“Look at these wrinkles.”

“I would do anything to look younger.”

“Do you want to come to a Botox party?”

You don’t have to read scientific journals to know that bad body image plagues women of all ages. There’s no getting away from the fact that, even before girls develop curves, self-perceived “figure flaws” are a deep source of distress for the vast majority.

Of course, there’s no shortage of scientific evidence confirming this sad fact of modern life. Just this month, a new study in the Journal of Eating Disorders confirmed what has become painfully obvious: bad body image knows no age limit.

If you missed that study, here’s the research recap: Trinity University psychologist Carolyn Black Becker and colleagues asked more than 900 American, British and Australian women between the ages of 18 and 76 about “fat talk” and “old talk” — complaints about feeling fat and old. All ages complained of feeling fat, but, surprisingly, even the youngest women worried about looking old.

To make sense of this surprising finding, I tracked down Becker and asked her why so many young women engage in “old talk.” Here’s what the San Antonio eating disorders expert told me:

“We live in a culture that constantly tells us that we should strive for an appearance that is not just perpetually young, but perpetually and abnormally line free. We are bombarded with these messages, and many are designed to increase appearance anxiety so that we will buy products companies are hoping to sell us. Given this environment, it is not surprising that old talk is trickling down to younger women.”

If commiserating with your girlfriends about sagging breasts and spreading hips strikes you as harmless, think again. While “old talk” and “fat talk” may make you feel better in the moment, if you keep talking the talk over time, you’re more likely to struggle with anxiety, depression and disordered eating, among other mental and physical health problems.

Rather than commiserating, consider doing as the “old talk” researcher says: “Imagine a world where we focused our energy and money on simply making sure we’re taking care of our bodies and minds from a functional perspective. Think about how differently people would feel about their bodies if we gave up the belief we should all look as young as possible for as long as possible. It would make it a lot easier to be comfortable in one’s own skin.”

You might also consider the increasingly popular solution of swearing off body bashing. Easier said than done, especially all by your lonesome. Which is why women’s groups are doing what Tri Delta sorority started doing five years ago — declaring “fat talk free” weeks.

Short of that, take a moment of body kindness. Simple suggestions for giving your body, your whole self, a break are available on my blog here.

Jean Fain is a Harvard Medical School-affiliated psychotherapist specializing in eating issues, and the author of “The Self-Compassion Diet.” Her website is www.jeanfain.com.

Patients facing treatment for prostate cancer expect to be warned of certain dismal side effects: erectile dysfunction and incontinence, for instance. But a new study suggests men should be warned of another possible complication: a shorter penis.

The new report found that a small number of men enrolled in a prostate cancer study complained to their doctors that their penises seemed shorter following treatment (though no actual measurements were taken). Some of the men reported that even this perception of a shortened penis interfered with their intimate, emotional relationships and caused them to regret the type of treatment they chose.

Prostate cancer is the second most common cancer in men, with about 241,740 new cases diagnosed last year, according to the American Cancer Society. Obviously prostate cancer can be serious: it’s the second leading cause of cancer death (behind lung cancer) in American men.

But most men diagnosed with prostate cancer will live — and live with the short- and long-term implications of the type of treatment they choose to undergo. While the problems of erectile dysfunction and incontinence are widely known as possible side effects, few studies have been done on treatment-related penile shortening. But doctors say it can and does happen — though it’s rarely discussed with patients.

In the current study, which was based on surveys completed by physicians treating 948 men with recurrent cancer, a total of 25 patients (2.63%) complained of a shorter penis. Complaints were most common in men who underwent surgery to have their prostate removed (19 of 510 men) and those treated with male hormone-blocking drugs combined with radiation therapy (6 of 225 men), researchers report. None of the men on radiation therapy alone complained of this particular problem.

These numbers are clearly small; but researchers say the phenomenon, due to its intimate nature, is likely underreported. The takeaway from this study, they say, is that the possibility of a slightly shorter penis after treatment should be made clear to patients as they consider their therapeutic options; a frank discussion upfront might minimize later regret. “Physicians should discuss the possibility of this rarely mentioned side effect with their patients to help them make more informed treatment choices,” the study, published in the medical journal Urology, concludes.

