then the perception of the view of the Other of one's self. The satisfaction resulting from this act is related to the libido, as a form of exchange between the self and the Other.

Deepening Freud's theory, Lacan (1949/1998) talks about the body image and the formation of this outline of the body. His theory on the mirror stage deals with a significant milestone in childhood development. According to the author, the baby, after six months of age, unlike the monkey or chimpanzee, can recognize itself when looking in the mirror and will perform different gestures, exploring its own image. The mirror integrates the child's body, until then perceived by the child in a fragmented way. It is this process of image integration in the mirror, supported by an adult, which allows the baby to identify with its own image.

When seeing its own image, its fantasy is complete. The baby creates a tension to form this unified image and simultaneously has a motor impotence. Thus, it formulates a self that will always need to be recognized for its image to be fixed, because the certainty of coinciding with its own image comes from outside (Lacan, 1949/1998).

The passage through the mirror stage is, symbolically, a prerequisite to comprehending the existence of both one's self and the Other. The mirror in Lacanian theory, has the function of integration of the body and, therefore, of the self.

It is worth mentioning that there are other approaches to this theme within psychoanalysis. However, in this article we chose to work from these concepts.

The difference is, therefore, clear between the anatomical, physiological or biological body studied by medicine and the body of psychoanalysis, as the source and purpose of drives and in constant search for satisfaction. Varela (2006) points out that, if instinct fulfills the need of the biological body, the drive establishes the body of psychoanalysis. Thus, instinct cannot satisfy the bodily drive.

Search for a Esthetics and Health

The satisfaction of driven desires is only comprehensively achieved, supposedly, when the baby has still not differentiated itself from the mother and feels omnipotent, with the subject constantly seeking to revive this satisfaction from his/her differentiation from the outside world. However, he/she will only partially achieve this (Freud, 1905/2006b).

Furthermore, according to Freud (1930/2006a), there are three sources of suffering that are perceived as threats and generate constant discomfort. The body itself is one of them, for it is condemned to decay and death, without the possibility of escaping from the anxiety this causes. The other two correspond to the outside world and its destructive force and to the relationships with others, because human rules do not mean benefit and security. Thus, it can be concluded that the human being is always in search of happiness, either actively or by trying to avoid unpleasantness and, therefore, uses methods such as solitude or love, beauty and art. According to Freud (1930/2006a), beauty would have effects of compensating for suffering; thus, seeking the aesthetics of the beautiful body is related to this.

Technological and scientific advances have been developed by humans to try to fill the empty feeling and alleviate suffering. The possibility of consumption as complete happiness is presented by the new laws of the capitalist market (Carneiro & Pinheiro, 2009). Considering that, nowadays, the beautiful body is the slim and/or strong, sculpted body (Goldenberg, 2005), consumption of new foods presented as healthy, of meals from books of famous diets and invasive procedures, such as body modification surgeries, are examples of proposals for the search for the beauty of the body.

Nevertheless, in order to improve the quality of life of the population and reduce the cases of obesity, government agencies have created actions and strategies for the promotion of healthy eating and exercise, developed by the articulation between government, productive sectors, civil society and commerce (Coutinho, Gentil, & Toural, 2008).

Another creation to meet the demand for the healthy body is the weight loss programs that have become popular through the television media, exalting improvements in both physical form and health, as well as self-esteem and body image of the participating person. With the advent of multidisciplinary teams in the public health area, such programs have become capable of being carried out with the community at large, considering that nutritional, physical and psychological support, even in the short term, have results in the body composition, such as reducing the percentage of fat, in the diet and in the lifestyle (França, Biaginni, Mudesto, & Alves, 2012; Saueressig & Berleze, 2010).

Thus, this study aimed to understand the meaning of eating and body perception for women that sought the Na Medida multidisciplinary program.

 

Method

An exploratory study was conducted in order to describe the perception of body image and the meaning of eating for women who were interested in participating in the Na Medida multidisciplinary program. This project was approved by the Human Research Ethics Committee of the State University of Londrina, approval No. 239/2013.

The multidisciplinary program included the following areas: psychology, nutrition, physical education, nursing and pharmacy. It was focused on women with cardiovascular and metabolic diseases, of reproductive age, so that they would experience significant changes in the quality of life, which would come from nutritional reeducation, physical exercise, mental health and general aspects of women's health.

The study included 27 women who lived in the north of Paraná state and attended the Primary Health Unit in their neighborhood. The age range was 32 to 68 years, with the mean age of the women being 50 years. Data on health complaints, use of medication, blood pressure and body mass index (BMI) were collected. Participation was voluntary and all subjects signed the terms of consent form.

