Photo: Cultura/Mischa Keijser, posed by model
I have been taking care of women of all ages for more than 20 years, and I can count on one hand the number who have told me they like their bodies.
Women's litanies are far-reaching and can be absolutely ludicrous: my arse is too flat; my breasts are too large, or too small (thanks to gravity, all breasts start to sag sooner or later); I wish I had blue eyes; I'm all hips; my upper arms wobble.
Women loathe their hair, the shapes of their faces, their complexions and their legs. But the most predictable complaint has to do with fat - its distribution, the overall amount, and its reportedly unrelenting presence, no matter what one does.
Ironically, this is true for many women regardless of how much they actually weigh, their overall fitness level or how old they are.
There are millions of books written specifically for women who want to slim down, beef up or beautify. Evidently, making friends with our flesh is one of the most arduous, consuming, expensive and emotionally upsetting accomplishments women attempt throughout life.
I have had an above-average fat quotient since the age of two. Long before we were tackling an epidemic of paediatric obesity, I was the poster child for what could happen if a kid really loved to eat and was genetically coded to be full-figured rather than slim.
Despite my enjoyment of exercise from an early age, regular physical activity made no difference when it came to my tendency to store kilojoules versus shedding them.
The genes of my petite Greek mother and strapping Czech father came together to create a broad-shouldered, buxom, farm-animal-strong girl. I, like everyone else, came into the world with my genetics predetermined. But genetics aren't everything, and we all have control over how we behaviourally and psychologically manage what nature has bestowed upon us.
When I lived in Greece in my early 20s, the Greeks I met were perfectly comfortable asking me how I got to be so big.
The story of Gulliver and the Lilliputians would cross my mind often, since just about everyone in the country seemed smaller than I was. But in truth I am not a giant. I am a robust woman who wears (Australian) size 20 or 22 - making me plus-size. However, my size is not my identity.
This is not true for many of the women I have worked with as a sexuality counsellor, especially women who seek me out as a result of a lack of interest in sex.
Unfortunately, the seeds of self-hatred concerning body image are planted early in life. The feedback and education many girls get about their sexuality is terrifying: they're told to look pretty and slim but not sexy, and if they have sex they will get pregnant, contract a disease or ruin their reputations.
In our culture, the concept that having satisfying and responsible sex could actually enhance a teenaged girl's self-esteem is blasphemous and bizarre. Girls grow up needing to hide their sexual feelings and forays. They learn that it's better, safer and more acceptable to just stick with their efforts to stay slim and attractive.
Being overweight makes many women feel undeserving of pleasure, as if it is something that must be earned. They believe the more flesh you have, the less pleasure you are entitled to. I have sat for countless hours with women who tell me they're fat and that their feelings about it are the reason they are estranged from feeling sexy and having sex.
Despite the mournful calls of their desperately lonely and hungry partners, who desire them, if a woman thinks of herself - primarily - as overweight, she'll do all she can to avoid physical and sexual intimacy.
So what is it that brings on this low self-esteem? Often, it's a negative mantra you repeat, telling yourself that you can't have sex because of your shape and size. If you're plagued by an internal dialogue such as this, I suggest you play a game of hot potato - whenever the negative thoughts come into your head, imagine them as hot potatoes and drop them to avoid getting burned.
When women hate their bodies, their first step towards reuniting with pleasure is to take up frequent movement: yoga, dancing, walking, bicycle riding and swimming.
Most women I work with who are struggling with their body image have an unhealthy relationship with movement; either they never get off the sofa or they're exercise addicts. Neither is healthy. If my interest in pleasure and sex has waned, I assess how physically active I've been.
I have days when I simply can't explain how I ate an entire box of vanilla sandwich creams. Other days, my diet is exemplary, demonstrating impressive self-control.
Like many of my clients, I have lived in various degrees of fatness, but I have remained open to pleasure and have always enjoyed sex, no matter how much I have weighed. I grew up with a mother who convinced me my weight should never be an impediment to pursuing what I really wanted in life - except wearing a bikini or miniskirt.
I am sure at the time she wasn't thinking that her emotional support and non-fat-hating opinions would positively influence my sexuality - but lucky for me, they did.
My mother's beliefs were not influenced or swayed by her own body size, which has never gone beyond a petite size 10. Either because her love for me was powerful, or because she loved a large man herself, my mother's opinions of what was attractive were broad and atypical and seem to have immunised me against a specific kind of self-hatred that could have eaten away at my self-esteem and experiences of pleasure my entire life.
Have I ever considered drastic measures like bariatric surgery or starvation diets? Of course I have. Anyone who is even slightly overweight considers those things, and if they tell you otherwise, they're lying.
The real key to managing my occasional self-loathing about my weight is to mastermind my own insurrection against my darkest thoughts. In the case of my big body, the real problem was not that my bigness itself was an impediment to what I wanted in life, it was my tendency to look to food for comfort and information.
I was repeatedly mistaking those vanilla sandwich creams for a brilliant psychiatrist, best friend, great comedy, or flawless partner. This never works.
Eventually, I came to terms with the fact that cookies have an IQ of zero and every time
I ate a million of them, I didn't become more adept at problem solving - just uncomfortably full and incapable of conceiving of myself as a sexually active human.
By reminding myself of this repeatedly, and in combination with my love of moving, my body shrank by more than 20 kilograms, which has now stayed off for several years. No magic pills, no fancy diets, no surgery.
While this metamorphosis was occurring, I continued to have great sex and find ways to make fun of the struggle I faced. I am still working on this - and guessing that this will be the case for the rest of my life.
The many women tormented by their full figures who come to see me for sexuality counselling need to speak with my handsome, physically fit and sexually sophisticated friend Eric. He's the man who told me that full-figured women are attractive in ways that lean women never will be, because they're full figured and not lean.
This conversation was like my very own French Revolution. Imagine, the very flesh you loathe can be fetching, hot, and sexy. It also may be comforting to a partner who loves all of you, including those extra kilograms you'd prefer to live without. •
This is an edited extract from Women, Sex, Power and Pleasure, out now through Hay House.