Lead author Paul L. Nguyen, M.D., a radiation oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Cancer Center in Boston, said the novelty of the work is that it shows how even the perception of a shorter penis can profoundly impact a man’s quality of life and lead to regret. “Some people might think this is frivolous — who cares about a slightly shortened penis — but it really does affect people’s lives,” he said in an interview. “If guys [in the study] had this bad result they were much more likely to regret the path they chose. This is important to talk about up front when people are making their decisions.”

Shortened penises are not a widely investigated phenomenon, Nguyen notes. But in the few published measurement studies, the shortening is on average about one centimeter, he said. There are several theories on what might account for this: in surgery, cutting out a chunk of the prostate may lead to some loss of length, Nguyen said. When it comes to combined radiation and hormone therapy, he said there could be some shrinking or fibrosis of the prostate or erectile tissue that makes it firmer and less elastic.

A 32-year-old man who didn’t have cancer, but noticed his penis was shorter after urethroplasty, surgery to repair an injury or defect of the urethra, expressed his shock and disappointment that he was never informed of this possible side effect. Writing in an online support forum, MedHelp, the man reflected what is likely a common reaction:

I specifically asked my doctors before the surgery multiple times about possible complications and cosmetic outcomes and never once was possible penile shortening mentioned. Stroke, heart attack and death were mentioned as risks during surgery and failure, recurrence, and ED were mentioned as possible side effects of the procedure. Also, scars at the incision site, of course…

Erectile length probably shouldn’t matter if the surgery is otherwise successful, but I would’ve preferred at the very least a warning about the risk of shortening — even if temporary — so I could’ve at least psychologically prepared for the possibility or perhaps opted for another treatment.

Dr. Sharon Bober, a clinical psychologist and director of Dana-Farber’s Sexual Health Program who was not involved in the study, has counseled men with shortened penises after cancer treatment. She has this message: Don’t give up hope. Even if there is an actual, measurable shortening, she says, it can often be reversed. “If you’re getting blood flowing, if you’re stretching the tissue and if you’re reducing atrophy and reducing the fibrotic process of radiation, you’re going to some degree address the shortening,” Bober said. “There may be some penile shortening in the short term that can be addressed in the long term with penile rehab.”

Bober added that the psychological impact of any real or perceived penile shortening should also be addressed. “When you notice that any part of your body is no longer the same as it was it has a profound impact on body image and self confidence,” she said, “but that doesn’t mean you can no longer give a partner pleasure or get pleasure. Even if you do notice your penis is a half-inch or centimeter shorter — maybe you can fix it, maybe you can’t – but that modest loss of length may not be a deal-breaker in terms of sexual satisfaction. It’s probably not as big a deal to your partner as you think.”

The key, she says is to prepare men for this possible side effect: “If somebody’s not prepared for the change, it feels very distressing because they had no idea — and it’s yet another way you feel embarrassed, different,” she said.

A 67-year-old man who was recently treated for prostate cancer at Dana-Farber said his penis size didn’t change after surgery, radiation or hormone treatment. But he did says that for many men, “the side effects of prostate cancer treatment usually involve some kind of impediments to former sexual performance…and this will create all sorts of anxieties and problems. There’s the natural, “My goodness, what’s happening?” that pretty much all men go through and maybe that includes all sorts of questioning: “Am I shorter or am I this or that.” But in addition, he said: “There’s likely a subset of people who have pre-existing issues with penile length and after they have prostate treatment, these penile length issues might become even more pronounced.”

Here are a few more details of the study, via press release:

Twenty-five men (2.63 percent of the group) complained of smaller penises after treatment – 3.73 percent for surgery, 2.67 percent for radiotherapy plus androgen deprivation therapy (ADT), and 0% for radiotherapy alone. Radiotherapy included both radiation administered by an external x-ray machine, and brachytherapy – the implantation of radioactive seeds directly into the prostate.

There were no direct measurements of penis size either before or after treatment, said the researchers. Nor did the patients’ physicians specifically ask about this side effect; the issue was brought up by patients in conversations with their doctors. For this and other reasons, the authors of the new study suggest that the problem is likely more common than reported in the survey.

