Teenagers who are unsatisfied with their physical appearance are at a notably heightened risk of developing depression by the time they become adults, researchers found, with boys at a nearly threefold risk of severe depression as a result of body dissatisfaction.

A new U.K.-based study, published Dec. 7 in the Journal of Epidemiology and Community Health, assessed the influence of body dissatisfaction on the frequency and severity of later depressive episodes in a sample of British adolescents. Body dissatisfaction is a formal term to describe any dislike of one’s own appearance, and has been cited as a risk factor in the development of eating disorders and mental health issues among adolescents and adults.

The researchers used participants from the Avon Longitudinal Study of Parents and Children cohort, which follows nearly 4,000 individuals who were born in the early 1990s. Every year, the participants are invited to fill out a questionnaire and travel to a clinic where their mental health is assessed. The study looked at body dissatisfaction indicators when the participants were 14 years old and tested to see if the presence of that dissatisfaction would predict the onset of depressive symptoms at 18 years old.

At age 14, 32% of the girls indicated that they were unhappy with their weight and 27% said they were dissatisfied with their figure, while 14% of the boys said they were unhappy with their weight and dissatisfied with their figure, respectively. Females indicated dissatisfaction with their weight and how their thighs or stomach looked, while males tended to be more dissatisfied with their body build and were less concerned about weight.

After being assessed for depressive symptoms at age 18, girls were overall more likely to experience depression than boys — with 10% of girls and just 5% of boys reporting at least one mild episode. However, the connection between body dissatisfaction and depression in girls and boys was different. Girls who had increased body dissatisfaction scores had an 84% increased risk of developing severe depression by age 18, but boys with the same body dissatisfaction scores had a 285% increased risk of severe depression by the same age. 

Anna Bornioli, a research fellow and lecturer in public health at the University of West England Bristol and an author of the study, said that the results regarding the boys “came as a surprise” to the researchers, and noted that much of the previous work into body dissatisfaction has been focused on females. The noted difference in how males and females are impacted by body dissatisfaction may stem from the culture in which the participants came of age, Bornioli said.

“These are really the first generation of teenagers that grew up with social media,” Bornioli added. “So they had this constant exposure to unrealistic beauty ideals.”

Women, even from a young age, are exposed to marketing and media that places them as an object of desire or attention, while men typically are not exposed to the same kind of social pressures regarding their physical appearance, Bornioli said.

“With social media, it kind of, all of a sudden, created a great exposure for guys as well,” Bornioli said. “We believe that they might be a bit more vulnerable [because of that].”

Traditional gender roles may also prevent boys from reaching out for help regarding their body image. “Maybe there’s a bit of an extra challenge … in communicating their fears or bad feelings,” Bornioli said. “They’re ‘not supposed to,’ because they’re males.”

Combating the impact of body dissatisfaction through adolescence entails creating an environment where teenagers are able to think about their bodies beyond simply their physical appearance and toward “a more holistic and functional understanding of the body,” Bornioli said.

“[We need] to shift the attention away from the body as just aesthetics, toward thinking more about everything that our body allows us to do — running, singing, listening to music — it’s not just about appearance,” Bornioli added. “It’s about a lot of functions, and we should be a bit more aware of all of this — and maybe grateful, as well. It’s important to promote this idea.”

A wider promotion of body positivity, especially by the adults who care for children going through adolescence, can also potentially be a way to offset feelings of body dissatisfaction. Bornioli stressed that adults should try to avoid “even making small assumptions based on the way a person looks,” especially around children who may internalize those kinds of comments.

“It’s difficult, because we’re all in this culture where it’s quite normal to make comments, either positive or negative,” Bornioli added. “But maybe it would be helpful, especially in front of kids, to try and avoid doing that, avoid the criticism. A more positive spin here would be beneficial.”

The study, “Body dissatisfaction predicts the onset of depression among adolescent females and males: a prospective study,” was published Dec. 7 in the Journal of Epidemiology and Community Health. It was authored by Anna Bornioli, Helena Lewis-Smith, Amy Slater and Isabelle Bray, all of the University of West England Bristol.