ABSTRACT
Illnesses that change the appearance can have a demoralizing impact on self-image and self-esteem. Whether it is weight loss or weight gain, loss of muscle strength and stamina, hair loss, or changes in complexion such as rashes or acne, the physical impact of illness can make you feel as if you are losing the person you used to be. Surgical procedures such as mastectomy, colostomies, and amputations are an abrupt assault on the body, and change physical identity. Serious illness can distance physicians from personal and physical relationships. People may be less likely to make physical contact because of their fear that they will cause pain, because they find the person less attractive, or because they are unsure if it is appropriate. Those who are ill sometimes withdraw, both physically and psychologically. They may be embarrassed by their appearance or too fatigued, anxious, or depressed to participate in social and sexual relationships.
