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Teen Angst or Body Dysmorphia?

When health authorities refer to obesity they call it a "health crisis".

There is another health crisis around - and it's not about being fat. It is a mental health crisis that abounds among young teenagers.

Responding to a post on teen weight gain, Claire writes:

I hate the way I look.

I am 14 years old, I weigh 128lb and I'm 5"8.

I know I'm fat, and girls at my school pick on me about it, and they tell me to lose weight.

Her comment goes on to describe an aggressive exercise schedule, and a diet that includes no fast food and a home-made packed lunch. Claire is brimming with frustration - she cannot lose the 18 pounds that she "knows will make her look a lot better". She ends her comment with a lament: "I don't know what's wrong with me!"

Almost Underweight

If those personal statistics are correct, Claire has a BMI (Body Mass Index) of 19.5 - putting her in the healthy weight range but quite close to the underweight range.

A well-meaning adult may try to convince Claire that there is no problem here. However it seems Claire's opinion of her weight is more than just an opinion - it is a deeply held belief. A belief that is confirmed by her peers.


Teenage boys are not immune either.
Psychiatric Diagnosis?
Body Dysmorphic Disorder (BDD) can be defined as "those who are extremely critical of their physique or self image, despite the fact there may be no noticeable disfigurement or defect" (see DSM-IV definition). BDD is sometimes referred to as "imagined ugliness".

Whether we use clinical diagnoses or not - there is a problem here - a problem that goes beyond teen angst. Claire is not worried that she might be fat - she is worried about how she cannot seem to lose weight despite "eating right and exercising".

Fat Phobia

Is there a link between this condition and the amount of obesity reporting that goes on? The alarm bells have sounded for many years now. "We are in the midst of an obesity epidemic" shout the headlines.

How does this filter through to youth? Do they fear fat as if it were impending doom? Do they believe that everyone is fat and if you're not trying to lose weight you are not normal?

Is this just teens being teens or is it symptomatic of a widespread and growing mental health 'crisis' ?

More like this in Body Image and Teens and Kids
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87 Comments(Now closed for this article)

Spectra

I am an extremely active person and I eat very healthy foods. I am not fat, but I do worry about it. Our society is waging this huge war on obesity and it's so common to see diet foods, exercise encouragement, and the like everywhere you go. It's like the media is telling our culture "you can never be too thin". No wonder teens have issues with weight...they think that if you aren't trying to lose weight, you are a bad person because you could OBVIOUSLY be thinner (according to society). I myself am underweight and healthwise, I actually need to gain some weight. By Hollywood standards, I'm normal or even a little on the heavy side. It's enough to make anyone sick.

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j

I am a teen (19) but consider myself past the highly self concious stage, I can remember at school getting by on a tuna salad sandwhich a day, if that, but it wasn't because of all of the reports about obesity, i was and still am far from that, i jus wanted to be skinny(im now over that and just want to look good). I think the reports are important, we can't become a noation where everyone is obese!!

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scone

It's crazy out there, and it's not just teenagers. Look through the weight loss blogs and you'll find many examples of people terrified of gaining an extra pound, even though their size is in the single digits! And then there are the trolls who put in their nasty comments, to the effect of "size 10 is fat." Curiously, some people who were once truly obese, feel even more pressure to be unnaturally thin-- many of the "successful" weight losers are exercising for two or more hours per day, restricting calories to 1200 or less, etc. This often leads to obsessing about food, binge behavior, yo-yo dieting, etc. A potentially dangerous cycle. The blogs themselves aren't necessarily helping, as there is a sort of unspoken rule in this subculture, that one should not question anyone else's weight loss goals, even if they seem to be leading to neurotic, even anorexic, behavior. Teenagers, IMO, are simply imitating the crazy behaviors they see all around them.

