self-care
CENTER FOR RESEARCH ON GIRLS
A SERIES OF RESEARCH AND INFORMATIONAL PUBLICATIONS BY LCRG
“Putting the world’s best research to work for girls.”
by Tori Cordiano, Ph.D, Kelly Bhatnagar, Ph.D., and Lisa Damour, Ph.D.
GIRLS AND WELL-BEING: BODY IMAGE In the mid-1980s, experts found body dissatisfaction among women to be so commonplace that it constituted a form of “normative discontent.”1 More recent research has documented that body dissatisfaction can begin in girls as young as 3-5 years of age and occurs at staggering rates among young girls and adolescent women.2 Surveys have found that 40% of third grade girls express a wish to be thinner and that by sixth grade, nearly 60% have tried to lose weight.3 By adolescence, as many as 80% of girls report that they are dissatisfied with their bodies, and nearly 20% of adolescent girls experience clinically significant body dissatisfaction.4,5 The presence and magnitude of body dissatisfaction is linked to higher rates of depressive symptoms and worrisome behaviors such as restricting one’s diet to lose weight.6 Eating disorders are the result of a complex interaction between genes and environment, and body dissatisfaction is a strong risk factor for the development of an eating disorder. They are diagnosed more often in women. The prevalence of eating disorders grew significantly between 2000-2018, and rates of eating disorders increased, particularly among adolescents, during the pandemic.7,8
self-care: GIRLS AND WELL-BEING: BODY IMAGE
...“Barbie”–designed for girls aged 3 to 7–would be 7’2’’ and weigh 125 pounds if her height, weight, and proportions were converted to human form. BODY DISSATISFACTION Sociocultural theorists maintain that body dissatisfaction among girls and women has risen in response to media images that equate thinness and physical beauty with success, intelligence, popularity, power, and self-control.9 Further, the implicit message of these images is that being higher than average weight (or even of average weight) is a reflection of laziness, weakness, stupidity or, at best, lack of self-control. Adult women may have a hard enough time resisting such media messages, but teenagers are naturally preoccupied with how they are viewed by others and often find such messages almost impossible to ignore. In addition, the increased consumption of digital media and the proliferation of social media in particular has been linked to higher levels of body scrutiny and dissatisfaction.10 Add to this scenario the natural tendency of the adolescent female body to begin to retain fat in late puberty and the stage is set for an epidemic of adolescent body dissatisfaction. Sadly, cultural messages celebrating unattainable standards of female beauty are not reserved just for adults or even adolescents. The popular doll “Barbie”—designed for girls aged 3 to 7—would be 7’2’’ and weigh 125 pounds if her height, weight, and proportions were converted to human form.11
Which came first? Media images or body dissatisfaction? Sociocultural theorists contend that women in Western, industrialized societies suffer from high rates of body dissatisfaction because they are constantly exposed to media images of ultra-thin models and actresses. But do we really know that such images are to blame? Remarkably, a group of researchers led by Dr. Anne Becker of Harvard Medical School was able to find a place where they could study this question.12 Prior to 1995, eating disorders were virtually non-existent on the island of Fiji, located in the South Pacific, and Fijians considered a hearty appetite and a robust figure to be signs of emotional well-being and physical health. In 1995, the island of Fiji began to receive Western television programs, and within three years, the number of teenage girls reporting eating disordered behaviors went from 12.7% to 29.2%. In 1995, not a single teenage girl included in the study had ever self-induced vomiting in an effort to control her weight; by 1998, 11.3% of the girls in the study reported having done so. In a culture where dieting had traditionally been frowned upon and discouraged, 69% of the girls surveyed in 1998 reported having dieted and 74% said they sometimes felt that they were overweight. Though this study is nearly thirty years old, it remains an important contribution to our understanding of how media messages influence body dissatisfaction. Today, smartphones, social media, and the ability to easily manipulate digital images have made it nearly impossible to escape thin-ideal media messaging. Research is ongoing as these technologies advance and become increasingly widespread, but current research indicates that these factors likely contribute to body dissatisfaction and may increase the risk of or exacerbate existing eating disorders.13
Weight Stigma and Mental Health Weight stigma, or discrimination based on weight or size, is prevalent among all age groups. Among children, weight-based bullying is more common than other forms of bullying and can be perpetrated by peers, siblings, and adults.14 During the pandemic, adolescents’ exposure to weight stigmatizing social media content increased, as did overall body dissatisfaction, particularly for girls.15 Weight stigma holds dangerous implications, including disordered eating, decreased physical activity, and health care avoidance.16 The psychological effects of weight stigma and sizeism may be especially pronounced for girls and women.17 Research underscores the importance of training and education to combat weight stigma for professionals working with children, including pediatricians and educators.18
