Emily had always been a popular girl. At primary school, she had plenty of friends to hang out with and she was invited to most of the parties of her year group. Emily was cheerful, seemed confident and did well in most of her classes; she was respected by her teachers and loved joining in music and drama productions.

However, Emily became deeply unhappy with herself during year 8 at secondary school. She was average height and her weight was within normal range, but over the past year had put on some weight, as part of the typical body changes in adolescence for girls. She was a little plump, but increasingly thought of herself as fat. When Emily looked in the mirror, she saw someone too short and with huge hips and thighs. They looked disgusting to her.

Like many of her friends, Emily browsed magazines and internet pages – celebrity gossip, fashion and trends were part of her every day world. Emily and her friends talked often about how everyone looked and what they wore. One night, Emily received an MSN in which she was referred to as “Em the Elephant”. Later that week, an SMS used the same name and soon it was joked around most of the year group.

This teasing heightened Emily’s insecurities to the point that she would no longer participate in swimming activities because of her sensitivity, believing that everyone would notice her oversized hips and be laughing at her. While the teasing was mainly thoughtless, it still had teasing a detrimental effect on this sensitive teenager. For some young people, if it goes further than that and becomes bullying about their weight and appearance, the effects on their self-esteem and body image can be serious.

As well as dealing with the pressures of their peers, many girls (and women) are influenced by the seemingly perfect appearance of others presented relentlessly in the media. Perhaps if they realised 95% of images they see have been digitally altered, they would be less demanding of themselves to conform to such unrealistic standards.

Nevertheless, society continues to exert pressure on both males and females to achieve perfect body appearance. For girls, the desirable look is long-legged and excessively thin. For boys, up until now it has been the muscles associated with sports stars that have counted. Recently, however, there is a disturbing new trend evident in the media, with recent images of unhealthy, stick-like male models suggesting a worrying new development.

The impact of these idealised images is disturbing: young people experience a loss of confidence, an increasing dissatisfaction with themselves and a growing feeling of anger about their natural flaws, criticising themselves for not looking like the images they see everywhere. In fact, in 2007, a large survey of young Australians found that body image was the most nominated number one concern.

Effects on Emily

Emily seemed to have internalised a negative body image and an unrealistic, idealised version of what she should look like. She was moving further along the continuum that started with feeling dissatisfied with her body, but at its worst Emily developing an eating disorder.

Emily started to control her eating quite drastically and began an excessive exercise program at the same time. Emily cut out junk food, ran every day and wanted to join a gym. Consequently, over the summer holidays, she lost 12 kilos and was looking thin. At first, it seemed to be a healthy initiative, so that her parents didn’t worry. It was only when an aunt asked whether there was a problem that Emily’s parents realised there might be.

Other problems

Low self-esteem is one possible consequence of a negative body image. A young person’s self-esteem is influenced by a number of factors, one of which is how they feel about their appearance. Others include their feelings about their ability in school, acceptance by peers and their sense of belonging to their family. Self-esteem is then related to confidence in responding to challenges, dealing with peer pressure and making the most of opportunities.

Other possible effects associated with a negative body image:

• There is a higher risk of depression, associated with feelings of being unworthy and feeling unattractive.
• Obsessions with weight loss are common, trying diets and failing, then entering a cycle of blame and guilt.
• Body dysmorphia can also develop: a preoccupation with perceived flaws in the body which can become debilitating and prevent a person socialising in its extreme form.
• Finally, eating disorders can originate in an unrealistic desire for thinness, although there are other contributing factors and complex theories about their causes.

Emily’s parents intervene

Once they identified that Emily was losing too much weight, her parents had a frank discussion with her. Emily denied that she was too thin and also that she had a problem of any sort. She maintained she was on a health kick and that her parents were making a fuss out of nothing. However, Emily’s parents established her weight and got an undertaking from Emily that she would not lose any more. They modified the family meals a little to cater for her “healthy” tastes and negotiated a more reasonable exercise routine. If that didn’t work, they were prepared to seek professional help, as they wisely believed early intervention was best. Emily’s mother also explained to Emily about the normal changes in weight and body shape as girls go through puberty and their growth slows down. She assured her daughter that “puppy fat” is often just a phase.

What can parents do to prevent a negative body image developing?

• Educate your children about the normal changes in body shape that occur in puberty and adolescence
• Discuss the ways in which media manipulate images and how the fashion industry has an investment in making us feel that we are not desirable without their constantly changing products
• Model and teach healthy ways of managing weight
• Educate about the dangers of crash diets
• Do as much as possible to develop their positive, but realistic, self-esteem
• Reinforce the idea that physical perfection is unattainable

Feeling good about yourself: do you have a positive or negative body image?

Signs of a positive body image

• Seeing your body and its shape as it truly is
• Being able to separate self-worth from physical appearance
• Accepting your individual body shape and characteristics
• Feeling comfortable and confident in your body

Signs of a negative body image

• Thinking parts of your body are unlike what they really are
• Believing that only other people can be attractive
• Feeling like a failure because of how you look
• Feeling self-conscious or embarrassed about your body