Body Image

Summary

Ask the Mediatrician: Body Image

Podcast: Ask the Mediatrician
Host: Dr. Michael Rich, with Kristelle Lavallee
Episode Date: December 10, 2019
Main Theme:
This episode explores the complex relationship between social media use, problematic interactive media behaviors, and adolescent girls’ body image. Dr. Michael Rich (“the Mediatrician”) and child development expert Kristelle Lavallee answer a middle schooler’s research question, referencing scientific research, personal observations, and practical advice for families.

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Episode Overview

In response to a 12-year-old listener’s question about whether social media is addictive and its effects on adolescent girls’ body image, Dr. Michael Rich and Kristelle Lavallee clarify terminology, discuss the science and mechanisms behind problematic media use, analyze how media influences body image, and share resources and recommendations to develop media literacy and resilience.

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Key Discussion Points & Insights

1. Is Social Media Addictive?

[02:00–04:24]

• Dr. Rich emphasizes the importance of language, cautioning against labeling social media use as “addiction,” which can stigmatize and confuse behavior with substance addiction.

  • Quote: "We need to be extraordinarily careful about using deeply stigmatizing terms such as addiction when discussing behaviors such as using social media because they're not exactly the same as addictions to substances." – Dr. Michael Rich [02:00]

• Social media use can become compulsive and excessive but lacks the physical dependence and withdrawal symptoms of true addiction.

  • Quote: "The psychological need to be on social media or to gamble, for example, can look very similar. You need more and more and you feel anxiety when you don't get it." – Dr. Michael Rich [03:04]

• Instead, the field uses the term “problematic interactive media use” (PIMU), which focuses on behaviors rather than blaming the technology or pathologizing users.

  • Quote: "What many people call Internet gaming or social media addiction is problematic interactive media use." – Dr. Michael Rich [04:37]

2. Adolescent Development & Social Media Use

[04:37–07:39]

• Adolescents naturally shift focus from family to peer relationships as a major developmental task. Social media amplifies this process, allowing constant and broad peer connection.

  • Quote: "A huge part of [adolescence] is migrating out of closer family relationships and into peer relationships as closer or more important to you." – Dr. Michael Rich [05:08]

• Media (including TV, movies, and social platforms) provide role models for teens, who use a "technological mirror" to compare themselves and learn how to behave.

  • Quote: "They really want to emulate them and use social media, in a sense, as a technological mirror to see how well they're doing." – Dr. Michael Rich [07:13]
  • Memorable Moment: Kristelle Lavallee humorously acknowledges this concept: "The tech mirror they're just staring into for hours." [07:31]

3. Body Image: Consumerism & Media Manipulation

[07:39–10:43]

• Dr. Rich shares how advertisers exploit young people's insecurities:

  • Advertisers deliberately foster inadequacy so they can sell the promise of "fixes" (beauty products, diets, etc.), thus objectifying youth and pushing unattainable standards.
    • Quote: "They can harness this natural desire to fit in and succeed socially as a way of making young people buy things. And the way they do it is by making them feel inadequate in some way and offering them a product..." – Dr. Michael Rich [07:39]
  • The cycle is endless: satisfaction is always kept just out of reach so products are bought repeatedly.
    • Quote: "You need to make it always out of reach. So no one is ever satisfied." – Dr. Michael Rich [08:51]

• There is scientific evidence of harm:

  • Quote: "Research shows that there are measurably increased levels of depressive symptoms in young women within an hour after starting to read a teen magazine." – Dr. Michael Rich [08:56]

• Social media embeds these pressures and "beauty bombardment" even more pervasively than traditional media, including the use of creative filters that double as advertisements.

  • Quote: "It's a constant beauty bombardment, like everywhere you are." – Kristelle Lavallee [10:15]
  • Memorable Moment: "[Social media] is 24 hours a day, seven days a week, 365 a day." – Dr. Michael Rich [10:22]

4. Extreme Outcomes: Eating Disorders & Online Communities

[10:45–12:16]

• Eating disorders like anorexia nervosa are the deadliest of all psychiatric illnesses, and social media can reinforce harmful behaviors and communities (e.g., “thinspiration” sites).

  • Quote: "Anorexia nervosa has the largest death rate of any psychiatric illness. It kills more people than any other psychiatric illness." – Dr. Michael Rich [11:01]

• Some online communities promote these disorders as lifestyles, sharing tactics to avoid detection and resisting help.

