While initiatives that support people who promote healthy body image, like the body positivity and body neutrality movements, are more important than ever — and more celebrities are talking about them — kids are struggling.
This week, CS Mott Children’s Hospital at the University of Michigan released its National Child Health Survey (PDF) which highlighted the seriousness of body image issues in children and teens.
The researchers interviewed a nationally representative sample of 1,653 parents of at least one child aged 8 to 18. Almost two-thirds of parents said their child was bothered by some aspect of their appearance, with skin issues (such as acne), weight and hair being the top issues reported.
Self-awareness about appearance was more common in teenage boys (73% of teenage girls and 69% of teenage boys) than in 8- to 12-year-olds; although 57% of younger girls and 49% of younger boys also said they were bothered by their appearance.
“We weren’t exceptionally surprised by our survey results, but we found that so many parents report that their children are self-conscious about certain aspects of their appearance and that many young children (8 to 12 years) also reported having these concerns,” says Susan Woolford, MD, MPH, pediatrician at CS Mott Children’s Hospital in Ann Arbor, Michigan, and co-director of the survey.
“It should also be noted that concerns about appearance are not limited to girls, but a significant proportion of boys would have similar concerns,” says Dr Woolford. And it’s a reminder that body shape and size aren’t the only aspect of their appearance that youngsters are concerned about – the children’s main concern was the appearance of their skin, according to parents.
Woolford says the issue is timely because of the overall rise in anxiety and poor mental health among young people, which has created what experts have called a youth mental health crisis.
Plenty of other data point to youth mental health issues
The Mott Poll provides some insight into the number of young people struggling with body image issues, but plenty of other data from the past two years has indicated that children struggle with mental health in many ways, and in different ways than previously.
US Surgeon General Vivek Murthy, MD, wrote in a December 2021 advisory (PDF) on the state of youth mental health: “Young people are bombarded with messages through the media and popular culture that erode their self-esteem self – telling them that they are not beautiful enough, popular enough, smart enough or rich enough. (According to the report, its purpose is to draw attention to an urgent public health issue; Dr. Murthy has called the current state of youth mental health a “mental health pandemic.”)
This, among other things, contributed to the fact that in 2019 — before the pandemic – 1 in 3 high school students (and 1 in 2 female students) reported lingering feelings of sadness or despair, up 40% since 2009, according to data from the advisory.
In 2021, that number reached 44% of high school students, according to a report from the Centers for Disease Control and Prevention (CDC). The report also states that lesbian, gay and bisexual youth report higher than average levels of poor mental health.
“The pandemic and its aftermath has led to increased social isolation from peers, especially among young people,” says Jenn DiLossi, PsyD, psychologist and clinical presenter for the nonprofit Youth Mental Health Minding Your Mind, based in Philadelphia. This increased their risk of mental health disorders like anxiety and depression, says Dr. DiLossi.
Teens today also spend a lot of time on social media, which has implications for mental health, DiLossi says. A study published in October 2018 in the Affective Disorders Diary found a small but significant positive association between social media use and depressive symptoms.
It’s also linked to body image, which is often aggravated by social media. “It’s a social comparison on steroids,” DiLossi says. A study published in March 2021 in the journal body image surveyed adolescents aged 11 to 17 and found that higher consumption of appearance-oriented social media content (in which posters depict “an idealized version of their appearance”) was associated with satisfaction and lower body well-being.
And this dissatisfaction is not just about body shape and size. Many users and influencers talk about cosmetic procedures such as lip fillers and Botox, and use editing apps to change the look of their skin, hair, teeth and facial features, explains DiLossi. This creates an even more unrealistic standard for what people “should” look like, DiLossi says.
Additionally, children and adolescents are exploring gender and sexual identities at this age (and research would suggest in different ways than past generations).
“The overlap with physical appearance and body shape and size is important when it comes to gender identification and sexual identity,” says Allison Chase, PhD, an Austin, Texas-based clinical psychologist and specialist supervisor certified in eating disorders at the Eating Recovery Center. Young people exploring their gender or sexual identity may feel distressed about their appearance if it doesn’t fit the societal ideal of what someone with their gender or sexual identity is expected to look like, she says.
“Having a poor body image can lead to lower self-esteem and negatively impact emotional well-being,” says Woolford. The Development and psychopathology A 2018 study found a bidirectional relationship between body dissatisfaction and depressive symptoms, meaning both appear to contribute to increased levels of the other. In order to tackle the mental health crisis among young people, body image is a major factor that needs to be addressed.
How Parents Can Help Kids Foster a Healthy Body Image
Here’s what the experts recommend:
Set a good example
Dr. Chase says parents can help their children by accepting bodies of all shapes and sizes. There are different ways to do this that encourage children to view many body shapes and sizes as healthy and ideal, such as not denigrating your own or someone else’s body, normalizing skin conditions like acne and not encouraging your child to lose weight or diet.
Focus less on outward appearance, even when it comes to positive reviews
DiLossi also suggests keeping comments about your child’s appearance to a minimum, whether positive or negative. “Highlight other things about them that are positive and make them special,” she says. “And when you feel compelled to compliment your appearance, go general, like ‘You look great today!’ or, ‘This outfit looks really good on you!’”
Tell your kids about social media
It can also be helpful to talk to your kids often about social media and how what people portray in their pictures and videos isn’t necessarily the real thing. “Unfortunately, the message often conveyed on social media is that having an ‘ideal’ body equals success and happiness, which we know is not necessarily the truth,” says Chase. It can also be helpful to set limits on what they can watch on social media and how much time they spend on it.
Help your children learn healthy emotional coping skills
Teaching and modeling a healthy emotional response can also be helpful, for body image and overall mental health. “Teach children to tolerate and deal with feelings and deal with difficulties when they arise,” says Chase. If children are unable to manage their emotions in healthy ways, they are more likely to turn to unhealthy coping mechanisms, such as obsessing over their appearance and trying to change.