Yeah, it's got nothing to do with having these unrealistic standards and the constant bombardment that you are not skinny/pretty/etc enough and instead everything to do with women wanting more attention and compliments.
As someone who's dealt/dealing with image problems, it's not about attention wanting. It's about validation through other people. And yeah, replying "you're not fat" might not do anything, but it's still confirmation that you're not getting a flat-out "yes, you are fat." It's complicated.