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Kitt

FWIW, I think some of this can be traced to early development, particularly in girls. I remember developing to the point of adulthood-size at age 10-11, after which I grew very little (though I did put on weight). You're kind of appalled to become what I'd call self-aware of yourself as a true individual simultaneous with popping out all over, and seeing yourself take up so much more space externally than your head believes you do/should makes for a dissonance that makes you feel fat, even if you're not. I remember being about 10 and weighing 102 at 5 foot 6 and thinking I better cut back severely. 100 seemed to be a terminal line over which a child should not cross -- even if an adult should. This is where I think we get this mental twisting that goes on, or at least some of it.

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Colleen

I think every teen girl whoever lived has some notion of being imperfect and for most, its a weight issue. I'm 5'3" and 125lbs and some days I feel like a 1000 pounds, but other days, I feel fine. With raging hormones and constand pressure at schools and elsewhere, most girls see there bodies differently than they actually are. Is BDD a disease? Yes, I read an article about a girl who didn't just think she was fat, but thought her nose grew overnight into twice its size. However, can the episode of Claire be considered BDD? Not necessarily, because she is most likely comparing herself to the girls in her class who are 5'1" and 100 pounds, not the girls that are 5'8".

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Helena

I do not entirely agree with you. I used to be 240 pounds. Now I am 135, at 5'7" (admittedly a slightly higher BMI than that of the girl you quote). Many people come to me, telling I look way too thin now, downright asking if I am anorexic. I am not. I even still have a fat belly, but if I have the courage to say that I am sure they will talk (or write a blog post :) ) behind my back. I have noticed many people think only models wear (EU) size 34, and that everybody who wears size 34 must have a model's figure. This made me feel very insecure for a while. I actually wondered if I were hiding an eating disorder from myself (I wrote about that here). Even though I wear size XS, I can pinch more than an inch of belly fat, so that means I am still not at my optimal weight, according to some doctors.

I am not saying the girl you quoted has the same issues as I did. Maybe she really has a distorted view of her body, like anorexics who still see fat even though it really is not there. However, people vary, bodies vary. It is very possible that somebody who has a low BMI still has a fat belly or a fat butt. Whether you should want to lose that is an entirely different question of course. It does sadden me very much to see teenage girls so obsessed with their weight. I wish the focus were much more on eating healthy instead of losing weight.

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ali

wow. we are so messed up by the media. 19.5 is so freaking healthy! if only models and celebrities are fatter, then we'll all feel better about ourselves. lol

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healthy_choices

It's interesting to me that the obesesity headlines would be blamed for eating disorders. When I was young, it was blamed on the media... It seems to me that whenever people are stressed (real or 'imagined') a person's mental health may be at risk. There are more eating disorders today because of stress.

As a mother of three daughers, I'm very aware of eating disorders/body image etc. of young people. Since my daughters were very young, I've taught them that it's about health, not weight. If make healthy food choices, and get daily exercise and sleep you'll be healthy. Unfortunately, we live in a time where making those those healthy choices are harder than ever. Even for educated, healthy adults!

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Melissa

I am going to be completely honest...not something that is easy when it comes to this topic. But I can totally relate to what this girl is talking about. I don't know if it is a disorder or not, but worth wondering about. I am 5"8 and 120-123 pounds (depending on time of day and what I have eaten :-) I feel like a cow all the time. I count EVERY calorie and have tried to live off solely vegetables alone many times in effort to gain weight. Having been heavy for most of my life, I have bene fiarly thin now for a couple of years (I am now 23 yrs old). I used to be 160 lbs. Maybe it is some kind of internal fear that if I dont obsess, that I will go back to that, I don't know. Maybe I will never be truly happy with my body. I think maybe I could be 110 lbs and STILL think that I could stand to lose a few. I feel fat all the time. And it is frustarting. It affects everything in my life and constantly takes over my mind. So yeah, really, unless you know what that is like, you can't really say that she is crazy. Because I understand a little. However, no one tells me I am fat. I would hate to think of how I would react if they did.

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Calorie-counter

What's crazy is our culture.

