Body image in young people, whether healthy or unhealthy, can have long-term consequences on their psychological, social and physical well-being, including behavior choices. An increase in the prevalence of obesity and mental health concerns among U.S. adolescent girls has prompted a rise in targeted prevention and intervention programs. It is important to consider the factors that contribute to positive beliefs about self and the development of health behaviors, as well as the relationship between body image and disordered eating or being overweight.

In addition to the information provided in the following research summaries, psychologists are encouraged to explore the literature more completely to determine what may be useful to them in practice.

Andrew, R., Tiggemann, M., & Clark, L. (2016). Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study. Developmental Psychology, 52, 463-474.

This study focused on adolescent girls 12 to 16 years of age who were recruited from five different schools in South Australia. A sample of 298 adolescent girls completed a questionnaire measuring their body appreciation, potential predictors such as activities, and possible health outcomes at two time points, about one year apart.

Concepts assessed in the questionnaire included perceived body acceptance by others, body appreciation, self-objectification and social comparison, followed by health behaviors including intuitive eating. Positive body appreciation is when one accepts one's body, flaws and all. Self-objectification is when one’s view of one's own body is based on beliefs regarding others’ judgments. Relatedly, social comparison is the act of evaluating one’s own body in comparison to others. Intuitive eating is eating in response to body cues and needs, rather than emotional or external reasons.

Positive body acceptance by others, negative self-objectification, negative social comparison and positive body appreciation were related to an increase in intuitive eating over one year in young girls. Intuitive eating demonstrates a healthier relationship with food and responsiveness to the body’s natural hunger signs. Also in this study, there were significant relationships between body appreciation, alcohol and cigarette consumption. Girls with higher body appreciation were less likely to smoke or use alcohol than girls with lower body appreciation. Girls with a more positive self-evaluation of their bodies also generally had healthier eating and lifestyle behaviors.

Tiggemann, M., & Slater, A. (2015). The role of self-objectification in the mental health of early adolescent girls: Predictors and consequences. Journal of Pediatric Psychology, 40, 1-8.  doi: 10.1093/jpepsy/jsv021

Female bodies are regularly objectified and sexualized in the media effecting how adolescent girls view themselves. This, in turn, may be linked to mental health. Two hundred and four adolescent girls between the ages of 11 and 13 were given a questionnaire that measured various daily lifestyle activities, ideas about their bodies and symptoms related to mental health. 

Using structural equation modeling, the authors found that exposure to images in the media and on the internet as well as conversations with peers about appearance predicted self–objectification. Self-objectification was significantly correlated with body shame, dieting and depressive symptoms. These findings are very similar to studies with adult women.

Sonneville, K.R., Grilo, C.M., Richmond, T.K., Thurston, I.B., Jernigan, M., Gianini, L., & Field, A.E. (2015). Prospective association between overvaluation of weight and binge eating among overweight adolescent girls. Journal of Adolescent Health, 56, 25-29. doi:10.1016/j.jadohealth.2014.08.017

A high degree of concern with weight or body shape appears to be related to eating disorders. While body dissatisfaction appears to be related to binge eating among adults, less is known about its relationship in adolescent girls. Data was collected and analyzed from 767 adolescent girls who were overweight and between the ages of 12 and 18. The data was collected as part of a larger study (Growing Up Today Study) with over 9,000 female participants completing annual or biennial surveys. Generalized estimating equations were used to measure the association between high concern of weight and the onset of weekly binge eating two years later, and any associated depressive symptoms and social functioning concerns.

Girls who had high concern (overvaluated) their weight were three times more likely to develop weekly binge eating two years later and, among those who did binge eat, those who overvalued their weight had more severe depressive symptoms. Higher concern about weight appears to be a risk factor for the development of binge eating and also an indicator of severity of functioning among older adolescent girls. 

Clinical Implications

Recognizing how beliefs about one’s body develop and influence healthy and unhealthy behaviors is useful for psychologists working with adolescent girls. Popular thinking suggests that girls are bombarded with images and ideas that promote unrealistic body ideals yet little is known about the development of healthy body image or how these unrealistic ideals might translate into more problematic thinking. These studies suggest fostering positive body appreciation and minimizing the importance of shape and weight have benefits for girls. Not only do girls who accept and appreciate their bodies seem to have less maladaptive dieting, they also seem to be less likely to consume alcohol and cigarettes. Supporting balanced and nonrestrictive approaches to eating, encouraging physical activities such as sports or dance and minimizing exposure to (or discussing the pros and cons of) media images may all serve to enhance positive body image.