Body Image and Self-esteem in Youth

Body image and Self-Esteem in Youth

Positive body image and healthy self-esteem are important to a child's health and wellbeing. The media, people around us, and popular culture all influence our body image.  In today's society, children and youth are exposed to many images that show being thin and muscular as a standard of beauty, elegance and masculinity. Television, magazines, movies, the internet and social media sites are full of these images.

 Seeing these images over and over again is linked to poor body image and feelings that our own bodies are not okay. These feelings can affect your child's self-esteem and negatively affect their mental health and wellbeing.

 Sadly, poor body image and self-esteem among children and youth is common and continuing to increase. The negative effects of these feelings can last throughout a person's life, not just in childhood and adolescence. Parents can help their children build a healthy body image at any age. It is never too early to start, as we know that about 30% of children as young as 10 to 14 are dieting, according to a study by the Children's Hospital of Eastern Ontario and the Royal Ottawa Mental Health Centre.

What is body image and self-esteem?
 Body image
Body image is a child's attitude towards their body. It includes the mental picture of how they see themselves when they look in the mirror, how they feel about the way they look, and how they think others see them. Society, the media, family and peers attitudes affect a person's body image.


Having a healthy body image means that a person:

  • Accepts the way they look without trying to change their body to fit what they think they should look like
  • Values what they look like, by seeing  the qualities and strengths that make them feel good about themselves beyond weight, shape or looks
  • Resists the pressure to have the "perfect" body that they see in the media, online, and in society
  • Does not spend a lot of time worrying about food, weight, or calories
  • Does not judge others on their body weight, shape, and/or eating or exercise habits
  • Understands that a person's physical appearance is not a sign of their character or values
  • Feels comfortable and confident in their body

Having a negative body image means that a person:

  • Believes that what they look like determines them as a person
  • Has constant negative thoughts about their body and constantly compares themselves to others
  • Has a distorted idea about their body, in that they see parts of their body unlike they really are
  • Is obsessed with trying to change their actual body shape/size to measure up to family, social, or media ideals
  • Is convinced that only other people are attractive and that their body's shape/size is a sign of personal failure
  • Feels ashamed, self-conscious, and anxious about their body
  • Feels uncomfortable and awkward in their body
Self-esteem is the value and respect a child places on themselves. It is about how they see themselves as a whole person, not just how they view their body. Self-esteem is the opinion people have about all aspects of themselves and it impacts how they take care of themselves, emotionally, physically, and spiritually.

Having a positive self-esteem means that a person:

  • Values themselves
  • Knows that they deserve good care and respect from themselves and from others
  • Knows that they are lovable, capable, and unique
  • Knows their strengths and abilities and celebrate them
  • Has a positive outlook
  • Feels satisfied with themselves most of the time, it is totally normal to have a few lows sometimes
  • Sets realistic goals

Having a poor self-esteem means that a person:

  • Does not value themselves and puts little value on their opinions and ideas
  • May constantly worry that they are not good enough
  • Focuses on their perceived weaknesses and faults and gives very little credit to their skills and assets
  • Believes that others are more capable or successful
  • May be unable to accept compliments or positive feedback
  • May have fear of failure, which can hold them back from trying new things

Self-esteem is more than just a person seeing their good qualities. It is being able to see all of their abilities and weaknesses together, accepting them, and doing the best they can with what they have. When a person has good self-esteem, they don't put themselves down when they make a mistake and they still feel like they are good enough even when they are dealing with difficult feelings or situations.

Factors that affect body image and self-esteem

Various factors will affect how we feel about ourselves and our bodies. Some factors are controllable, others are not. Certain factors may also affect one person more than another person. How we react to all these factors can determine our self-esteem and body image.

Personal Factors


Thoughts and feelings about your body start in late childhood and early adolescence. However, poor body image can affect people of all ages.


