Healthy Body Image Intervention

Middle School

This activity is intended for children/youth and requires no additional cost.

Intervention Overview

Contrary to the belief that body image issues are only prevalent among teens, it has been found that body dissatisfaction begins in young children, with nearly 50% of children ages six to twelve reporting unhappiness with their appearance (Bird et al., 2013). It has also been found that nearly 60% of teens and pre-teens also struggle with body image concerns (Al Sabbah et al.,2009). Unhealthy thoughts and behaviors regarding body appearance put students at risk for eating disorders, unhealthy weight control, drug and alcohol use, and self harm (Diedrichs et al., 2015). Poor self image also negatively impacts students’ mental health and self esteem (Bird et al., 2013). Luckily, there are now many resources promoting healthy self image education in schools. The popular beauty product company, Dove, has researched and developed the Confident Me program, complete with free worksheets, videos, and lesson plans for use in school settings. They also provide teacher training resources on how to teach students about healthy body image. These resources are available in multiple languages. We encourage you to visit their site in the reference section as you prepare a healthy body image intervention for your students.  Most healthy body image interventions, including Dove’s Confident Me program, are intended for students ages 11-14, but can be adapted to younger or older students.

Intervention Guide

Grade Level: 6th-9th (Can be adapted to other grade levels)
Materials: Free worksheets, videos, lesson plans, etc. provided by DOVE Confident Me program (visit link in Reference section below)
Duration:

Varies, but likely several 50 minute sessions. 

Implementation:
  • Follow lesson plans provided by Dove for either a single 90-minute session, or five to six 50 minute lessons. 
  • Include self-reflection and group discussion
  • Important lesson themes to address with your students include:
    • Media Literacy, advertising, and appearance manipulation
    • Cultural/historical ideals of body image
    • Appropriate responses to appearance-based talk and teasing
    • Body Comparison

Does it work?

A few studies have been completed to test the effectiveness of the Dove Confident Me body image intervention for both male and female early adolescents. A study of the single 90 minute session found that all students had reduced negative affect and eating disorder symptoms immediately following the intervention (Diedrichs et al, 2015). Particularly among female students, there was a reported decrease in eating restraint and improved perception of body image. All students showed improved engagement and less avoidance of extracurricular and social activities. It was also found that this intervention was most effective when led by a trusted teacher, rather than an outside clinician or researcher (Diedrichs et al., 2015). However, although the 90-minute session did report an immediate impact in students’ self image and healthy behaviors, these improvements were not maintained long term. It is recommended to use multiple sessions, or include a follow up (Diedrichs et al., 2015). A study of the five session Confident Me intervention supports this conclusion, as improvements to the body image of both male and female students, as well as reduced appearance-based teasing, were maintained up to a year following the intervention (Diedrichs et al, 2021).

Similar healthy body image interventions, such as Happy Being Me, include similar themes to the Confident Me program, and report similar improvements in students’ healthy perceptions of self (Richardson & Paxton, 2010). In a study of the Happy Being Me program (adapted for both boys and girls) three, 50 minute sessions were administered to pre-adolescent students addressing themes such as media literacy and digital appearance manipulation, appearance-based teasing or “fat talk,” and body comparison(Bird et al., 2013). It was found that following the intervention, while no significant results were found regarding the self image of male participants, female students showed improvements in body satisfaction and eating habits (less restrained or emotional eating). For both boys and girls, improvements were made in appearance-related conversations and reduced internalization of body image ideals (Bird et al., 2013).

References:

Al Sabbah, H., Vereecken, C. A., Elgar, F. J., Nansel, T., Aasvee, K., Abdeen, Z., Ojala, K., Ahluwalia, N. & Maes, L.(2009). Body weight dissatisfaction and communication with parents among adolescents in 24 countries: International cross-sectional survey. BMC Public Health, 9, 52. http://dx.doi.org/10.1186/1471-2458-9-52

Bird, E.L., Halliwell, E., Diedrichs, P.C. & Harcourt, D. (2013). Happy being me in the UK: A controlled evaluation of a school-based body image intervention with pre-adolescent children. Body Image, 10(3), 326-334. https://doi.org/10.1016/j.bodyim.2013.02.008 

Diedrichs, P.C., Atkinson, M.J., Steer, R.J., Garbett, K.M., Rumsey, N. & Halliwell, E. (2015). Effectiveness of a brief school-based body image intervention ‘Dove Confident Me: Single Session’ when delivered by teachers and researchers: Results from a cluster randomised controlled trial. Behavior Research and Therapy, 74, 94-104. https://doi.org/10.1016/j.brat.2015.09.004

Diedrichs, P.C., Atkinson, M.J., Garbett, K.M. & Leckie, G. (2021). Evaluating the “Dove Confident Me” five-session body image intervention delivered by teachers in schools: A cluster randomized controlled effectiveness trial. Journal of Adolescent Health, 68(2), 331-341. https://doi.org/10.1016/j.jadohealth.2020.10.001

Dove (n.d.). School workshops on body image: Confident me. https://www.dove.com/us/en/dove-self-esteem-project/school-workshops-on-body-image-confident-me.html 

Richardson, S.H. & Paxton, S.J. (2010). Evaluation of a body image intervention based on risk factors for body dissatisfaction: A controlled study with adolescent girls. International Journal of Eating Disorders, 43, 112-122.  https://doi.org/10.1002/eat.20682

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