The way that your child views their body is essential in building self-esteem and can have a lasting impact on other areas of their lives including school performance and forming healthy relationships. Children who begin to obsess over their appearance or lack body positivity may be subject to experiencing body dysmorphia.

According to Jennifer Northridge, M.D., FAAP, section chief of Adolescent Medicine at Joseph M. Sanzari Children’s Hospital, “During the pandemic, there has been a mental health crisis including an increase in body dysmorphia that particularly affected teenagers and young adults. Early recognition of body dysmorphia is an essential first step to linking adolescents and their families with the support they need.”

“Body dysmorphia can be associated with an eating disorder that manifests as shape, weight and eating preoccupation. Signs of an eating disorder can include skipping meals, eating alone, elimination of a food group previously enjoyed or compulsive exercise. It is important to recognize and treat an eating disorder because it can be life threatening,” she warns.

What is body dysmorphia?

Body Dysmorphic Disorder (BDD), or body dysmorphia, is a mental health condition where a person spends much of their time worrying about their appearance. People who have body dysmorphia see flaws in their body that are often unnoticeable to others. Body dysmorphia can affect anyone regardless of their age or sex, but is most common in teenagers and young adults. 

Symptoms of body dysmorphia typically begin during adolescence include: 

• Thinking about appearance majority of the day
• Constantly comparing your looks and body to others
• Avoiding social situations
• Having perfectionist tendencies
• Attempting to hide perceived flaws through makeup, clothes or accessories
• Looking at mirrors very frequently or trying to avoid them altogether
• Believing others take special notice of your appearance and will make fun of it
  
  

Body dysmorphia can affect your child’s daily life as it causes many people to feel embarrassed, ashamed or anxious about their looks. The most common areas of your child’s life that may be affected by body dysmorphia are: 

• School
  • Time consuming thoughts about their body can affect ability to concentrate and take longer to complete assignments
  • Feelings of anxiety or embarrassment about their appearance can make it difficult to talk to other students, and some children may want to avoid school altogether
    
    
• Social Media
  • Body-shaming and fat-shaming online can lead to low self-esteem due to the negative effect these have on body image
  • The need to compare one’s body to others can be even more intense when using social media especially as there are some sites that promote disordered eating

How can body dysmorphia be treated?

If you believe your child may be suffering from body dysmorphia or an eating disorder, talk to your health care provider about taking steps to relieve the negative effects on their mental health. Your doctor may recommend trying: 

• Cognitive Behavioral Therapy for body dysmorphia or an eating disorder can help teach your child to: 
  • Understand how to control their negative thoughts, emotional reactions and behaviors
  • Improve mental health by combating social avoidance and increasing engagement in social activities
  • Challenge negative body image thoughts that may arise

How can eating disorders be treated?

• Therapy including Cognitive Behavioral Therapy in addition to Family Based Therapy or Dialectical Behavioral Therapy can be effective for helping adolescents with an eating disorder:
  • Family Based Therapy may be the best treatment for adolescents who are significantly malnourished and focuses on weight rehabilitation
  • Dialectical Behavioral Therapy may be recommended especially if there are signs or symptoms of depression or self injury
    
    
• Medications have been approved to treat certain types of eating disorders such as:
  • Selective serotonin reuptake inhibitors (SSRIs), specifically fluoxetine, is approved for Bulimia Nervosa. Additionally adolescents with other types of eating disorders or body dysmorphia may benefit from SSRIs to treat comorbid mood disorders 
  • Venlafaxine is approved for adolescents 18 and older for binge eating disorder

Body positivity can be an effective way to combat your child’s negative thoughts about their body in practicing healthy ways to think about themselves. Body positivity is a mindset that involves loving your body regardless of shape, size, color or ability. Helping your child learn how to think positively about their body can make the difference in their mental health and confidence.

How can I teach my child to have body positivity?

There are five key ways that you can help your child to learn to have body positivity: 

1. Be a role model
   • Avoid associating certain foods with shame, such as saying “Ugh, I shouldn’t have eaten that cookie!”
   • Your child notices how you perceive and talk about yourself, make sure you are practicing body positivity too
2. Develop a healthy relationship with food
   • Don’t create “good” or “bad” labels for food and instead recommend a variety of foods
   • Promote nutritious foods by teaching your child how they can help to make them strong and grow 
3. Make physical activities about having fun rather than weight loss
   • Sports and other physical activities can lose their fun for your child when associated with the pressure of weight loss
   • Encourage your child to participate in sports/activities that they enjoy and emphasize movement as part of a lifelong healthy lifestyle
4. Celebrate all of your child’s qualities, not just the physical ones
   • Help your child learn to associate their bodies with more than just looks
   • Make sure to compliment their other qualities that you love such as their sense of humor or how thoughtful they are
5. Encourage wearing clothes that fit and they feel comfortable in
   • Do not keep clothes that your child has outgrown in their closet as this could make them feel anxious about fitting into them again
   • Remind your child that it is okay to size up or size down and that clothes are about expressing yourself and being comfortable
     
     

Some more fun ways to incorporate body positivity in your home are: 

• Put positive affirmations on your mirrors
  • “Love yourself” “You look amazing!” “I am enough”
• Create a support system in the house
  • If any friends or family practice body-shaming rather than body positivity, teach them how to be more positive when talking about themselves and others
• Remove your scales
• Give compliments and accept them when they are given to you
  
  

Next Steps & Resources:

• Meet our source: Jennifer Northridge, M.D.
• Learn more about children’s mental health services offered at Hackensack Meridian Health.
• To make an appointment with Dr. Northridge or a physician near you, call 800-822-8905 or visit our website.
  
  

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.