The sample was purposive and by saturation (i.e., the women were chosen according to personal characteristics that would provide information about the theme of the study and data collection was terminated when the responses become repetitive; Turato, 2003).

A questionnaire was applied by the psychologist, with semi-structured questions, namely: "in one word, what does eating mean to you" and "how do you feel about your body?", aiming to investigate the meanings of eating and body perception.

Data analysis was carried out from the thematic-categorical content. For this, the steps proposed by Turato (2003) for content analysis were used: Pre-analysis (free-floating reading), categorization of the emerging topics according to criteria of relevance and repetition, external validation (supervision with adviser, discussion with the research group and debate of the results at events) and presentation of the results (descriptive), with illustrations of the responses. Steps of the thematic-categorical content analysis were included that complemented the previous ones: definition of provisional hypotheses, determination of registration units, definition of the themes through the registration units, quantification of the themes and categorical analysis of the text (Oliveira, 2008).

The framework of psychoanalysis was used for the discussion of the results, with the contemporary socio-historical context being considered.

 

Results and Discussion

The Meaning of Eating

In this theme, The meaning of eating, the categories analyzed were: survival; feelings of pleasure; feelings of displeasure; greed; and health.

Table 1 presents the percentage of responses for each category.

Survival, illustrated by the words "to satisfy hunger", "to feed the physical", " to sustain" refers to the instinct of hunger and preservation of life and the species present in all animals. The association with its denotative meaning suggests that the women were limited to the concrete reality (i.e., to give the literal meaning to the act of eating, with no contact or development of the response regarding their history, culture and emotions).

The health category presented the same perspective, because, as previously mentioned, food is related to the question of survival in different cultures (Carneiro, 2005). However, this idea may also have been influenced by the proposal of a healthy life for prevention of diseases, as healthy eating and physical activity are considered the main means for health promotion (Ministério da Saúde, 2006). That is, the statements that give meaning to eating as "health" have a positive aspect, taking into consideration the change in eating habits of Brazilians that favor excessive eating and obesity (Bleil, 1998). This idea has been appropriated by the consumer market, offering diet or light food or suggesting care for the body itself (Marins et al., 2011).

The other categories point in another direction. Eating was related to feelings of pleasure, for example, through the words "eating is everything good", "satisfaction", "pleasure", "overcomes sadness", "relief", and eating was also shown to have a relationship with feelings of displeasure, from the words "horrible", "problem" and "control". Varela (2006) states that hunger can be confused with the feelings, characterizing driven hunger, when a person continues to eat even when their body is satiated.

As noted above, prior to constituting a self, the baby is permeated by constant drives that are satisfied in specific locations, in the erogenous zones. The first satisfaction experienced for the baby is by means of sucking milk, assuaging hunger and providing pleasure, later, the pleasure is directed toward other objects, such as its own finger (Freud, 1905/2006b). By identifying the different requests of the baby, for example, the cry of hunger, the cry of pain, and offering food at the appropriate time, a relationship is constructed that will influence the other relationships of this individual and also those related to food and oral satisfaction (Freitas et al., 2006).

Finally, the women gave the meaning of "greed" to eating. Greed is characterized by religion as overeating, constituting a sin. The main aspect of sin is something that exceeds or is missing in the relationship of the subject with the Other. Thus, it can be said that greed and the emotions that accompany it are not mediated by the consciousness, but regulated by the unconscious; in other words, greed would name the jouissance (Campos et al., 2012).

Thus, it was observed that even when not referring to eating directly linked to feelings of pleasure and displeasure, it was related to unconscious processes in the constant search for satisfaction, generating constant discomfort.

Perception of the Body Image

In this theme the category analyzed was: dissatisfaction with one's own body. The statements related to the way the women perceived their bodies were "fat", "huge", "I feel ugly", "I do not look at myself in the mirror", "I'm fine, I weighed 70 kilos, but now I'm 66", "indisposition, helplessness, sadness". All the women made statements regarding dissatisfaction with their bodies, that is, no woman reported feeling good about herself or not wanting to change.

These statements corroborate studies that indicate that women and adolescents are dissatisfied with their body images, with low self-esteem due to comparing their bodies to those exposed by the media, even though these are manipulated images that appear without imperfections (Alves et al., 2009; Martins et al., 2010; Posavac et al., 2010).

