Why body dysmorphia has exploded among teens, and what parents can do to help: 'We’re seeing quite a big uptick'

Scrolling through TikTok — with all of its filter enhancements and ripped dance routines — you’ve probably been compelled to turn the camera on yourself to see how that one angle or dance move looks on you. Maybe it works. Maybe it doesn’t. But if not, just delete it and move on, right?

For some social media users — many of them children and teens — it’s not that simple.

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In fact, if you scroll a little further in your feed, you might find teens talking confessional style about their feelings surrounding their body, their face, their general appearance. Even adult TikTokers like @nicoaramagda have publicly shared that they’re struggling with body dysmorphia.

“You always check urself in every reflection to make sure u look the same,” she writes in her post.

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Some admit to the more severe body dysmorphic disorder (BDD), a mental health condition, as the Mayo Clinic explains, in which “you can’t stop thinking about one or more perceived defects or flaws in your appearance.” Keep in mind, when the behavior becomes compulsive (think excessive avoidance, extreme exercise or even skin picking), it’s important to seek professional help.

Body dysmorphia has always been one of the aspects of eating disorders, says Jillian Walsh, RD, RP, a dual-credentialed dietitian and psychotherapist who founded the Change Creates Change eating disorder treatment center in London, Ontario.

While BDD affects just under 2% of the general population, the numbers are slightly higher among students (3.3%). According to one study, about 50% of 13-year-old American girls report feeling dissatisfied with their bodies. That number jumps to nearly 80% by the time they’re 17. And it’s not just girls. Roughly 20% of boys report feeling “concerned” about their muscularity and leanness.

So where did all of this start?

“Prior to social media, it was just television,” says Reena B. Patel, LEP, BCBA, a child and educational psychologist and behavioral analyst based in San Diego, California. “It was [TV] shows. It was having those magazines out on the table and starting to show these unrealistic images that even youngsters — they don’t have to necessarily be teenagers — preteens, even younger, are feeling that they have to live up to.”

“However,” says Walsh, “we’re seeing quite a big uptick [in body dysmorphia], especially in the past couple of years. And it is hard to put our finger on whether or not this is directly related to the global pandemic of COVID-19. It also coincides with the increase in popularity of social media platforms, but especially things like TikTok.”

While social media platforms like Facebook and Instagram are no strangers to overly curated feeds with adjusted angles and manipulated personal storylines (nothing bad to see here, folks!), it’s TikTok that has Gen Z’s attention. After all, Facebook has been sidelined as the platform “for old people,” and Insta is the hub for cheugy millennials. TikTok, on the other hand, with its younger demo, is where Gen Z is — and where they’re comparing themselves to others in the under-25 set.

On TikTok, what Walsh is noticing is that there’s a “major focus” on certain body types and aesthetics. And some, of course, have been labeled as more desirable than others. While those aesthetics naturally shift from decade to decade, most, if not all, don’t resemble typical teenage bodies, which are in the middle of development and growth.

“Right now, what folks seem to be aspiring for is this, quote-unquote ‘slimthicc’ aesthetic,” Walsh says, referring to a slim yet curvy build. “And it’s not overly natural, especially for teens. Teens are in the middle of puberty, so their bodies aren’t done changing and growing. And so what we’re finding is a lot of these teens are trying to hit the pause button on their bodies at 13, 14 years old, and then they get quite upset and dysregulated when their bodies continue to change. So it’s almost like this, I would say, like a false expectation.”

‘Zoom dysmorphia’

While social media gets a lot of the blame for a distorted sense of self and false expectations among both kids and adults, there’s another element that came into play as the global health crisis hit, changing the way adults work and kids attend school.

“We’re on it right now,” certified life coach Adam Jablin, who’s based in Boca Raton, Florida, says during our video interview.

“Thank God for Zoom,” he says about the video conferencing platform. “It saved so many of us. But this idea that you have the capability of constantly looking at yourself is so f—— unhealthy.”

So unhealthy, in fact, that the experience led to a so-called “Zoom dysmorphia,” which inspired adults to book appointments for not only Botox but also a packed menu of other plastic surgery procedures.

“Unlike the still and filtered selfies of social media, Zoom displays an unedited version of oneself in motion, a self-depiction very few people are used to seeing on a daily basis,” write Shauna M. Rice, BS; Emmy Graber, MD, MBA; and Arianne Shadi Kourosh, MD, MPH, in the journal Facial Plastic Surgery & Aesthetic Medicine. “This may have drastic effects on body dissatisfaction and desire to seek cosmetic procedures.”

