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My child feels ugly! What can I do to help?

"Today" contributor Dr. Ruth Peters offers advice to parents to help their kids feel more comfortable in their own skin.

Q: My 12-year-old daughter had a horrible Thanksgiving. She barely ate and complained about being fat and ugly compared to her cousins. Not only do I disagree with this perception, but it breaks my heart to think that she’s feeling poorly about herself. I can only imagine how she’s going to handle Christmas, with the dinners, treats and parties that our large family engages in. She’s a lovely young lady and beautiful in my opinion. I can remember feeling too pudgy as a kid, and she does have my somewhat unruly hair. But to think of herself as “ugly” is just not true! Many times I’ve tried to point out how nice she looks in a certain outfit, but she blows that off, saying that it makes her look fat or out of style. It’s as if she wishes she were someone else — like one of the models on the magazine covers! No matter what her dad and I say to her, it just doesn’t seem to make a difference. And with the holidays approaching, she seems to become angry or depressed when I suggest going shopping at the mall. Is this normal, or should my daughter seek counseling? Any other suggestions?

A: Pre-teens are like puppies in many ways — with some body parts just begging to be grown into, and others that they wish would just stop growing! It’s a developmental stage that resides in the middle ground, with childhood being left behind and adolescence looming in the not-too-distant future. And, to make matters worse, many kids this age believe that they truly are “ugly,” and there just doesn’t seem to be anything that their folks can say that would change that perception. Tweens and teens, especially girls, often express concerns ranging from feeling that one’s face, body, weight, or hairstyle is unattractive — causing lots of self-absorption, introspection, anxiety and perhaps even depression.

So, what’s normal?
A focus on appearance during the adolescent years is a common and expected aspect of development — for boys as well as for girls. But, it becomes problematic when kids begin to worry about their appearance to the exclusion of many other values or activities. Growth spurts (or lack thereof), acne, braces (or crooked teeth) can affect the youngster’s emerging self-esteem. Add in your child’s increasing understanding of what society believes to be beautiful — cool clothes, flawless complexion, a six-pack abdomen for guys or an hourglass figure for girls, and the issue can seem insurmountable to the vulnerable tween or teen. So, what can you do as the parent to help ease the pain as well as helping your child feel more comfortable within her own skin? Check out these possibilities:

Warning signs:
Be on the lookout for your child’s frequent references to feeling ugly, the consistent need to be told that she looks fine, excessive exercise or calorie counting, and guilt or distress about overeating. These are warning signs that the child is overly focused on bodily appearance to the exclusion of her positive attributes.

What to do about it:

  • Athletics encourages the child to focus upon her body more for performance than for attractiveness. Whether it's team sports, lifting weights or jogging down the block with the dog in tow, encourage activity. This helps kids to reduce anxiety and feelings of self-consciousness and depression, and it can jump-start the process of building muscles and becoming trim and fit.
  • Let your daughter know that you’ll help her to plan appropriately for the upcoming holiday parties and events. This may mean eating a nutritious, filling meal before going out to dinner with the extended family (so she can have a salad or appetizer and not feel guilty), or helping her to plan fun activities with her cousins when they are together again. Perhaps she can bring a board game or a deck of cards, or if the weather is nice they can engage in outside activity that not only burns calories, but is fun and a great stress-reducer. If she sees that she has control in the situation, she’ll better be able to relax and enjoy herself.
  • Some of the “uglies” cannot be changed immediately — that gawky body just needs to catch up with itself, and the face will eventually grow into the nose by age 15! However, you can advise specific ways to help your child to look her best — by checking in with the dermatologist or orthodontist to help out with embarrassing acne or crooked teeth. Helping her to find clothing and hairstyles that work well with her body and hair texture should help during this awkward time, but many kids will not trust their parents’ judgment. If necessary ask a friend or relative who your daughter considers stylish and knowledgeable to help with this endeavor.
  • A review of the literature suggests that about 40 to 60 percent of adolescents say they are unhappy with how they look. Kids come in all shapes and sizes — tall, short, muscular, flabby, curly-headed or straight-haired. I’ve found that a redefinition of what makes someone really attractive is necessary — which includes their compassion and personality as well as physical attributes.
  • Bookstores and libraries offer several selections for the pre-teen and teen about “what’s happening to my body.” Also, books are often more accurate than your memory in terms of what to expect when it comes to body changes during puberty and when they will occur. (For single parents with a child of the opposite gender I feel that a good job of educating the kid about puberty and what’s up with the underarm hair can still occur — just be sure to do a little research yourself so that you don’t scare the wits out of him!)
  • Media idols really aren’t so perfect in person. Explain to your daughter that camera angles, lighting and makeup help the stars to look as they do. Even celebrities are now complaining about the “reality” shown by HDTV — wrinkles and skin imperfections are even more visible with the newest technology.
  • Praise positive effort such as perseverance at school or persistence on the practice field. Watch out for “person praise” such as looks, intelligence or ability. Your effort praise helps your child to develop her sense of identity, and if it can extend beyond the physical to character, commitment and conscience, most likely she’ll feel better about herself no matter how bad a hair day she’s having!
  • Realize that the clothing that your child wears helps her to feel more accepted within her peer group. It’s your child’s self-expression, and unless it is inappropriate, try to let her make her own selections. Again, as mentioned above, if a certain style shows off her coloring, body characteristics or personality, it may be a good idea to throw in a nice compliment about her wise taste in fashion.
  • Even cheerful comments can harm a child’s self-confidence, “What a cutie you are — so petite, and look at that red hair — how unusual!” may not be taken well by pre-teens and teens.
  • A new outfit, contact lenses, a makeover or new haircut can be just the thing to give your daughter the right ego boost to get her through this tough time. But, back up the focus on appearance with interest, encouragement and support for other activities such as chorus, softball or working out at the gym.
  • Pre-adolescents often live in a culture of cruelty where teasing is in and difficult to avoid. Often, your child will feel better just telling you about the criticisms or comments, and may not listen to your advice or suggestions. That’s OK — as long as she’s talking about the situation it allows you to monitor her moods and self-perceptions.
  • Evaluate your own weight and body concerns and how you talk to your daughter about them. Instead, discuss health, exercise and nutrition when it comes to your own body — don’t focus on weight, calories or dress size.

If it gets out of hand:
If you feel that “the uglies” are getting the better of your daughter, and you’ve tried most of these suggestions and she’s still upset, consider a visit or two with a child/adolescent specialist. Sometimes mom or dad just won’t do, and the child needs the guidance of a trained professional. Remember, this is a tough stage of development and a difficult time of the year for just about any kid. Support and encourage your daughter to realize that a healthy body is a beautiful body — one that remains attractive longer and leads to a better lifestyle than an over focus upon weight, dress size or hairstyle.

Copyright ©2005 by Ruth A. Peters, Ph.D. All rights reserved. Dr. Peters is a clinical psychologist and regular contributor to the “Today” show. Her most recent book, “Laying Down the Law: The 25 Laws of Parenting to Keep Your Kids on Track, Out of Trouble, and (Pretty Much) Under Control,” is published by Rodale. (See excerpts .) For more information you can visit her Web site at .

PLEASE NOTE: The information in this column should not be construed as providing specific psychological or medical advice, but rather to offer readers information to better understand the lives and health of themselves and their children. It is not intended to provide an alternative to professional treatment or to replace the services of a physician, psychiatrist or psychotherapist.