When adolescents look at their bodies: Individual and social explanations for the dissatisfaction with what they see-A cross-sectional study

Can J Public Health. 2026 Jul 9. doi: 10.17269/s41997-026-01229-3. Online ahead of print.

ABSTRACT

OBJECTIVES: Poor body image perception, such as overestimating or underestimating size, aligns with low self-esteem, poor mental health, and unhealthy behaviours like disordered eating. While girls consistently report greater dissatisfaction with their bodies than boys, the factors underlying these perceptions remain unclear for both. This study examines individual, social, and environmental factors influencing adolescent body image perception and whether these vary for girls and boys.

METHODS: This cross-sectional study was conducted in Canada using an online survey administered between August 2021 and August 2023 to 802 youth aged 13-18. This survey assessed body image and possible influences including social relationships, social media engagement, physical characteristics, and behaviour. Principal component analysis (PCA) identified latent factors underlying body image ratings.

RESULTS: Forty-three percent of boys (95% CI, 36.4-49.8) rated their body image positively compared to 23% of girls (95% CI, 19.1-26.4) and 13% of non-binary youth (95% CI, 4.7-25.3). Bivariate analyses showed a positive association between unfavourable body image and poorer self-rated physical and mental health, particularly among girls. PCA identified three domains associated with body image perception: social relationships, personal behaviours, and media comparison. Boys emphasized factors including fitness and sense of self-identity, while girls focused on social comparisons and media portrayals.

CONCLUSION: Overall, only a minority of youth have positive body images. Perceptions are shaped by an interplay of social, behavioural, and environmental factors, with clear differences between both groups. Recognizing these influences can guide the development of tailored interventions that promote positive body image among youth.

PMID:42426549 | DOI:10.17269/s41997-026-01229-3