Counseling Adolescent Girls for Body Image Resilience: Strategies for
School Counselors
Laura Hensley Choate. Professional School Counseling. Feb 2007. Vol. 10, Iss. 3;
Early adolescence presents extensive developmental challenges for girls. As they face
the onset of puberty and its associated psychological and physical changes, girls also
confront the emergence of dating relationships, school transitions, and contradictory
gender role expectations. During early adolescence girls also become more focused on
their appearance, weight, and shape as key aspects of their identities. With the
considerable weight gains that accompany puberty, girls become concerned about the
discrepancy between their developing bodies and the societal ideal for female thinness
that is portrayed in Western cultures (Thompson, Heinberg, Altabe, & Tantleff-Dunn,
1999). In other words, at a time when a girl's physical appearance is most important to
her, her body is changing in ways that are increasingly discrepant from the thin ideal.
These influences leave many girls vulnerable to body image dissatisfaction (BID) and
eating-related problems (Levine & Smolak, 2002; Thompson et al.)
According to Levine and Smolak (2002), between 40% and 70% of adolescent girls are
dissatisfied with two or more aspects of their bodies, most generally with the hips,
buttocks, stomach, and thighs. One study found that over 80% of girls surveyed reported
body dissatisfaction (Kostanski & Gullone, 1998), while another large-scale study
revealed that 42% to 45% of 9th-to-12th-grade girls were dieting to lose weight
(Thompson et al., 1999). With such large numbers of girls experiencing dissatisfaction
with their bodies, it is important for school counselors to note that BID is associated with
emotional distress, obsessive thinking about appearance, unnecessary elective cosmetic
surgery, depression, poor self-esteem, smoking onset, and maladaptive eating practices
(Stice & Shaw, 2003; Stice & Whitenton, 2002). Further, BID is the primary precursor for
the development of eating disorders such as anorexia or bulimia (Polivy & Herman,
1999; Thompson et al.), particularly during the adolescent period (Kalodner 8c DeLuciaWaack, 2003).
Because BID is such a pervasive problem in adolescent girls, school counselors need to
develop effective prevention and intervention programs in this area. Current research
indicates that successful BID prevention incorporates two primary strategies: (a) the
enhancement of protective factors; and (b) the inclusion of a broad-based, holistic focus.
Rather than a pathology-driven model that emphasizes treatment for the concerns of
girls in clinical samples, the most promising programs incorporate protective factors that
build on girls' strengths, promote resilience, and buffer them from the development of
body dissatisfaction and subsequent disordered eating practices (Cash, 2002; Crago,
Shisslak, & Ruble, 2001; Irving, 1999; Piran, Levine, & Steiner-Adair, 1999; StriegelMoore & Cachelin, 1999, Taylor & Altman, 1997). Promoting protective factors would
include assisting all girls as they confront the multiple challenges of adolescence and
also help them to define their identity and sense of worth apart from physical
appearance (American Psychological Association, 1999). Researchers in this area have
also called for holistic approaches that are focused on multiple dimensions of an
individual's environment. Instead of an exclusive view of body image problems and
eating disturbances as disorders that originate within an individual adolescent girl,
programs should also target family, peers, schools, media, and other sociocultural
influences (Barker & Galambos, 2003; Crago et al., 2001; Irving, 1999; Levine & Piran,
2001; Piran et al.; Smolak & Murnen, 2001).
The profession of counseling in general and school counseling in particular is based
upon a comprehensive, developmental model that emphasizes students' positive
resources and strengths (American School Counselor Association, 2004; Gale & Austin,
2003, McAuliffe & Eriksen, 1999; Myers, Sweeney, & White, 2002). School counselors
are therefore poised to take the lead in designing and implementing holistic approaches
that strengthen protective factors in adolescent girls. Specifically, school counselors
need a prevention approach that identifies protective factors at the individual, family,
peer, and school level, as well as teaches girls how to challenge broader sociocultural
influences. Elsewhere I have identified a five-factor theoretical model of body image
resilience that addresses these concerns (Choate, 2005) and in this article I will apply
the model specifically to school counselors' work with adolescent girls. In the paragraphs
that follow, I first provide an overview of sociocultural theories that describe the process
of body image development in adolescence. I then explore the five protective factors
included in the body image resilience model and provide specific prevention and
counseling strategies that school counselors can use to promote positive body image in
adolescent girls.
SOCIOCULTURAL CONTEXT AND THE MASSMEDIA
Sociocultural theories have strong empirical and theoretical support to explain the impact
of social and cultural influences on the development of BID in Western societies
(Heinberg, 1996; Stice & Whitenton, 2002). These theories assert that contemporary
Western societies emphasize thinness as a central aspect of beauty for women
(Mussell, Binford, & Fulkerson, 2000) and that pervasive social pressures to achieve
extreme thinness result in women's "normative discontent" (Rodin, Silberstein, &
Striegel-Moore, 1985) with their bodies. Even as women have made great educational
and vocational advances during the past several decades, there has emerged increasing
pressures for women to refocus their energies on achieving a largely unattainable ideal
of beauty and thinness (Bordo, 1995; Thompson et al., 1999; Wolf, 1991). For example,
in recent years the thin ideal has become progressively thinner while the average
woman has become larger (Heinberg). Further, the beauty ideal also encompasses often
unattainable and frequently contradictory attributes including extreme thinness, White
and flawless skin, thin waist, long legs, tall, young, physically fit, muscular, and angular
while also espousing a curvaceous and full-breasted body type (Barber, 1998; Groesz,
Levine, & Murnen, 2002; Heinberg; Levine & Smolak, 2002). The pervasiveness of these
messages leads researchers and practitioners to conclude that BID and even eating
disorders are natural outcomes of extreme social pressures to achieve thinness (Attic &
Brooks-Gunn, 1989; Thompson et al.).
