Take for instance, one of my 15 year old clients who is so convinced that she is fat that when I first met her she was only drinking water mixed with apple cider vinegar for breakfast and lunch.
For dinner she would have a very small meal. She was not overweight, but due to teasing about her “putting on some weight” by both her mom and peers, she see’s herself as fat and ugly.
Because of all this, her self-esteem is shot and it’s taken weekly individual therapy sessions and weekly support group sessions to get her to at least start eating a light breakfast and lunch, although she is still struggling with body image and self-esteem issues.
Society Creates Body Image Issues In Girls
Unlike boys, teenage girls are put under immense pressure to be beautiful, thin and feminine in most Western industrialized countries. However, biological changes and weight gain are natural parts of pubertal development.
Like the client I was talking about above, her weight gain seems to be more of a womanly weight gain. She seems to be filling out and taken on the body of a woman, compared to that of a prepubescent child. This natural weight gain that most girls experience during puberty, goes against our cultural’s view of what being beautiful is, which for women includes extreme thinness.
These are conflicting messages for preteen and teenage girls.
On one hand, they are naturally developing and putting on weight, while on the other hand, they are getting messages from society that says their weight gain is unattractive.
Female identity in one part is defined in relational terms, society says they are supposed to be interpersonal and care about other peoples needs, feelings and interests which makes them more vulnerable than males to other people’s behaviors towards and opinions of them.
Another major part of female identity is beauty. In our culture, physical attractiveness contributes a lot to interpersonal success, which is one of the main reasons females strive to be beautiful, to assure popularity and respect.
Also, physically attractive girls are typically seen as more feminine compared to less attractive girls or girls who challenge our cultures traditional views on femininity through their political views such as feminist, or through their sexual orientation, such as lesbians.
Girls tell our society that they are feminine by being concerned with her looks and trying to achieve our culture’s ideal of beauty.
Because our culture demands that girls care about other people’s opinions and that they are defined by their physical appearance, which society says includes being very thin, there’s no wonder girls are motivated to pursue thinness, at times by any means necessary including starving themselves to death.
Combine these issues with the natural weight gain of puberty and there’s no wonder many teenage girls develop body image issues.
Many teenage girls I’ve worked with who are physically perfect, not even slightly overweight, some were even underweight, suffer from intense body image dissatisfaction.
A girl I’ve been working with since last year was naturally thin, yet wanted to be thinner so bad that she starved herself to the point of needing to be hospitalized. Like many of the girls I work with who have body image issues, her pursuit for thinness and beauty was so consuming that almost every other aspect of her life, including her education, goals and future took a back seat.
Not all girls with body image issues go on to develop an eating disorder like the young girl I just mentioned above, but many of them will.
Eating disorders are a major concern when it comes to the health of teenage girls with an estimated 1% to 3% likely to meet diagnostic criteria for either anorexia nervosa or bulimia nervosa.
Anorexia nervosa is when someone refuses to maintain a minimal average body weight and has body image disturbances such as feeling fat even when they are very thin, and in females who are menstruating, they may experience amenorrhea if their body weight is low enough.
Bulimia nervosa typically includes periods of binge eating, followed by drastic methods to compensate for the binge eating including excessive exercising, fasting, vomiting, using laxatives, etc., accompanied with body image disturbance such as thinking one is much more overweight or unattractive than they really are.
Besides these two eating disorders, there are some girls who have other patterns of eating that fall under disordered eating, such as laxative abuse, vomiting after eating some meals, extreme calorie restriction, and binge eating.
Eating disorders typically begin in early adolescence with much of it’s symptoms typically evident by the late teen years.
While not all girls with body image issues develop full blown eating disorders, there is little research into why some girls do and others don’t develop an eating disorder.
During part 2 we will look at some of the risk and protective factors for young girls to develop an eating disorder.