The beginning of puberty brings on many changes for young teenagers. During this period, it is normal for teens to put on 30-40 lbs as the body changes and develops. For girls, this extra weight is usually noticed in gains around the hips, waist, thighs and buttocks. For boys, they will get broader shoulders, more muscle mass and grow taller than girls. This is the time when young teens start to focus on their looks, their weight and their shape and often compare themselves to their friends and what they see in the media.


Teenage girls are more at risk for having poor body image than other children of the same age group.  However, more and more boys are having body image issues.

Body size

Children and teens who believe they are overweight (whether they are or not) tend to be more at risk for poor body image. 

Societal Factors

Society and culture

Society's norms and views may stop boys and young men from talking about negative feelings about their bodies or reaching out to others to get support. This will often lead to an under reporting of the issue of poor body image in boys. Boys are also told at a young age that being a man means being strong which can make them feel that they want to be more muscular.

Body weight is the number one reason for bullying in schools which can lead to poor body image and low self-esteem in the victims. Children who get teased or bullied about their looks, weight or body shape are also more likely to have poor body image.

In young men, body image issues often start in early adolescence. Boys with poor body image either want to gain weight or want to lose weight and be thin. Those who want to increase their muscle mass are more likely to abuse drugs, alcohol and muscle-building supplements, while those who want to lose weight and be thinner are more likely to develop depression. Trying to get the "ideal or perfect" body is not just an issue for girls.

Beauty/fashion industry

Every day we see ads from the beauty, fashion, diet and exercise industries that show "perfect" bodies. Many youth compare themselves to these ads. This can lead to low self-esteem and poor body image because:

  • Teenage girls often look at women's magazines or websites for their makeup and fashion tips
  • Teenage boys often look at fitness and muscle magazines or websites to get their information on health, fitness and fashion


Messages and images on the internet, social media, TV and radio and in video games affect how we see others and ourselves. These messages can change how we dress, look, eat, and act with others. Youth will compare themselves to these images and form their identity based on them.

Sport industry

The current beauty "ideal" of lean and muscular men and women is seen in athletes as well as in models and actors. Teens may see this new "norm" and try to get this super athletic look by doing unhealthy things like:

  • Exercising too much
  • Dieting too much, cutting out certain food groups or being too focused on "clean eating" (eating only whole, raw, organic, locally grown foods). This may be a sign of an eating disorder.
  • Taking protein powders, supplements or steroids.

Being active is a great way for teenagers to feel better about themselves and their body. But working out only to get a muscular body and doing extreme things to achieve it is a concern. Male teenagers may feel the pressure from coaches and teammates to "bulk-up" and have a muscular and lean body that is often not possible. In fact, only 1-2% of the population has a body naturally lean like the "ideal" shown in the media.

Family and friends

Families affect how teens think they should look and act.

  • Girls who feel that their parents are pushing them to be thin or who judge them on their weight and body shape are more likely to have poor body image and to diet.
  •  If a girl feels her family approves of her looks and body, then she most likely will have a positive body image of herself.
  • The way a parent thinks about body image has a big impact on how children see themselves. How a parent feels about their own body and concerns about their weight are one of the leading causes of poor body image issues in girls.
  • Talking about dieting and ways to gain or lose weight, or teasing others about their looks can lead to a poor body image. 
Consequences of poor body image

A poor body image can cause many mental and physical effects on children and youth. These effects can be profound and complex because of the many factors involved.

Mental health challenges

Poor body image and self-esteem is linked with various mental health and other health conditions like depression, unhealthy dieting, eating disorders, self-harm, and substance abuse.

Body image and self-esteem directly influence each other and a person's feelings, thoughts, and actions. If a youth doesn't like their body or a part of their body (poor body image) it is hard for them to feel good about their whole self (positive self-esteem). The reverse is also true. If a person does not value themselves (poor self-esteem), it will be hard for them to notice the good things and give their body the respect it deserves (good body image).

The diagram below shows how good body image and self-esteem have a positive effect on mental health: 

Credit: Body Image, Self-Esteem and Mental health, heretohelp, 2015


These are just a few examples. As you can see, good body image, self-esteem, and mental health are not about making a person feel happy all the time. They are really about respecting themselves and others, thinking realistically, and taking action to cope with problems or difficulties in healthy ways.

