Adolescent Health
Practice Update from the National Association of Social Workers

Volume 2, Number 4
November 2001

Adolescent Girls and Body Image

Eating Disorders

Anorexia nervosa is self-starvation. People with anorexia have an intense fear of body weight, and eat very little even though they are thin.

Bulimia nervosa is characterized by cycles of binge eating and purging. People with bulimia fear body fat although their weight may be normal.

Binge eating disorder means eating large amounts of food in a short period of time without being able to stop when full. Bingeing is often accompanied by feeling out of control and followed by guilt or depression.

Disordered eating
refers to troublesome eating behaviors, such as restrictive dieting, bingeing, or purging, which occur less frequently or are less severe than those required to meet the full criteria for an eating disorder diagnosis.

Adolescence marks a time of rapid and intense emotional and physical changes. There is an increased value placed on peer acceptance and approval, and a heightened attention to external influences and social messages about cultural norms. Body image and related self-concept emerge as significant factors associated with health and well-being during this developmental phase, as youths begin to focus more on their physical appearance. How adolescents formulate and define their body image ideals and subsequent self-comparisons is strongly influenced by personal, familial, and cultural factors.

Social influences, however, which include the media and popular/mainstream culture, may promote specific images and standards of beauty and attractiveness that contradict good health practices and one's ability to achieve a specific body type or image. U.S. society places great value on looks and exalts images unachievable by most. For example, fashion models weigh 23 percent less than the average female, although these representations are perceived to be normal (National Women's Health Information Center, Office on Women's Health [NWHIC], 2001).


Although these messages permeate the whole of society, including adolescent boys and girls, girls are often targeted by media and social body image ideals and are more likely to suffer negative health outcomes associated with body dissatisfaction. Consider the following:

  • According to a survey of adolescent girls, the media was identified as the primary source of information about health issues (Commonwealth Fund, 1997).
  • A study of mass media magazines revealed that women's magazines had 10.5 times more advertisements and articles promoting weight loss than men's magazines (Guillen & Barr, 1994).
  • Frequent music video viewing may be a risk factor for increased perceived importance of appearance and increased weight concerns among adolescent girls (Borzekowski, Robinson, & Killen, 1999).

Many adolescent girls believe physical appearance is a major part of their self-esteem and their body is a major sense of self (American Association of University Women, 1991). The experience of body dissatisfaction can lead to poor health habits and low self-esteem. These negative feelings may contribute to a higher prevalence of depressive symptomatology and lower self-esteem among girls (Siegel,et al., 1998) and can affect health behaviors associated with poor eating habits, dieting, depression and anxiety, and eating disorders.
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