One of the strongest and most effective conveyors of these socioculturel messages is
the mass media. In early adolescence, girls are especially likely to make social
comparisons in forming a self-identity and media images serve most often as their
comparison standard. Research in social comparison theory demonstrates a consistent
relationship between adolescent girls' BID and the viewing of media images promoting
the thin ideal (Botta, 2000; Cusumano & Thompson, 2000; Groesz et al., 2002;
Hargreaves & Tiggemann, 2003; Jones, 2001; Thompson et al., 1999). In one study by
Dunkley, Wertheim, and Paxton (2001), girls most often cited magazine advertisements
as the source they turned to for information regarding how to achieve their ideal body
size and shape. Even though these standards are largely impossible to achieve, the
media also transmits the message that the body is infinitely mutable (Heinberg, 1996)
and that with enough hard work any individual can achieve the ideal. Rather than
questioning these unrealistic standards, girls and women learn to blame themselves for
not being able to reach the prescribed norm; this selfideal discrepancy results in BID.
Some sociocultural theorists have also examined race and ethnicity as influences on
adolescents' body image development. Because all girls in the United States are
inundated with messages regarding the importance of thinness for women's success in
Western culture, no racial or ethnic group is immune to these influences. While eating
concerns were formerly regarded as a "White woman's issue," research currently
indicates no significant differences in Hispanic, Asian, American, and Caucasian girls in
terms of BID (Levine & Smolak, 2002). On the other hand, African American girls are
also vulnerable to maladaptive eating practices, yet as a group they are less likely to
possess negative body image than are other girls. This is due in part to cultural
messages within the African American community that de-emphasize thinness as an
essential component of beauty (Levine & Smolak; Mussell et al., 2000; Striegel-Moore &
Cachelin, 1999). Drawing on these and other components of body image resilience, I
now describe the five protective factors and strategies designed specifically for school
counselors' work with adolescent girls.
BODY IMAGE RESILIENCE MODEL
Protective Factor 1: Family and Peer Support
Adolescent girls are confronted with cultural pressures regarding how they should look
and act, and for many girls these messages are strongly reinforced by family and peers.
Research indicates that a girl's perception of her family's approval of her overall
appearance is positively related to her body esteem (McKinley, 1999). Conversely, those
girls who perceive parental pressures to be thin and who receive criticism about their
weight and shape are the most likely to experience BID and to diet (Green & Pritchard,
2003; Haworth-Hoeppner, 2000; Smolak & Murnen, 2001; Stice & Whitenton, 2002;
Striegel-Moore & Cachelin, 1999). Girls' sense of body satisfaction is also strongly
related to their mothers' personal attitudes toward their own bodies (McKinley; Usmiani &
Daniluk, 1997). Daughters observe the ways in which their mothers cope with cultural
pressures and are highly influenced by such maternal modeling.
To develop positive body image, therefore, girls need family members who provide them
with affirming messages about their bodies and who possess positive attitudes toward
their own appearance, weight and shape. Several authors have noted that in comparison
with Caucasian girls, African American girls receive maternal messages to be strong and
selfreliant and are therefore less vulnerable to body image problems because these
qualities lead to an enhanced sense of competence and independence (Celio, Zabinski,
& Wilfley, 2002; Pedcrsen, 2000). Further, general family qualities such as supportive
parental relationships, open communication and expressiveness, and low family stress
can also protect against adolescent BID (Barker & Galambos, 2003; Graber, Archibald,
& Brooks-Gunn, 1999; Haworth-Hoeppner, 2000; Kearney-Cooke, 2002; Striegel-Moore
& Cachelin, 1999).
Peers also have a significant impact on adolescent girls' body image development and
serve as relevant sources of information regarding the culture of thinness. Paxton,
Schutz, Wertheim, and Muir (1999) found that girls share the attitudes and behaviors of
their peer group regarding dieting, drive for thinness, and overall body image concerns.
A girl's peer group negatively influences body image when her friends frequently discuss
dieting and other weight loss behaviors, or tease peers regarding their appearance
(Smolak, 1999). Being the target of peer teasing is also strongly related to BID (Paxton
et al.; Smolak). Negative body image is exacerbated as peer group discussions center
around heightened interest in boys; research indicates that increases in girls' weight
consciousness and dieting occur with the onset of dating (Graber et al.,1999). School
counselors should note, however, that friends can serve as a protective factor in a girl's
body image development when they arc less invested in the achievement of
appearance-oriented goals and are less competitive with one another regarding weight
and shape (Paxton ct al.). Overall, the presence of a strong social support network
comprised of both friends and family serves as a protective factor in body image
development (Striegel-Moore & Cachelin, 1999).
Here are some strategies for school counselors:
1. Educate parents regarding the impact of their weight, food, and appearance-related
attitudes and behaviors on their children. Mothers in particular should be aware of the
strong effects of modeling on their daughter's developing body image. Parents can
change family discourse around the importance of weight and shape, and can
discourage daughters from evaluating themselves based on how they appear to others
(McKinlcy, 1999). Graber et al. (1999) suggested that school counselors create an
informative newsletter regarding these issues for students to share with their parents. To
aid in this initiative, counselors can draw from the specific prevention strategies and
guidelines for parents available from the National Eating Disorders Association (NEDA,
2004a).
2. Inform students, parents, teachers, and school staff of the negative effects of dieting
(e.g., slowed metabolism, increased likelihood of binge eating, and eventual weight
gain), how to discourage diet talk at school and home, and ways to take a nondieting
approach to healthful eating. Programs should not focus on educating girls regarding the
signs and symptoms of eating disorders, as this approach can often result in girls'
adoption of these behaviors.
3. Encourage parents and all members of the school community to display a low
tolerance for peer teasing, particularly regarding weight and shape. Serve as a model by
refusing to engage in "fat jokes" among faculty and staff. Further, teach students how to
intervene to assist a teased peer, and provide strategies for coping when a student is the
victim of peer teasing.