The study’s subjects were men enrolled in a registry called COMPARE that collects data on patients whose prostate cancer shows signs of recurring after initial treatment. Of the 948 men in the study, 22 percent were younger than 60 and the majority were in their 60s, 70s and 80s. Just over half – 54 percent – had undergone surgery to remove their cancerous prostate, while 24 percent received radiation therapy combined with hormone-blocking treatment, and 22 percent had radiation therapy alone.

Luc Cormier, M.D., with the Department of Urology, at Dijon University Hospital in France wrote an accompanying editorial comment noting, wisely, that the whole notion of “’penile length’ is decidedly complex,” and fraught with imprecision. (What, exactly, and when are you measuring, anyway?) Still, he wrote, despite some of the shortcomings of this study which relied on both physician and patient surveys: “Penile length trouble is often discussed in clinical practice, and physician should be aware of the necessity of informing patients of the possible risk.”

Readers, have you faced prostate cancer treatment and been warned of these possible side effects? Do you feel like you got full disclosure on potential problems stemming from treatment? Tell us your stories.

The study, funded by the National Institute of Mental Health and published in International Journal of Eating Disorders found that “identical twins have closer levels of thin idealization than fraternal twins, which suggests a significant role for genetics.”

From the MSU news release:

From size-zero models to airbrushed film stars, thinness is portrayed as equaling beauty across Western culture, and it’s an ideal often cited as a cause of eating disorder symptoms in young women.

The researchers focused on the potential psychological impact of women buying into this perceived ideal of thinness, which they call thin-ideal internalization. Changes in self-perception and behavior, caused by this idealization, can lead to body dissatisfaction, a preoccupation with weight and other symptoms of eating disorders.

“We’re all bombarded daily with messages extoling the virtues of being thin, yet intriguingly only some women develop what we term thin-ideal internalization,” said Jessica Suisman, lead author on the study and a researcher in MSU’s Department of Psychology. “This suggests that genetic factors may make some women more susceptible to this pressure than others.”

To explore the role of genetic factors in whether women “buy in” to the pressure to be thin, the idealization of thinness was studied in sets of twins. More than 300 female twins from the MSU Twin Registry, ages 12-22, took part in the study. Suisman and colleagues measured how much participants wanted to look like people from movies, TV and magazines. Once the levels of thin idealization were assessed, identical twins who share 100 percent of their genes were compared with fraternal twins who share 50 percent.

The results show that identical twins have closer levels of thin idealization than fraternal twins, which suggests a significant role for genetics. Further analysis shows that the heritability of thin idealization is 43 percent, meaning that almost half of the reason women differ in their idealization of thinness can be explained by differences in their genetic makeup.

In addition to the role of genes, findings showed that influences of the environment are also important. The results showed that differences between twins’ environments have a greater role in the development of thin ideal internalization than wider cultural attitudes, which women throughout Western societies are exposed to.

“We were surprised to find that shared environmental factors, such as exposure to the same media, did not have as big an impact as expected,” Suisman said. “Instead, non-shared factors that make co-twins different from each other had the greatest impact.”

Although the study did not look at specific environmental triggers, non-shared environmental influences typically include experiences that twins do not share with one another. This could include involvement by one twin in a weight-focused sport like dance, one twin being exposed to more media that promotes thinness than the other, or one of the twins having a friendship group that places importance on weight.

“The take-home message,” Suisman said, “is that the broad cultural risk factors that we thought were most influential in the development of thin-ideal internalization are not as important as genetic risk and environmental risk factors that are specific and unique to each twin.”

Well, it turns out that screwed up behavior around food and body image persists in women over 50 as well, according to new research out of the University North Carolina. Surprise.

Here’s part of the news release:

…a new study reveals that age is no barrier to disordered eating. In women aged 50 and over, 3.5% report binge eating, nearly 8% report purging, and more than 70% are trying to lose weight. The study published in the International Journal of Eating Disorders revealed that 62% of women claimed that their weight or shape negatively impacted on their life.

The researchers, led by Dr Cynthia Bulik, Director of the University of North Carolina Eating Disorders Program, reached 1,849 women from across the USA participating in the Gender and Body Image Study (GABI) with a survey titled, ‘Body Image in Women 50 and Over – Tell Us What You Think and Feel.’