  • Quote: "[They] encourage their peers... that this is the right choice to make. And they even go to the point of teaching them how to fool and ignore parents, teachers, doctors who are trying to help them, frankly, survive." – Dr. Michael Rich [11:54]

5. Practical Guidance: Media Literacy & Critical Thinking

[12:35–14:28]

• Dr. Rich urges listeners—especially teens—to practice media literacy: ask critical questions about what they see, who posted it, and the intent behind it.

  • Quote: "Be a critical thinker and look at what is happening on these, what is being posted, why they are posting it, who is posting it, what their intent is for you to do once you have seen it..." – Dr. Michael Rich [12:46]

• Recognizing manipulation can protect youth from unhealthy comparisons and pressures.

• Dr. Rich suggests resources:

  • Center on Media and Child Health (for PIMU info)
  • Center for Young Women's Health at Boston Children's Hospital (research-based info on body image and self-esteem)

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Notable Quotes & Memorable Moments

• "We need to be extraordinarily careful about using deeply stigmatizing terms such as addiction when discussing behaviors such as using social media." – Dr. Michael Rich [02:00]
• "Teenagers often learn how to be teenagers from the movies they watch or the social media they use." – Dr. Michael Rich [06:13]
• "They really want to emulate them and use social media, in a sense, as a technological mirror to see how well they're doing." – Dr. Michael Rich [07:13]
• "'Thinspiration' websites ... argue that anorexia nervosa or bulimia nervosa are not illnesses but are chosen lifestyles and desirable lifestyles..." – Dr. Michael Rich [11:24]
• "Be a critical thinker and look at what is happening on these, what is being posted, why they are posting it, who is posting it, what their intent is for you to do once you have seen it..." – Dr. Michael Rich [12:46]

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Timestamps for Major Segments

• [02:00] – Defining problematic media use vs. addiction
• [04:37] – Adolescent development and social media’s role
• [07:39] – Advertising, media manipulation, and objectification
• [10:45] – Eating disorders and harmful online communities
• [12:35] – Media literacy and protective strategies
• [13:54] – Practical resources for further information

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Conclusion

Dr. Rich and Kristelle Lavallee stress the importance of thoughtful, critical engagement with media, recognizing commercial motives and unattainable ideals, and supporting one another in developing healthier, more resilient self-images. Parents and caregivers are encouraged to foster conversation and critical thinking rather than focusing on discipline or stigmatizing labels. Listeners are referred to reliable resources and urged to share what they learn with their peers—emphasizing the power of media literacy as the first line of defense in a digital age.

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Resources Mentioned:

• Center on Media and Child Health (Problematic Interactive Media Use)
• Center for Young Women’s Health at Boston Children’s Hospital
• AskTheMediatrician.org

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This episode is an engaging, thoughtful exploration of a crucial topic for families navigating digital culture—and an excellent primer on teaching kids critical media skills for today’s world.

Transcript

[A]

Hey, it's Dr. Michael Rich, the mediatrician. I'm a practicing pediatrician, a child health researcher, and a lifelong filmmaker who understands how powerfully screens can engage and change us all. Every day. As a doctor who takes care of kids, I see young people who are struggling with the screens in their life, whether it's the smartphone in their pocket or the television on the wall. And I also see the concern in parents who are worried that the way their kids are using these screens may be affecting their physical, mental, or social health. So I try to bring these two worlds together to help us all understand how to raise healthy, happiness, happy, productive children in a world filled with digital screens. Mediatrix educator Christelle Lavallee joins me here each week to address your questions.

[B]

Yes, I do. Thank you, Michael. Michael, I'm really excited because today we get to go back to seventh grade.

[A]

Oh, boy. Yeah.

[B]

So we get to have 12 year old Emma who is from Wellesley, Massachusetts, and she wrote. I am working on an independent research project about whether using social media can be addictive and how using social media affects adult adolescent girl's body image. What does the scientific research show and how can I learn more about this? But first, nice project. Pick Emma. How can we help her with the science?

[A]

Michael, this is great, Emma. And I think this can help not only you, but all of your friends that you share it with as a seventh grader to research and teach your friends. Especially as you're about to turn 13, the age at which you're legally able to start using social media, it's really important to discuss your concern about whether social media are addictive.

[B]

Break that down.

[A]

Okay, y'.

[C]

All.