4. Facilitate girls' development of friendship groups that provide support and help them
to feel good about themselves (versus friends that are competitive or make them feel
judged). Intervene with friendship groups to encourage them to adopt more positive
attitudes toward body image (Paxton et al., 1999; Smolak, 1999).
Protective Factor 2: Gender Role Satisfaction
In early adolescence, girls become increasingly more dissatisfied with their bodies and
overall physical appearance than boys (Feingold & Mazzella, 1998). This discrepancy
may be explained in part by two gender role socialization processes that occur during
adolescence. First, girls are taught the importance of attracting a dating partner and
gaining popularity as a measure of their self-worth. They are also socialized to take
responsibility for the establishment of relationships and to sacrifice their own needs in
order to maintain their social connections (Miller, 1990). This interpersonal orientation
leaves girls vulnerable to others' opinions and motivates them to go to great lengths to
achieve the approval of peers and potential dating partners. Girls receive the message
that the best way to gain such approval is through conformity to the beauty ideal.
Unfortunately, early adolescence is also a time in which the onset of puberty brings an
average weight gain of 50 pounds in girls, with 20-30 pounds of fat deposited in the hips,
waist, thighs, and buttocks; weight gains in these areas are in direct contradiction with
the beauty ideal espoused in Western cultures (Levine & Smolak, 2002). Girls are better
protected from BID when they begin to question the discrepancy between their changing
bodies and how girls are represented in the media, and when they understand that
achieving the beauty ideal is not the only avenue for achieving peer acceptance or
popularity.
A second socialization process for girls occurs as they are also confronted with societal
messages for what it means to be successful as a woman: She is expected to fulfill the
traditional female gender role by being nurturing, family- and relationship-oriented, and
passive. At the same time she is expected to be independent, self-reliant, assertive, and
high achieving in academic and career pursuits, while also achieving the cultural
standard for thinness and attractiveness (Denmark, 1999; Hart & Kenny, 1997;
Thompson et al., 1999). The message that "you can have it all" (termed the super
woman myth by Steiner-Adair, 1986) results in a sense of inadequacy, confusion, and
frustration for all girls. For many adolescents this gender role discrepancy is manifested
somatically as BID (Thompson et al.).
Smolak and Murnen (2001) suggested that contradictory expectations are related to
eating problems because thinness is valued in many of the roles to which girls aspire
(e.g., both in the workplace and in maintaining relationships). Further, girls who strive to
be "superwomen" often do so at the expense of meaningful relationships, leaving them
feeling disconnected and isolated. In order to regain a sense of control, many girls learn
to avoid facing contradictory pressures by refocusing their energies on trying to perfect
their bodies (Friedman, 1999; Hensley, 2003). To manage feelings of confusion, they
learn to define themselves solely in terms of their appearance and in controlling their
weight. School counselors can help girls to acknowledge contradictory cultural
expectations and, rather than internalizing their feelings, to begin to address and
understand these conflicts (Choate, 2005).
Here are some strategies for school counselors:
1. Provide girls in early adolescence with information regarding the physical and
psychological changes that occur with the onset of puberty. Girls can learn of the
normative nature of their weight gains and begin to challenge the inconsistencies
between the thin ideal and their maturing bodies.
2. Because girls are being socialized to suppress their feelings in order to maintain
relationships, assist girls in developing the skills to assertively express anger, conflict,
and power in their relationships (Compitello, 2003).
3. Girls can be assisted in recognizing the effects of gender stereotyping and the harmful
nature of the super woman myth. Instead of avoiding their confusion and frustration, girls
can begin to acknowledge and question the diverse roles they are expected to fulfill.
4. Rather than comparing their appearances to others in striving to achieve interpersonal
success, counselors should reinforce girls' acceptance of each individual's unique body
type. Expose girls to female role models representing a diversity of shapes and sizes
who are praised for both their accomplishments and their appearances.
5. Because boys also are exposed to pervasive images regarding how women should
look, they also need assistance in developing an appreciation for attractiveness that
includes an array of body types (Halpern, Udry, Campbell, & Suchindran, 1999).
Protective Factor 3: Global and Physical Self-Esteem
In adolescence, body image becomes the most salient aspect of girls' global selfesteem, which may partially explain the significant decrease in girls' selfesteem during
this period (Basow & Rubin, 1999). It is interesting to note that African American girls
have higher levels of self-esteem than White girls do, in part because their self-esteem is
not based on narrow definitions regarding what is considered attractive (Compitello,
2003). Even when they weigh more, Black girls are more likely than White girls to be
satisfied with their bodies and with their overall appearance (Jaflfee & Lutter, 1995). For
all girls there is a strong relationship among high self-esteem, strong identity, and
positive body image, suggesting that self-esteem and identity can play a role in the
development of body satisfaction (Crago et al., 2001; Smolak & Murnen, 2001; StriegelMoore & Cachelin, 1999).
One important aspect of global self-esteem that has direct implications for body image
development is physical self-esteem, defined as one's attitudes toward physical activity,
endurance, strength, coordination, flexibility, sports competence, body fat, appearance,
and general health (Dunton, Jamner, & Cooper, 2003; James, Phelps, & Bross, 2001).
Participation in physical activity is a central feature of physical self-esteem. When girls
exercise to improve their overall fitness or health (versus working out to burn excess
calories) they are more likely to possess positive body image. Further, physical activity
leads to body satisfaction when girls develop an appreciation for what their bodies can
do, rather than how they appear to others (McKinley, 1999). While encouraging girls to
engage in exercise is important, school counselors should be aware of the potential
inadvertent negative effects of physical activity promotion. Zabinski, Calfas, Gehrman,
Wilfley, and Sallis (2001) found that a university program designed to teach students
skills for enhancing their physical fitness actually increased women participants' drive for
thinness and had no effect on changing their BID or body mass index. The authors noted
that when girls are encouraged to become more engaged in physical activity, they also
need assistance in setting realistic expectations for the effects of exercise on changing
body shape or for improving other aspects of their lives.