“We know very little about how women aged 50 and above feel about their bodies,” said Bulik. “An unfortunate assumption is that they ‘grow out of’ body dissatisfaction and eating disorders, but no one has really bothered to ask. Since most research focuses on younger women, our goal was to capture the concerns of women in this age range to inform future research and service planning.”

The average age of the participants was 59, while 92% were white. More than a quarter, 27%, were obese, 29% were overweight, 42% were normal weight and 2% were underweight.

Results revealed that eating disorder symptoms were common. About 8% of women reported purging in the last five years and 3.5% reported binge eating in the last month. These behaviors were most prevalent in women in their early 50s, but also occurred in women over 75.

When it came to weight issues, 36% of the women reported spending at least half their time in the last five years dieting, 41% checked their body daily and 40% weighed themselves a couple of times a week or more.

62% of women claimed that their weight or shape negatively impacted their life, 79% said that it affected their self-perception and 64% said that they thought about it daily.

The women reported resorting to a variety of unhealthy methods to change their body, including diet pills (7.5%), excessive exercise (7%), diuretics (2.5%), laxatives (2%) and vomiting (1%).

Two-thirds, 66%, were unhappy with their overall appearance and this was highest when it came to their stomach, 84%, and shape, 73%.

“The bottom line is that eating disorders and weight and shape concerns don’t discriminate on the basis of age,” concluded Bulik. “Healthcare providers should remain alert for eating disorder symptoms and weight and shape concerns that may adversely influence women’s physical and psychological wellbeing as they mature.”

Judith Shaw never meant to create art.

She was just annoyed at a “really pedantic” assignment in her recovery program, to make a timeline of her life with anorexia. She was in her 50s, had raised a family and had a career – unlike the other participants, who were adolescents or 20-somethings. And she couldn’t write a history of key events in her eating disorder, because that would mean distinguishing her anorexia from herself.

Instead, she made a life-sized portrait. And somehow a switch flipped in her brain. Making art could allow her to express what she had long kept deep inside.

That self-portrait was the first of many artworks Shaw would make as she came to terms with giving up her anorexia and claiming a new life.

Next Thursday, Shaw’s art goes on exhibit at Harvard, in the Student Organization Center at Hilles (SOCH) Penthouse level, 59 Shephard Street, in Cambridge. The exhibit is open to the public that first night from 8-10 p.m., and then to the Harvard community through March 10.

Pieces on exhibit include several self portrait cutouts, and UPS boxes filled with items that represent her struggles. (Yes, she made friends with the guy at her local UPS store who called her the “box lady” and told her of his sister’s eating disorder.)

Zuri Sullivan, co-ordinator of Harvard’s Eating Concerns Hotline and Outreach, the student-run organization that is sponsoring the exhibit, said the group felt Shaw’s work “spoke to the external experience” of having anorexia.

“Judith does a great job of capturing the tension between full recovery and partial recovery and all the ambivalence that goes into it… that people don’t necessarily talk about,” said Sullivan, a senior majoring in molecular and cellular biology. Eating disorders are a perceived solution to an underlying problem that isn’t solved by “just eating” or not purging, as many people suggest, she said.

Student artwork will also be shown alongside Shaw’s cardboard cutouts and displays.

Shaw said she sought out treatment after breaking two bones and being diagnosed with osteoporosis – a direct result of depriving herself of food and exercising compulsively for so many years.

She organized  her first exhibit herself, to thank the people who had helped her through treatment. She has been showing her artwork to students and doctors over the last six years, hoping to  give them a better understanding of the experience of living with an eating disorder.

“Everyone, if not touched personally with an eating disorder, they likely know someone who is,” she said.

Emily Fox-Kales, a clinical psychologist who teaches at both Harvard Medical School and Northeastern, said she’s often found art to be an important part of the recovery process. One man she treated drew expressionistic giants to represent his hunger.

“Because he was giving me this information about his inner sense of himself, it was very helpful to the recovery process,” remembered Fox-Kales, author of Body Shots: Hollywood and the Culture of Eating Disorders. Other patients “would sculpt these beautiful Degas-like bodies with large breasts and hips and begin to feel they could control their sensuality in a way.”

