“My thighs are too fat. My abs aren’t ripped enough. My body is too hairy. My face has too many zits.” Comments like these are typical of kids who are going through puberty and worried about fitting in. Body dissatisfaction among America’s youth has become so widespread that researchers now consider it a natural part of growing up. When kids are unhappy with their bodies, it can lead to self-esteem issues, depression, obsessive exercising and eating disorders.
Unrealistic expectations for the “perfect” body shape and size are communicated at an early age, starting with busty Barbie with the pencil-thin waist, as well as G.I. Joe and superhero characters with massive muscles. Kids are bombarded 24/7 with images of super-thin women and men with bulging biceps and six-pack abs. The media portrays underweight female models as the ideal body type, yet they represent only 5 percent of women in the United States, according to the American College of Obstetricians and Gynecologists (ACOG) Committee on Adolescent Health Care.
“The message is very clear that women and girls are supposed to be thin, and that is the celebrated ideal,” says Child and Teen Development Expert Dr. Robyn Silverman, author of Good Girls Don’t Get Fat: How Weight Obsession Is Messing Up Our Girls and How We Can Help Them Thrive Despite It. “Our tendency is to compare constantly,” says Silverman. “Where do I fit in? Am I worthwhile? Am I okay?”
Educating kids about normal body development can help them be more accepting of their bodies. For example, when girls go through puberty, they typically develop 50 percent more body fat than they had before they started puberty, says Dr. Leslie Sim, psychologist and clinical director of the Mayo Clinic Eating Disorders Program in Rochester, Minn. “They call it the fat spurt.” Some researchers estimate that girls pack on an average of 40 pounds during this peak growth period.
Combining physical activity with nutritious eating continues to be the most effective way to maintain a normal weight and build self-confidence. Eating too much and not getting enough exercise can lead to obesity, especially for kids who sit for hours on end playing the hottest video games or surfing the Net. Overweight kids are often teased or excluded from sports, and are at risk for a wide range of health problems.
Kids are understandably confused about how they should look. Just look at the commercials and magazine ads of slim healthy-looking people eating sugary, high-fat foods. Portion sizes are huge and the temptation of fast-food restaurants is everywhere. Society encourages obesity, yet glamorizes being thin and muscular.
Body shape and size are largely determined by genetics; each person is born with a unique bone structure, body frame and metabolism. Yet some people are so determined to change their bodies that they will resort to drastic measures, including extreme dieting, compulsive exercising, drug abuse and cosmetic surgeries.
The Dangers of Dieting
Being ridiculed by family members or looking different from peers can contribute to kids’ unhappiness with their bodies. “Body image dissatisfaction is associated with depression, low self-esteem and self-worth, which fuels dieting behavior,” says Dr. Dena Cabrera, psychologist and director of Educational Outreach at Remuda Ranch Programs for Eating and Anxiety Disorders in Phoenix.
“For those kids who don’t like their bodies and are pushed into dieting, it actually leads to more weight gain,” Cabrera says. Dieting means following a structured eating plan and restricting calories with the goal of losing weight. Making certain foods off limits – like that chocolate cake with the creamy fudge frosting – makes people crave it even more. And being hungry all the time slows down their metabolism and sets them up for binge eating.
“All foods can fit into a healthy lifestyle,” says Cabrera. “When we deprive kids and we don’t have balance, and we’re rigid, they’re going to feel that. It threatens their freedom so they feel they have to have it.” The key is to find balance and eat a variety of foods. She advises making junk food and sugary soft drinks a special treat instead of the “forbidden fruit.”
Like Cabrera, Sim advises against dieting: “Dieting is the biggest predictor of binge eating and bulimia. It’s the worst thing we can tell our kids. Ninety-five percent of the people who go on a diet and lose weight successfully will gain it all the way back within one to five years.”
Research shows that more than half of teenage girls and almost one-third of teenage boys engage in unhealthy weight loss behaviors such as skipping meals, vomiting, smoking cigarettes, or taking laxatives. Drugs prescribed for Attention Deficit Disorder, such as Ritalin or Adderall, are also being used to lose weight.
