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Body Confidence Linked to Better Mental Health in Teens

Boosting children's self-esteem and satisfaction with their appearance could help reduce the risk of poor mental health among those of higher weight when they reached later teenage years, a study  suggested.

Prevention strategies in the national curriculum, in commerce, and on social media platforms aimed at destigmatising weight could help schoolchildren avoid a range of negative social and emotional problems in later years, according to researchers at Imperial College London (ICL).

In a longitudinal cohort study, published in the journal eClinicalMedicine, investigators used anonymised records for 12,450 singleton children aged between 11-17 years from the Millennium Cohort Study. The participants comprised 51.7% boys and 48.3% girls, with most of White British heritage.

Weight, Body Image, and Self-Esteem

The data was used to measure a range of factors that included how the participants felt about their appearance, their self-esteem, body mass index (BMI), dieting behaviours, experience of being bullied, and any mental health difficulties encountered.

The results suggested that having higher weight at the age of 11 years was reflected in having poorer body image and lower self-esteem in early teenage years compared with those who were normal weight. Each successive point at which BMI increased from the norm at the age of 11 was associated with an increase in scores of unhappiness with appearance (0.12 for boys, 0.19 for girls) and an increase in odds of low self-esteem (16% for boys, 22% for girls) at the age of 14. 

At the age of 14, being unhappy with the way they looked and having lower self-esteem was reflected at age 17 in a higher risk of emotional and social symptoms, including anxiety, depressive symptoms, aggression, and impulsivity. 

Children with obesity had a greater prevalence of emotional problems at the age of 11 compared with children of healthy weight (18.9% vs 10.3% for boys; 18.7% vs 10.8% for girls).

Having higher weight has previously been associated with being bullied as a child, and the study suggested that children who reported frequent bullying were more likely to have poor mental health outcomes during adolescence than those who were not bullied. However, there was no significant link between being a higher weight and frequent bullying, or being bullied impacting later weight status, according to the researchers.

Reducing Weight Stigma

Dr Dougal Hargreaves, from ICL's School of Public Health and senior author of the study, said that "investing in the right support for young people during this critical window of development can lead to lifelong health and economic benefits". He added that "reducing weight stigma during adolescence could be one important step to improving long term outcomes".

Dr Dasha Nicholls, a child psychiatrist and eating disorders specialist from ICL's Department of Brain Sciences, and study co-author, said the findings "adds to the evidence that supporting young adolescents to have a positive body image and developing confidence and self-esteem is important for both their mental and physical health in the longer term".  

The research was funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research. SS, DN, and DH are also funded by the NIHR Northwest London Applied Research Collaboration.