SM: How do you think these body image worries impact our sex lives?
Sue Johanson: The first time you have sex with any new partner, it’s usually the missionary position because that’s the one that allows you to be the most covered up. With you on top, all he can see is your head and maybe your shoulders. So the rest of you, your cellulite and your stretch marks, aren’t going to show. I’ve worked with a couple who’d been in a relationship for months and the woman would not have sex with her t-shirt off. I just couldn’t understand why someone would want to have sex with her shirt on.

SM: Did she ever get over it?
Sue Johanson: No, not while I knew her.

SM: Is there a particular body part or body image issue that you hear about a lot?
Sue Johanson: It can be anything from facial hair, down to a turkey neck that’s starting to appear. Breasts too big, breasts too small, armpit hair and armpit odor. And fat anywhere on the body. Under their arms—the bulge under the bra line is really disconcerting for many females. The other thing, of course, is the tummy.