Positive self-esteem and body image are also associated with girls' and women's
participation in organized athletic activities (Jaffee & Lutter, 1995; Mussell et al., 2000).
While previous research indicated that girls' sports participation was a risk factor for the
development of BID, such participation is a risk factor only for girls who participate in
sports that emphasize leanness, who display high levels of perfectionism, and who
possess beliefs that having a lower weight will enhance their athletic performance
(Mussell et al.). Another study indicated that girls' participation in refereed sports (e.g.,
basketball, tennis, volleyball, track) versus judged sports (e.g., diving, cheerleading,
gymnastics) can serve as a protective factor against developing excessive concern with
body size and shape (Zucker, Womble, Williamson, & Perrin, 1999). Therefore it is not
sports participation per se that influences body satisfaction or dissatisfaction, but certain
aspects of an athletic environment that can contribute to its protective effects; these
include the presence of supportive peer groups, emphasis on the body's physical
competence rather than how it looks, and promotion of flexible gender role attributes
(Richman & Shaffer, 2000; Zucker et al.).
Here are some strategies for school counselors:
1. To help build girls' self-esteem in adolescence, encourage girls to become involved in
a variety of school, volunteer, or work activities that are not focused on physical
appearance or achievement of the thin ideal (Smolak & Murnen, 2001).
2. Develop mentoring programs between older and younger girls as a means to
discourage girls from overreliance upon attractiveness as the only indicator of their selfworth (Crago et al., 2001; Smolak, 1999).
3. Play an active role in promoting a broader, more fluid definition of beauty on your
school campus. This comprehensive view of beauty would include non-appearance
qualities such as selfrespect, assertiveness, caring about others, wisdom, selfawareness, individuality, confidence, and motivation (NEDA, 2004b; Smolak, 1999).
4. Encourage girls to participate in a variety of physical activities that they enjoy;
however, monitor girls' motivations so they learn to exercise for the purposes of health
and improved fitness rather than for weight control or body shape change.
5. Work with girls to focus on their positive physical attributes. For example, ask girls to
list all aspects of their bodies that they appreciate and then help girls create a list of
positive body affirmations to practice daily. An excellent resource for conducting this
exercise can be obtained from the NEDA Web site (2004c).
Protective Factor 4: Coping Strategies and Critical Thinking Skills
As outlined previously, girls face many developmental transitions and challenges during
the adolescent period. They need the internal resources to cope successfully with life
demands. It is unfortunate that many girls focus on their weight and shape as a way of
avoiding these complex issues. Steiner-Adair and Vorenberg noted, "Clearly dieting,
eating, and shopping are not adequate skills for coping with life's ups and downs . . . yet
it is not surprising that girls turn to these self-limiting behaviors in times of need" (1999,
p. 109). In response, prevention in the area of BID and eating disorders has increasingly
emphasized life skills training (e.g., promoting problem-solving abilities, interpersonal
competence, assertive communication, stress management strategies, and internal
locus of control) as an effective program component (Crago et al., 2001; Irving, 1999;
McVey & Davis, 2002).
A life skills training approach can play an important role in facilitating a girl's
developmental capacity to understand her environment in a qualitatively different way.
While she previously defined herself only in terms of the beliefs and values of others, in
adolescence a girl slowly develops the ability to become a self-authoring knower (Kegan,
1994; McAuliffe & Eriksen, 1999). Self-authoring knowers learn to step outside of the
values of their culture/peers/family, evaluate these norms, and make decisions for
themselves. At this more cognitively complex stage of knowing, they can consider the
opinions of others as important, yet also realize that their suggestions are but one option
from among an array of alternatives. They begin to recognize that ultimately they are the
authors of their life scripts. A girl must possess this ability in order make informed
decisions about how she will allow sociocultural pressures from media, family, and peers
to influence her sense of self worth. This is a difficult transition for girls, as adolescents
are also highly concerned with external approval and acceptance and are not socialized
to express their own voices (Gilligan, 1982). School counselors have to demonstrate an
understanding of how important the approval of others can be during this time, while also
encouraging girls to formulate their own beliefs and values.
School counselors can facilitate girls' cognitive development by teaching them the critical
thinking skills needed to question sociocultural norms, including the beauty ideal. One
important prevention initiative in this area is to foster media literacy: the ability to identify,
evaluate, and resist media messages (Levine, Piran, & Stoddard, 1999). These
promising approaches teach students how to become active consumers rather than
passive victims of media influence (Levine & Piran, 2001; Levine et al.). Media literacy
can be conceptualized as a fourstep process: (a) identifying harmful cultural images, (b)
exploring and deconstructing their underlying messages, (c) resisting the message being
sent, and (d) actively working to change these messages. In the paragraphs that follow, I
describe these four components.
As part of identifying and exploring harmful media messages, school counselors can
highlight the social construction of beauty in Western culture and the unrealistic,
unattainable nature of the images girls see. For example, they can learn how the
majority of images that represent the beauty ideal are created through intricate
strategies used to enhance models' appearances, including airbrushing, softfocus
cameras, digital editing, or cosmetic surgery (Botta, 2000; Groesz et al., 2002; Heinberg,
1996). It is powerful for adolescent girls to discover that even the models and celebrities
that portray the beauty ideal don't meet these standards.
Once girls have identified the ways in which images are constructed, they must then
begin to question the values embedded in these images. The Media Education
Foundation (2004) suggests that girls can explore such questions as "Do real women
look like these models?" "What is the real purpose of this advertisement?" "Will buying
this product help me look like this?" "IfI did look like this, would my life really become like
the life portrayed in this ad?" "Does this model really use this product to help her look
like this?" and "What are the consequences of these messages for girls?"
