This document discusses normal adolescent development and body image issues. It covers the three phases of adolescent development according to age: early, mid, and late adolescence. It also discusses how body image is shaped by various factors like perception, emotion, and environment. The document then examines common etiological factors that can influence poor body image among adolescents, such as media messages promoting unrealistic body standards. It outlines consequences like unhealthy dieting behaviors and prejudice against overweight individuals. Finally, it provides implications for healthcare providers and parents, emphasizing the importance of promoting healthy body image and lifestyles during this developmental period.

1. BODY IMAGE AND SELF
ESTEEM
Moderator: Dr. Surender
By Dr. J vikas reddy

2. NORMAL ADOLESCENT DEVELOPMENT
➤ Normal adolescent development is the foundation stone for
healthy adulthood. Early, mid- and late adolescence are the
three phases in adolescent development.
➤ Early adolescence (10-13 yrs) is characterized by
1. concrete thinking,
2. growth spurt and
3. the beginning of sexual maturation.
➤ In mid-adolescence(14-15 yrs) the physical changes are
complete, abstract thinking begins and the adolescents
develop a strong sense of identity and are very much under
peer influence although family still remain important. There
is an increased tendency for experimenting and risk taking.

3. ➤ In late adolescence (16-19 yrs) physical and sexual
maturity is complete, identity is significantly
developed and abstract thinking is well developed.
➤ WHO defines adolescence to be between the ages of
10 and 19 years of age.
➤ Puberty is a dynamic period of development with
rapid changes in body size, shape, and composition,
which are sexually dimorphic.

4. ➤ Normal adolescent development includes cognitive
skills, emotional maturity, self-identity and social
development.
➤ Health professionals should always give adequate time
to an adolescent for determining his/her degree of
biological maturity and level of cognitive development.
➤ All stake holders dealing with adolescents should impart
WHO life skills to empower the adolescents, teachers in
schools and colleges and parents.
➤ For adolescents to develop optimally, resilience and
positive environment act as protective factors to reduce
negative peer influence and risk taking behavior. A
supportive environment in homes, community and
teaching institutions is vital.

5. BODY IMAGE
➤ Body image is the dynamic perception of one’s body- how it looks,
feels, and moves
➤ It is shaped by perception, emotion, physical sensation, and is not
static, but can change in relation to mood, physical experience and
environment.
➤ Body image is influenced strongly by self esteem and self evaluation,
more so than by external evaluation by others.
➤ It can also be influenced and affected by cultural messages and societal
standards of appearances and attractiveness

6. ➤ There is overwhelming prevalence of thin and lean female
images and strong and lean male images, body image concerns
have become widespread Among adolescents.
➤ About 50-88% adolescent girls feel negatively about their
body shape or size.
➤ Only 33% girls say they are “right weight for their body” ,
while 59% want to loose weight . Just 9% want to gain weight
➤ Females are much more likely than males to think their
current is too large (66% vs 21%)

7. ➤ Over one-third of males think their current size is too
small, while only 10% woman consider their size is
smallGoing through puberty can amplify body image
concerns.
➤ Puberty for boys brings characteristics typically admired
by society– height, speed, broadness, and strength.
➤ Puberty for girls brings with it characteristics often
perceived as less laudable, as girls generally get rounder
and have increased body fat.
➤ These changes can serve to further enhance
dissatisfaction among girls

8. ETILOGY / CONTRIBUTING FACTORS
Media Messages
➤ Strong social and cultural forces influence body image
in young people.
➤ From childhood to adulthood, television, billboards,
movies, music videos, video games, computer games,
toys, the Internet, and magazines convey images of
ideal attractiveness, beauty, shape, size, strength and
weight.

9. ADVERTISEMENTS

10. BILLBOARDS

11. MAGAZINES

12. ➤ These advertisements promote poor body image
through their “beauty” ads and provide mixed
messages regarding adolescent lifestyle
➤ In childhood, popular toys such as action figures and
dolls have similar body shapes: tall and slender for
female figures and tall, slender, and muscular for
male figures. The body shapes advertised by these
toys, dolls and media sources are not realistic.
➤ If Barbie were real, her neck would be too long and
thin to support the weight of her head, and her upper
body proportions would make it difficult for her walk
upright.

14. ➤ Magazines targeted at female adolescents are full of
images of young, slim, attractive, blemish-free
females with small waists, large chests and only ever-
so-slightly-rounded hips, while magazines produced
for males are full of strong, lean, attractive, blemish-
free males, frequently displayed with the
aforementioned females in close proximity.
➤ Beauty pageants continue to be a popular and avidly
watched showcase of ideal societal beauty.

