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Q
Do Clothes Make the Man - or Woman?

Do you consider fashion frivolous? I find that my choice of clothes is an indication of my moods. Can you tell me if any particular fashion or trend impacts health?

A
Answer (Published 12/24/2013)

Fashion certainly can be frivolous. Women are much more subject to the dictates of fashion than men and are often persuaded to wear and do things that aren't good for them – super-high heels come to mind. But there is also a positive aspect to fashion that can affect how you view yourself, particularly if you've lost a lot of weight and have to rethink how you present yourself in the working world.

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People often feel good when they know they look good, so fashion (or style) can play an important role in maintaining a positive self-image. And the opposite is true, too. If you don't feel good about yourself, you may not dress well or present yourself well, which can be a professional and social handicap. An interesting study published in 2012 in the Journal of Experimental Social Psychology showed how the clothes a person wears can influence psychological processes. Researchers from Northwestern University's Kellogg School of Management recruited 74 college students and asked them to wear either a doctor's coat or a painter's coat (which were the identical white coat, different in name only) or to simply look at a doctor's coat during a series of mental tests. Those wearing the doctor's coat boosted both their test scores and attention levels. They attributed these results to the symbolic meaning of the clothes, and the physical experience of wearing them, and reported that simply seeing or thinking about a physician's white coat won't improve cognition as much as actually wearing the coat will. The researchers called this phenomenon "enclothed cognition" and suggested that wearing a well-tailored suit or dress might make you feel more empowered and confident so that you perform better at work, or that wearing fitness gear might give you the motivation and energy to get a better workout.

Despite the psychological boost you may get by wearing the "right" clothes, fashion can present some health perils. For example, the American Osteopathic Association (AOA) warns that of the one in 10 women who wear high heels at least three days a week, one-third have fallen while wearing them. According to the AOA, habitually wearing high heels can lead to a long list of foot and leg problems including ingrown toenails, irreversible damage to leg tendons, nerve damage, overworked or injured leg muscles, osteoarthritis of the knee, plantar fasciitis and low back pain.

I've written before on this site about the dangers of wearing flip flops, a trend that shows no signs of abating. A study presented at the 2008 meeting of the American College of Sports Medicine (ACSM) found that wearing flip-flops repeatedly can lead to leg or foot pain, probably because they can alter an individual's stride and do not provide arch support. A comparison of flip-flops and sneakers in 39 men and women aged 19 to 25 to evaluate the angles and force with which the feet hit the ground showed a statistically significant decrease in force with flip flops and concluded that this difference may change normal gait in those who wear them, and may explain why some people who wear flip-flops experience lower leg pain.

Bottom line: Wearing clothes that look good and fit well is unquestionably an advantage in our society. And if wearing the right clothes boosts your mood or gives you the impetus to get more exercise – as research suggests it they can - I'm all for it. However, risking injury to pursue the latest trend is different, and likely to set the stage for problems down the road.

Andrew Weil, M.D.

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