Girls also must possess the skills to actively resist, challenge, and generate positive
alternatives to the messages conveyed through the mass media. Rather than
conforming to cultural norms, girls can learn to make informed choices regarding how
they allow media messages to influence their personal lifestyles, beliefs, and values.
They can use cognitive behavioral strategies to dispute any maladaptive beliefs
regarding media portrayal of the thin ideal (Strachan & Cash, 2002). For example, they
can replace the thought, "I must look like the model in this swimsuit ad in order to be
popular," with the more rational belief, "This image is airbrushed. I don't have to look like
this in order to feel good about myself. Others will be attracted to my positive attitude
when I accept myself as I am."
Finally, girls can learn media activism skills as they work to challenge the social status
quo and shape healthier cultural norms. To this end, they can actively protest media
products they identify as transmitting harmful messages to girls, and praise advertisers
when they portray women of varying ethnicities, ages, sizes, and shapes (Crago et al.,
2001; Levine et al., 1999). Girls become empowered as they recognize themselves as
citizens in a democracy who have the power to take collective action for change (Levine
& Piran, 2001).
Here are some strategies for school counselors:
1. Reinforce girls' skills in developing an internally-derived value system and internal
locus of control so they can begin to rely less on others' opinions about the importance
of appearance. Girls can begin to explore what it would be like to trust their own values
regarding how they should look and act.
2. To incorporate media literacy into prevention programs for girls, consult the Center for
Media Literacy (2004) and Media Education Foundation (2004) Web sites. Both Web
sites contain excellent critical media viewing activities and resources, including
downloadable handouts and study guides for students. Encourage the infusion of media
literacy throughout the curriculum, as students benefit from repeated exposure to
positive messages about self-esteem that are not based on achievement of the thin ideal
(Steiner-Adair & Vorenberg, 1999).
3. Include education about the nature of the thin ideal and how it changes historically.
Girls should learn to recognize the unrealistic images presented in the media, the
methods used for altering and perfecting these images, and how these do not represent
the average woman. Excellent films by Kilbourne (1995, 2000) are helpful resources in
this area.
4. As reviewed previously, teach girls critical thinking skills for deconstructing harmful
media images. As an example, they can review popular magazines and collaboratively
create a "wall of shame" and "rave wall" collage based on images that represent both
negative and helpful messages to girls and women (Levine et al., 1999).
5. As suggested by prevention specialists, school counselors can involve girls in a media
activism project. For example, encouraging a girl to write a letter of support or protest to
an advertiser can empower her to believe that she can make a difference in changing
sociocultural norms. Examples of ongoing media activism campaigns in which girls may
participate can be found through the Media Watchdog Program on the NEDA Web site.
Protective Factor 5: Holistic Wellness and Balance
A review of the previous four factors of the resilience model-family and peer support,
gender role satisfaction, physical self-concept, and coping skills-demonstrates that
adolescent girls need a broad foundation of internal resources and external support to
develop body image resilience. The resilience model indicates that when girls place an
excessive emphasis on physical appearance, they may neglect the development of
those supportive relationships and essential life skills needed for managing the
challenges of adolescence (Striegel-Moore & Cachelin, 1999). Therefore, the fifth
protective factor, a sense of holistic wellness and balance, suggests the importance of
enhancing and balancing all life areas in order to foster body image resilience. When
girls are encouraged to develop and value their strengths in multiple life dimensions,
including spiritual, intellectual, social, emotional, and physical competence, they learn to
view their identities as extending beyond their appearances. Unfortunately an exclusive
focus on only one life area-physical appearance-is culturally reinforced for women. As is
strongly emphasized in the mass media, girls are socialized to believe that being highly
invested in achievement of the thin ideal is the only way to achieve social approval and
success. It is easy to see how a girl learns to perceive her body as a reflection of her
total self; she believes that "who I am" is equated with how she appears to others.
To challenge these beliefs, school counselors can introduce girls to the concept of
holistic wellness. One effective framework to help girls conceptualize life balance is the
Wheel of Wellness model (Myers, Sweeney, & Witmer, 2000). The model defines
wellness as "a way of life oriented toward optimal health and well-being in which body,
mind, and spirit are integrated by the individual to live more fully within the human and
natural community" (Myers et al., p. 252). The Wheel of Wellness comprises five
interrelated life tasks, indicating that changes in one area of wellness affect all other
areas. At the center of the wheel is spirituality, surrounded by the life tasks of selfdirection, work and leisure, love, and friendship. School counselors can use the wheel as
an evaluation tool to help girls conduct an assessment of their strengths and areas for
improvement in each life dimension (for suggestions, see Myers et al.). As girls decrease
their emphasis on appearance and bolster their sense of self-worth not contingent on
unattainable standards, they can dedicate their time and energy to the pursuit of goals in
all areas of wellness.
School counselors can provide girls with some of the specific strategies drawn from
Myers, Sweeney, and Witmer (1998) and NEDA (2004b) to develop all dimensions of
wellness:
1. To develop their sense of spirituality, girls can spend more time with individuals whose
spiritual lives they admire and relate to, and talk with their parents about their spiritual
development.
2. Girls can practice keeping a gratitude journal, focusing on what is working well in their
lives rather than focusing on their complaints.
3. Girls can learn to nurture their bodies, incorporating proper nutrition and sleep habits.
They can create opportunities to move their bodies, exercising for pleasure rather than
as a means to purge excess calories.
4. Through activities such as mentoring programs, girls can learn to view academics and
work as activities that provide a sense of accomplishment, purpose, and competence.
5. To encourage the development of leisure as an important component of wellness,
girls can find things that they like to do for fun that are congruent with their beliefs and
values. They can engage in these activities on a regular basis as an expression of their
creativity.
6. To develop social competence, girls can seek out a stable, supportive network of
peers and adults who help them to feel good about themselves and their
accomplishments.
