Unhealthy Body Image Misperceptions Linked to Higher Alcohol Use Among Teen Girls

A recent report has found a significant correlation between body image misperceptions and adolescent alcohol use in girls. Alcohol is the most commonly used, and misused drug amongst adolescents in the United States, according to the U.S. Department of Health and Human Services. Dieting culture is also widely present in American society, and the two often influence each other, as weight-loss behavior has been associated with substance abuse in adolescents.

Among high school girls 14-18 years of age, those acting on reported body image misperceptions are more likely to have engaged in heavy drinking than teen girls of the same age without body image misperceptions. The study, published in the Journal of Studies on Alcohol and Drugs, defined a body image behavioral misperception (BIBM) as “trying to lose, maintain or gain weight when there is no medical need to do so based on self-reported weight status.”

The researchers analyzed data from the 2013 National Youth Risk Behavior Surveillance System, a national, school-based survey conducted by the Centers for Disease Control and Prevention. Of the 6,579 female students ages 14-18+, 37.5 percent reported having a BIBM; 67.7 percent of the girls had had at least one drink in their lifetime; and 17.8 percent had episodes of heavy drinking in the past 30 days(1).

“Negative self-image can lead to negative behaviors. Body image and behavioral misperception occurs when actions are taken based on a perceived weight status or body image,” said senior study author Margie Skeer, Sc.D., M.P.H., M.S.W., assistant professor of public health and community medicine at Tufts University School of Medicine. Skeer added,

Paying attention to this behavior in this population could help identify factors supporting the relationship between this misperception and drinking, as well as other risk behaviors, beyond high school.

This research shows the importance of being aware of adolescent perceptions of body image, self-esteem and substance use. These are issues that need to be considered at both the family, social, and medical level.

  1. Schlissel AC, et al. The Association Between Body Image and Behavioral Misperception (BIBM) and AlcoholUse Among High School Girls: Results From the 2013 Youth Risk Behavioral Survey.J Stud Alcohol Drugs. 2017 Jan;78(1):97-105.


email-photoNode Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision. 

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