SCHOOL-BASED INTERVENTIONS The results of numerous school-based interventions to reduce body dissatisfaction have been reported in the academic literature. Reviews find that the most successful programs help to improve girls’ attitudes toward their bodies and encourage healthy behaviors. Further, evidence indicates that the most effective programs are interactive (as opposed to didactic), involve more than one session, are taught to solely to girls, and are targeted to participants over the age of 15.19 Given the role of media images in perpetuating body dissatisfaction, educational programs that include media literacy interventions such as The Social Institute may be particularly important.20, 21
WHAT CAN PARENTS DO? Parents can help inoculate their daughters against negative and unhealthy body messaging. Through direct influence (e.g., talking about weight with or in front of their daughters, encouraging their daughters to lose weight) and indirect influence (e.g., modeling body dissatisfaction, antifat bias, and disordered eating), mothers in particular contribute to the development of girls’ body image.22 Mothers’ “fat talk” has been linked to daughters’ internalization of the thin ideal, body dissatisfaction, and disordered eating.23 Knowing the impact they can have on their daughters’ body image, mothers can take steps to reduce negative body talk and behaviors. Parents also play a role in protecting girls against negative body messages through digital media. Given that adolescent girls may be more susceptible to the negative psychological effects of excessive digital media use, ongoing conversations about what type of media girls consume, the inherent media messages about bodies and beauty, and clear guidelines for healthy media use can help lessen the negative effects of media on girls’ body image.24
GIRLS AND WELL-BEING: BODY IMAGE 1
Rodin, J., Silberstein, L., , & Striegel-Moore, R. (1984). Women and weight: A normative discontent. Nebraska Symposium on Motivation, 32, 267-307.
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Perez, M., Kroon Van Diest, A. M., Smith, H., & Sladek, M. R. (2018). Body dissatisfaction and its correlates in 5-to 7-year-old girls: A social learning experiment. Journal of Clinical Child & Adolescent Psychology, 47(5), 757-769.
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Maloney, M., McGuire, J., Daniels, S., & Specker, B. (1989). Dieting behavior and eating attitudes in children. Pediatrics, 84(3), 482-489. Kostanski, M., , & Gullone, E. (1998). Adolescent body image dissatisfaction: Relationships with self-esteem, anxiety, and depression controlling for body mass. Journal of Child Psychology and Psychiatry, 39(2), 255-262. McLean, S. A., Rodgers, R. F., Slater, A., Jarman, H. K., Gordon, C. S., & Paxton, S. J. (2022). Clinically significant body dissatisfaction: Prevalence and association with depressive symptoms in adolescent boys and girls. European child & adolescent psychiatry, 31(12), 1921-1932.
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McLean, S.A., et al. (2022).
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Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: a systematic literature review. The American journal of clinical nutrition, 109(5), 1402-1413.
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Gao, Y., Bagheri, N., & Furuya-Kanamori, L. (2022). Has the COVID-19 pandemic lockdown worsened eating disorders symptoms among patients with eating disorders? A systematic review. Journal of public health, 30(11), 2743-2752.
[endnotes] 12 Becker, A. E., Burwell, R. . A., Herzog, D. B., Hamburg, P., , & Gilman, S. E. (2002). Eating behaviours and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls. British Journal of Psychiatry, 180(6), 509-514. doi:10.1192/bjp.180.6.509 13 So, B., & Kwon, K. H. (2023). The Impact of Thin-Ideal Internalization, Appearance Comparison, Social Media Use on Body Image and Eating Disorders: A Literature Review. Journal of Evidence-Based Social Work, 20(1), 55-71. 14 Bucchianeri, M. M., Gower, A. L., McMorris, B. J., & Eisenberg, M. E. (2016). Youth experiences with multiple types of prejudice-based harassment. Journal of Adolescence, 51, 68-75. 15 Lessard, L. M., & Puhl, R. M. (2021). Adolescents’ exposure to and experiences of weight stigma during the COVID-19 pandemic. Journal of Pediatric Psychology, 46(8), 950-959. 16 Abrams, Z. (2022, March 1). The Burden of Weight Stigma: Weight Gain is on the Rise, but Shaming People Won't Reverse the Trend. APA Monitor on Psychology, 53(2), 52. 17 Magson, N. R., & Rapee, R. M. (2022). Sources of weight stigma and adolescent mental health: From whom is it the most harmful? Stigma and Health, 7(2), 152–160. 18 Tanas, R., et al. (2022). Addressing weight stigma and weight-based discrimination in children: preparing pediatricians to meet the challenge. The Journal of Pediatrics, 248, 135-136. 19 Stice, E., & Shaw, H. (2004). Eating disorder prevention programs: A meta-analytic review. Psychological Bulletin, 130(2), 206-227. doi:10.1037/0033-2909.130.2.206
Szmukler, G. I. & Patton, G. (1995). Sociocultural models of eating disorders. In G. Szmukler, C. Dare, & J. Treasure (Eds.), Handbook of Eating Disorders: Theory, Treatment and Research pp. 177 – 192. New York, NY: Wiley.
