Social media, body image and self-esteem: What’s the connection?

Ever since social media burst on the scene in the early 2000s, parents and health experts have worried about the potential impact on kids, particularly those in their early teens. Now researchers are asking how the curated content kids see online makes them feel about themselves.

Newer studies show that picture-perfect selfies and videos on Instagram, TikTok and other social media platforms can shake a young person's confidence. Kids who compare their authentic lives to these unreal images may find themselves feeling anxiety, envy and sometimes obsessive thoughts that can harm their health.

Celebrities and influencers work hard to attract social followers — usually with an army of stylists, makeup artists, trainers and videographers helping them. But thanks to filters and photo editing tools like Facetune and others, kids may feel they can make themselves look perfect too. More than 70% of social media users refuse to post pictures online before photoshopping them, one study shows.

This desire to erase all flaws can be especially harmful for kids of color. Research shows that photo editing apps often use beauty standards modeled on white people, reinforcing racist views of what's attractive and what's not.

Setting goals and striving to meet them can be good for kids. But extreme content on social media can push them toward unrealistic standards that encourage dangerous habits. Some trends fueled by social media reflect unhealthy body images. This includes trends such as bigorexia, which drives young people to spend countless hours in the gym and eat a protein-heavy diet to build a “jacked” body, or ultra-low-calorie eating plans displayed in “what I eat in a day” videos posted by celebrities and influencers.

Social platforms are designed to keep kids scrolling by serving up the content they like best. Most social media platforms use an algorithm to track what users view and watch to deliver similar content. This means that a teen who views unhealthy content out of curiosity may be shown more and more content of that type. It can become nearly impossible for them to outrun the images and stories that can drive compulsive behaviors.

Social media's overall impact on an individual child is fueled by several factors. This includes their temperament, personality, health status, peer group and the content they view. However, it is also important to keep an eye on ways that social media can crowd out healthy behaviors that are also critical to mental health and self-esteem.

For example, social media can contribute to reduced quality and quantity of sleep. It can also crowd out other important responsibilities such as schoolwork and time with family and friends. Even kids who don't fall into harmful eating or workout regimes may experience this crowding out of healthy behaviors and habits.

Here are some suggestions from the American Academy of Pediatrics (AAP) Center of Excellence on Social Media and Youth Mental Health that can help your child use social media in positive ways to learn, connect and grow.

The first step is to engage in open communication. Kids often resist any move adults make to curb their freedom, so aim for a nonjudgmental approach. Ask your child to guide you by asking questions like what types of media they have been enjoying lately or simply asking if any content they’ve come across worries them or makes them uncomfortable.

As your child opens up, try to listen more than talk. Make this a learning session that will help you uncover possible concerns and topics for future conversations. You don't have to “solve” everything about social media in one conversation, the goal is to keep the lines of communication open over time.

You may find your child knows a lot about the inner workings of the digital world. Still, they may not think too deeply about the content “bubble” that algorithms create.

If they're willing, try this experiment: open your own social platform and search for something new. For example, if your feed focuses on sports or fashion, search for “home improvement” or “coin collecting.” Within a few clicks, you'll start to see new content on those topics.

If your child is showing signs they have been comparing themselves to the unattainable content they see online, it may help to acknowledge that comparing ourselves to others is natural, but perfectionism can harm us.

Pointing to examples from your own life may be helpful. For example: “I used to watch hours of videos showing how to improve my tennis swing. But in the end, it just made me feel nervous about my game. Going out and practicing worked a lot better.”

If you feel social media is harming your child's health, reach out to your pediatrician right away if you notice red flags such as:

• Dramatic changes in eating habits.

• Extreme or obsessive workouts.

• Difficulty falling asleep or staying asleep.

• Loss of interest in friends or activities they used to enjoy.

• Looping worries that won't leave them alone.

• Hiding out in their room much more than normal.

• Signs they’re thinking about suicide.

No matter what symptoms you see, your pediatrician or family doctor is ready to support you in finding the right care and resources for your child.

• Children's health is a continuing series. This column was provided by the American Academy of Pediatrics. Author Dr. Megan Moreno, MD, is a Fellow of the American Academy of Pediatrics and holds master of science in education and master of public health degrees. See more at www.healthychildren.org.