Mrs Zürrer-Simmen, do teenagers suffer from beauty mania?
Mrs Zürrer-Simmen, do you treat more young people in your practice who are critical of their bodies than you used to?
Cases of anorexia and bulimia - serious psychological disorders affecting the body - have not increased in my practice in recent years. But of course, children and adolescents take a critical look at their bodies and are not always happy with them, but this does not equate to illness. After all, puberty is a revolutionary phase characterised by doubts and insecurities. Teenagers want to please themselves and the opposite sex, and this is no different today than it was in the past.
Young people do experience more pressure regarding their appearance than in the past.
I'm not sure about that. I rather have the feeling that today's young people are more relaxed about their bodies than we were back then. For example, I often see girls confidently wearing skintight dresses in line with the latest fashion, regardless of their figure. It seems to me that there is greater tolerance of appearance today than in the past. What's more, appearance isn't just a way of looking good, it's often also a way of positioning yourself and provoking others.
We all want to be perfect. Perfection is almost celebrated, especially on social media.
That is definitely the case. People like to show their best and most favourable side. Young people are also often quite open about their physicality, which also poses a potential threat. On the other hand, they can encourage each other in what they do, how they are and how they look; they can emphasise their own advantages, which can even strengthen their own self-image.
«Many young people today have a negative self-image
that doesn't correspond to reality.»Susanna Zürrer-Simmen
And if a child is bullied online?
Bullying in general and especially online - via WhatsApp, Facebook and even in class chats - is a problem that I encounter much more frequently in my practice today than in the past. The content is far more perfidious, psychologically hurtful and sometimes massively anxiety-inducing than problems with «external» appearance, even though these are also bullying issues. Adults, whether parents or teachers, need to be vigilant in this respect, observe carefully and listen.
Do you notice a difference in how boys and girls deal with the topic of the body during puberty?
I have noticed that boys, in particular, are paying more attention to their bodies, working out in the gym and wanting a sporty figure. Girls are more aware of their diet, many don't eat meat, for example. But I also see the exact opposite. Young people let themselves go, eat fast food and hardly do any exercise, which is a growing social problem. I don't see any gender differences here.
Do programmes like «Germany's Next Top Model» convey a false body image?
The fashion world in general conveys false body images, but at least this is being publicly discussed and questioned. I am convinced that the majority of young people do not identify 1:1 with these ideals. Healthy children are perfectly capable of setting themselves apart and looking for their role models elsewhere. I always advise parents to watch such programmes together with their children in order to start a conversation. This also applies to social media such as Instagram or Facebook. Ask your child questions, show interest and don't just criticise!
How does a «sick» body image manifest itself in a child or adolescent?
If I start from the fat/thin pattern, many young people see themselves as too fat, which is not a problem per se. They watch what they eat and do more sport. The changes to the body during puberty mean that the body has more curves and becomes heavier. Many young people can experience this with pride. It becomes problematic when a «diet» doesn't end. It's like a long-distance runner who simply continues to run past the finish line. The person concerned continues to feel that they are too fat and wants to lose more and more weight. This can lead to them withdrawing from family life and then from their peer group, focusing mainly on food and calories and seriously damaging their health. Teenagers can also feel generally worthless just because they don't conform to the so-called body ideal.
How do you work with your young patients?
I try to get to know the perspective of the young person concerned. Many of those who come to me have a negative self-image that does not correspond to reality or is one-sided. It's not just the «facade of the body» that characterises them, but many other features - how they think, how they feel, who they are, their special abilities and other facets of their personality. In this way, I broaden their perspective and try to strengthen their self-confidence by helping them to recognise their individual qualities. If there are specific causes or triggers for their difficulties, such as bullying, difficulties at school, problems in the family, traumatic experiences, these must of course be addressed, if possible with the involvement of the adults involved.
Struggling with your own body is part of puberty. When do you need professional help?
In general, I recommend talking to a specialist, for example your paediatrician or family doctor, if there are changes in your child's behaviour or mood that worry or unsettle parents. They may then arrange for paediatric psychiatric or psychotherapeutic treatment. Interventions at an early stage are usually shorter than for more advanced health problems. I have also noticed positively that the threshold for seeking specialised help is lower today than it used to be.
About the person:
Susanna Zürrer-Simmen is an FMH specialist in child and adolescent psychiatry and psychiatry in Wetzikon ZH.