Eating Disorders and Body Image in Teens: a Pediatrician’s Perspective
By Michelle DeRamus, Ph.D.
The first time I remember being aware of my own body image was when I was in second grade. I was on the bus, and a girl a few years older than me asked with a smirk, “Do you think you’re fat? ‘Cause I don’t… I think you’re skinny as a rail.” I didn’t think I was fat, but I could tell by her sarcasm that she did. And so began the lifelong battle that so many of us face – developing and maintaining a positive body image. So many things affect our body image, that is, the way we perceive their own bodies and how we think others perceive our bodies. It is influenced by our own personality, our life experiences with peers and family, and of course, what we are exposed to in the media. While most people have some difficulty with their body image at some point in their lives, girls and women tend to have a significantly greater struggle than boys and men, especially during the teenage years. The effects of a negative body image in teens can be devastating, leading to low self-esteem, unhealthy habits, depression, anxiety, and even eating disorders.
Tips to help
As we enter summer (and swimsuit season), here are some tips to help you promote a more realistic and positive body image in your child or teenager.
1. Help your children have a realistic understanding of media images.
As adults, most of us know that the models we see in the media have been airbrushed and “touched up” in a variety of ways. Several examples in recent years have given us the opportunity to see “before” and “after” pictures of models and actresses to help us understand that the final image we see is not reality. It is important for our teens to realize that the images they see in the media are not realistic. These images are also not attainable by approximately 95% of the population. Just because we see dozens of images of “beautiful people” each day does not mean that is the norm. However, if children and teens do not understand this concept, it can lead to expectations that most people look like those we see in the media, which creates unrealistic expectations for perfect bodies and creates poor body image in teens.
2. Help your children develop a positive self-esteem.
Everyone has strengths and weaknesses. It is important for children and teens to recognize their strengths across different aspects of life, whether it is sports, academics, personality and character traits, hobbies, other extracurricular activities, or social skills. Help your child identify and then strengthen their positive qualities. Guide them in understanding how these positive qualities can help them reach their goals and that success is not dependent on physical appearance.
3. Help your children develop good social skills.
Much of our desire to look a certain way is driven by an underlying desire to fit in. Society, peers, and sometimes even family tell us that we will be more successful or better liked if we are a certain size or shape. However, the reality is that there are other ways to make friends and feel like you belong to a group. Children who know how to get along with others and have a positive peer group that supports and encourages them may be better able to keep their body image concerns in perspective.
4. Help your children learn how to focus on being healthy
…rather than focusing on looking a certain way, weighing a certain amount, or eating a certain number of calories. A focus on overall health can help children learn moderation in all things, both the excesses (e.g., desserts, sedentary activities) and the restrictions (e.g., limiting food intake). A focus on health also takes the emphasis off the image in the mirror and back onto how your child feels. Point out that your body is an amazing tool that can help you reach your goals, rather than something to be scrutinized and criticized.
5. Help your children learn positive stress management techniques.
Many unhealthy habits develop in response to stress. Teaching children and teens to manage stress appropriately with fun activities, social support, problem solving, exercise, and relaxation can prevent unhealthy habits from developing.
6. Be an example.
Children, and even teens, learn the most about how to “be” from their immediate family members. Even at a very young age, children notice when adults are critical of their own bodies in front of their children. If children see other family members modeling poor body image, they will grow to think that is the norm. One of the best ways to teach the above strategies to your children is to follow them yourself.
While almost everyone struggles with body image at some time, most people are able to ultimately keep appearance in perspective as only one part of who they are as a person and do not develop serious consequences as a result of their perception of ideal body image. However, for some individuals, body image becomes so distorted or such a priority, that significant problems develop, such as depression, anxiety, or eating disorders. Some warning signs of body image issues in teens that preclude a more serious condition include:
- Changes in eating patterns (e.g., decreased intake, binging, vomiting after meals)
- Preoccupation with weight, food, calories, exercise, etc.
- Dramatic changes in weight
- Frequent comments or anxiety about being “fat” or overweight
- Development of rigid food or exercise rituals
- Withdrawal from friends, family, or previously enjoyed activities
If you are concerned your child may be experiencing emotional problems or an eating disorder as a result of poor body image, it is important to get help right away. Early treatment leads to better outcomes. Talk to your child’s doctor about resources in your area.
Dr. DeRamus is a child psychologist with Preferred Medical Group’s Phenix City Children’s clinic. She specializes in Autism Spectrum Disorder (ASD) and provides diagnostic testing and therapy services for developmental delays, learning problems and ADHD. She also works with kids with anger, anxiety, depression, family problems and peer relationships.