Let’s talk about self-esteem and body image

I think it’s safe to say that most of us have wished we could change something, or many things, about our bodies. Adolescence is one of the most common times for us to have such thoughts. Considering today’s environment of 24-hour social media access, teens and tweens are bombarded with images of perfection that are often not real or not realistic for them. They are also subject to bullying through these means, which can further impact their self-esteem. As caregivers, teachers, coaches, health care providers and friends of adolescents, we need to come together to help battle this problem.

First, let’s revisit what we mean by body image. It is generally defined as a person’s subjective picture or mental image of their own body. This includes one’s perceptions, beliefs, feelings, and actions that are related to physical appearance. It can include positive and negative feelings, and these can of course change over time.

We tend to think, “When I get in better shape, I’ll like my body,” or “When I lose 20 pounds, I’ll look great.” These thoughts are not productive and, in fact, can be quite harmful. There needs to be a focus on accepting one’s looks. Parents and other caregivers need to be aware of how they talk about their own bodies by modeling acceptance, which, while challenging for many, is healthy for the adults as well.

Another way to start is to help our kids realize that nobody is perfect, even those with what appear to be perfect bodies. It is important that they see their bodies the way they are, not the way they want them to be. It is also important to teach them not to participate in body-shaming. One way to think about it is to remind them not to say anything to themselves that they wouldn’t say to their best friends. Another path to acceptance is to avoid comparison with others. Each individual body has a strength that can and should be celebrated. Finally, we need to remind our children to accept compliments and say, “thank you,” and consider the compliment as true.

Part of accepting their bodies to improve self-esteem and body image involves taking care of their bodies. Eating healthy foods and appropriate amounts of food can help them feel good about themselves. This means teaching them about making good choices that they can maintain over time which is again another opportunity for good role-modeling behavior for the caregiver. This approach also helps improve energy, which in turn boosts self-image. Getting good sleep ties into this as well, with teens needing as much as 9 to 10 hours of sleep per night. A good night’s sleep almost precludes too much screen time when homework, meals, and after-school activities are accounted for.

Another important part of taking care of themselves is maintaining a basic level of activity with some form of physical activity daily, be it taking a dog for a walk, participating in JROTC, helping around the house, dancing at home, or of course participating in a sport. Help the children find activities they like and find fun. For those with an intense school schedule, studying while riding a stationary bike may be all they have time for.

Finally, it is critical to help teens and tweens maintain a healthy weight. What this weight is can be determined with the assistance of a doctor. As many of my patients have heard me say, when they are active daily, eat a healthy diet with lots of vegetables and fruit of different colors, limit their intake of processed foods, and get at least 9 hours of sleep most nights, they are most likely at a healthy weight for their body.

Unfortunately, sometimes body image and self-esteem problems become too much for a teen or tween to handle on their own. They can develop depression, anxiety, phobias, and eating disorders. Combating these diseases can take time, and treatment is not always successful. Anyone working with a child with low self-esteem and poor body image should make sure caregivers and doctors are aware of the challenges they are facing and help them get the help they need. Since COVID, we have seen an enormous increase in depression, anxiety, and eating disorders in our pediatric population. Fortunately, help is available in traditional office settings, through online mental health providers, and through religious communities.

These suggestions are simple ones from a pediatrician, not a psychiatrist or other mental health professional. This topic is vast and complicated, but hopefully these ideas can at least be a starting point for discussion and help our children begin the process of acceptance of who they are.

Dr. Alexandra Cvijanovich is an Albuquerque pediatrician.