[A]

You know, as a doctor who works with young people who are constantly changing and developing, I think we need to be extraordinarily careful about using deeply stigmatizing terms such as addiction when discussing behaviors such as using social media because they're not exactly the same as addictions to substances such as alcohol, tobacco, or other drugs. While there are certainly social media behaviors that can be compulsive and excessive, and I see young people who are struggling with these things who are constantly checking updates, counting likes, changing what they have posted if they didn't get enough likes. Exactly.

[B]

Oh, yeah.

[A]

Even staying up late into the night, they are still very different than the behaviors surrounding true addictions. When you use heroin or alcohol or tobacco or cocaine, physical changes occur in your body. It causes you to need more of the substance all the time to feel all right, and you are very sick when you don't get that substance.

[B]

That withdrawal.

[A]

Exactly. However, the psychological need to be on social media or to gamble, for example, can look very similar. You need more and more and you feel anxiety when you don't get it.

[B]

And they don't want to be cut off, that's for sure.

[A]

But those changes are not physiologic or physical, but behavioral nevertheless. There are many young people who have a deep engagement with their online lives, whether it's social media or gaming. And that can be really unhealthy and can really impair them in their school performance, in their social lives, and even in their physical health, particularly around sleep. They may need to help regain balance in their lives, but I still remain concerned that using the word addiction actually gets in the way of seeking that help. They are in denial. They think they're doing just what everybody else is doing. They don't have perspective on it, and neither do their parents. Many times because their parents just think of them as having problems being a disciplinary problem, but they don't think of them as an addict like someone who is shooting heroin.

[B]

Gotcha. So, Emma, make sure you cut the word addiction from that research project of yours and focus on how social media use can become problematic for teen girls body image.

[A]

In fact, what we're calling what many people call Internet gaming or social media addiction is problematic interactive media use. So it doesn't name the technology as the problem, and it doesn't use the word addiction, but says we have problems with our use. That makes a lot of sense, these interactive media. And it's actually the interactivity, the system of variable rewards that occurs either in games or in social media, that keep us hooked in because we can always do a little bit better. So let's understand how young people use social media through adolescence. A major developmental task is to establish your independence or autonomy from your parents. And a huge part of that is migrating out of closer family relationships and into peer relationships as closer or more important to you. Seeking out friendships, even romantic relationships and groups to join has always been huge. In middle and high school life. Social media have simply extended that reach beyond the school and the community and also increased the amount of time you can spend reaching for that.

[B]

Almost 24 7.

[A]

It is 247 if you can stay awake that long. But given young people's drive to connect with peers and those whom they like to be peers, who may not be in their school or community, but may even be celebrities, they turn to social media, even to traditional media like tv, movies or magazines, for what to aspire to, for validating their aspirations. Not just for body image, but for essentially everything they do think and are. So teenagers often learn how to be teenagers from the movies they watch or the social media they use because they're figuring out the world and how to live in it.

[B]

And those are their models.

[A]

Exactly. So they also want desperately not only to draw people's attention to them, but to fit in.

[B]

It's such a delicate balance.

[A]

Absolutely.

[B]

Yeah.

[C]

It's hard.

[A]

Many of them feel they need to look okay and check on it constantly, to say the right things and check on it constantly. And they don't want to appear silly or different in some ways because they see what happens to that kid who doesn't fit in. Young people learn how to behave in the world from the role models they choose. Sometimes those role models are their parents or close friends. Sometimes they're celebrities and they really want to emulate them and use social media, in a sense, as a technological mirror to see how well they're doing.

[B]

I love that. A technological mirror. I think that's so true, Michael. The tech mirror they're just staring into for hours.

[A]

Right. But here's the issue. That's a real vulnerability that consumer products companies have really manipulated and exploited because they can harness this natural desire to fit in and succeed socially as a way of making young people buy things. And the way they do it is. The way they do it is by making them feel inadequate in some way and offering them a product with which they can not only be adequate, but be special. Look at teen magazines. Their articles are about things like thin thighs in 30 days. And look at their advertising, products that allow you to have ever thinner thighs. And they go on to offer those products, whether it be for thinner thighs or more kissable lips by design. Yet what they're doing to the young people is they are objectifying them, teaching them to objectify themself and offering them unattainable ideals because if they could only buy the product once and succeed. You're not gonna sell a lot of product.

[B]

Right? Right.

[A]

So you need to make it always out of reach.

[B]

So no one is ever satisfied.

[A]

No one is ever satisfied. And actually, research shows that there are measurably increased levels of depressive symptoms in young women within an hour after starting to read a teen magazine.

[B]

Oh, my gosh, I believe it. With the content of those.

