Body Image Curriculum
Adolescence is a period of social, cognitive, emotional, and physical change and transition that can be challenging. During this period there is rapid and drastic physical change that can be disruptive to an individual's sense of self and body self-image. This article provides a brief discussion about the issue of body dissatisfaction and how this has been promoted by our socio-cultural ideals through messages transmitted by the media. This discussion of the problem is followed by an overview of suggestions that have been made by researchers, clinicians, and health educators about the incorporation of prevention programs and what information and skills students should be acquiring through the programs. The World Health Organization's Health-Promoting Schools framework is discussed in detail and is followed by examples of body image programs that have been created for both genders and specifically for female students.
Keywords Adolescence; Body Dissatisfaction; Body Image; Diet Mentality; Eating Disorders; Health Literacy; Health Promoting Schools Framework; Psychosocial Development; Self-Esteem; World Health Organization (WHO)
The period of adolescence involves rapid change and many transitions that are social, cognitive, physical, or emotional and relate to identity formation, sexuality, and social and familial relationships (LeCroy, 2004). The primary task of the early and middle adolescence periods is to attain a positive sense of self in response to the changes that are occurring (Blythe, 1987, as cited by LeCroy, 2004). The attainment of a positive sense of self is challenging, as it requires the individual to call upon coping mechanisms (that he or she may not possess) to navigate through the changes and transitions. Unfortunately, girls have a particularly challenging time gaining a positive sense of self, as research has indicated that adolescent girls have lower self-esteem and self-confidence than adolescent boys (Blythe, 1987 as cited by LeCroy, 2004). In the early twenty-first century, policy makers, researchers, and clinicians have grown more concerned about the overall health status of adolescents, adolescent girls in particular (LeCroy, 2004). Adolescent girls are feeling increasing pressure to be physically beautiful and sophisticated, which often results in the use of chemicals and becoming sexually active at an early age (LeCroy, 2004). These pressures are also leading adolescents to feel a general dissatisfaction with their body shape and size, which has become the norm for young American women and is increasing with young men and pre-teens (Kater, Rohwer, & Londre, 2002).
The Body Image Issue in America
The emphasis on physical beauty and perfection is underlined by socio-cultural forces in America (Kater, Rohwer, & Londre, 2002). American culture equates feminine desirability with physical appearance, and that desired appearance with an unnaturally and unhealthily lean look (Kater, Rohwer, & Londre, 2002). This socio-cultural value is promoted incessantly in the media, where Americans are inundated with images of the desired appearance, and advertisements for diet miracles, exercise equipment, and beauty products. These media campaigns reinforce the message that being thin is beautiful and desirable, leading to body dissatisfaction for many who do not fit this ideal. Body dissatisfaction is the general dissatisfaction that one has with body size and shape. This is manifested in the preoccupation with the subjective experience of "feeling fat," or a fear of becoming fat regardless of actual size (Kater, Rohwer, & Londre, 2002). These deep-seated cultural values have also contributed to the "diet mentality," which is the belief that restricting calories and nutrients is the method by which one can attain the desired body, and that anyone with willpower can obtain a fat-free appearance. Those who do not meet the ideal are considered as not doing what it takes and subsequently receive negative judgment and discrimination (Kater, Rohwer, & Londre, 2002).
These cultural norms and diet mentality have been cause for the aggressive dieting trends in America. As a result, socially vulnerable adolescent girls are increasingly anxious and dissatisfied with their developing, fuller bodies, causing them to compromise their nutritional intake during their formative years (Kater, Rohwer, & Londre, 2002). This disproportionate emphasis on controlling external appearance during the formative years of adolescence creates a disconnection with the "deeper sense of identity and integrity in which healthy ego strength is built" (Kater, Rohwer, & Londre, 2002, p. 199). This disconnection and inability to develop and confirm personal identity and ego strength contributes to higher rates of depression in adolescent girls (more so than boys), which causes them to focus on obtaining the right look, make-up and beauty products, fashion, and denying their hunger (Kater, Rohwer, & Londre, 2002). There becomes a preoccupation with eliminating fatness and attaining the "right" appearance that is not grounded in the desire to achieve a healthy weight. This preoccupation leads to a "willingness to compromise physical, psychological, and ethical integrity to achieve that look" (Kater, Rohwer, & Londre, 2002, p. 199). Research has indicated that 6 percent of adolescent girls will experience body dissatisfaction that eventually manifests itself as a diagnosable eating disorder (Kater, Rohwer, & Londre, 2002). Eating disorders are serious illnesses that can be life threatening.
Prevention of the Poor Body Image Problem
The severity of poor body image issues and the medical and psychological problems that result have led health professionals to develop programs, literature, and other resources to focus on the prevention of body dissatisfaction. The period of adolescence, particularly early adolescence, is an ideal time for educators, agencies, and other health-focused organizations to conduct preventative interventions as they can have a positive impact on the mental health of girls and help in the prevention of decreased self-esteem and self-confidence (LeCroy, 2004). School-based prevention programs should be introduced into the upper level elementary school curriculum as a means to create a foundation to stop unhealthy behaviors and attitudes from developing (Kater, Rohwer, & Londre, 2002). Prevention models have been created by researchers, treatment providers, government health providers, and non-profit organizations and focus on the cultural factors that contribute to concerns about body image and eating problems (Kater, Rohwer, & Londre, 2002).
Prevention models typically vary in approach; however, they typically focus on fostering resistance to culturally transmitted risk factors and messages (i.e., media messages about feminine "ideal," dieting) (Kater, Rohwer, & Londre, 2002). Most prevention models focus on:
• “Genetic influence and acceptance of diversity in height, weight, and body fat,
• Developmental changes in appearance expected with puberty,
• Counterproductive and dangerous effects of weight loss dieting, and the importance of choosing sufficient, varied, wholesome food,
• Value of physical activity,
• Skepticism and critical thinking regarding mass media messages that contribute to body dissatisfaction, and
• Protective factors such as self-acceptance, life skills, and healthy coping mechanisms” (Kater, Rohwer, & Londre, 2002, p. 200).
Specifically, the body image curriculum should incorporate activities that include peer involvement, parental involvement, and sports/physical activities (O'Dea & Maloney, 2000). Intervention programs should also address feminist issues (i.e., stereotypes and empowerment of women) and teach students how to deconstruct the social body image ideals and related messages from the media (O'Dea & Maloney, 2000). Programs provide adolescents with information that helps them to know who to ask/where to go for help and how to use the help/information that they are provided (LeCroy, 2004). This power of knowledge is critical, as many adolescents are faced with problems that are not visible to their families, teachers, or friends, such as depression, eating disorders, and poor body image (LeCroy, 2004). Programs should also implement a process or actively identify students who are at-risk for developing eating disorders (e.g., ballet students, athletes, and overweight students and/or those with high trait anxiety...
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