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July/August 2011 Issue

Raising Healthy Families in a Weight-Obsessed Culture
By Deborah Russo, PsyD, and Amy Spahr, LCSW
Social Work Today
Vol. 11 No. 4 P. 20

Therapists can’t stop the unhealthy media messages about “perfect bodies,” but they can encourage parents to prepare children with accurate information about body weight, exercise, genetics, and the myth of perfection.

Studies have confirmed the powerful influence our consumer culture has on imprinting behavioral norms. Family dynamics, biology, technology, and our media culture contribute to shaping attitudes toward weight and body image. How do we help parents, caregivers, and other leaders navigate the factors influencing our youth culture, especially concerning weight-related and body image issues?

What We Know
We have learned a great deal working with more than 10,000 women and girls with eating and anxiety disorders for the past 20 years, including the following:

• Eating disorders, including body image issues, are complex and involve myriad interrelated contributing factors.

• There is no such thing as physical perfection and therefore it can never be attained.

• Popular media and marketing will never let you believe physical perfection is unattainable.

• Friends and family are often the worst sounding board for negative thoughts about body image.

• Countless girls and women of various shapes and sizes have engaged in the fruitless pursuit of physical perfection.

• The pursuit of physical perfection often begins in adolescence and persists throughout the entire lifetime.

Perfection in our culture is often viewed as a woman being taller or shorter, curvier or thinner, softer or more toned, and lighter or darker than she is. However, these targets are often a reflection of the negative feelings we foster about our own appearance and are not defined by some measurable goal.

Dissatisfaction with physical appearance is a growing trend among both men and women and is steadily affecting younger and younger people. Bedford and Johnson (2006) compared body image concerns in younger and older women, and their study revealed no age-related differences in body dissatisfaction. Similar findings were reported by Reel (2000), who discovered that although no significant differences existed among women of various ages, women who were 40 to 59 years old reported the highest body dissatisfaction.

It’s Not Just About Dieting
But where does body dissatisfaction start? The influencing factors of weight-related and body image issues are complex. Eating disorders and obesity are caused by many factors that interact with each other. Individual characteristics, including genetics and temperament, family dynamics, peer influences, community factors, and societal norms, may play various roles in causing weight-related issues and body dissatisfaction. Whatever the factors that start body dissatisfaction, the consequences for an individual are profound.

Numerous research studies have confirmed that body dissatisfaction is closely linked to self-esteem in adolescents, more so than in adults. Thus, if a teen is struggling with body dissatisfaction, it may interfere in the development of that person’s self-concept and sense of identity. Regardless of our level of sensitivity to our own imperfections, vulnerability to criticism increases during the developmental years as puberty leads to rapid physical and emotional changes. Children are often confused by the social constructs of the narrow standard of beauty projected. Teen girls often make statements such as “Those images are living inside of me; how am I supposed to be feminine without being overly sexual?” or “How do I see my strengths apart from my looks?”

Internalizing the Fantasy Ideal
The influence of the internalization of negative body images is magnified by visions of perfection seen in the media and powerfully reinforced by role expectations, peer groups, and family members who are also dissatisfied with their own physical appearance. For many people, these negative thoughts manifest as nothing more than fleeting reminders to exercise more often or return to healthier eating patterns. However, others will focus on these perceived flaws and exaggerate them until these people no longer have a realistic view of their own body. Left unchecked, such a negative and inaccurate body image can lead to low self-esteem or depression and even develop into an eating disorder.

The physical archetype to which a person aspires can be formed at a very young age and evolve over time. Youths are exposed to unattainable models of physical beauty through a variety of media, including television shows and magazines. They often fail to recognize that this one-dimensional version of perfection can be achieved only with hours of make-up, perfectly tailored clothing, generous lighting, and carefully selected camera angles to conceal imperfections. In the most blatant cases, print media are often airbrushed or otherwise edited to not only remove imperfections but to create the illusion of unachievable proportions and beauty. By comparison, people constantly fall short of nearly every target set before them.

Though it is easy to blame the media for setting these unrealistic standards, society may do little to discourage it. People acknowledge the desirable traits of famous individuals, complain about their own physical condition, and loudly protest the punishment induced by specific foods. Again, for most, these comments are no more than simple statements intended to give voice to likes and dislikes. However, for others, these comments can serve to establish goals and guidelines for a lifetime of negative body image and self-doubt.