15. ➤ Adolescent females watching the most media
idealizing thin body types, such as soap operas and
movies, report the highest body dissatisfaction and
those watching music videos report a strong drive for
thinness
➤ Drive to attain the ideal standard of attractiveness for
males (bigger, bulkier, and more muscular) has been
associated with poor self-esteem and depression

16. ➤ Familial concerns and pressures may also contribute to increased
body dissatisfaction and body image concerns.
➤ Socialization encourages males to strive to become stronger and
more developed, while females are to make their bodies more
beautiful. Parents tend to become less positive and more critical
regarding their children’s appearance, eating and physical activity
as they move into and through adolescence.
➤ Parental over-concern with children being thin or encouragement
to avoid being fat can influence young people to become constant
dieters and use unhealthy weight control methods.
➤ Health professionals should work with parents to help them
encourage their children to be healthy in a manner that supports
healthy body image development.

17. CONSEQUENCES
➤ Overconcern with body image and shape can lead to
restrictive dieting and unhealthy weight control
methods which may lead to potentially dangerous
disordered eating behaviors.
➤ Societal promotion of the thin ideal may also lead to
prejudicial treatment of overweight individuals or
teasing based on weight and shape, especially among
youth. Over-concern with body image can have
damaging effects.

18. IMPLICATIONS FOR PROVIDERS AND PARENTS
➤ Providers can help parents approach their child’s
adolescent years by reframing some of the “challenges” of
adolescence as normal developmental milestones that
should be anticipated and accepted.
➤ Puberty and emerging sexuality should be approached as
positive and health affirming life changes, rather than
focusing discussions only on the negative reproductive
risks and outcomes.
➤ Even good-natured teasing about bodily changes can be
detrimental to the adolescent’s self-image.

19. ➤ Providers need to determine the young adolescents’
cognitive development and capacity for abstract
thought, and to tailor their communication and
counseling style accordingly
➤ As adolescents develop more independence and
parent–child conflict peaks, providers should remind
parents that this is typical, and that arguing does not
mean the adolescent does not value the parents’
input and perspectives

20. ➤ Although some may rebel initially, most adolescents
ultimately adopt a value system very similar to that
of their parents. Even if discussions feel ineffective to
parents, they should continue to demonstrate and
model these values to their child.
➤ Providers may need to help parents distinguish
normal adolescent development and risk-taking
behaviors from possible signs of a more serious
mental health or conduct problem.
➤ Empower youth and parents by providing them with
accurate information regarding healthy eating

21. ➤ Hypertention, dysmenorrhea, acne vulgaris and
anemia are the commonly encountered medical
problems in adolescents.
Acne vulgaris:
➤ Acne vulgaris (common acne) is an inflammation of
the pilo-sebaceous unit. It affects adolescents of both
sexes in the age group 10-19 years.
➤ The sites of predilection areface, neck, upper arms,
trunk and buttocks. The lesions of acne are a
complex interaction between hormones (androgens)
and bacteria (Propionibacterium acnes).

22. ➤ Emotional stress, comedonic cosmetics, occlusion or
pressure on skin (phone, sports equipment) and
tight fitting clothes (fashion accessories) are often
important unrecognized exacerbating factors
➤ The three common types of skin lesions of acne
vulgaris are
A. Comedones:Open (black heads) or closed(white
heads) obstructive lesions which are first to appear,
B. Papules/Papulopustules:With or without
inflammation (red). Size varies from 1-2 mm micro
papules to large 5 mm nodules and
C. Nodules/Nodulo-ulcerative lesions /Cysts:1-4cms in
diameter

23. ➤ Besides scarring, acne may give rise to major
psychological side effects such as reduced self-esteem
and depression.
➤ Medical management of acne includes an evaluation
of types of lesions, extent of involvement and
severity of the inflammation / infection
➤ Counselling for body image concerns and tips for
coping strategies are an integral part of treatment in
adolescents.

24. ➤ Care to give clear instructions on topical
applications. Benzoyl peroxide and retinoids need to
be applied only at night times and washed away in
the morning as they can cause pigmentation with sun
exposure. Retinoids can cause scaling and peeling.
➤ Parents can be reassured that although adolescence
can pose unique challenges, their adolescent, like
most adolescents, will come through it to become a
successful and happy adult

25. References:
➤ Vol 17 no 2 indian journal
pediatrics adolescent care by
swati y bhave
➤ Nelson 20th edition of pediatrics
➤ Kaplan & sadock’s behavioral
science/clinical psychiatry
Thank you