By Dr. Marshneil Chavan, a primary care physician at Premiere Pediatrics in Irvine, part of Rady Childrens Hospital Orange County’s primary care network
Right before schools resume in the fall, there is usually a sense of excitement in the air.
However, for many middle and high schoolers, this is also a time of severe anxiety about their appearance.
Teens have always cared about fitting in. However, today’s social media — with its AI capabilities and filters — rewards perfection, which can push normal self-consciousness into a dangerous obsession.
And this obsession can lead to body dysmorphic disorder (BDD), a mental health condition in which one cannot stop thinking about minor or sometimes perceived flaws. This can eventually lead to significant distress and impact a teen’s ability to function in daily life.
Although BDD is most common in older adolescents and young adults, the age of onset can be in the pre-teen years or even younger. Also, while more common in girls, it can affect boys as well, manifesting as an obsession with spending hours in the gym to become hyper muscular and lean.
Recognizing body dysmorphia in its early stages is important. If left untreated, it can lead to depression, eating disorders, isolation, self-harm — or worse. So early intervention is critical.
Here are some signs to watch for and some things every parent should know:
Seeking reassurance: How do I look? Do I look fat? How’s my face?
If your child frequently asks you these and similar questions, and if despite your reassurances they don’t appear to be satisfied, this could be a red flag.
Mirror obsession or avoidance: Spending hours in front of or constantly checking themselves in a mirror — or completely avoiding mirrors or photos — also are warning signs
Hiding their body: Hiding themselves under baggy clothes and heavy hoodies even in hot weather
Excessive self grooming: Be on the lookout for your teen applying layers and layers of
makeup to hide some minor or imagined flaw.
Withdrawal: Be wary if your child consistently skips family events or avoids spending time with friends.
Weight fluctuations: Rapid or frequent fluctuations in weight, hunger and eating patterns also is a concern.
If you recognize any of these behaviors in your child, talk to your child’s pediatrician. After an initial assessment, your pediatrician may refer your teen or pre-teen to a psychologist for treatments such as cognitive behavioral therapy (CBT). In severe cases of body dysmorphia, your child may be referred to a psychiatrist if medications are necessary.
At home, you can also make a difference by changing how you talk about body image.
It is important to model positive behavior about your own appearance. Instead of focusing on your flaws such as weight or wrinkles, focus on health goals and say things like, “I want to move my body more.”
Shift the focus off your child’s weight. Avoid commenting on their weight. Instead, tell them that weight is a tool to measure overall health and an indicator of lifestyle and not a definition of who they are. Remember to praise your child’s efforts and achievements, instead of their physical appearance.
When your teen voices their insecurity, do not dismiss their concerns. Acknowledge what they are feeling and don’t debate their flaws — perceived or real. Let them know that you are there to support them and get them the help they need.