The diagram below shows how poor body image and self-esteem have a negative effect on mental health:

Credit: Body Image, Self-Esteem and Mental health, heretohelp, 2015


As you can see, the problem with negative thinking and feelings is that once people start to focus on shortcomings or problems in one area or one situation, it becomes very easy to only see problems in other areas or situations. Negative thinking has a way of leading to more negative thinking.

Eating disorders

Body image will affect almost everyone at some point in their lives. Every day, we get a lot of mixed messages about how we "should" look or think about our bodies. For some people, poor body image is a symptom of a serious problem like an eating disorder. Eating disorders are not just about food. They are often a way to cope with difficult problems or regain a sense of control. They are complicated illnesses that affect a person's self-esteem, worth and sense of identity.

This section will provide you with some general information about the most common types of eating disorders, anorexia nervosa, bulimia nervosa and binge-eating disorder. At the end of the section, you will find some tips on how you can help your child or youth to develop a good body image that may help prevent the start of an eating disorder. If you are worried about your teen and think that they may have an eating disorder, please refer to the online and local resources listed in the resources section for more detailed information and please speak with your healthcare provider or a mental health professional immediately.   

Anorexia Nervosa

Anorexia nervosa (anorexia) is a serious mental illness that can be life-threatening. People with anorexia nervosa eat very little or not at all and lose dangerous amounts of weight because of this. It is more common with females, and usually starts in early or mid adolescence but can happen to anyone at any age.

A person with anorexia may:

  • Restrict the amount of food they eat
  • Exercise a lot
  • Have a lot of fear about gaining weight 
  • Feel "overweight" regardless of their actual weight
  • Think about their body weight often and use it to measure their self-worth
  • Not fully realize the seriousness of their condition

 Not eating enough can affect a person's entire body. Consequences of anorexia can include:

  • Feeling cold all the time
  • Very low energy
  • Poor concentration
  • Low blood iron
  • Bone loss
  • Digestive problems
  • Low heart rate
  • Low blood pressure
  • Fertility problems
  • Heart and kidney problems

Sadly, up to 10% of people who have anorexia die as a result of health problems or suicide.

Bulimia Nervosa

Bulimia nervosa (bulimia) is a serious mental illness that can be life-threatening.  People with bulimia go through cycles where they binge (eat large amounts of food) and then purge (get rid of the food and calories) by vomiting, using laxatives or over-exercising. The person often feels ashamed or embarrassed about bingeing and purging and may try to hide their actions. They may often be at a "normal" weight, but they may go up and down in weight, so it is hard to see what is happening.

A person with bulimia may:

  • Restrict food at times and then binge eat
  • Consume  a really large amount of food in a short time
  • Feel out of control over what and how much they eat
  • Purge by vomiting, using laxatives or over-exercising
  • Feel negatively about their weight, shape and self-worth
  • Not fully realize how serious their condition is

Consequences of bulimia may include:

  • Dehydration
  • Electrolyte imbalance
  • Digestive problems
  • Damage to teeth mouth and throat (due to vomiting)

Bulimia is often linked with anxiety, depression, self-harm and thoughts of suicide. 

Binge-Eating Disorder
Binge-eating disorder is a mental illness where a person has episodes of overeating. People who have binge-eating disorder may feel like they can't control how much they eat, and feel distressed, sad, or guilty after bingeing. Like all eating disorders many people try to keep bingeing a secret. Binge-eating can be a way to cope or find comfort, and it can sometimes develop after dieting.

A person with binge-eating disorder may:

  • Eat a very large amount of food during a relatively short period of time
  • Feel out of control about how much and what they eat
  • Not be able to stop eating once they start
  • Eat very quickly
  • Eat even if they are already full
  • Eat until uncomfortably or painfully full
  • Eat alone because they are embarrassed by what and how much they eat
  • Feel sad, guilty and disgusted after eating

Some people may fast (not eat for a period of time) or diet after periods of binge-eating but the binge-eating episodes are not usually followed by purging, like in bulimia.

