A distorted body image is one of the symptoms that define anorexia and related eating disorders. Patients may be painfully thin but still see themselves as fat while they continue to cut calories, over-exercise, purge, or use enemas in an effort to lose more and more weight.

Those of us who enjoy normal weight often also suffer from a warped view of our physical selves. Like the old carnival house of mirrors, we fail to see the true reflection of our bodies because of an inner eye that focuses on the elements we hate: sagging arms, knobby knees, saddlebag thighs, a roll of belly fat. That personal distaste for certain body parts is what drives slender, attractive, healthy individuals, despite the adverse reactions of family and friends who see no need for change, into cosmetic surgery.

Those of us who are overweight also display selective vision. We tend to avoid full-length mirrors, preferring to focus on just our upper body and face. When we do catch a full glimpse, we suck in our stomachs and look at ourselves sideways, trying to convince ourselves that we don't look as overweight as the scales so nastily suggest. We believe that our clothes shrank in the wash or that the size tags are in error. In our mind's eye we see ourselves as we yearn to be and linger long on the fantasy of how great we will look when we can get into our favorite outfit.

So no matter our weight, our body image frequently fails to reflect what is in the mirror but represents what is held in our mind's eye. The closer we can approach to the differing views being compatible, the more comfortable we will be in ourselves and the more valuable any changes we seek to make.

You may have gained, and lost, an appreciable amount of weight several times on your life, as many of us have. There were undoubtedly times, on your way up and down the weight ladder, when your appearance and your self-image diverged. This can be a critically dangerous time. If you are on a diet and losing, but still see yourself as fat, you become anxious: "This diet isn't working," and the chances of your just giving up become significant. If you are gaining and still see yourself as thin, you ignore the need to take immediate action until one day you can't button any of your clothes. You look at the scale in confused surprise: how did this happen without my noticing it ten or fifteen pounds ago?

To permanently control our weight requires a constant awareness of our body in all of its full reality. It doesn't matter if we want to be model-thin, enjoy a middle ground, or even have no emotional distress at remaining pleasantly plump, we need to be aware of our external presentation in order to accurately internalize all aspects of our appearance.

An accurate self-appraisal of your image-in-the-world makes so many decisions easier: should I eat dessert? Should I drive over to the gym? Should I take a walk or start that new thriller I've been dying to read? Because you're aware of what needs to be done, and what is allowed, you shake the burden of guilt off your shoulders and can truly enjoy the activities you choose to pursue. Your mental and physical efforts are synchronized which avoids self-destructive vacillation -- "Should I or shouldn't I?" - and the later self-disgust when you feel you made the wrong choice.

How do we train ourselves to coordinate our self-perception with our self-presentation? It is undoubtedly a difficult task to accomplish. How many times have you been astonished to learn that others see your words and actions in a totally different light than you meant to convey? We judge others, and they judge us, by external criteria. I am only completely and intimately knowledgeable about one person in the world, me, because I am privy only to the internal criteria of myself.

We are now going to try to turn ourselves inside out in order to look at ourselves with both an internal and external view.

Here are some personal characteristics and attributes:

LIST

Next to each personal quality, write down one to three adjectives you feel best describe you on that facet of yourself.

Now give the list to several friends, your spouse, relatives, coworkers. Tell them you're involved in a project or survey and make sure they can submit it anonymously. Having it completed by someone you think doesn't like you can be the most revealing of all!

How closely do all of the lists overlap?

Typically, there will be substantial repetition in a number of areas. There will likely be divergence between people who know you very well and those who only see a certain side of you, at work, at school, in business.

Now combine the lists, deleting the repetitions, so that you have anywhere from a few words to dozens of words to describe your public persona. Since we are primarily interested here in weight management, concentrate on the descriptors that relate to your physical attributes. Do others see you as you see yourself or are there a few shockers showing up?

Focus on those and try to ferret out the source of the contradictions. Are you misleading yourself about the way you look or are you unconsciously facing the world in a manner designed to create a certain image? Do you focus on your "good points" - a small waist you cinch tight with a belt - and forget about other areas - your hips look enormous in comparison? Do you fake something imperfectly such as a hairpiece, a show lift, padded underwear? Have you convinced yourself that long, flowing clothes, or oversized suits, make you look slim? Do you always study your face in the glow of bathroom warming lights to convince yourself that the wrinkles don't really show?

What can be very gratifying and self-affirming about this exercise is that much of what is written about you is far more tolerant and non-judgmental than how you describe yourself. You are your own biggest critic because you know yourself so well - that old internal criteria stuff. You want to be good, you want to be perfect, but you are acutely aware of your weaknesses and dark secrets.

This is where balance can be so nurturing: knowing how others see you can help you make any changes you want to pursue. You can start to emphasize certain aspects of yourself while discarding the tricks that everyone saw through. If you want to modify your appearance, lose weight, build strength, it will be valuable only if it is built on the reality of where the internal and external converge. You are considerably more likely to attain your goals if they arise out of where you are and lead naturally to where you want to be.

One more side effect of this little exercise: you find out that no one in the whole world is as interested, or as focused, on you as you are! Even close friends and family may have difficulty in finding descriptors for you: "I just never really thought about it." Of course they didn't because they were too busy concentrating on themselves. Once you really grasp this concept, it can be incredibly freeing. You can start to lose that self-consciousness that tells you others are studying and judging you. That standing-out-from-the-crowd vulnerability can start to fade. That "I can't go looking like this" panic can start to wane.

And as you start to realize that your weight and appearance are the primary focus of only yourself, you can start to understand that whatever your physical shape reflects, it is your appreciation which is vital, not other people's. Manage your weight, and manage your life, for yourself - not for those others "out there" who don't even notice.