Up to 46 percent of adolescents in America report feeling dissatisfied with their bodies, which can lead to eating disorders, obesity, poor mental health, and other serious problems. A study involving School of Public Health data and researchers recently tracked how people feel about their bodies from adolescence into adulthood and found evidence body dissatisfaction begins before adolescence and remains constant to at least age 30. 

“Having a positive body image is integral to positive well-being during adolescence, when one is developing a sense of self-identity, but it can be challenging due to rapid growth and many physical changes during this period and the many social pressures that young people face to conform to a certain ideal,” says the study’s senior author Professor Dianne Neumark-Sztainer. “In this study, we were interested in learning whether body image attitudes, established in one’s early years, remain stable as young people transition from adolescence to young adulthood.”

Neumark-Sztainer is the director of Project EAT, a 15-year program tracking the health and well-being of adolescents into adulthood that provided data for the research.

This latest study was led by PhD student Shirley Wang from Harvard University and published in the journal Clinical Psychological Science.

For her study, Wang analyzed survey data from 1,455 Project EAT participants who have routinely completed surveys about their eating, weight, and mental health and other aspects of well-being every five years. The participants completed the surveys between approximately age 15-30 and are now providing the researchers with data snapshots into their health at different phases of development. 

“In particular, we looked to see if any patterns emerged in body dissatisfaction as people moved from adolescence into adulthood,” says Wang. “For instance, maybe some people continue to feel worse about their bodies whereas some might start out feeling bad and then get a little bit better. In such cases, we’d wonder what distinguishes which group people fell into.” 

The analysis showed:

• Overall, body dissatisfaction increased slightly over time for both men and women, however, the trend is attributed to people who also experienced gradual weight gains. 
• Four patterns emerged in the levels of body dissatisfaction participants reported:
  • Consistently high beginning in adolescence but slightly decreasing into adulthood
  • Consistently low beginning in adolescence but slightly increasing into adulthood
  • Starting high, decreasing during adolescence, then increasing into adulthood
  • Starting low, increasing during adolescence, then decreasing into adulthood 
• Nearly 95% of participants fell into the consistently high or consistently low patterns.

“The findings seem to suggest that body dissatisfaction develops and becomes relatively fixed even before adolescence,” says Wang. “The numbers remain stable from the start of the surveys in adolescence all the way into adulthood, and even the groups that fluctuate return to their initial levels.”

Wang said the fluctuating patterns could be explained by factors such as social influence. For example, those who started low and fluctuated reported that they had peers who were dieting during adolescence and young adulthood, which may have temporarily changed how they felt about their own bodies. 

In response to these new findings, Wang recommends that the public health community develop or adapt body dissatisfaction prevention programs to suit children and address the problem sooner. She also said the results provide evidence that there may be a window in childhood or early adolescence when ideas about the self and self-image are developing. Understanding the window could be a path for related research to help refine the targeting of future interventions.