CONCLUSIONS
In adolescence, girls struggle to formulate an answer to the question "Who am I?" Girls
are currently socialized to view their appearance as the most salient aspect of their
identities, and their self-evaluation in this area becomes increasingly determined by
comparisons with others. When girls base their identities on comparisons with the
current standard for women's beauty as portrayed in the mass media, it is not surprising
that BID and low self-esteem are pervasive. When school counselors work to prevent
BID, they must recognize difficulties inherent in asking a girl to challenge developmental
gender norms and cultural standards at a time that she might not yet possess the skills
to do so (Oliver, 2001). School counselors' goal in building girls' body image resilience,
therefore, should be twofold: First, they must provide girls with the skills and support
necessary to resist sociocultural pressures; and second, they must work tirelessly to
reduce negative messages regarding the importance of the thin ideal that are present in
school communities (Levine et al., 1999).
The body image resilience model gives school counselors a framework within which they
can begin to address these two objectives. The model provides conceptual and practical
strategies for enhancing protective factors in multiple life dimensions and for working
with students, families, school staff, and the media in changing the status quo. While
progress in creating this type of cultural shift might be slow, this work is important for
school counselors to undertake because girls need help in recognizing the many ways in
which they have value beyond their physical appearances. By reclaiming their strengths,
girls can cultivate the resilience to navigate the complex sociocultural and developmental
challenges of adolescence.
[Sidebar]
With the considerable weight gains that accompany puberty, girls become concerned
about the discrepancy between their developing bodies and the societal ideal for female
thinness that is portrayed in Western cultures.
[Sidebar]
Body image dissatisfaction is the primary precursor for the development of eating
disorders such as anorexia or bulimia, particularly during the adolescent period.
School counselors need a prevention approach that identifies protective factors at the
individual, family, peer, and school level, as well as teaches girls how to challenge
broader socioculturel influences.
[Sidebar]
School counselors can facilitate girls' cognitive development by teaching them the critical
thinking skills needed to question socioculturel norms, including the beauty ideal.
By reclaiming their strengths, girls can cultivate the resilience to navigate the complex
socioculturel and developmental challenges of adolescence.
[Sidebar]
Earn CEUs for reading this article. Visit www.schoolcounselor.org, and click on
Professional School Counseling to learn how.
[Reference]
References
American Psychological Association. (1999). American Psychological Association task
force on adolescent girls: Strengths and stresses. In N. G. Johnson, M. C. Roberts, & J.
Worell (Eds.), Beyond appearance: A new look at adolescent girls (pp. 25-52).
Washington, DC: Author.
American School Counselor Association. (2004). Vision and mission. Retrieved March
24,2004, from http://www. schoolcounselor.org
Attie, I, & Brooks-Gunn, J. (1989).The development of eating problems in adolescent
girls: A longitudinal study. Developmental Psychology, 25(1), 70-79.
Barber, N. (1998).The slender ideal and eating disorders: An interdisciplinary "telescope"
model. International Journal of Eating Disorders, 23, 295-307.
Barker, E.T., & Galambos, N .L. (2003). Body dissatisfaction of adolescent girls and
boys: Risk and resource factors. Journal of Early Adolescence, 23,141-165.
Basow, S. A., & Rubin, L. R. (1999). Gender influences on adolescent development. In
N. G. Johnson, M. C. Roberts, & J. Worell (Eds.), Beyond appearance: A newlookat
adolescent girls (pp. 25-52). Washington, DC: American Psychological Association.
Bordo, S. (1995). Unbearable weight: Feminism, Western culture, and the body. Los
Angeles: University of California Press.
Botta, R. A. (2000, Summerl.The mirror of television: A comparison of black and white
adolescents' body image. Journal of Communication, pp. 144-159.
Cash,T. F. (2002). Cognitive-behavioral perspectives on body image. In T. F. Cash & T.
Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp.
38-46). New York: Guilford Press.
Celio, A. A., Zabinski, M. F., & Wilfley, D. E. (2002). African American body images. InT.
F. Cash &T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical
practice (pp. 234-242). New York: Guilford Press.
Center
for
Media
Literacy.
(2004).
Retrieved
March
24,2004,
from
http://www.medialit.org
Choate, L. H. (2005).Toward a theoretical model of women's body image resilience
.Journal of Counseling and Development, 83,320-330.
Compitello,V.(2003).Through the eye of the needle:The emerging adolescent. In M.
Kopala & M. A. Keitel (Eds.), Handbook of counseling women (pp. 243-255). London:
Sage Publications.
Crago, M., Shisslak, C. M., & Ruble, A. (2001 ). Protective factors in the development of
eating disorders. In R. H. StriegelMoore & L Smolak (Eds.), Eating disorders: Innovative
directions in research and practice (pp. 233-254). Washington, DC: American
Psychological Association.
Cusumano, D. L, & Thompson, J. K. (2000). Media influence and body image in 8-11year-old boys and girls: A preliminary report on the Multidimensional Media Influence
Scale. International Journal of Eating Disorders, 29,37-44.
Denmark, RL(1999). Enhancing the development of adolescent girls. In N. G. Johnson,
M. C Roberts,* J. Worell (Eds.), Beyond appearance: A new look at adolescent girls (pp.
337-404). Washington, DC: American Psychological Association.
Dunkley J. L., Wertheim, E. H., & Paxton, SJ. (2001 ). Examination of a model of
multiple sociocultural influences on adolescent girls' body dissatisfaction and dietary
restraint. Adolescence, 36,265-280.
Dunton, G. R, Jamner, M. S., & Cooper, D. M. (2003). Physical selfconcept in
adolescent girls: Behavioral and physiological correlates. Research Quarterly for
Exercise and Sport, 74, 360-365.
Feingold, A., & Mazzella, R. (1998). Gender differences in body image are increasing.
Psychological Science, 9,190-196.
Friedman, S. S. (1999). Discussion groups for girls: Decoding the language of fat. In N.
Piran, M. P. Levine, & C. SteinerAdair (Eds.), Preventing eating disorders: A handbook
of interventions and special challenges (pp. 122-133). Philadelphia: Brunner/Mazel.
