February 09, 2024
BMI, body dissatisfaction and depression: positive steps forward
We know that more adolescents are experiencing depressive symptoms than in the past, but we don’t yet know precisely why. Noting a need to understand modifiable risk factors for depression, which could inform future preventative work, our researcher of the month, Dr Francesca Solmi, and her team, have recently published new and novel findings about the impact of high BMI and body dissatisfaction on children’s later mental health. They “found strong longitudinal evidence that a high BMI in childhood is linked with an increased risk of depressive symptoms multiple years later” and discovered that body dissatisfaction accounts for a significant proportion of this link, finding strong evidence that being unhappy with one’s appearance at the age of 11 is linked with increased depressive symptoms during the teen years.
Summary
Body dissatisfaction refers to a person’s negative feelings towards their body as a result of a discrepancy between their perception of their body and the body that they would like to have. Their body does not match their desired appearance and this mismatch creates a sense of unease and unhappiness. Body dissatisfaction can be related to different aspects of body image. People may have concerns about their height, skin, hair. In many cases, this unease focuses on concerns with weight and shape.
The study used data from the Millennium Cohort Study, an ongoing nationally representative longitudinal birth cohort study that recruited 18,552 families with a child born between 1st September 2000 and 11th January 2002 in the UK. The young people in the study have been followed up at regular intervals, and both they and their parents have been asked various questions about their lives, thoughts and behaviours. Examining data from 13,135 children, the researchers used a measurement of BMI taken when they were seven, a measurement of depression which young people completed themselves at the age of 14, and data on body dissatisfaction which was gathered at age 11. Children were asked, ‘How satisfied are you with the way that you look?’ and they answered on a scale of 0-6.
The researchers found that high BMI at age seven was linked with increased depressive symptoms (including low mood, loss of pleasure and poor concentration) by age 14, as well as with greater body dissatisfaction at age 11. The researchers found that about 40% of the association between higher BMI and depression was explained by the fact that the children with higher BMI at seven years of age, experienced greater body dissatisfaction at some point between the BMI measurement and the measurement of depressive symptoms at the age of 14. All of these associations were twice as large in girls compared to boys.
Weight and shape concerns are more common in younger people with higher BMI. It is thought that, in the context of people with higher weights, body dissatisfaction often stems from the internalisation of stigmatising beliefs and societal attitudes towards people with higher weights and the notion that being slimmer is preferable.
The findings suggest that any efforts to reduce weight in childhood need to consider their potential mental health impacts, in order to avoid stigmatising weight and increasing body dissatisfaction, and instead support children’s mental health and wellbeing.
Implications
“Reducing body dissatisfaction in young people could be an important way of preventing depression, particularly in girls, at ages when social environments and peer relations become increasingly impactful.”
Implications for parents
We should consider doing everything possible to decrease the likelihood of a young person with a high BMI developing body dissatisfaction. This may have a protective impact on their mental health during the teen years.
Talk about what bodies can do, not just what they look like. Research shows that focusing on the functionality of your own body and of your child’s, rather than appearance, leads to a higher level of physical resilience and a more positive body image. This encourages young people to value how their body helps them to achieve physical tasks, not just its aesthetics.
Avoid negative talk about your own body. Try not to let your child hear you say things like, “I hate my tummy”, “I look so fat today” or, “Look at my wobbly thighs”. If you do have these thoughts, try to reject them and consciously notice the parts of your body that you do like. We want our children to like their bodies, so try not to disparage your own.
Promote body gratitude. Recent studies show that expressing gratitude for the ways that our bodies serve us can improve body image. Encouraging your children to note down the things that they like about their bodies can help to counter the pervasive messages that we are all exposed to about fixing and improving our bodies. Make sure that your child understands that it is not big-headed or vain to like things about their body or to care about how they look.
Give your child compliments that are not appearance-related. Talk about their kindness, their lovely manners, and all of their other wonderful qualities, attributes, attitudes and skills.
Tackle teasing. Teasing about appearance and weight can be hugely detrimental to positive body image and to young people’s relationship with food. Try to have open conversations with your children about their relationships with friends. Make sure they know that teasing is not acceptable. If they are being teased, talk through strategies for dealing with this.
Implications for schools
Carefully consider curriculum content and whole school campaigns about ‘being healthy’. Ensure that any messaging around fitness and healthy eating is evaluated through a body image lens before implementation.
Dr Francesca Solmi
Principal Research Fellow in the Division of Psychiatry at University College London.
Dr Francesca Solmi is a Principal Research Fellow in the Division of Psychiatry at UCL. She is an epidemiologist by background and her research mostly focuses on understanding risk factors for eating disorders in young people and the role of body dissatisfaction in causing adolescent mental health difficulties. She is currently leading a programme of research trying to understand if and how some environmental risk factors, such as schools and social media, can contribute to body dissatisfaction and eating disorder risk in young people, so that we can develop preventative interventions to improve mental health in adolescents.
Dr Francesca Solmi
Principal Research Fellow in the Division of Psychiatry at University College London.
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