Consequences of binge-eating may include:

  • Weight concerns
  • High blood pressure
  • Increased risk of type 2 diabetes
Disordered Eating

Disordered eating is a condition where the person has some symptoms of an eating disorder but the symptoms do not occur as often or to such an extreme that a health care professional would diagnose them to have anorexia, bulimia, or binge-eating disorder. Disordered eating behaviours can include weight, shape or size  preoccupation, a striving for perfection, yo-yo (on and off) dieting, cutting out certain food groups with no medical reasons like allergies, excessive exercising, fasting or restricting, compulsive overeating, purging, steroid use, and laxative abuse.

Disordered eating can happen once in a while or at certain key moments in your child's life, often as a result of a stressful event, illness or preparing for an athletic event. However, when disordered eating goes on for long periods of time and starts to get in the way of your child's everyday life and activities, or is used to cope with strong feelings, it may lead to an eating disorder. People who engage in disordered eating are more at risk for eating disorders.

Credit: Body Image, Self-Esteem and Mental health, heretohelp, 2015

Who is affected by eating disorders?
Eating disorders can affect anyone of any sex, age, backgrounds and cultures. However, there are some things that make a person more likely to develop an eating disorder:
  • Low self-esteem or poor body image
  • Being a perfectionist
  • Difficulties coping with stress
  • Not having good social supports
  • Genetic predisposition
  • Having a mental illness like anxiety or depression 

While the media may often show unrealistic body images as the ideal, such as very thin or muscular body types, this alone does not cause an eating disorder. How we think about and act on what we see is what affects our self-esteem and self-worth.  

What can I do to help my youth with an eating disorder?
Supporting someone living with an eating disorder can be very challenging. The symptoms of an eating disorder can often be viewed as signs of other conditions.  If you do see some signs and have concerns about your child's well being, trust your instinct.

It is important to know that those with eating disorders try very hard to keep it a secret, so parents may not pick up on the signs or symptoms until the disorder is more advanced. So parents should not feel guilty or blame themselves if they did not see it earlier.

Many people feel upset or even frightened when learning someone they care about has an eating disorder. Focusing on how to best support and understand what they are going through, instead of trying to control the person and the issue will bring about the best outcomes. Here are some tips on how you can support your child with an eating disorder:

  • Be aware of your own thoughts and actions around food and body image
  • Model healthy and positive attitudes towards food and body image
  • Remember that eating disorders are not just about food, they are a sign of mental health problems and/or coping strategies, so try not to focus on food or eating habits alone.
  • Never force someone to change their eating habits or trick someone into changing their eating pattern
  • Try not to react positively or negatively when a loved one talks about their bodies (ex. If your loved one expresses "I'm so fat", instead of saying they are not, say something like "it sounds like you feel uncomfortable in your body today. Did something happen at school that might be stressing you out?" then talk about that issue.
  • Seek help from a professional early and support them through this process
  • Get professional help for yourself and other family members to learn how to best support the individual and yourself
  • Take care of yourself! In order to support someone else, we must first take care of ourselves
How can I support a positive body image and self-esteem for my youth?

Although a child's body image and self-esteem will be influenced by many factors, parents can play a crucial role in supporting their child's relationship with their body and in helping them build a healthy body image and self-esteem.

Be a positive role model
Parents are the first and most significant role models in their child's life. You are faced with the difficult challenge of modeling positive feelings toward their body image, nutrition, and exercise. Here are some tips that you can use to help your child develop a positive body image and self-esteem.

