outreach: understanding self-worth

Alison*, age 15, asked her parents to come to Outreach after telling them “I just don’t feel good about myself.” She met with counselor Christina Hostutler and explained that she is often consumed with thoughts about her appearance and the belief that she is fat. These beliefs have started to negatively impact Alison’s life. She is failing gym after months of refusing to change in the locker room. She avoids going out with friends especially if she feels there would be peers present who would be looking at her and judging her appearance. All of these attitudes have led Alison to engage in some risky methods of weight loss including skipping meals, using laxatives and fad diets.

Hostutler asserts that it’s not unusual for teenagers not to like their body or appearance, especially during puberty when their bodies are constantly changing. However, it becomes more of a problem when these thoughts become obsessive, change behaviors, lead to poor health choices and become a driving factor in self-concept. Hostutler explains, “A negative body image can lead a child to feel ashamed, self-conscious and uncomfortable with their body; it can also contribute to a distorted perception between their belief of their size and reality.” If body image issues go unchecked, there is an increased risk of developing an eating disorder.

Alison began to uncover how her beliefs about her body and her ideas about an ideal body developed. Like many girls her age, she was very influenced by images of extraordinarily thin models and the way women are portrayed in the media. Influences can be home-grown as well. Alison described her mother as someone who constantly criticizes her own body, picks apart how she looks in clothes and is on a perpetual diet. Alison recalled a very damaging turning point when she noticed the “pen test” going around on an app called Tumblr. Girls would lie on the ground and measure their waists by placing an upright pen next to their stomach. That night Alison remembers failing the “pen test” and vowing not to eat lunch.

Through counseling, Alison began to develop a more positive body image. Her goal was to appreciate her shape and the uniqueness of not only her body, but of her as a whole person. One of the first steps was to help Alison recognize the ways she distorted her thoughts about her body and her assumptions that everyone was looking at her and judging her negatively. She worked diligently to replace these thoughts with more realistic self-talk including acknowledging everything that her body did well such as play softball. She began to make a list of her positive attributes and those of her friends. Through this exercise, Alison realized that she values internal traits more than external appearance and it has helped her not to compare herself to others as much. Finally, Alison and her counselor discussed elements of a healthy lifestyle and worked to replace her extreme weight loss measures with a plan to eat healthy and increase her activity level. Alison chose to walk more with friends, which provides not only health benefits but also has served to improve her mood and increase time being socially engaged.


*Alison represents a typical Outreach client. Details do not correspond with any specific case in order to protect client anonymity.

Outreach Teen & Family Services is a nonprofit, confidential counseling service. We offer counseling and educational programs to youth and parents that are affordable, accessible and discreet; all within a welcoming, supportive environment.