UCL research shows body image concerns in teens raise the risk of depression in adulthood, highlighting the need for early support
Body image issues during adolescence may have long-lasting effects on mental health, according to a new study from University College London. The research shows that teens who struggle with body dissatisfaction are significantly more likely to experience depression in adulthood. The findings underline the importance of early intervention, mental health support, and education to help young people develop a healthy relationship with their bodies and reduce long-term psychological risks.
The study is published in The Lancet Psychiatry and funded by Wellcome.
The rise of depression and eating disorders in children
The research followed over 2,000 twins born in England and Wales, using data from the Twins Early Development Study (TEDS), a long-running birth cohort tracking the health and well-being of twins born between 1994 and 1996.
Higher body dissatisfaction at 16 linked to more eating disorders and depression symptoms in the twenties, even after accounting for family background and genetics.
The researchers compared identical twins, who share 100% of their DNA, with non-identical twins, who share roughly 50% of their DNA, to examine the roles of shared genetics and environmental influences.
Lead author Dr Ilaria Costantini, from UCL’s Division of Psychiatry, said: “In the last 20 years, there has been a concerning increase in depression and eating disorders among young people, so it’s important to find out what is driving this increase in order to develop ways to prevent mental health problems from occurring.”
Body image concerns more strongly impacted girls
Participants were asked at 16 years old about body image concerns, including fears of weight gain and judging themselves by their weight or body shape. They were then surveyed again at ages 21 and 26 about depressive and eating disorder symptoms.
The researchers found that higher levels of body dissatisfaction at age 16 were linked to significantly higher eating disorder and depressive symptom scores in early adulthood. Their twin study design enabled them to factor out the effects of shared genes and other environmental factors, such as the same family, neighbourhood, and school, to determine that body image concerns in adolescence do appear to increase the risk of later mental health issues.
The researchers found stronger links between body dissatisfaction and later mental health problems in girls.
Dr Costantini explained that this could reflect increased cultural and social pressures on young women to meet unrealistic appearance standards, noting: “In Western societies, young women often face greater pressures than young men regarding appearance, particularly thinness. Our findings suggest these pressures may contribute to more significant long-term mental health effects for girls.”
“However, it is important to recognise that this may partly reflect the limited way in which body dissatisfaction was measured in this cohort. The items focused mainly on weight and shape, which tend to be more salient concerns for girls. If we had captured body dissatisfaction in a broader way — for example, by including muscularity, height, skin, or other appearance-related concerns — our findings for boys might have been different.”
The association between body dissatisfaction and later BMI was weaker in identical twins than in non-identical twins, suggesting that shared genetics may explain much of the link between feeling unhappy with one’s body and actual changes in weight.
How can we support adolescents as they transition to adulthood?
Senior author Professor Francesca Solmi (UCL Division of Psychiatry) stated that the findings highlight the importance of addressing body dissatisfaction through public health strategies: “It is essential to address body dissatisfaction during the teenage years across various contexts, including the school system, healthcare strategies, and the wider culture.”
Effective prevention is needed, such as regulating harmful social media content or creating school and public health campaigns to promote body acceptance.
Professor Solmi added, “We need to create environments that value diversity in appearance and avoid sending harmful messages about weight or beauty ideals. That means working with families, schools, and the media to ensure we are not promoting unhealthy beauty and weight standards.”
Umairah Malik, Clinical Manager of Beat, the UK’s eating disorder charity, commented: “This study advances our understanding of eating disorders and the various factors that can increase the risk of developing one. Increased knowledge of these challenging mental illnesses supports improved prevention efforts.”
She continued: “The research clarifies that while body dissatisfaction has a genetic component, environmental factors also play a role, likely contributing to its growing prevalence. It also offers important insights into the relationship between body dissatisfaction and both mental and physical health.”
“It’s vital that we address societal stigma around weight as it can contribute to body image concerns. These findings reinforce the urgent need for preventative approaches. We strongly support its call for sustained prevention efforts across different environments, including in schools, public health messaging and in the media.”