The facts of mainting a healthy weight haven't changed: you need to consume the same amount of energy that you burn. It sounds so simple, but it certainly isn't easy. Particularly in today's world. Food is so readily available - and it's super saturated with calories. For example, the plethera of coffee shops... constantly tempting us to stop in for cup. And if we choose a cup of black coffee (or better yet, green tea!) we're fine. But that's not what people are drinking - it's not frozen mocha carmel delight blah blah blah that can easily cost 350 calories!

Our only defense is to count calories. Melissa, your not crazy! You're very wise. Keep up the good work :)

P.S. Eating disorders are a mental illness and shouldn't be confused with what the majority of us are struggling with.

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Mandy

No, Calorie-counter, please don't encourage Melissa's negative body image and obsessiveness over food as "good work :)." Melissa sounds like she's on the verge of an eating disorder, not doing a great job--feeling "like a cow all the time" and "living solely off vegetables at times" is not healthy. Something that "takes over your mind" and "affects everything in your life" is different than just counting calories.

I agree about counting calories and exercise as a way of life, but you must balance that with self-love. It doesn't seem like Melissa can or will appreciate her body for what is good about it. She says that at 5"8 she could drop to an astounding 110 lbs and still want to lose more, and you think this is "good work?" I just don't see it that way. I have been exercising and eating right, and counting calories to either lose or maintain weight is part of that, but I also appreciate what is good about my body and give myself a pat on the back when I make a positive change or get great results after months of hard work at the gym.

Melissa, if you continue to feel fat and out of control when it comes to dieting and/or exercise, talk to your doctor at your next check-up and find out what you can do. Talk to someone who can help. I hope that someday you'll see yourself as more than just a woman who could lose more weight. Good luck.

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Robin

Though I am not a teen I am the mother of one and another waiting in the wings. My oldest thinks she is ugly. Every once in a while she speaks also of being fat. I have tried through out her life to never say words that hurt and ruin her self esteem. However I can't help what her friends have done. I can only try damage control. Now at 17 it's very difficult to reverse what has been done. She also has a tendency to skip breakfast and it doesn't matter how I try I can't get through to her how important this is. Her eating habits are not good. She occasionally tries to eat right but then falls off the wagon again. When that happens it means not eating any meals untill eavning. As for being ugly I don't understand. While I know everybodies taste is differnt I'm certain anyone would agree she's far from ugly. I don't know what I'm going to do, I still have an 11 year old to deal with!!!!!!!!!

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Krystina

I'm 17 years old and 5'7" and i weigh 126 lbs. According to a chart on "healthy weight" for that age and height that i was looking at in a health office, that's overweight.
Yes, it makes me insecure to know that. And yes, i worry about my weight a great deal, and am very critical of my self-image.
But i don't let it affect me to the point of doing things i wouldn't normally do. I don't go on diets, i don't skip meals, and i don't beat myself up everytime i eat fast food (because i don't eat it often anyway).
I do work out three times a week or more, and i do what i can to eat healthy. It's not always easy though because i'm a person that loves food. And most of the food i love is packed with carbs.
I don't think this girl should worry so much about what other people think of her. I know I don't. And it's not an easy thing to ignore comments that hurt you, but if you do, they'll eventually get bored of getting no reaction from you and stop.
Just keep exercising NORMALLY not BRUTALLY and eat properly. You will eventually lose weight and you'll be a lot happier with your health.

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amy

I don't understand how on any chart 5'7" and 126 lbs is overweight. A healthy BMI range is 20-25 and at those stats your BMI is 20, at the low end. Even given the formula of "5 lbs for every inch over 5 feet" a healthy weight would be 135. Either you read the chart wrong or you need a new doctor.

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anonymous

I am also and I am 5’5” I used to weigh 165 pounds. I now range any where from 115 to 105. Lowest weight I ever was I think was a bit below 100. I started out an exercise bulimic in junior high, when I reached high school I became just bulimic, then later anorexic, and I really have just gone back and between the two since then. I think dieting can be seriously addictive I never set a goal I just kept wanting to loose more.

