Body Image and Self-Esteem in High School Students

 I am too fat. I am too skinny. My butt is too big. My hair is too curly. Does any of this sound familiar? To me, these statements help define the issues that the teenage girls have to deal with, the emotions that come along, the behavior that results from the issues and emotions. So this week’s post is devoted to the health behavior as it relates to the body image in teens.
During one of my first visits to a high school somewhere in the United States, I took a tour of the school to familiarize myself with the surroundings in case we get called into one of the buildings for an emergency. When I was walking in the health education section of one of the buildings, my gaze got drawn to a very colorful board made up of clippings from what looked like students’ essays. I came closer, and here is w hat I saw:

  The board was a collection of the thoughts on body image. At the beginning of the semester, one of the health education teachers made up a collage that reflected the feelings the students experienced regarding their body image. She kept the postings anonymous, and displayed the collection on the wall to make the rest of the students realize they were not the only ones to go through changes that affected their body and their self-esteem.
 

 
 
 
 
 
 
 
 
 
 
 
 
 A few weeks later, I was lucky to visit this teacher’s health education class, and I was even luckier to visit it during the time, when body image and disordered eating were discussed with the students. Part of the homework for the class was to visit the board that I mentioned earlier and to make observations about it. I was amazed by the feedback that the students provided about the postings, the students’ comments were very insightful and mature for the age. Here is what I heard:
“All [the postings] were about physical things”
“I can relate to some of them”
“I noticed that some of those things you could change by exercising, or eating right. Other things, you could change my dying your hair, or dressing in different clothes. But doing so can change who you truly are”
“A lot of the postings were about weight. I noticed that it was about what [the students imagined] people thought about you and your body”
“I think about my body image all the time; you can’t escape it, it is everywhere: it is in the mirror, in the movies, and your friends talk about the looks”
The issue of body image and self-esteem is very important during the high school years. Body image is how people feel about their own physical appearance, while self-esteem is about how much people value themselves. Self-esteem is important because feeling good or bad can affect how people act. This is where theories of health behavior may provide some information about why people feel a certain way about themselves, and why people act a certain way. These answers may be useful to the nurses so that they can provide better care. For example, a problem of body image and self-esteem can be viewed from the macroscopic approach of conceptualization of the health problem (Yes, I do think that body image is a community health problem, because it leads to multiple problems including eating disorders, cutting, and suicide). According to this model, the individual, here a teenager, is in the middle, the center contains the problem of interest: inadequate self-esteem based on the distorted body image. In this context, interventions would focus on individual high school students, or a small group of students with this problem.
The rest of the class time was built according to the principle of microscopic approach; the teacher incorporated various activities to examine the students’ attitudes to body image, to examine the prevalence of distorted body image, to locate the sources of influences, and to introduce ways the students can optimize coping with the developmental changes occurring to their bodies as well as mental issues that accompany these changes. She explained that the student struggle with the issue of self-esteem at this vulnerable age, because puberty causes changes in the body. By asking the class respond to how they felt about other people criticizing the way they looked, she examined the sources of influences. Since all the activities were conducted in a very informal manner, and the students could move freely in the classroom, they felt more comfortable expressing their feelings.
I think that this class taught me about the ways to talk to the girls if they come to the nurses’ office to discuss body-image issues, help me find ways to examine causes of disordered eating, and allow me find strategies to make these girls feel like they are not the only ones, that there are things they can do, and that after all, there is a person they can trust and always talk to.