Shaw said her artwork has helped her reconnect with her body. “I feel like now for the first time, I’m really living as myself,” she said. “I feel like I was masked by the eating disorder for a good part of my life. I couldn’t really focus on anything else other than getting thinner.”

Normally I don’t notice my body. I’ve always been relatively thin and people tell me that I appear to be fit even when I know that I’m not. Growing up, I wore glasses, was physically awkward, and didn’t feel particularly attractive, so I studied diligently and lived more in my head than my body. Sure, I love fun clothes, but more for how they make me feel than how I look in them. On top of all this, I live in Cambridge, Mass. where you can pair a Chanel dress with Birkenstocks and no one would look twice.

But the other day after a shower, I caught myself in the mirror. Suddenly noticing the scars from all my surgeries, the colostomy bag on my abdomen and the power port embedded in my chest, it felt like I was looking at someone familiar but not me. I was jolted into accepting that this is really me, now.

The noises from the kids getting ready for school snapped me back to starting my day, so I got dressed and moved on.

Later, I reflected on how much my life has changed since I was diagnosed with colorectal cancer four years ago. Sure, there were the physical changes, including my shorter hairstyle. Nothing says “chemo patient” like a super-short hairstyle.

After each physical change occurred, it was upsetting, and then I would get used to it. I got used to the way my once-flat abdomen now pooches. I got used to dealing with the colostomy bag. I got used to the power port. I even love the super-short hair.

The diagnosis itself shook the ground beneath me, but I was lucky enough to find a new stable spot to stand. Then the ground shook a few more times: When I learned of a recurrence, and then another. When I learned it was stage four. When I learned that I would need to integrate chemotherapy every other week into my otherwise happily full calendar. Each time, I was unsettled for awhile, then eventually got used to the change and found a new normal.

It is the intangible changes that rock my daily life and the life of my family.

Most people would say that, on my good days, I look like any other person walking around. They can’t see the change in how my mind works, but it looks like this:

I watched my husband drive a new, sporty car into our driveway. He has been thinking about getting a sportier car since we met 20 years ago, so I was thrilled for him.

The boys and I made a big fuss about the car, then we continued with our evening.

Later, I asked my husband what made him decide to get a new car today. I didn’t mind that he didn’t consult me; it is just unlike him to do anything without careful thought over an extended period of time.

“We talked about this,” he reminded me, without defensiveness or blame. “I asked if you wanted to look at cars with me, and I told you that I was trying to decide between a practical car and something sporty. Do you remember?” He showed me a few brochures. “We talked about it with our neighbors at the party last month. You told me to go for something sporty, something that made me feel good.”

I remembered none of these conversations (blame it on chemo brain). But, like a doddering old lady, I knew they all very likely happened and I genuinely appreciated that my husband explained things so patiently and kindly.

Our children are impacted by my inept mind. For example, I cannot seem to keep track of which day is library day and which day they have movement. At ages 5 and 8, they are fully responsible for knowing when to return their library books and when they need to dress for sports. Honestly, I am not much help here: It’s not my picture of the totally on-top-of-everything mother I aspire to be, but it is our reality.

My energy level is unpredictable as well. One minute I am dancing; the next, I am sacked out on the sofa. One minute I tell the kids we are headed for the museum, and just before we leave the house, I abruptly cancel and tell them to play together in the backyard instead.

Like my body, this is not the life I envisioned. It falls short of the “me” that I hold in my mind.

Then, just as suddenly, I reframe it. So my kids have a crazy, unpredictable mother. They wouldn’t be the first, and they seem to take it in stride. My husband became a very involved father, and he would say a better parent than he even envisioned. I allow myself to be taken care of, in ways that I never imagined I would need, much less welcome. We lead less stressful, lower-key lives together, and we learned that we have quite a resilient relationship. I see blessings around every corner and find few things to complain about.

So my body has missing parts, added parts, and scars, but it still seems to work. My life has daily bumps and twists and turns, as well as joy and beauty. If I feel that my body, my life, or I, fall short in any way, it is because those things are not what I imagined they would be, and not necessarily because of what they actually are.

Marie Colantoni Pechet lives in Cambridge with her husband and two sons. Read her previous posts here and here and listen to her speak frankly about her life with cancer here.