Sex File: I've lost the dad bod but I still don't feel sexy

It's a really interesting question because it is about something that is rarely addressed: negative body image in the middle-aged male. Picture: iStock

I have always had a bit of a dad bod but after losing 2st quite quickly on Mounjaro, I still don't like the way I look without clothes on - older and saggier. My wife says she finds me attractive but I don't feel it. What can I do to get over this and regain some confidence? 

In one way this is a really boring question because I'm pretty sure you know that the answer is exercise. GLP-1 jabs such as Mounjaro may help you to lose weight but you need to compensate for the simultaneous loss of muscle with strength training. Weight training, whether you are lifting weights or doing Pilates, will help you to tone up and stop feeling so saggy, while getting stronger will make you feel more confident. Problem solved.

In another sense, though, it's a really interesting question because it is about something that is rarely addressed: negative body image in the middle-aged male. There are few studies on body image dissatisfaction in older men, largely because most of the measures have been designed for research into women who have eating disorders. The research that we do have, however, suggests it is an issue that merits attention. In a 2023 study of 2,256 Canadian men at the University of Toronto, the prevalence of muscle dysmorphia was 26%. In a 2019 Mental Health Foundation survey of 2,103 men in Britain, 28% felt anxious because of body image issues and 11% had experienced suicidal thoughts because they didn't like the way they looked.

Getting older is challenging for everyone. Women in particular talk about how ageing makes them feel invisible but it may present an even bigger psychological challenge for men. 

The ideal male body is lean and muscular and linked to attributes such as strength, power and control. In contrast, the ageing male body has reduced physical strength and sexual virility - changes that challenge notions of masculinity. 

For you, losing weight was a way of exerting control over the ageing process, but you have done only half the work because you haven't learnt to like who you are rather than what you look like.

You were unhappy with yourself when you were overweight. You have lost weight yet still find ways to criticise yourself. Your skin is too saggy. You look older. You don't feel attractive. All that may or may not be true but the fact that it matters so much to you suggests the issue is not your body but your mind. Your wife loved you when you were heavier and now you've lost weight she still loves you. Despite her consistent support, your self-image and self-esteem are hugely negative.

Your wife is probably the best person to help you but I suspect that, like many men, you find it difficult to talk about how you feel. If you are not sure how to articulate what is bothering you, try downloading the free version of the Tellmi app from the App Store or Play Store (full disclosure, I'm a co-founder). Tellmi is a pre-moderated (by humans) peer support app, so once you register you can click on the topic tags - "body" or "body dysmorphic disorder" - and talk anonymously to other adults dealing with the same issues.

 Often realising that you are not the only one struggling is enough to help shift your perspective and begin to feel more positive. 

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