Gale, A. U., & Austin, B. D. (2003). Professionalism's challenges to professional
counselors'collective identity. Journal of Counseling and Development, 81,3-9.
Gilligan, C. (1982). In a different voice. Cambridge, MA: Harvard University Press.
Graber, J.A., Archibald, A.B., & Brooks-Gunn, J.(1999).The role of parents in the
emergence, maintenance, and prevention of eating problems and disorders. In N. Piran,
M. P. Levine, & C. Steiner-Adair (Eds.), Preventing eating disorders: handbook of
interventions and special challenges (pp. 44-62). Philadelphia: Brunner/Mazel.
Green, S. P., & Pritchard, M. E. (2003). Predictors of body image dissatisfaction in adult
men and women. Social Behavior and Personality, 31,215-222.
Groesz, L. M., Levine, M. P., & Murnen, S. K. (2002).The effect of experimental
presentation of thin media images on body satisfaction: A meta-analytic review.
International Journal of Eating Disorders, 31,1 -16.
Halpern, C. T., Udry, J. R., Campbell, B., & Suchindran, C. (1999). Effects of body fat on
weight concerns, dating, and sexual activity: A longitudinal analysis of black and white
adolescent girls. Developmental Psychology, 35,721-736.
Hargreaves, D., & Tiggemann, M. (2003).The effect of "thin ideal" television commercials
on body dissatisfaction and schema activation during early adolescence. Journal of
Youth and Adolescence, 32,367-373.
Hart, K., & Kenny, M. E. (1997). Adherence to the superwoman ideal and eating disorder
symptoms among college women. Sex Roles: A Journal of Research, 36,461-479.
Haworth-Hoeppner, S. (2000).The critical shapes of body image: The role of culture and
family in the production of eating disorders. Journal of Marriage and the Family, 62, 212227.
Heinberg, J. K. (1996).Theories of body image disturbance: Perceptual, developmental,
and sociocultural factors. In J. K.Thompson (Ed.), Body image, eating disorders, and
obesity (pp. 27-48). Washington, DC: American Psychological Association.
Hensley, L. G. (2003). Stepping off the scale. In B. RopersHuilman (Ed.), Gendered
futures in higher education: Critical perspectives for change (pp. 55-76). New York:
SUNY Press.
Irving, L. M. (1999). A bolder model of prevention: Science, practice, and activism. In N.
Piran, M. P. Levine, & C. Steiner-Adair (Eds.), Preventing eating disorders: A handbook
of interventions and special challenges (pp. 63-84). Philadelphia: Brunner/Mazel.
Jaffee, L, & Lutter, J. M. (1995). Adolescent girls: Factors influencing low and high body
Image. Melpomene Journal, 14, 14-22.
James, K. A., Phelps, L, & Bross, A. L (2001 ). Body dissatisfaction, drive for thinness,
and self-esteem in African American college females. Psychology in the Schools, 38,491
-496.
Jones, D. C. (2001). Social comparison and body image: Attractiveness comparisons to
models and peers among adolescent girls and boys. Sex Roles, 45,645-664.
Kalodner, C. R., & DeLucia-Waack, J. L (2003).Theory and research on eating disorders
and disturbances in women: Suggestions for practice. In M. Kopala & M. A. Keitel (Eds.),
Handbook of counseling women (pp. 506-532). London: Sage Publications.
Kearney-Cooke, A. (2002). Familial influences on body image development. In T. F.
Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical
practice (pp. 99-107). New York: Guilford Press.
Kegan, R. (1994). In over our heads: The mental demands of modem life. Cambridge,
MA: Harvard University Press.
Kilbourne, J. (1995). Slim hopes: Advertising and the obsession with thinness [Video].
(Available from Media Education Foundation, 28 Center Street, Northhampton, MA
01060; www.mediaed.org)
Kilbourne, J. (2000). Killing us softly III [Video]. (Available from Media Education
Foundation, 28 Center Street, Northhampton, MA 01060; www.mediaed.org)
Kostanski, M., & Gullone, E. (1998). Adolescent body image dissatisfaction:
Relationships with self-esteem, anxiety, and depression controlling for body max.
Journal of Child Psychology and Psychiatry, 39, 255-262.
Levine, M. P., & Piran, N. (2001 (.The prevention of eating disorders: Toward a
participatory ecology of knowledge, action, and advocacy. In R. Striegel-Moore & L
Smolak (Eds.), Eating disorders: Innovative directions in research and practice (pp. 233254). Washington, DC: American Psychological Association.
Levine, M. P., Piran, N., & Stoddard, C. (1999). Mission more probable: Media literacy,
activism, and advocacy as primary intervention. In N. Piran, M. P. Levine, & C.
SteinerAdair (Eds.), Preventing eating disorders: A handbook of interventions and
special challenges (pp. 1-25). Philadelphia: Brunner/Mazel.
Levine, M. P, & Smolak, L. (2002). Body image development in adolescence. In T. F.
Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical
practice (pp. 74-82). New York: Guilford Press.
McAuliffe, G. J., & Eriksen, K. P. (1999).Toward a constructivist and developmental
identity for the counseling professlontThe context-phase-stage-style model. Journal of
Counseling and Development, 77, 267-278.
McKinley,N.M.(1999).Women and objectified body consciousness: Mothers'and
daughters' body experience in cultural, developmental, and familial context.
Developmental Psychology, 35, 760-769.
Mcvey, G. L., & Davis, R. (2002). A program to promote positive body image: A 1 -year
follow-up evaluation. Journal of Early Adolescence, 22, 96-108.
Media
Education
Foundation.
(2004).
Retrieved
March
24,2004,
from
http://www.mediaed.org
Miller, J. B. (1990). The development of women's sense of self. In C. Zanardi (Ed.),
Essential papers on the psychology of women (pp. 437-454). New York: New York
University Press.
