While initiatives that support people fostering a healthy body image, like the body positivity and body neutrality movements, are more prominent than ever — and more and more celebrities are speaking out about it — kids are struggling.
This week, the University of Michigan C.S. Mott Children’s Hospital published its National Poll on Children’s Health (PDF) that highlighted the severity of body image issues among children and teens.
Researchers surveyed a nationally representative sample of 1,653 parents of at least one child between 8 and 18 years old. Nearly two-thirds of parents said their child is self-conscious about some aspect of their appearance, with skin concerns (like acne), weight, and hair being the top issues reported.
Self-consciousness about appearance was more common among teens (73 percent of teen girls and 69 percent of teen boys) than children ages 8 to 12; although 57 percent of the younger girls and 49 percent of the younger boys also reported self-consciousness about their appearance.
“We were not exceptionally surprised by the results of our poll, but we found it concerning that so many parents report that their children are self-conscious about some aspect of their appearance and that many young children (8 to 12 years of age) were also reported to have these concerns,” says Susan Woolford, MD, MPH, a pediatrician at C.S. Mott Children’s Hospital in Ann Arbor, Michigan, and co-director of the poll.
“It was also noteworthy that concerns about appearance were not limited to girls, but that a substantial proportion of boys were reported to have similar concerns,” Dr. Woolford says. And it serves as a reminder that body shape and size aren’t the only aspect of their appearance that young people worry about — the top concern for kids was the look of their skin, according to parents.
Woolford says that the issue is timely because of overall increases in anxiety and poor mental health among youth, which have created what experts have deemed a youth mental health crisis.
Much Other Data Points to Youth Mental Health Struggles
The Mott poll adds insight into how many youth are struggling with body image issues, but much other data from the past couple of years have indicated that kids are struggling with their mental health in many ways, and different ways than before.
U.S. 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 sense of self-worth — telling them they are not good looking enough, popular enough, smart enough, or rich enough.” (Per the report, its purpose is to bring attention to an urgent public health issue; Dr. Murthy called the current situation around 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 one in two female students) reported persistent feelings of sadness or hopelessness, up 40 percent since 2009, according to data in the advisory.
In 2021, that number was up to 44 percent 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 among young people in particular,” says Jenn DiLossi, PsyD, a psychologist and a clinical presenter for the youth mental health nonprofit Minding Your Mind, who is based in Philadelphia. This has raised their risk of mental health disorders like anxiety and depression, Dr. DiLossi says.
Today’s adolescents also spend lots of time on social media, which has implications for mental health, DiLossi says. A study published in October 2018 in the Journal of Affective Disorders found a small but significant positive association between social media use and depressive symptoms.
This also ties into body image, which is often worsened by social media. “It is social comparison on steroids,” DiLossi says. A study published in March 2021 in the journal Body Image surveyed adolescents between the ages of 11 and 17 and found that higher consumption of appearance-focused social media content (in which the posters portray “an idealized version of their appearance”) was associated with lower body satisfaction and well-being.
And this dissatisfaction isn’t just about body shape and size. Many users and influencers talk about cosmetic procedures like lip fillers and Botox, and use editing apps to alter the look of their skin, hair, teeth, and facial features, DiLossi says. This creates an even more unrealistic standard for what people “should” look like, DiLossi says.
Additionally, children and teenagers are exploring gender and sexual identities at this age (and research would suggest in different ways than generations past).
“The overlap with physical appearance and body shape and size is significant in relation to gender identification and sexual identity,” says Allison Chase, PhD, an Austin, Texas–based clinical psychologist and certified eating disorder specialist supervisor at the Eating Recovery Center. Young people who are exploring their gender or sexual identities might feel distressed about their appearance if it doesn’t match up with the societal ideal of what someone with their gender or sexual identity is supposed to look like, she says.
“Having a poor body image can lead to lower self-esteem and can negatively impact emotional well-being,” Woolford says. The Development and Psychopathology study from 2018 found a bidirectional relationship between body dissatisfaction and depressive symptoms, meaning that both seem to contribute to increased levels of the other. In order to combat the youth mental health crisis, body image is a major factor that needs to be addressed.
How Parents Can Help Kids Foster a Healthy Body Image
Here’s what experts recommend:
Set a Good Example
Dr. Chase says that parents can help their kids by expressing acceptance for bodies of all shapes and sizes. There are various ways to do this that encourage kids to see lots of body shapes and sizes as healthy and ideal, like not bashing your own body or anyone else’s, 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 Feedback
DiLossi also suggests keeping comments about your child’s appearance — both positive and negative — to a minimum. “Highlight other things about them that are positive and make them special,” she says. “And when you feel compelled to compliment appearance, keep it general, like ‘You look great today!’ or, ‘That outfit looks really nice on you!’”
Talk to Your Kids About Social Media
It can also help to talk to your kids often about social media, and how what people portray in their images and videos isn’t necessarily reality. “Sadly, 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,” Chase says. Setting limits around what they can look at on social media and how much time they spend on it could also be helpful.
Help Your Kids Learn Healthy Emotional Coping Skills
Teaching and modeling a healthy emotional response can also be helpful, for body image and mental health in general. “Teach children to tolerate and navigate feelings and how to deal with difficulties when they arise,” Chase says. If children aren’t able to cope with their emotions in a healthy way, they’re more likely to turn to unhealthy coping mechanisms, like obsessing about and trying to change their appearance.