Think about your own body image

How you think about your body, and how it affects you, is really up to you. Here are some ways to re-frame the way you think about your body:

  • Remember that health and looks  are two different things
  • Realize that a certain body size, shape will not bring you happiness or fulfillment 
  • Try not to judge people based on their weight, their eating habits or their activity level. Try not to judge yourself either!
  • Value yourself based on who you are, not what you look like. Appreciate yourself for your character, strengths, achievements, and talents
  • Try not to let your feelings about your weight, shape, and what you eat determine the course of your day 
  • View media with a critical lens. Consider whether the messages they send about body image are healthy and/or realistic. Remember that it's your body, and how you feel about it is up to you

Improve your own body image

Here are some tips for improving your body image: 

  • If you are feeling down about yourself, talk to someone you trust like a friend, family member or healthcare professional.
  • List your strengths, talents and other qualities that you love about yourself.
  • Surround yourself and spend time with people who make you feel good about yourself and who support you.
  • Find a balance in achieving health and in life too! Focus on healthy eating, being active, and feeling good about yourself.
  • Choose a physical activity you enjoy. You are more likely to do it often if you like it. Do it for the joy of it, not to lose weight.
  • Wear clothes that express your personal style and that are comfortable to you.
  • Carry yourself with confidence and pride in knowing who you are.
  • Do something positive every day.
  • Find beauty in yourself and in others.
Media Literacy
The media is a powerful force in our lives. Movies, music, TV, video games, magazines and social media affect how we see themselves and their environment. This impact starts in early childhood. It is good for youth to question the messages they see every day about beauty and body shape. Parents can help their youth by teaching them to think about the message and ask questions like:
  • Who created the message or ad?
  • Who is the message meant for?
  • Who is the message trying to reach and why?
  • What creative things are used to get my attention?
  • What values, lifestyles, and positive points of view does the message show or not show?

Girls and young women:

Talk about how media images of beauty are not realistic. Girls can learn how these images are made to make the models look more beautiful or thinner. Tell them that companies use things like airbrushing, soft focus cameras, digital editing, makeup application or cosmetic surgery to make models look a certain way.  This will help youth realize that even models and celebrities in the beauty industry do not even meet the standards.

Ask your youth:

  • Do real women look like the models?
  • Will buying this product make me look like this?
  • Does this model really use the product to help her get that look?
  • How does this message make me feel?
  • What do these messages do to girls?

Boys and young men

Talk to your youth about the athletes they look up to. Most sports stars train for long hours as part of their job and have a team of professionals helping them with training and proper nutrition. This is also true for actors. Remind them that images they see are made using things like airbrushing, soft focus cameras, digital editing, makeup or cosmetic surgery to make them look perfect.

General Tips
  • Model positive self esteem and body image. As a parent your teen can see all the good things bodies can do. By having a healthy lifestyle, being active, eating well and feeling good about yourself you are helping your teenager resist extreme exercise plans and dieting messages.
  • Build strong relationships with your youth as good communication and less family stress will help your child develop a positive body image. This will allow you to ask questions about their feelings and know what is going on with your child.
  • Encourage your teen to be active. Being active is an important part of physical self-esteem. Physical self-esteem is the attitude someone has towards physical activity.  When teens exercise to improve their health, instead of to lose or gain weight, they are more likely to have a positive body image. They can learn to appreciate what their bodies can do, instead of how it looks to others.
  • Help your teen develop and value their strengths and abilities in different parts of life. For example, get them involved in extracurricular activities like art classes, martial arts and yoga. This can include spiritual, intellectual, emotional, social and physical qualities.

Do you have more questions about parenting?

  • Connect with a registered nurse from Health811 for free, secure, and confidential health advice. Service is available 24/7 in English and French, with translation support also offered in other languages. Call 8-1-1 or visit
  • Connect with a Community Navigator from 2-1-1 for information about community programs and resources across Eastern Ontario. Helpline service is available 24/7 and in many different languages. Call 2-1-1 or visit
  • Connect with other parents on the Parenting in Ottawa Facebook page.
  • There are a variety of services to make it easier for your child to grow up healthy in Ottawa.
  • You can update your child's immunization record using either the CANImmunize App or the Immunization Connect Ontario (ICON) Tool
  • If you have received a message from Ottawa Public Health such as a letter or a call regarding immunization, an infectious disease, or infection control lapse, please call 613-580-6744 and listen to the menu options carefully.

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