A Positive Body Image

Teens often have negative body images—how can parents help?

By Sara Ackerman

Ateenager’s body image can affect everything from selfesteem to choices about clothing, diet, and exercise. It can also lead to afflictions—from anorexia to body dysmorphia. During this last year of pandemic living, body image issues have exploded, and from 2020-2021, there was a 41-percent increase in people seeking help for eating disorders. Plus, COVID led to more time on social media, which only adds to the problem. What can parents do to ensure teens develop a healthy body image and how should they respond when issues arise?

How Parents Can HelP

The first step for parents is to model a happy body image, says Connie Sobczak, author of Embody: Learning to Love Your Unique Body (and Quiet that Critical Voice!) and founder of The Body Positive, a California-based nonprofit devoted to helping individuals work toward body positivity. They should avoid obvious dieting or making negative comments about their own physical appearance—such as body size or aging. Making comments about their child’s physical appearance, whether positive or negative, may also have detrimental effects. Another way parents can help is by demonstrating a healthy relationship with food. Parents “should avoid language that moralizes food, such as eating ‘clean,’ or labeling food as bad or unhealthy,” says Rosie Barton, LCSW, a therapist at Cobb Psychotherapy in Brooklyn Heights. “In the same vein, parents should aim to speak about body size in a neutral way and promote the idea that health is not dependent on a certain body.” Claire Mysko, an internationally recognized leader in eating disorders advocacy and education, explains that having conversations with your child from a young age about health and nutrition is a protective factor against a range of mental health issues, including eating disorders. Mysko recommends these conversations include emotional and mental health, as well as physical. Rather than talking about the importance of exercise, she recommends talking to kids about what physical activities they find fun. When parents talk too much about what foods are healthy, she adds, “we lose sight of the fact that meals are more than nutrition.” Mysko says reframing meals as a time for community and enjoyment can help prevent eating disorders. Social media frequently exposes teenagers to unrealistic images of health and beauty, despite influencers who promote fitness or “wellness.” Mysko says parents should be aware of the platforms their children are using and the accounts they follow. Talk to your child about how the images they are seeing are quite likely altered and not an accurate portrayal of realistic bodies. Limiting and monitoring teen’s screen time allows them to spend more time engaging with real-world, varied, and realistic bodies, rather than the curated and filtered images on social media.

eating DisorDers anD BoDy DysmorPHia

About half of all teenage girls and a third of all teenage boys have engaged in unhealthy weight control practices including skipping meals and the use of laxatives, steroids, and supplements, according to Mysko. And because there is so much shame around eating disorders, there is a good chance the numbers are even higher, especially for boys who may be even less likely to seek help for something typically labeled as a “girls’ issue.” In addition to disordered eating, teens with a negative body image may experience anxiety, low self-esteem, or mood disorders such as depression. Negative body image may also contribute to body dysmorphia—a mental health disorder in which someone can develop a distorted perception of their appearance and fixate on “flaws,” real or imagined, to the point where it affects functioning in their lives. Body dysmorphic disorder affects about 1.7-2.4 percent of the general population, according to Melissa Horowitz, Psy.D., director of Eating Disorders and Weight Management Program at

director of Eating Disorders and Weight Management Program at the American Institute of Cognitive Therapy in Manhattan. Researchers have found that symptoms can develop in early adolescence, although the average age of onset occurs in middle adolescence. The cause of body dysmorphic disorder is not entirely clear, but factors include genes, personality traits, temperament, and the environment.

When to Seek help

In general, there are several red flags parents should be aware of when it comes to body image and disorders. Teens who are struggling with body image may cover up certain body parts and make increasing negative comments about specific body parts, including talking about surgery to change their bodies. They may have decreased interest in school, hanging out with friends, and other activities. They may spend significant time scrutinizing themselves in the mirror or refuse to look in the mirror. They may avoid looking at pictures of themselves or being photographed. Increased irritability or other changes in mood are other signs parents should be aware of. Parents should also take note if their teenager abruptly cuts out certain foods from their diet they were previously eating, such as dairy, meat, or carbs, or begins paying significant attention to calories or grams of fat. Mysko notes that eating disorders are often preceded by dieting. If parents have concerns, a crucial first step is to seek out a mental health professional who has expertise in supporting teens with developing a positive body image and a healthy relationship with food and exercise. “Sometimes it might be difficult for a teen to open up to a parent, but they might trust an external source more,” Barton says. Parents can also turn to their doctor or a pediatrician or reach out to a nonprofit group that can provide resources. Dr. Horowitz, however, cautions against over-pathologizing comments teenagers make about their bodies. For example, if your teen says, “I hate my stomach,” don’t jump to conclusions. This is first and foremost an opportunity for the parent to start a conversation with their teen.

Where to Find Help

In addition to discussing concerns with a child’s doctor or pediatrician, who can provide recommendations for psychiatrists or local treatment centers, parents can also turn to the following resources:

the national eating DiSorDerS aSSociation

nationaleatingdisorders.org

NEDA offers a screening tool, helpline, and a database of treatment centers around the country.

the BoDy poSitive

thebodypositive.org

This is a nonprofit devoted to helping individuals work toward body positivity. The website includes a number of online resources.

health at every Size

haescommunity.com

This site has a list of resources, including blogs, podcasts, and online groups.

nyc Well

nycwell.cityofnewyork.us

The 24-hour hotline (888-NYC-WELL) is staffed by mental health professionals. Plus, it has additional resources listed on the website.

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