Teenagers unhappy with their physical appearance at 50-285% higher risk of depression by age 18, warns study
Teenagers who are not satisfied with their physical appearance are at a significantly greater risk of depression by the time they reach early adulthood, according to researchers. They found that this increased risk ranges from 50% to 285%, with boys more likely to experience severe depression than girls.
“Social media has a strong influence on how adolescents perceive their body. It is possible that in the era of social media and increasing pressures on body ideals, male adolescents have also become sensitive to these pressures, which may translate into later depressive episodes,” write authors from Erasmus University,
Rotterdam, The Netherlands. The study has been published in the Journal of Epidemiology & Community Health.
Dislike of one’s physical appearance, which is formally referred to as body dissatisfaction, affects up to 61% of teenagers worldwide. It has been identified as a risk factor for eating disorders, unhealthy behaviors, and poor mental health. “Studies have shown that women tend to be more dissatisfied in the Americas compared with other world regions and in urban, rather than rural, contexts, with no effects of ethnicity. Prevalence of body weight dissatisfaction in Western countries ranges between 34.1% and 61.8% among teenage girls, and between 14.1% and 39.9% among teenage boys,” investigators explained.
However, few studies have explored the issue among young men and millennials -- those born between 1981 and 1997 -- to factor in the influence of the internet, technology, and social media. To plug these knowledge gaps, the investigators drew on nearly 4,000 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based long-term tracking study of women and their children born in 1991/1992 and living in Somerset, England.
When they were 14, about 3,753 teenagers were asked to rate satisfaction with their physical appearance by scoring their weight, figure, body build, and specific areas, including breasts, stomach, waist, thighs, buttocks, hips, legs, face and hair, on a 5-point scale, where 0 equals “extremely dissatisfied” and 5 equals “extremely satisfied.”
The analysis suggests that both the boys (1,675) and the girls (2,078) were mildly satisfied with their body, overall. But girls were more dissatisfied than boys. Girls tended to dislike their thighs, stomach, and weight but liked their hair and hips. Boys tended to be dissatisfied with body build, stomach, and hips, but were not bothered about their hair, weight, or legs.
At age 14, nearly 1 in 3 (32%) of the girls and around 1 in 7 (14%) of the boys were dissatisfied with their weight, and around 1 in 4 (27%) girls and 1 in 7 (14%) boys were dissatisfied with their figure.
When they were 18, depressive symptoms were formally assessed using a validated scale. Girls were more likely to experience episodes of depression than boys. One in 10 (10%) of the girls reported at least one mild depressive episode compared with 1 in 20 (5%) of the boys. Nearly 7% of the girls and nearly 3% of the boys reported at least one moderately severe depressive episode, while severe depressive episode(s) affected 1.5% of the girls and less than 1% (0.7%) of the boys.
Analysis revealed that body dissatisfaction at the age of 14 predicted depressive episodes of all degrees of severity among the girls and mild and severe depressive episodes among the boys by the time they were 18 years old. These findings held even after taking account of depressive symptoms at the age of 14.
Among the girls, each increase in the body dissatisfaction scale at the age of 14 was associated with a heightened risk of experiencing at least one mild (63%), moderate (67%), and/or severe (84%) depressive episode at the age of 18. The strength of this association increased with the severity of the depressive episode.
The authors emphasize that the impact of body dissatisfaction on mild depressive episodes was comparable between boys and girls, but its impact on severe depressive episodes was stronger among the boys. Each increase in the body dissatisfaction scale at the age of 14 among the boys was associated with a heightened risk of experiencing at least one mild (50%) and/or severe (285%) depressive episode at the age of 18.
The experts acknowledge that the lack of ethnic and socioeconomic diversity in the ALSPAC data, and the absence of any information on sexual orientation may limit the wider applicability of the findings. They suggest that future studies might consider exploring the role of dissatisfaction with specific body parts as opposed to looking at body image “as a whole.”
According to the researchers, the findings point towards interventions targeting body dissatisfaction from early adolescence. Public health efforts should adopt a “more holistic approach” that considers both physical and mental well-being, they recommend. “These findings demonstrate that body dissatisfaction should be considered as a public health issue of pressing concern. (It) is highly prevalent among young people in the general population and has an increasing incidence; the findings indicate that reducing body dissatisfaction might be an effective strategy to reduce mental health issues,” the team concludes.