Body Image Issues

Our ‘body image’ is how we see and feel about our body and how we imagine other people see us. Sometimes those thoughts are neutral or even positive. At other times, they can become harsh, critical and exhausting to live with.

For many young people, worries about appearance show up during adolescence. Bodies are changing, social comparison ramps up, and social media can make it feel like everyone else has somehow figured out the ‘right’ way to look. If your child seems more focused on their appearance, more self-conscious, or more critical of themselves, you’re not alone in noticing this.

These struggles are often shaped by the world around them, for example, things like:

• Social media promoting narrow ideas of the “perfect” body
• Comments from friends, family or peers about appearance
• Media messages about dieting, fitness or weight loss
• Clothes and fashion that only cater to certain body types
• School or health messages that unintentionally create pressure around what a “healthy” body should look like

Over time, these influences can chip away at confidence and self-esteem.

When Body Image Issues Become More Serious

For some young people, body image concerns can develop into a condition called Body Dysmorphic Disorder (BDD).

BDD is a mental health difficulty where someone becomes intensely preoccupied with one or more perceived flaws in their appearance – flaws that usually look very minor to other people, or aren’t visible at all. The anxiety around these worries can become overwhelming and lead to repetitive behaviours aimed at checking, hiding or “fixing” the perceived problem.

BDD often begins during adolescence and is thought to affect around 2% of young people, although it is frequently missed or misunderstood.

Common signs include:

• Constantly checking mirrors — or avoiding mirrors altogether
• Comparing their appearance to others
• Seeking reassurance about how they look
• Excessive grooming, skin picking, checking or weighing
• Avoiding social situations where their “flaws” might be noticed

It’s Not ‘Vanity’

Body image struggles aren’t about being shallow or overly focused on looks. For many young people, they are closely tied to self-esteem, anxiety and identity.

They might feel ashamed of their body, avoid social situations, struggle to find clothes that feel comfortable, or feel misunderstood if their appearance is linked to things like acne, scars, disability or visible differences.

Over time, this can affect mood, confidence, friendships and daily life.

How I Can Help

The recommended first-line treatment for Body Dysmorphic Disorder is Cognitive Behavioural Therapy (CBT) – the same evidence-based therapy used and recommended by the NHS and NICE.

In therapy, I help young people:

• Understand what’s driving their worries about appearance
• Reduce the anxiety linked to perceived flaws
• Break the cycle of checking, comparing and reassurance-seeking
• Build a healthier relationship with their body and themselves

My work is always young-person centred and neurodivergent-affirming, adapting CBT to how each young person thinks, learns and experiences the world.

If you’re worried about your child’s relationship with their body — or if your child feels stuck in constant appearance worries — support can make a real difference. Early help is key, and things can get better.