My eating patterns are pretty messed up. I will go 3 days on nothing at all then almost pass out then binge because I get so scared that I will just pass out for no reason at all. Then I will feel better the next day and go back to not eating again till I feel like I am going to pass out and so on. When I binge I eat well a lot. I have never been the type of person to count calories, but I eat as much as 3 or 4 people would eat in one day and when I do not eat I do not even drink water I usually do genmaicha tea which is a mixture of green tea with brown rice.

It really saddens me to that so many girls more than ever these days seem to be developing eating disorders. I suppose I could blame it on the media, but for some people like me I think it is really a lot deeper than that. I just really wish eating disorders did not exist and we can all be happy with our bodies because these last 4 or 5 years have been hell for me.

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Raquel

My BMI is 19.9. im 5'', i'm 15, and i weigh on average about 102. Depending on if i'm sick or on my period, i can weigh between 98 and 105. i'm going to try for the next couple of months to loose 8 pounds so i can ge my BMI down to 18.4! that would be great (maby i'll even grow a bit) when i'm done groing i would like to idely be about 5''5' and 115 pound.

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Andrea

hi i am 5"1 and i weigh 126 lbs. i think am fat but the doctor says i'm fine. i don't think i am fine. i want to lose 7 lbs before september. am i really fat?

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Tiffany

when i was 9, i weighed a shocking 135 lbs. i was so unhappy. but then i lost 13 lbs. and gained some back. i now weigh about 130 and i am 5'1. its weird bcause some days i wake up thin, and some days i wake up fat. i am not sure how much i weigh because i don't like to weigh myself. i think i have some sort of problem. i am constantly looking in the mirror to see if i "gained weight" since the day before. i skip meals. i constantly exersise. i continuesly look at my wrists. please help me to think good of myself. also my mom won't let me lose weight.

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sandia

I am a fourteen year old teenage girl and i have been wanting to loose weight. It is almost impossible in today's world. I thought i actually had the chance to loose weight when i ordered some diet pills called EP200 and instead of loosing the weight, i gained like ten pounds now. I used to weigh 130 pounds, at 5'2 and i just can't believe it. right now i'm in vacation and could u believe it now how am i going to look when i come back. i want to sue that stupid pill program for doing that but i'm to young and i cant afford a lawyer. i still cant believe it. what i thought was going to be a dream turned out to be a nightmare.

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piggy

I am 5 '6 and 15 years old. I have been struggling with my weight for 2 years now. I used to weigh 232 pounds, and then I got down to around 130, but recently it's like I can't control my eating and I eat when I'm not hungry. I even ACKNOWLEDGE the fact that I'm not hungry....but I just keep eating!! I've come all the way back up to around 150-155....and I just don't even want to go outside. I feel very ugly and fat. I don't know what to do. Is eating the way I do a problem?? And most of the time when I diet I eat around 400-700 calories a day and don't drink that much water.

Should I go see a doctor?

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DERİN

You should go outside.As long as you stay at home,you will want to eat more.Go outside and walk.Don't feel ugly or fat.Just walk.If you stay at home,you will put on weight.COS THE THINGS YOU CAN DO AT HOME ARE LIMITED.AND YOU ARENOT THAT FAT.

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Kashia

Im 5" 11" and i weigh about 110 pounds! i wear a triple 0!! my doctor says im way to thin. i dont really like the way i look i want to put on about 15pounds but my body wont let me b/c ive been starving myself for so long! i can eat a egg and be full! indeed i am anorexic and it dosent feel good! i am a model and in order to be the face of models you have to be stick thin! to all young people love yourself b/c when you let yourself go only you can fix it! being anorexic might look good but it dosent feel good! i would give anything to be a normal weight

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carolina

ever since i was around 10 ive been overweight and although ive lost weight since then i feel as though i will never be thin enough. I guess that it has had an effect on me now im 16 5'5" around 138 and athletic but i hate the way i look. I constantly wish i was skinny. everytime i look in the mirror i see a chubby face and when i shop i have to look for sliming clothes to wear, im so sick of being fat. Attending my school especially doesnt help considering that most girls are anorexicly thin. I hate the fact that the only celebrities who make the covers of magazines are the ones who have become dangerously thin. When i express the way i feel to my friends they say im normal size but i dont see that, i always seem to be thinking "well i lost 15-20 pounds id be decent size". but its not that simple to loose weight when i play volleyball and gain muscle in my legs and the rest of my body.