[A]

And they can end up obsessing about their visible but very superficial characteristics, being unhappy with their appearance, constantly comparing themselves to others, either on social media or in magazines where the images are almost always photoshopped.

[B]

Oh, yeah, right.

[A]

Cropped, filtered, striving to change themselves, even at the cost of their health and happiness.

[B]

Yeah. I feel like what you're talking about has only become more prominent on social media because now those kind of traditional teen mag stories and ads that you were referencing, those are just embedded into social media. So they're in everyone's Instagram feed. And I think I love Snapchat. It's my favorite. But the filters, for as creative as they are, advertisers are now in there. And you can. There's a product that they're advertising. You literally use this filter, and it shows you how you look using that product. And you look gorgeous. You're like, oh, my gosh, I look amazing. Of course I'm gonna go buy this product. But that's built into this social media application. It's a constant beauty bombardment, like everywhere you are.

[A]

And by CONSTANT you mean 24 hours a day, seven days a week, 365 a day.

[B]

You cannot get away. And your phone is in your pocket.

[A]

And it's set up in such a way that you are always wondering what's on that phone, even when it's in your pocket.

[B]

Oh, yeah, right.

[A]

So when you're not looking at it, you're wondering whether you should be right.

[B]

Oh, God.

[A]

And an extreme example that I unfortunately see all too often in patients is eating disorders. You know, because, you know, was it Gloria Vanderbilt who said you can't be too thin or too rich? Well, you can be too thin, in fact.

[B]

Absolutely.

[A]

Anorexia nervosa has the largest death rate of any psychiatric illness. It kills more people than any other psychiatric illness. And this includes depression and suicide.

[B]

Oh, my gosh, Emma, include this in your. Include that stat in your research project.

[A]

And here's what can happen on social media. Not only are advertising agencies and consumer products companies advertising products to make you thinner, but young people who are struggling with eating disorders themselves create thinspiration web sites. I have seen those that argue that anorexia nervosa or bulimia nervosa are not illnesses that. But are chosen lifestyles and desirable lifestyles, either for political reasons or for reasons that you can never be too thin or too rich. And so they encourage their peers who are struggling with similar body image dissatisfaction that they are okay, that this is the right choice to make. And they even go to the point of teaching them how to fool and ignore parents, teachers, doctors who are trying to help them, frankly, survive.

[B]

Right. I see that every now and again on the news, those kinds of thin inspiration and the hashtags to be concerned about and things like that. So what is some of the final guidance that we can give Emma as she works on her project and as she uses social media herself? We know that there's, you know, there's a lot of information out there. Michael, how can you help her distill that?

[A]

Well, the first thing that Emma is already doing and that she should do as much as she can is think critically about what she sees.

[B]

Media literacy.

[A]

Media literacy. Be a critical thinker and look at what is happening on these, what is being posted, why they are posting it, who is posting it, what their intent is for you to do once you have seen it and recognize and understand these issues and understand that those social media posts, just like advertising, are put there quite intentionally with a goal in mind, whether it is just making that person feel better and more attractive or making you feel less attractive.

[B]

That inadequacy that you were talking about.

[A]

Exactly.

[B]

Yeah.

[A]

So in this way she and hopefully her friends whom she can teach with her research project can avoid being manipulated by those media images and avoid participating in that I am cooler, sexier, edgier and have more friends comparison because that's one that they'll never win, they will never achieve. So I would check out our resource pages at the center on Media and Child Health, particularly those on problematic interactive media use or Paimu Pai Mu. Yeah, the social media component of that is just as huge among girls as gaming is among boys. And the center for Young Women's Health at Boston Children's Hospital also has a website that is a research based resource that has information on what affects girls self esteem and body image. Links to all of these are also available through askthemediatrician.org thank you Emma for

[B]

letting us go back to middle school with you and help you with your research project. Please let us know how you do so. As Michael said, all of those resources and links are available at askthemediatrician.org AskTheMediaLian.org is also where you can submit your own question and you can connect with our Mediatrician on Twitter Mediatrician. Thank you so much for listening. Please subscribe and share this podcast and

[A]

enjoy your social media and YouTube. Use them healthily and enjoy your friends and help them to use media healthily as well. Ask the Mediatrician is hosted by Dr. Michael Rich, joined by Mediatrix educator Christelle Lavallee. Jill R. Kavanagh is our Chief Knowledge Officer. Original music composed by Christopher Cerf podcast and music recorded mixed and edited at Saturn Sound Studios. Executive Producer Alicia Haywood.

[C]

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