20 Kurz, M., Rosendahl, J., Rodeck, J., Muehleck, J., & Berger, U. (2022). School-based interventions improve body image and media literacy in youth: A systematic review and meta-analysis. Journal of Prevention, 43(1), 5-23.
So, B., & Kwon, K. H. (2023). The Impact of Thin-Ideal Internalization, Appearance Comparison, Social Media Use on Body Image and Eating Disorders: A Literature Review. Journal of Evidence-Based Social Work, 20(1), 55-71.
21 The Social Institute. (n.d.). Home. Retrieved February 13, 2024, from https://thesocialinstitute.com/
11 Brownell, K.D. & Napolitano, M.A. (1995). Distorting reality for children: Body size proportions of Barbie and Ken dolls. International Journal of Eating Disorders, 18, 295-298.
22 Brun, I., Russell-Mayhew, S., & Mudry, T. (2021). Last Word: Ending the intergenerational transmission of body dissatisfaction and disordered eating: a call to investigate the mother-daughter relationship. Eating Disorders, 29(6), 591-598.
23 Deek, M. R., Prichard, I., & Kemps, E. (2023). The mother-daughter-sister triad: The role of female family members in predicting body image and eating behaviour in young women. Body Image, 46, 336-346. 24 Twenge, J. M., & Martin, G. N. (2020). Gender differences in associations between digital media use and psychological well-being: Evidence from three large datasets. Journal of adolescence, 79, 91-102. 25 Barkla, C. (2021). All bodies are good bodies. (E. Salcedo, Illus.). Little Hare Books. 26 Anand, S. & Ellenson, N. (2022). I love my body because. (E.R. Medina, Illus.). Simon & Schuster. 27 Button, P. (2021). Beautifully Different. (E. Bibza, Illus.). Bridge Creek Press. 28 Sanders, J. (2020). Love your body: Your body can do amazing things. (C. Rossetti, Illus.). Frances Lincoln Children's Books. 29 Schaefer, V. (2024). The care and keeping of you 1: The body book for younger girls. American Girl Publishing. 30 Natterson, C. (2024). The care and keeping of you 2: The body book for older girls. American Girl Publishing. 31 https://thesocialinstitute.com 32 Dove. (n.d.). Dove Self-Esteem Project: Help for Parents. Retrieved February 7, 2024, from https://www.dove.com/us/en/dove-self-esteemproject/help-for-parents.html 33 Dove. (n.d.). School workshops on body image: Confident Me. Dove SelfEsteem Project. Retrieved Retrieved February 7, 2024, from https://www. dove.com/us/en/dove-self-esteem-project/school-workshops-on-bodyimage-confident-me.html 34 National Eating Disorders Association. (n.d.). Information for educators. Retrieved Retrieved February 7, 2024, from https://www. nationaleatingdisorders.org/information-for-educators/ 35 TrueSport. (n.d.). Body image. TrueSport: Teach & Learn. Retrieved Retrieved February 7, 2024, from https://truesport.org/teach-learn/ truesport-topics/body-image/
self-care: GIRLS AND WELL-BEING: BODY IMAGE
RESOURCES FOR PARENTS, EDUCATORS, AND GIRLS Books ALL BODIES ARE GOOD BODIES25 I LOVE MY BODY BECAUSE26 BEAUTIFULLY DIFFERENT27 From a young age, picture books such as these encourage body satisfaction and help younger children recognize that all bodies are good and different.
LOVE YOUR BODY28 THE CARE AND KEEPING OF YOU 1 AND 229, 30 Books aimed at school-age and early adolescent girls can help sustain body satisfaction and combat unhealthy media messaging related to body image.
Online Resource THE SOCIAL INSTITUTE31 With an abundance of resources for educators, students, and families, this online learning platform supports healthy and positive use of technology. https://thesocialinstitute.com
DOVE SELF-ESTEEM PROJECT32, 33 This organization’s mission is to teach girls to navigate media messages and increase their body confidence, with helpful resources for parents and mentors of adolescent girls. The organization also offers evidence-based resources and workshops for educators of girls ages 11-14. https://www.dove.com/us/en/dove-self-esteem-project/help-for-parents.html https://www.dove.com/us/en/dove-self-esteem-project/school-workshops-on-body-image-confident-me.html
NEDA RESOURCES FOR EDUCATORS34 The National Eating Disorders Association (NEDA) offers information for educators on body dissatisfaction, weight stigma, and eating disorders and prevention. https://www.nationaleatingdisorders.org/information-for-educators/
TRUE SPORT35 This platform for youth coaches includes resources for coaches to help female athletes develop a healthy relationship with their bodies. https://truesport.org/teach-learn/truesport-topics/body-image/
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