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krys<3

hi i'm 17 years old and im 5'10.5" last school year at the end of 10th grade I let myself go and got up to 170 pounds(about 20 pounds above what my height should be) so that summer I exercised a lot, ate healthy foods but had my "cheat days" as well. And I got down to 143 pounds which is healthy..then school started up again and i got up to 165...now summer is here and i gained 5 more poundz which sucked, but now I'm 159 and am still losing. I think a weight that I have a lot of energy and look really good in clothes is 150. But to all you girls conserned about thinness, do not fall for that. Why would you want to be super thin? You lose all your shape and womanly parts like your boobs! And what guy wants a girl that will crush in his arms? Also, you all should stop worrying about being super skinny. Try to build muscle so you can defend yourself. Being really skinny makes you an easy target! All my love goes out to you!..And I will pray 4 all of you!..mwah

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Cassie

I am almost 14 years old. I weigh about 106lbs. Is that normal? I feel way over weight! I exercise and try to diet but i think it would be easier to just not eat. Everyone says i look like i weigh less than 100 and that makes me feel good. I think WOW! maybe i lost maybe i look 98lbs. When i get on the scale and it says 106.5 i sometimes cry. I hate it. Am i just obsessed with my weight?

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kate

hi i am a 15year old girl about 5ft6-5ft7 i weigh 123 pounds i really think am fat am i overweight ?

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derin

123 POUNDS MAKES ABOUT 56 KG AND YOUR HEIGHT IS ABOUT 1.72-1.73 cm,right?If so,you are not fat.

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chelsea

im 5'4 and weigh 120 i feel grooooooooossss and overwieght and it makes me upset, im not an ididot and won't start puking my brains out, but i wont to lose allot of wieght.

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chelsea

Am i over weight?

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chelsea

want*

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chelsea

i'm 15 tooo

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derin

chealsea you are not overweight.you are normal weight.

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derin

if you are 120 pounds(nearly 55 kg) you are normal.

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chelsea

but normal isn't normal anymore is it? :( i just feel idk i just feel gross. i really want to just drop a few to make myslef feel healthier or better image, but i always go to extremes with excersise and not eating or eating, and i just dont know what to do. thank you for responding.

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derin

Chealsea,I calculated your body mass index thanks to natural physiques(Jeremy Likness's site) which is a recommended site here.And it says normal.If you feel gross,you should change the way you think.Don't go to extremes if you don't wanna lose your health.

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trish

i feel so bad for the girls out there today that weigh 100 pounds and still see themselves as fat. I am 5'0 and weig at least 180, i am fat, i understand that, but at least i can deal with it. It hurts me so bad to see these tiny girls wanting to be thinner, its sad how they put themselves down so much that their mind acually belives it doesnt need food. and if they try to eat they are lucky to keep it down naturally, their tummys being as tiny as they are can bearly keep anything down.

if only the media today wouldn't protray skinny to be sexy. girls are suppose to have curves, that is what is sexy. but alas, the shallowness of todays teen boys see it differently, therefore to them thin is the thing... (well some of them anyhow, not all!)

For thoes out there that are actually over weight significantly and want to loose it, walking early in the morning is great! fresh air, not as much traffic, and its not hot outside. stay away from sugar of course, cuz its just empty calories! also, smaller portions during the day instead of a great big meal, apple here, orange there, you know good snacks.