The body is inserted into the culture and is marked by it. In narcissistic contemporary culture, the main characteristic that is given emphasis is lipophobia, that is, the fear of fat (Freire & Andrada, 2012). The fat person is seen as someone who cannot control his/her body and also does not make an effort for this (Novaes & Vilhena, 2003). Considering that the capitalist society establishes the individual, his/her growth and personal valuation as merit and individual effort, the fat person would be unable to maintain a good appearance and solely responsible for his/her condition.

The women reported not just feeling "fat" but also "ugly", with "low self-esteem" and that they "do not look in the mirror". It is clear, then, that the discomfort with themselves goes beyond weight. By changing the body through aesthetic interventions one would be changing his/her life, with social gratification resulting from the process. What is presented as the norm for the woman is the constant assertion that she can be beautiful, if she wants. That is, it is not the imposition or obligation that exert a greater influence in relation to the pursuit of beauty, but the possibility that any woman can be beautiful, with them also being responsible for this (Novaes & Vilhena, 2003).

As mentioned in the introduction, body image is formed in early childhood in the driven investment of the Other in the body, which is felt to be fragmented, with the accommodation of this image occurring throughout life, that is, the subject will seek an image to confirm his/her form (Rocha et al., 2003).

By investing in her own body, the woman tries to remedy its failure, (re)signifying this body and trying to create an idealized image under the gaze of the Other. To attract the gaze of the Other gives the woman the feeling of ensuring the female identity, an identity that is formed through beautification and the use of accessories and makeup. In addition, the search for this ideal of form in which the subject becomes trapped suggests that there is an obstacle in the acceptance of finitude (Silva & Rey, 2011).

Thus, the dependence on the longing gaze of the Other continues to exist, even though this Other is the media (Lima, Batista, & Lara, 2013). If the media reinforces the beautiful and perfect body, the woman comes to recognize herself from this social desire (Zorzan & Chagas, 2011).

The perception of the body, of the body image and the relationship that is established with food are constructed throughout life, even before birth, when the parents invest desire and expectation in the person is being generated. Thus, it is important to consider that every human being is unique and establishes unique relationships with the world and with him/herself; therefore, the women who participated in this study may not represent the entire population, however, reflect a striking and current aspect with regard to human suffering.

The bodily symptoms, such as obesity, may be understood as a process in which the subjective questions follow a pathway contrary to the pathway that would lead to the symbolic representation process. Excess weight translates into body issues of psychological distress that cannot be symbolized (Varela, 2006).

 

Final Considerations

This study aimed to understand the meaning of eating and body perception of the women who sought the Na Medida multidisciplinary program. Accordingly, the women interviewed gave the act of eating the meaning of survival and health, which refers to the instinct of hunger and preservation of the species. However, meanings related to feelings of pleasure and displeasure and linked to unconscious processes show that eating also goes beyond hunger, often being a means to momentarily alleviate the anguish. This management of anguish is a precarious form of psychic functioning, which seeks the complete satisfaction, supposedly achieved in the moment of life when the self had not yet been formed, that is, when the baby could not differentiate itself from its mother and lived in a state of omnipotence and autoerotic satisfaction.

The dynamic of excess eating provides the subject with symbolic resources to deal with the frustration resulting from the impossibility of fulfillment and complete satisfaction of the demand. Therefore, the obese body and the hunger itself seem to manifest the drive, at the point where it cannot be described, highlighting the close relationship between the somatic body and the driven body of psychoanalysis (Seixas, 2009).

The same search for satisfaction appears in the perception of the body. When the participants said "fat", "huge" and "ugly", they demonstrated dissatisfaction with the ideal of the perfect body socially constructed in the contemporary capitalist culture. Beautifying oneself to attract the gaze of the Other, in order to fill the gap, is a characteristic of the narcissistic culture stimulated by consumption.

Although the results do not allow generalization, these analyzes demonstrate the importance of multidisciplinary care with the presence of the psychology professional in programs for the improvement of the quality of life, as they deal directly with the body image of the participants, linked to feelings and unconscious processes that cannot be ignored. They also allow a better comprehension of the themes studied here and form the basis for further studies.

 

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Mailing address:
Nayara Tiemi Naves
Rua Pio XII, 865, Apto. 304, Centro
Londrina, PR, Brazil, 86020-381
E-mail: naytiemi@hotmail.com

Recebido: 26/02/2015
1ª revisão: 30/11/2015
Aceite final: 21/02/2016

 

 

We would like to thank Professor Clísia Mara Career, Coordinator of the Na Medida Project, and the residents that participated and contributed to the realization of the project.