Setting the Stage for Eating Disorders
Extreme dieting paves the way for eating disorders, which often begin in adolescence.
The three main eating disorders are anorexia, bulimia and binge eating.
Of all psychiatric disorders, anorexia has the highest death rate. Although the physical complications of anorexia cause deaths, a large number of lives are also lost to suicide. Anorexics are so frightened of getting fat that they severely restrict their calories, sometimes to the point of starvation.
“These kids could be the valedictorian of their school, and if they gain two pounds, they hate themselves,” says Sim. “They tend to be very driven kids who do not get off task very easily.”
Bulimics are also obsessed with their weight, but instead of starving themselves, they binge on food and then purge. Purging is a way to get rid of the unwanted calories and can take many forms, including self-induced vomiting, laxatives, enemas and diuretics. Some will also turn to compulsive exercising or fasting to take off pounds.
Parents should stay alert for warning signs of eating disorders, says Dr. Chris Kouteres, pediatrician and American Academy of Pediatrics executive council member on Sports Medicine and Fitness in Anaheim Hills, Calif. “I would be looking for changes in eating habits. They leave the table early, they’re in the bathroom more often. They just don’t seem to enjoy meal time like they used to. They’re more apt to read labels; they’re starting to measure their food out. You’re seeing them wear baggy sweaters and it’s 90 degrees outside. They’re just different in their general behavior. Those are things that would tip me off that something might be going on.”
The most common eating disorder is binge eating. Like bulimics, they consume huge amounts of food in a short period of time and feel guilty or ashamed afterwards. The big difference is they don’t purge after eating. Instead, they may get caught in a cycle of bingeing and rigid dieting. Some binge eaters simply pack on the pounds and become obese.
The Pressure of Competitive Sports
Year-round competitive sports and pressure from coaches and parents can also make kids preoccupied with their bodies. “In most of the boy sports, the bigger guy gets the prize, whereas some of our female sports, where judging is a component, the thinner the better,” says Kouteres, “You gotta be thin to win. I hear that a lot.”
Some sports place athletes at greater risk of body-image issues than others. Wrestlers are frequently pressured to cut weight before a match weigh-in so they can compete in a lower weight category. Endurance athletes such as runners, swimmers and cyclists also may try to drop pounds so they can improve their speed. Sports such as gymnastics, figure skating and diving are judged not only on performance, but also body appearance.
Sports such as bodybuilding and football encourage kids to get bigger and leaner by hitting the weight room constantly and guzzling protein drinks. Desperate to improve their performance, boys, as well as some female athletes, may turn to anabolic steroids to increase muscle mass and strength. Steroids are synthetic versions of the naturally occurring male hormone testosterone and are illegal when taken for non-medical purposes. They have a number of serious physical and psychological side-effects, including increased risk of liver cancer, heart attack, shrunken testicles, baldness, extreme aggression, and stunted growth in children.
Another disturbing trend is the use of prohormones, which are sold as a legal alternative to steroids, says Kouteres. After prohormones are ingested into the body, they are converted to active hormones and cause side-effects similar to anabolic steroids. Because they are legal and can be found in health food stores and on the Internet, many kids mistakenly believe they are safe.
Perfect Body at All Costs
The drive for the ideal body shape and size is so strong that some will undergo risky, expensive surgeries to get the body they want. In 2003, over 223,000 cosmetic surgeries were performed on kids 18 years or younger, and nearly 39,000 of them involved tummy tucks, breast augmentations, liposuction and nose reshaping, according to the ACOG Committee on Adolescent Health Care. Especially worrisome is the fact that parents are often encouraging these types of surgeries. In fact, Silverman says parents are increasingly giving their girls “boobs and nose jobs as graduation gifts instead of a car.”
“We really need to watch what we do and say,” says Silverman. “We are models for our children.”