Low self-esteem and body image harm teenage mental health, study shows

Promoting positive body image and self-esteem among children could help to reduce poor mental health associated with being higher weight in adolescence, according to new research.

A study of more than 12,000 children in the UK saw researchers from Imperial College London explore the impacts of psychological and social factors on the relationship between mental health and body mass index (BMI) throughout adolescence.

The link between children having a higher weight and being more likely to have poor mental health outcomes is well established. But in the latest study, researchers found that increasing children’s satisfaction with their appearance and self-esteem from early adolescence could help to protect against the negative impacts of having higher weight on their mental health.

Using data collected when young people were 11, 14 and 17 years old, they measured a range of factors including how adolescents felt about their appearance, self-esteem, experience of bullying and dieting, along with BMI and mental health difficulties.

They found that at a population level, children’s happiness with their appearance and their self-esteem had the greatest influence on the relationship between BMI and mental health, further compounding poor mental health into their late teens.

The study found that 11-year-old children at higher weight were more likely to have poor body image and lower self-esteem as they entered their teens, than those with average weight. Subsequently, both boys and girls unhappy with their appearance and with low self-esteem at age 14 were more likely to have mental health difficulties at age 17, such as anxiety, depressive symptoms, aggression, and impulsivity and were also likely to have a higher BMI than those with a more positive self-image.

They authors of the report said prevention strategies in the national curriculum, industry and on social media platforms to destigmatise weight and encourage healthy body image in children were needed to help alleviate a range of negative social and emotional problems in later years.

Dr Hanna Creese, from the School of Public Health at Imperial College London, and first author of the study, said: ‘The links between mental and physical health are well established, and we know that children who are overweight or obese are much more likely to suffer social and emotional problems, such as depression and anxiety. But unpicking the different factors driving these outcomes is challenging – such as the complex two-way relationship between mental health and BMI.

‘It’s important for children to maintain a healthy weight, but our study highlights that this shouldn’t be achieved at the expense of children’s long-term mental health or by stigmatising their weight and driving poor body image and low self-esteem, as this can have damaging and long-lasting impacts.’

Image: Hannah Xu