Risk and protective factors are equally important to the promotion of sexual health. Yet, in body image and sexuality research, most of the focus has been placed on the deleterious effects of appearance dissatisfaction and body mass index (BMI) at the expense of more adaptive dimensions. Furthermore, although age can affect appearance and sexual function, little is known regarding the experience of older women. Therefore, this study was aimed at comparing how positive body image (operationalized as body appreciation) and negative body image (operationalized as appearance dissatisfaction) each contribute to indicators of sexual health when controlling for BMI in a sample of age-varied women. Cross-sectional data were collected online from 215 heterosexual women aged 18-88 years. Results showed that body appreciation was a unique predictor of sexual function, satisfaction, and distress, above and beyond the effect of BMI and appearance dissatisfaction. Body appreciation was not found to fluctuate with age. Further, body appreciation moderated the relationship between age and sexual satisfaction, but not sexual distress. Post hoc analyses showed that high body appreciation may serve as a buffer against age-related changes in sexual satisfaction only in women with clinically significant sexual function difficulties. Increasing body appreciation may be a promising clinical intervention in the treatment of sexual problems in older adult women.

According to objectification theory, women become culturally desexualized during midlife and have the opportunity to let go of their propensity to self-objectify. In young women, self-objectification is negatively related to sexual adjustment. Yet little is known about what could ameliorate this relationship or whether it continues after midlife. Body appreciation (i.e., acceptance and positive regard for the body) has been substantiated as a contributor to improved sexual adjustment in young and older women alike. Hence, this study was designed to examine whether it helps mitigate the deleterious effect of self-objectification on sexual function, satisfaction, and distress in women over the age of 50 (n = 193). Path analyses revealed that self-surveillance is related to body shame and appearance anxiety, the latter of which was related to body self-consciousness during sex. In turn, body self-consciousness during sex mediated the relationship between body shame, appearance anxiety, and all three indicators of sexual adjustment. Furthermore, high body appreciation attenuated the negative associations between self-objectification constructs, body self-consciousness during sex, and sexual satisfaction and distress. Overall, this study supports the use of objectification theory in midlife and older women. Sex therapy interventions that incorporate mindfulness and body appreciation principles are discussed.

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