Now, with people having to deal with actual unedited moving images, they’re becoming hyper-focused on things like acne, the size of their nose and even hair loss (a real thing brought on by the added stress of the pandemic.)

“During real-life conversations, we do not see our faces speaking and displaying emotions, and we certainly do not compare our faces side-by-side to others like we do on video calls,” the authors add.

And that’s adults. Imagine what those similar feelings are doing to children and teens in digital classrooms where they’re not only checking out themselves but 30 other kids, too.

A perfect storm of increased screen time, social media and Zoom

With this toxic mix of hyper-curation on social media and an exponential increase in kids’ interaction with Zoom, many parents unwittingly fed the beast during a confounding year when screen time went through the roof. (No judgment, by the way — I was right there with them as a parent of two.) Exhausted moms and dads juggled their jobs, remote learning and housekeeping all at once and often relied on the so-called “digital babysitter” while they held meetings in their bedrooms or just needed 20 minutes of sanity.

Meanwhile, many of those kids started “body-checking” themselves, according to Walsh.

“So, for example, if a teen is experiencing anxiety around weight gain, they will consistently check their body, whether or not it’s with [a] measuring tape or weight scales or mirrors — however they want to check their body — to gain, or in hopes of gaining, reassurance that their biggest fear is not happening.”

But, as with anything you stare at long enough, you’re bound to find faults.

“The tricky thing is is that if we continually scrutinize an image or reflection, we will just naturally start to pick out issues with it,” Walsh says. “So what ends up happening is that it perpetuates the body dysmorphia because we’re constantly looking [at ourselves and others].”

So, what can parents do to help their children?

What parents can do to help their kids

1. Seek professional help, if needed — Says Patel: “If you find that your child cannot stop thinking about what they perceive as a deficit — it could be a flaw in their own appearance, and it could be so minor, but they can’t move about their day. They’re constantly fixated on it, or they’re wanting to change it. They feel anxious. It causes anxiety, causes depression. They don’t want to leave their room. They don’t want to go outside. If you’re seeing a change in eating habits, sleeping habits, anything that affects their day-to-day routine — definitely seek out support.”

2. Talk to your kids — “Have an open communication. Ask questions. That’s really the main thing,” Jablin says. “It’s not always some lesson that us wise, older adults are going to teach the kids. It’s not some monologue from my past.” He suggests asking questions like, “I noticed that you haven’t eaten. Are you OK?” or “I noticed that you started taking these protein bars.”

Engaging helps, he adds. “Show kids that [you’re] on this ride, too.”

3. Watch your words — “Look at yourself as a parent, and be mindful of what you share,” Patel says. “Sometimes you say, ‘Oh my gosh, my hair is a mess,’ or ‘I don’t like the way my nose is,’ or ‘I wish I could lose some weight.”

Children pick up on those messages, she adds. So instead of doing those things, focus on nutrition and a healthy balance of choices. Don’t make it about counting calories or repeated self-criticism.

4. Limit screen time and diversify what you watch — Parents shouldn’t be afraid to set limits and create healthy balances of screen time and activities like going outside or reading books. Not only that, but when you are watching TV shows or movies, Patel says, “make sure you’re showing diversity.”

“Think about what programming, what books you’re bringing into the home, what type of diversity in terms of family and friends you have around them,” Patel adds, “because you want them to be able to see those differences in our community, in our society, that there’s no ‘one size fits all.'”

5. Boost confidence with positive affirmations — Because kids are still figuring out their self-identities amid so many changes, Patel stresses that “it’s up to us as parents, as educators, as a society to check in with children, to make sure to help boost their confidence. Pay attention to attributes that make them who they are, focus on what makes them different. And capitalize on that.”

Patel also recommends positive affirmations. Post a sticky note to your child’s mirror with words that boost their self-esteem. “Those self-talking points really do help,” she says. “When you say it multiple times, at least three times, and you do it consistently, it actually starts to embed in your own thinking process. It does shift.”

Hope for the coming school year?

In the next couple of months, kids and teens will be heading back to school — most of them in person. After so many months of attending classes online followed by a summer of limited camp activities and no school, parents might be understandably anxious about what the upcoming school re-entry might look like.

“To be honest,” Walsh says, “I suspect that the re-entry may work in our benefit.”

“A lot of us lost our hobbies. We lost our relationships, we lost our interests, or it all went online,” she adds. “So as we reintegrate or reconnect with those old interests, I really do hope that it will crowd out these body-dysmorphic thoughts — but I think time will tell.”

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