Studies indicate a growing trend of preteen girls believing they must restrict their food intake to become thinner because they just can’t measure up. This internalized critic may be carried throughout life.

As an example, a study by Brown and Slaughter (2011) examined body attractiveness and normality in females aged 4 to 26 and found that all age groups rated photos of women who were significantly thinner as more attractive than women they viewed in normal weight ranges. Many women continue echoing that they would be more attractive to people of both sexes if they were to lose a significant amount of weight.

More interestingly, studies have shown the sociocultural influence on distortions of body type preferences among opposite sexes, and they strongly influence the ability to exaggerate expectations of perfection and project them onto others. That is, people internally establish an ideal body shape and convince themselves that if they could achieve that shape, the opposite sex would find thinner women more attractive and that peers would be striving to be even thinner still (Cohn & Adler, 1992).

What is truth is relative to our inner perceptions and unique experiences and influenced by technology and mainstream media.

Peer Influence
It is no coincidence that a country obsessed with physical beauty and thin ideals produces preschoolers concerned that certain foods will make them fat. Adolescent girls and boys also openly discuss weight, body shape, and dieting. In many cases, these conversations extend beyond feedback related to negative appearance to include how appearance impacts popularity, weight-related behaviors, and the selection of a model body image.

Our experiences with others in relationship to self and body awareness helps lay a foundation for how we see ourselves. As an example, children who are teased by their peers for body shape or size are more likely to develop a poor sense of body image and may suffer from symptoms of depression. The saying “sticks and stones may break my bones, but words will never hurt me” just doesn’t ring true. Peers can have a tremendous influence on children’s beliefs and ideals.

Who’s in Charge?
Parents’ own inner dialogue related to body and weight are directly linked to a child’s inner sense of “fit” concerning his or her own body, attitudes, weight, and food choices. Studies have noted the direct influence of parents’ attitudes related to children’s food intake and how attempts to control food intake often have the opposite effects on a child’s habits and choices (Brown & Ogden, 2004).

A recent study of the correlation between parents’ weight-related ideals found that their overt and covert restriction of their children’s food intake was significantly associated with child body dissatisfaction (Schuman, 2010). This research, along with other recent studies, concludes that education is necessary for both parents and health professionals concerning the influence of both direct and indirect parent weight-related attitudes and behaviors on a child’s body satisfaction.

A Proactive Approach to Help Families
Given the countless ways children are bombarded with messages that reinforce negative body image, parents can play a powerful role in shaping weight-related ideals but must start with themselves to encourage healthy perceptions, beliefs, and actions in their children.

The following is a list of 10 ways to help families foster resilience and positive body awareness and regard:

1. Inner Dialogue
Parents and caregivers have tremendous influence on children’s inner thoughts related to their worth and abilities. Help parents understand the importance of talking by explaining that the parents are developing a template for their own inner dialogue, including sense of mastery, coping styles, and ability to nurture and self-soothe.

Working with parents on how to listen, process, and engage with their children is important. Families can pay attention to how children speaks to themselves during play—you can learn a lot about how they are processing emotions and resolving conflict. Help families utilize purposeful play techniques to introduce respect and regard for diversity of body sizes and people in general. It is never too early. This is the best time to engage this developmental phase to build bridges of healthy cognitive functioning, including healthy body awareness and image.

2. Puberty
Body image is influenced throughout our lives by multiple factors. Experiences and changes in puberty greatly influence body image and can remain fairly constant through life. Puberty brings windows of opportunity to guide as children’s bodies change and the desire to “fit in” and meet ideals intensify. This is a perfect time to emphasize appreciation for different body sizes and shapes. Parental modeling is a powerful teaching tool.

Some parents need resources and guidance on how to interact with their children about this sensitive topic. Provide them with a variety of ways to interact with their children, such as going online or to the library with them to find positive, fun educational sites to help their children understand their bodies better. Sites such as www.kidshealth.com provide creative ways to talk about questions related to body, growth, and self-esteem. Parents can also teach children resiliency tips and how to respond to peers who may focus on unhealthy ideals.

