Promoting healthy body image in middle school

Professional School Counseling, Dec, 2002 by Patrick Akos, Dana Heller Levitt

Middle school and preadolescence is a formative period in development. Students in middle school, in the midst of puberty, begin to establish an individual identity outside the family unit (Berk, 1999). Vast arrays of personal and contextual changes occur simultaneously (Berk; Eccles, Lord, Roeser, Barber, & Jozefowicz, 1997). Part of personal and social development in middle school is the development and continued evolution of one's body image. Physical changes, the mounting importance of peers, and the search for identity are related developmental changes that contribute to one's body image. Physical change in middle school students is varied, as students reach puberty at different times. While boys tend to benefit from early puberty, girls who develop either early or late tend to have difficulties with the timing of physical changes and feeling good about themselves (Brooks-Gunn, Attie, Burrow, Rosso, & Warren, 1989; Faust, 1983).

The increasing attention and intimacy of peers amplify physical differences that become evident as bodies change and develop. As preadolescents move away from parental influence, peers play a large role in identity formation. Physical appearance becomes a major factor in peer and opposite sex relations, and students' physical development takes center stage. With the changes in physical development, the onset of puberty, peer focus, and the task of identity formation, the development of healthy body image is an important factor for middle school students (Mussell, Binford, & Fulkerson, 2000).

The development of identity has not been consistently connected to physical development and body image (Massey-Stokes, 2000; Mussell et al., 2000). School counselors need to be aware of both risk (e.g., gender, low self-esteem, timing of maturation, disordered eating) and protective factors (e.g., healthy self-esteem, positive feelings about physical changes in puberty, accurate information about puberty, healthy eating and exercise patterns) to effectively address developmental issues related to body image. For example, Attie and Brooks-Gunn (1989) emphasized the need to focus developmentally because risk factors like disordered eating typically have their onset during early to middle adolescence and are related to both biological and social changes. In fact, because body dissatisfaction is the single strongest predictor of eating disorder symptomology (Archibald, Graber, & BrooksGunn, 1999; Franko & Omori, 1999; Leon, Fulkerson, Perry, & Cudeck, 1993), body dissatisfaction during puberty "may predispose the adolescent to develop eating problems in middle to late adolescence" (Attie & Brooks-Gunn, p. 76). While increasing protection and decreasing risk are not mutually exclusive (Munoz, Mrazek, & Haggerty, 1996), less research has been directed to protective factors or proactive intervention by school counselors.

In some schools, the discussion of body image is often limited solely to didactic instruction from physical education and health teachers. While teachers can and do play an important role, the development of a healthy body image is a protective factor that can be promoted individually and systemically by school counselors. The purpose of this article is to integrate current literature on body image and provide school counseling interventions to promote healthy body image in middle school students.

BODY IMAGE IN MIDDLE SCHOOL STUDENTS

It is nearly impossible for girls to grow up in Western society today without feeling pressure to adhere to artificially determined appearance norms. Whereas puberty for males is generally more positive, the physical changes girls experience may factor into the increased prevalence among females of body dissatisfaction and weight management behaviors. Girls are generally more influenced by body image, with 28% to 55% wanting thinner bodies compared to 17% to 30% of boys (Ricciardelli & McCabe, 2001). While boys grow bigger and stronger, consistent with the cultural ideal, girls struggle with normative weight gain that is the antithesis to the female cultural ideal (Maine, 2000). At ages 10 and 11 years, 80% of girls are convinced that they should be thinner (Friedmann, 1998). These feelings about body image often surface as behaviors that could be damaging to development. In a longitudinal study, 17.8% of 11- to 14-year-old girls reported having gone on a diet within the past 6 months, and 34.5% at the one-year follow-up indicated dieting activity within the past 12 months (Byely, Archibald, Graber, & BrooksGunn, 2000). Over one third of adolescent females report aggressive weight control such as chronic dieting, excessive exercise, self-induced vomiting, and abuse of laxatives, diet aids, and water pills (Phelps, Andrea, & Rizzo, 1994).

These disturbing behaviors most often begin in middle school, where school counselors may be the only adults who are sensitive to the integration of the various aspects of development. Understanding the physical changes of puberty and the associated behaviors that middle school students exhibit are essential. Additionally, understanding levels of body image is helpful in determining appropriate intervention. The perceptual level involves evaluation of one's body size, and the affective-cognitive level refers to attitudes held towards one's body (Pesa, Syre, & Jones, 2000).