Who said you can't have great sex if you're fat?

On the day you were born, how did you feel about the chub of fat on the back of your thighs?

How did the adults around you feel about it?

Every baby needs her caregivers to hold her in their arms with affection and joy, and most of the time in the Western world, those caregivers are bursting with eagerness to meet that need. On the day we're born, most of us are celebrated and called beautiful.

But something happens between that joyful day when every inch, every ounce, every roll, and every bump of a girl's body is celebrated as perfect and lovable precisely as it is . . . and the day she hits puberty.

What happens is she absorbs messages about what is or is not lovable about her body. The seeds of body self-criticism are planted and nurtured, and body self-confidence and self-compassion are neglected, punished, and weeded out.

Students laugh like I made a joke when I ask, "What would happen if you met your friends at dinner and said, 'I feel so beautiful today!'?

"Really, what would happen?" I insist.

"No one would do that," they tell me.

"But . . . how often would someone meet friends at dinner and say, 'I feel so fat today'?

"All the time," they say.

All the time.

Show me the love

Women have cultural permission to criticise ourselves, but we are punished if we praise ourselves, if we dare to say that we like ourselves the way we are.

And it's messing with our orgasms, our pleasure, our desire, and our sexual satisfaction. There is a direct trade-off between sexual wellbeing and self-critical thoughts about your body. A 2012 review of fifty-seven studies, spanning two decades of research, found important links between body image and just about every domain of sexual behaviour you can imagine: arousal, desire, orgasm, frequency of sex, number of partners, sexual self-assertiveness, sexual self-esteem, using alcohol or other drugs during sex, engaging in unprotected sex, and more. The results vary somewhat among different age groups, among women of different sexual identities, and across different racial groups, but the overall result is universal:Women who feel worse about their bodies have less satisfying, riskier sex, with less pleasure, more unwanted consequences, and more pain.

I don't think anyone will be surprised to hear that feeling good about your body improves your sex life. It's obvious once you think about it, right? Just think about having sex if you feel insecure and unattractive.How would it feel to have a person you care about touching you and looking at you, when the thought of your own body makes you uncomfortable? Would you pay attention to the sensations in your body and your partner's - or would you pay attention to all the things you feel compelled to hide?

And does that activate the sexual accelerator, or does it hit the brake?

Now imagine having sex when you feel tremendously confident and beautiful. Imagine a person you care about touching your skin with their hands and their gaze, when you love every inch of yourself and can feel your partner appreciating how gorgeous you are.

The eagerness mechanism is fully on board in both cases - but in the first case the mechanism is torn between moving toward the sexual experience and moving away from your own body. In the second, when you enjoy living inside your own skin, the mechanism moves toward sex and toward yourself, without conflict.

So of course body self-criticism interferes with sexual wellbeing. We can't understand women's sexual satisfaction without thinking about body satisfaction, just as we can't understand women's sexual pleasure without thinking about attachment and stress. And women will not be fully, blissfully satisfied with their sex lives until they are fully, blissfully satisfied with their own bodies.

So, to have more and better sex, love your body.

Which is one of those things where you're like, "Yeah! . . . But . . . how?"It's hard, because you never chose not to love your body. You didn't choose much that happened to you between the day you were born and the day you hit puberty, and that's when most of the body self-criticism was taking root. You never even got a chance to say yes or no to the self-criticism being planted in your garden.

What it comes down to is that a lot of women trust their bodies less than they trust what they've been taught, culturally, about their bodies.

But culture has taught you stuff that is both incorrect and just wrong. Hurtful. I want to address two things you've been taught that are definitely wrong, and what's right: first, that self-criticism is good for you and second that fat is bad for you. These things are both false.

Here's why:

criticising yourself = stress = reduced sexual pleasure

Women have been trained to beat ourselves up when we fall short.We criticize ourselves - "I'm so stupid/fat/crazy," "I suck," "I'm a loser" - as a reflex when things don't go the way we want them to. And our brains process self-criticism with brain areas linked to behavioural inhibition - brakes. So, it's not surprising that self-criticism is directly related to depression - and does depression improve your sexual wellbeing? It does not.

Women tend to have a two-layered response to this idea. First, they instinctively love the idea of being more accepting of themselves and not blaming themselves when life isn't perfect. The research tells women what they already know intuitively: Self-criticism is associated with worse health outcomes, both mental and physical, and more loneliness.

That's right: Self-criticism is one of the best predictors of loneliness - so it's not just "I am at risk," it's also: "I am lost."

But then, when women start to think concretely about it, they begin to discover a sense that they need their self-criticism in order to stay motivated.We believe it does us good to torture ourselves, at least a little bit.

As in: "If I stop beating myself up for the ways I'm not perfect, that's like admitting to the world -and to myself - that I'll never be perfect, that I'm permanently inadequate! I need my self-criticism in order to maintain hope and to motivate myself to get better."

When we tell ourselves, "I can't stop criticising myself or else I will fail forever!" that's like saying, "I can't stop running/fighting/playing dead, or the lion will eat me!" That's absolutely what our culture has taught us, so it makes sense that many of us believe it. It's so entrenched in our culture that it sounds . . . sane.

Rational, even.

But it's not.Think about it: What would really happen if you stopped running from yourself or beating yourself up? What would happen if you put down the whip you've been flogging yourself with for decades? When you stop beating yourself up - when you stop reinjuring yourself - what happens is . . . you start to heal.

Self-criticism is an invasive weed in the garden, but too many of us have been taught to treat it like a treasured flower, even as it strangles the native plants of our sexuality. Far from motivating us to get better, self-criticism makes us sicker.

Yep. That.

Health at every size

One evening during the conference whereI learned about "Health at Every Size" (HAES), I actually went on a date with a cardiologist. I told him about the conference and asked him about this specific statistic that a speaker mentioned.

I said, "Dr Date, is it true that it can be healthier to be seventy-five pounds over your medically defined 'ideal weight' than to be five pounds under it?"

And Dr Date said, "I don't know if I'd use those precise numbers, but that's the right idea. For different reasons, being just slightly underweight carries greater risk than being obese."

The date wasn't very successful, and two years later I married a cartoonist and his two cats, but Dr Date and I had a nice dinner and he verified that weight is not what matters, healthy behaviours are what matter.

Which brings me to Health at Every Size.

HAES is, as the name implies, an approach to living inside your body based on health rather than weight. Linda Bacon literally wrote the book on HAES- Health at Every Size: The Surprising Truth about Your Weight - based on her decades of research on nutrition, exercise, and health.

There are four major tenets, according to "The HAES Manifesto": (1) accept your size, (2) trust yourself, (3) adopt healthy lifestyle habits including joyful physical activity and nutritious foods, and (4) embrace size diversity.

It's almost too simple: Welcome your body just as it is, listen to your own internal needs, and make healthful choices around food and physical activity. You might lose weight (you probably won't), but you'll definitely be healthier and happier.

Can it be true? Happy and healthy without losing weight?

It can.

Do you want it to be true? That's another story.

(Reprinted with publisher's permission.)