3. Sports and Games
Youths who are involved in athletic endeavors tend to have a healthier body image than those who don’t. Encourage parents to involve children in fun and doable appropriate sports that will challenge and provide experience of mastery. These activities will help kids find their own unique physical strengths and provide excellent ways to reduce stress and increase mood and energy level.

It is important to challenge the family but also to work within its resources and capabilities. Help introduce doable activities that include the whole family’s preferences.

4. Modeling Body Gratitude
Teach parents to be models to their children. Give them ideas and homework on ways they can appreciate their own bodies and their functions. It is important that children catch their mother or father smiling when looking in the mirror or expressing gratitude for their strong legs, bright smile, and skillful hands.

5. Critical Thinking Skills
Media images and messages about food and bodies are often distorted. Children are the most vulnerable to these messages if they are not taught to be media watchdogs. Parents can question advertisements and use talk-back techniques with their children when hearing messages that both discourage healthy, realistic attitudes and behaviors related to eating and weight. The National Eating Disorders Association has project ideas to build resilience and tips on how to be proactive against negative media messages.

6. The Whole Picture
Take a realistic and relational approach to family heath. Identify free seminars on nutrition and activity lifestyles for families, and lead kids to resources that provide building blocks for healthier choices. Provide direction to assist parents with creating balance and boundaries with food and weight. There are multiple tools that are free and easily available to help guide families make the right choices to improve eating and exercise and make the best of their bodies. BodyWorks at www.womenshealth.gov is one excellent resource.

7. Genes vs. Jeans
It’s important to broaden parents’ understanding of the influence of genetics on body types. Families are often relieved when they realize that biological traits influence body shape and individual frames. Children can benefit from understanding genetic influences vs. the time and energy wasted on failed attempts to be something they are not. Help families keep the goal on body health and move away from fitting a specific ideal. It’s what’s on the inside that counts.

8. Family Adventure
Include activities in counseling that promote physical movement as well as problem-solving and communication techniques for a family. Experiential and adventure activities help families get out of the box and into a new awareness and learning through fun challenges with themes related to choices, team work, individual responsibility, and negotiating family goals.

9. Tool Kits
More than ever families need guidance and assistance related to overall health and nutrition. Keep your resources plentiful. Include updates of online and community resources such as free educational seminars on nutrition, family stress busters, and healthy self-esteem and body image enhancers. Your resources should also be treatment providers who are experts in all areas of family health.

10. Red Flags
Know the warning signs for a child with poor or distorted body image, as this may indicate deeper problems. We know even committed and concerned parents may miss early signs. One behavior does not cause eating disorders; however, some behaviors can be indicators that someone could be more vulnerable to an eating disorder. Some of these include the following:

• anxiety that does not resolve;

• isolation and withdrawal;

• extreme change of attitude and mood;

• unrelenting disparaging talk about hating his or her body;

• increasing rigidity about food to the point of eliminating healthy and necessary food for proper growth;

• excessive exercise and obsessive calorie counting; and

• strict and fad dieting practices.

— Deborah Russo, PsyD and Amy Spahr, LCSW, are on staff at Remuda Ranch Treatment Center.


Bedford, J. L., & Johnson, C. S. (2006). Societal influences on body image dissatisfaction in younger and older women. Journal of Women and Aging, 18(1), 41-55.

Brown, F., & Slaughter, V. (2011). Normal body, beautiful body: Discrepant perceptions reveal a pervasive ‘thin ideal’ from childhood to adulthood. Body Image, 8(2), 119-125.

Brown, R., & Ogden, J. (2004). Children’s eating attitudes and behaviour: A study of the modeling and control theories of parental influence. Health Education Research: Theory and Practice, 19(3), 261-271.
Cohn, L, & Adler, N. (1992). Female and male perceptions of ideal body shapes: Distorted views among Caucasian college students. Psychology of Women Quarterly, 16(1), 69-79.

Reel, J. J. (2000). Body image and physical self-perceptions among African-American and Caucasian women across the adult life span. Dissertation Abstracts International, 61(5-B).

Schuman, S. (2010). Parent weight-related attitudes and behaviors: Influence on child and adolescent body dissatisfaction. University of Florida Journal of Psychological Science, 1, 24-43.