Mussell, M. P., Binford, R. B., & Fulkerson, J. A. (2000). Eating disorders: Summary of
risk factors, prevention programming, and prevention research. The Counseling
Psychologist, 28,764-796.
Myers, J. E., Sweeney,T. J., & White, V. E. (2002). Advocacy for counseling and
counselors: A professional imperative. Journal of Counseling and Development, 80, 394402.
Myers, J. E., Sweeney, T. J., & Witmer, J. M. (1998). The WEL workbook. Greensboro,
NC: Authors.
Myers, J. E., Sweeney, T. J., & Witmer, J. M. (2000). Wheel of Wellness counseling for
wellness: A holistic model for treatment planning. Journal of Counseling and
Development, 78, 251-266.
National Eating Disorders Association. (2004a). Retrieved March 24,2004, from
http://www.nationaleating disorders.org
National Eating Disorders Association. (2004b). Fifty ways to lose the 3D's: Dieting, drive
for thinness, and body dissatisfaction. Retrieved March 24,2004, from http://
nationaleatingdisorders.org/p.asp?Webpage_ID= 323&Profile_ID=41163
National Eating Disorders Association. (2004c). No weigh. Retrieved March 24,2004,
from http^/nationaleating disorders.org/p.asp?WebPage_ID=325&Profile_ID=41164
Oliver, K. L. (2001). Images of the body from popular culture: Engaging adolescent girls
in critical inquiry. Sport, Education, and Society, 6,143-164.
Paxton, S. J., Schutz, H. K., Wertheim, E. H., & Muir, S. L. (1999). Friendship clique and
peer influences on body image concerns, dietary restrain, extreme weight loss
behaviors, and binge eating in adolescent girls. Journal of Abnormal Psychology,
/08,255-266.
Pedersen, S. (2000). Multicultural perspective on middle-class women's identity
development .Journal of Counseling and Development, 78, 63-71.
Piran, N., Levine, M. P., & Steiner-Adair, C. (Eds.). (1999). Preventing eating disorders:
A handbook of interventions and special challenges. Philadelphia: Brunner/Mazel.
Polivy,J.,& Herman,CP.(1999).The effects of resolving to diet on restrained and
unrestrained eaters: The "false hope syndrome." International Journal of Eating
Disorders, 26, 434-447.
Richman, E. L, & Shaffer, D. R. (2000)."lf you let me play sports": How might sport
participation influence the self-esteem of adolescent females? Psychology of Women
Quarterly, 24,189-199.
Rodin, J., Silberstein, L R., & Striegel-Moore, R. H. (1985). Women and weight: A
normative discontent. In T. B. Sonderegger (Ed.), Psychology and gender: Nebraska
Symposium on Motivation, 1984 (pp. 267-307). Lincoln, NE: University of Nebraska
Press.
Smolak, L. (1999). Elementary school curricula for the primary prevention of eating
problems. In N. Piran, M. P. Levine, & C. Steiner-Adair (Eds.), Preventing eating
disorders: A handbook of interventions and special challenges (pp. 85-104).
Philadelphia: Brunner/Mazel.
Smolak, L, & Murnen, S. K. (2001). Gender and eating problems. In R. H. Striegel-Moore
& L Smolak (Eds.), Eating disorders: Innovative directions in research and practice (pp.
91 -110). Washington, DC: American Psychological Association.
Steiner-Adair, C. (1986).The body politic: Normative female adolescent development
and the development of eating disorders. Journal of the American Academy of
Psychoanalysis, 14, 95-114.
Steiner-Adair, C., & Vorenberg, A. P. (1999). Resisting weightism: Media literacy for
elementary-school children. In N. Piran, M. P. Levine, & C. Steiner-Adair (Eds.),
Preventing eating disorders: A handbook of interventions and special challenges (pp.
105-121 ). Philadelphia: Brunner/Mazel.
Stice, E., & Shaw, H. (2003). Prospective relations of body image, eating, and affective
disturbances to smoking onset in adolescent girls: How Virginia slims Journal of
Consulting and Clinical Psychology, 71,129-135.
Stice, E., & Whitenton, K. (2002). Risk factors for body dissatisfaction in adolescent girls:
A longitudinal investigation. Developmental Psychology, 38,669-678.
Strachan, M. D., & Cash,T. F. (2002). Self-help for a negative body image: A comparison
of components of a cognitive-behavioral program. Behavior Therapy, 33,235-251.
Striegel-Moore, R. H., & Cachelin, F. M. (1999). Body image concerns and disordered
eating in adolescent girls: Risk and protective factors. In N. G. Johnson, M. C. Roberts,
& J. Worell (Eds.), Beyond appearance: A new look at adolescent girls (pp. 85-108).
Washington, DC: American Psychological Association.
Taylor, C. B., & Altman,T. (1997). Priorities in prevention research for eating disorders.
Psychopharmacology Bulletin, 33,413-417.
Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999). Exacting
beauty: Theory, assessment, and treatment of body image disturbance. Washington,
DC: American Psychological Association.
Usmiani, S., & Daniluk, J. (1997). Mothers and their adolescent daughters: Relationship
between self-esteem, gender role identity, and body image. Journal of Youth and
Adolescence, 26,45-62.
Wolf, N. (1991). The beauty myth. New York: William Morrow.
Zabinski, M. F., Calfas, K. J., Gehrman, C. A., Wilfley, D. E., & Sallis, J. F. (2001).
Effects of activity intervention on body image. Annals of Behavioral Medicine, 23,247252.
Zucker, N. L, Womble, L. G., Williamson, D. A., & Perrin, L. A. (1999). Protective factors
for eating disorders in college female athletes. Eating Disorders, 7, 207-218.
[Author Affiliation]
Laura Hensley Choate is an associate professor in counselor education at Louisiana
State University, Baton Rouge. E-mail: lhensley@hu.edu