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Mirror, Mirror On The Wall

My Kid’s Body Image (Zits and All)

When my children were babies, I loved buying adorable outfits. I’d dress each one up for the pediatrician’s visit, and off we’d go to see how things were going with growth and development. I always left those check-ups with great ideas about healthy living, but I’d sometimes wonder as I looked at the growth chart with my pediatrician, “Do you think he’s too skinny?” or “Is she too chubby?” I have come to see how common our concerns about appearance are, and now more than ever, part of growing up healthy means developing a positive body image. 

When I go to work every morning, I swap my Mom Hat for my Doctor Hat because my job is to help take care of other mothers’ children. I’m often asked about nutrition and how a child is growing. Feeding a family is hard work, and growing our children properly is an ongoing concern. I hear concerns like, “He’s so big – are you sure he’s not too fat?” from a nursing mother about her cherubic little boy. “Her friends seem to think she’ll never need a bra,” wonders the mom of a petite middle school girl.

Kudos to the parents who have concerns about a child’s body image and ask for ideas to help shape a positive one. We are all surrounded by messages about what our children should and shouldn’t eat, about how they should look, and in spite of our best efforts, we sometimes lose sight of the real task: building a healthy body and helping our children see that it has great value. When I serve my family healthy foods, I try to help them make the connection between what they eat and how they feel. Sometimes, it’s as simple as saying, “When you eat healthy foods, you grow a big, strong body that can run and play.” What kid wouldn’t buy into that body image? On the other hand, I have heard parents say, “If you only eat the French fries, you’ll definitely get fat.” That’s a mixed message, and one that’s very difficult for children to understand. How can something that tastes so good (French fries) make my growing body turn into something bad (i.e. fat)? And why would you let me have it in the first place if this were true?

Where does body image come from? For the young child who has to be coaxed into cleanliness and the bathtub, there’s very little thought about appearances. But almost overnight it seems, kids are growing up and broad-sided by puberty. Boys and girls both are confronted with amazing changes in their bodies. It’s almost expected that they will become more interested in their appearance around this time. Developing a healthy body image means that most of a child’s feelings and ideas about his or her body are positive ones, but ensuring that this happens takes real effort.

The world doesn’t always reassure and lead our kids in the direction of a healthy self-image. During the tween and teen years, there are constant messages about how to look and dress, and about what looks cool. Each child’s body is made differently, and it’s often hard to accomplish the right look, or to feel attractive and confident, when a rapidly changing body seems to thwart efforts at every turn.

I sometimes compare a person’s body to a car. You only get one, and it has to last for a long time, but not everybody gets a Porsche. Some bodies develop faster than others. Some makes of cars are more popular than others. Sometimes a good car wash and a coat of wax will go a long way to make the car look really good.

The car analogy bridges nicely to a discussion of what kids see in the media. Most celebrities have a fancy sports car body and usually the look to go with it. Our children are immersed in media with the same message in many different formats. Make-up and hair products and clothes are all available to ensure that you look and feel just right. Buy this stuff, and happiness comes with it. Most often, these products are sold by super-thin models and media personalities with perfectly sculpted bodies who have created unrealistic ideas of what a healthy body actually is.

It takes time for children to mature and to develop a complete self-image. We know that our kids are much more than how they look to friends, but they are only just discovering this truth. They spend extra time in the bathroom on their appearance, and their fashion statements are trying to express an emerging personality, but they are also working to gain acceptance and to find a place in something bigger than themselves. It’s no surprise that some get lost along the way.

Most kids fall short of their ideal body image, and they can obsess about whatever body part fails to match the media definition of ideal. If their concerns become a focus for constant comparison and seem out of proportion to their other interests, it may be a reason to speak to your doctor. Kids who are overly fixated on weight or who restrict their diet and exercise excessively may also need professional attention. Conditions like body dysmorphic disorder, anorexia nervosa, or bulimia are real medical conditions that deserve to be treated.

As we watch our children grow, we should think of ourselves as the balancing mirror to the one they use every day in the bathroom. Help your child to see what you see beneath the surface. Remember to be generous with your compliments, and be sincere. He does look nice in those new jeans, even if you’d prefer he hadn’t chosen the skinny ones. She does have a really warm smile – even with braces. Don’t minimize the importance and value of cultivating a healthy body image.


For more on this topic, check out Online Extras under Community at Read more from Dr. Smith at the syndicated DrDownload blog.


Gayle Schrier Smith is a pediatrician-mother who works with children at Partners in Pediatrics, a concierge pediatric practice in Richmond. Learn about Dr. Smith’s practice at
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