Body dissatisfaction linked with depression risk in children

Body dissatisfaction at age 11 is linked to increased risk of depression by age 14, according to new research from the Millennium Cohort Study.

The UCL-led study, published in The Lancet Psychiatry, shows that body image concerns play a major role in explaining the relationship between body mass index (BMI) and depression in children, particularly in girls.

New research using Millennium Cohort Study

The research, supported by Wellcome, involved 13,135 participants taking part in the Millennium Cohort Study, which follows people born across the UK between 2000 and 2002.

The researchers found that high BMI at age seven was linked with greater body dissatisfaction at age 11, and increased depressive symptoms (which can include low mood, loss of pleasure and poor concentration) by age 14.

The link between high BMI, body dissatisfaction and depressive symptoms was twice as strong for girls than boys.

“We found strong evidence that being unhappy with one’s appearance is linked with increased depressive symptoms years later.”

Dr Francesca Solmi (UCL Psychiatry)

Lead author Dr Francesca Solmi (UCL Psychiatry) said: “Depression has become more common among young people, as have being overweight and body dissatisfaction.

“Here we have found strong longitudinal evidence that a high BMI in childhood is linked with an increased risk of depressive symptoms multiple years later.

“But we were particularly interested in how much body dissatisfaction might be the driver of this link. We found strong evidence that being unhappy with one’s appearance is linked with increased depressive symptoms years later. Our findings suggest that any efforts to reduce weight in childhood need to consider their potential mental health impacts, so that we can avoid stigmatising weight and instead support children’s mental health and wellbeing.”

Other factors

The research did not cover what other factors, besides body dissatisfaction, could explain why children with high BMI are more likely to develop depressive symptoms, but they say that other biological (for instance, inflammation) or environmental (for instance, bullying) pathways might explain part of the association.

“It is important to ensure that any interventions to reduce BMI in childhood do not inadvertently increase body dissatisfaction.”

Emma Blundell, trainee clinical psychologist at UCL Psychology & Language Sciences

First author Emma Blundell, trainee clinical psychologist at UCL Psychology & Language Sciences, said: “Many public health strategies seek to reduce weight in childhood. Primary school children are being taught about the importance of calories and exercise, and all young people in England are being weighed at school to determine whether weight loss efforts are needed. Whilst promoting healthy diet and exercise is important, it may be that some public health messaging could be fostering feelings of guilt or shame.

“It is important to ensure that any interventions to reduce BMI in childhood do not inadvertently increase body dissatisfaction and harm children’s mental health.”

The researchers say that some strategies to target body image concerns in early adolescence have been developed, such as with psychological interventions or media literacy training that could address self-esteem, social comparisons, and social media influences, but more research is needed to more effectively tackle body image concerns in young people.

Dr Solmi added: “Reducing body dissatisfaction in young people could be an important way of preventing depression, particularly in girls, at ages when social environments and peer relations become increasingly impactful.”

Further information

‘Longitudinal pathways between childhood BMI, body dissatisfaction, and adolescent depression: an observational study using the UK Millennium Cohort Study’ by Francesca Solmi et al. is available on The Lancet Psychiatry website.

If you have been affected by the issues raised in this report and need support:

Children and young people affected by mental health issues can find support, information and details about their local NHS mental health services on the Young Minds website or call Childline on 0800 1111.

For adults, whether you’re concerned about yourself or a loved one, you can find local NHS urgent mental health helplines and a list of mental health charities, organisations and support groups offering expert advice, on the NHS website. You call also call Samaritans on 116 123.