Social Media, Body Image & Self Esteem: What’s the Connection?

By: Megan A Moreno, MD, FAAP

Ever since social media burst on the scene in the early 2000s, parents and health experts have worried about the potential impact on kids, particularly early teens. Now researchers are asking how the curated content kids see online makes them feel about themselves.

Newer studies show that picture-perfect selfies and videos on Instagram, TikTok and other social media platforms can shake a young person's confidence. Kids who compare their authentic lives to these unreal images may find themselves feeling anxiety, envy and sometimes obsessive thoughts that can harm their health.

Photo editing: blurring lines between reality & fantasy

Celebrities and influencers work hard to attract social followers (usually with an army of stylists, makeup artists, trainers and videographers helping them). But thanks to filters and photo editing tools like Facetune and others, kids may feel they can make themselves look perfect too. More than 70% of social media users refuse to post pictures online before photoshopping them, one study shows.

This desire to erase all flaws can be especially harmful for kids of color. Research shows that photo editing apps often use beauty standards modeled on white people, reinforcing racist views of what's attractive and what's not.

When healthy self-improvement turns into an unhealthy obsession

Setting goals and striving to meet them can be good for kids. But extreme content on social media can push them toward unrealistic standards that encourage dangerous habits. A few examples of social media-fueled trends that may have unhealthy effect on body image:

• Bigorexia, a condition that drives young people to spend countless hours in the gym and eat a protein-heavy diet to build a "jacked" body.

• The "small waist pretty face" TikTok challenge may trigger deep insecurity, driving many kids toward the distorted self-images linked with body dysmorphia.

• Ultra-low-calorie eating plans posted by celebrities and influencers can worsen eating disorders in kids who already have them—and inspire unhealthy eating in others.

Social media algorithms keep the cycle going

Social platforms are designed to keep kids scrolling by serving up the content they like best. Most social media platforms use an algorithm to track what users view and watch, and deliver more similar content. This means that a teen who views unhealthy content out of curiosity may be shown more and more content of that type. It can become nearly impossible for them to outrun the images and stories that can drive compulsive behaviors.

Ways this may affect your child

Social media's overall impact on an individual child is impacted by many factors. This includes their temperament, personality, health status, peer group and the content they view. However, it is also important to keep an eye on ways that social media can crowd out healthy behaviors that are also critical to mental health and self-esteem.

For example, social media can contribute to reduced quality and quantity of sleep. It can also crowd out other important responsibilities such as schoolwork and time with family and friends. Even kids who don't fall into harmful eating or workout regimes may experience this crowding out of healthy behaviors and habits.

5 ways to help your child use social media in healthy ways

Here are some suggestions from the American Academy of Pediatrics (AAP) Center of Excellence on Social Media and Youth Mental Health that can help your child use social media in positive ways to learn, connect and grow.

Start with open communication

Kids often resist any move adults make to curb their freedom, so aim for a non-judgmental approach.

Ask your child to guide you by asking questions like these:

• What types of media have you been enjoying lately?

• What types of content do you like to view on social media?

• Do you ever see content that makes you feel worried or uncomfortable?

• What strategies do you use to limit your viewing of content that you don't want to see?

• Let's talk about content that is designed to make people look a certain way. Do you sometimes see content that looks totally fake? How do you think those photos and videos are created?

• In your own feeds, do you avoid posting anything that isn't "perfect?"
  

As your child opens up, try to listen more than you talk. Make this a learning session that will help you uncover possible concerns and topics for future conversations. You don't have to "solve" everything about social media in one conversation, the goal is to keep the lines of communication open over time.

Talk about how social algorithms work.

You may find your child knows a lot about the inner workings of the digital world. Still, they may not think too deeply about the content "bubble" that algorithms create.

If they're willing, try this experiment: open your own social platform and search for something new. (For example, if your feed focuses on sports or fashion, search for "home improvement" or "coin collecting.") Within a few clicks, you'll start to see new content on those topics.

Challenge the idea that people should be perfect.

Has your child ever felt influenced by an influencer? Or jealous of a peer whose social presence seems to show an ideal life? It may help to acknowledge that comparing ourselves to others is natural, but perfectionism can harm us.

Share some of your own experiences.

Though your main goal is to learn from your child, pointing to examples from your own life may be helpful. For example: "I used to watch hours of videos showing how to improve my tennis swing. But in the end, it just made me feel nervous about my game. Going out and practicing worked a lot better."

Create a family media plan.

The American Academy of Pediatrics (AAP) offers a free tool you can use to build guidelines that reflect your children's ages, needs and interests. The plan you create will show your commitment to help all family members use digital media—including social media—in a healthy, responsible way.

When to reach out to your child's doctor

If you feel social media is harming your child's health, reach out to your pediatrician right away. Red flags may include:

• Dramatic changes in eating habits

• Extreme or obsessive workouts

• Difficulty falling asleep or staying asleep

• Loss of interest in friends or activities they used to enjoy

• Looping worries that won't leave them alone

• Hiding out in their room much more than normal

• Signs they're thinking about suicide
  

No matter what symptoms you see, your pediatrician or family doctor is ready to support you in finding the right care and resources for your child.

More information

• More about social media and teen mental health health
  

• Helping your teen create a self-care plan

• Conversation starters about media
  

• Dangerous social media challenges
  

• When teens see and create curated images (AAP Center of Excellence on Social Media and Youth Mental Health)