For thoes out there that think they are overweight, ask your doctors opinion. if he tells you to loose a few pounds, then maybe go for a walk, but dont jump into these crash diets! some girls out there are simply gorgeous, and they ruin themselves by making their body look like a toothpick. if you are 14 years old, weigh 128lb and ur friends call you fat... maybe its time for some nicer friends... how skinny are they to call you fat? it is so crazy how mean girls are to eachother today!

id better stop, im ranting and raving too much...

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Kandis

I can relate. Im turning sixteen in 4 days and I weigh between 120 and 125 lbs...plus I am about 5'4" which is normal. I used to be able 5'3" and 160 lbs but I lost alot of weight over three months or so. I have gone through the anorexia and bilimic ordeal. Trying to find any way to become "thin" so boys would like me and girls would admire me. I went overboard, all I thought about was food and counting my calories, fat, and saturated fats was my life. But I went into "rehab" to be fixed and now stay on medications and am watched constantly to make sure I dont "disfigure" myself.
Before I didnt realize how much people didnt see my weight and loved me for me. Now I get asked constantly if I am sick and I even get the occasional..."you look disgusting". I do feel better buying clothes and things, but I still feel HUGE!Im not overweight at all, I kno it. But the mirror tells me something completely different every day and that can never change.
Even though you dont see it, you all are beautiful. You are perfect without diets, the latest clothes, and makeup. I hope you have someone there that can see that and be able to remind you of it everyday....

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marie

i'm in college now; about 5'3" and weigh between 125-135 pounds but like the others feel huge at certain times and not others. when i was 11-12 i developed an eating disorder and became nearly anorexic. however, i recovered and now it seems 100% impossible to lose weight. i can't do it. don't know what to do because college is so stressful it makes me want to eat and not exercise.the times when i do get myself out to the gym i feel great afterwards; the hard part is being consistent and stop turning to food as a comfort blanket from the stresses of school. i don't know why i can't just use the elliptical or the treadmill as a comfort blanket instead?

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fattgirl

I feel so incredibly fat! I'm almost 14 years, 5"5 and I weigh 127-132. I can't stand it! I have a skinny stomach, lots of muscles, I'm athletic, but my butt and thighs are so massive, I just don't know what to do about it! If i ever lose a kg or 2kg or sumthin it only seems that I stomach is gettin smaller, which is not the place that I really want 2 be smaller. My friends are always commenting 2 me on how skinny I am and they think I weigh a lot less than I do 2. I don't wear pants or a mini skirt ever (never tried on a mini skirt) so they cant really even see my fattest parts. I really need a good diet 2 go on, I don't want to become anorexic or anything though, 1 of my friends is buleamic and a couple of other girls in my skool r anorexic, so this really does not help my self esteem. I need help :(

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Jan

fattgirl: you're not fat. You're at a good weight for your height and you're athletic. I know it is hard not to compare yourself to those skinny girls, but they are SICK and you're healthy. Their teeth will rot away, their hair will fall out, while you'll remain healthy.

You do not need a weight loss diet but eating healthy is always a good idea. You know, no junk food, eating your vegetables, fruits, dairy, lean meats, carbs like potatoes, rice, and bread (preferably whole grain ones, if available), and good fats like olive oil, avocados, nuts, fatty fish like salmon. That is really all you need.

I doubt your legs are as big as you think they are, and even people who wear size 12 look good in body-skimming pants (not pants that look painted on, that is not what I'm saying, just pants that fit your thighs). Wearing baggy pants will just make your legs look bigger. If you are not comfortable in a miniskirt, you just aren't (sometimes it isn't for looks at all, it is also for the practical "how to sit" etc. aspects), but I'm sure that at your weight, your legs would look perfectly fine in one. Try one on at a dressing room, to get used to it. And remember: you're not fat. You're not as big as you think. You're doing fine and those girls at your school are killing themselves. If you have to write these in a notebook 100 times to believe it, or repeat them to yourself 100 times, do it.

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