Touching up her makeup, 16-year-old Liya* stepped back from the mirror and smiled at her own reflection. Since she started on the weight loss drug Wegovy a year ago, she has lost over 30 pounds, following years of failed diets and workouts. She said this night was the first party she had gone to in a while, and she was beyond excited.

“Taking [Wegovy] seemed like the most logical choice to make for me at the time,” Liya said. “Nothing was working for me, and I was beginning to lose hope. I was desperate and really just felt horrible about my body. My confidence was at an all-time low, so much so that I even stopped hanging out as much as I used to. I talked about it with my parents, and they agreed to let me give this a shot.”

The National Institutes of Health(NIH) defines body image as the subjective picture of individuals of their own body, irrespective of how their body actually looks. Upper School Psychologist Emily Joyner said body image encapsulates a universal experience of having mental distortions on how one views themself as a result of external experiences.

“[Body image] is often developed through relationships with other people, or messages that we get about our bodies, [and] it builds on itself,” Joyner said. “Bodies in general, [and] the fact that we all have them, can be a very loaded topic. Often, we will learn about ourselves through other people almost like mirrors that we see. [Ideas about body image] start when we’re so young that we don’t even realize it affects us. We see our parents or a friend comment ‘I’m so fat’, and it continues through our lifetimes.”

Negative body image has become incredibly prevalent in adolescents and adults. By the age of 13, 53% of American girls are unhappy with their bodies, and this number grows to 78% by the time they reach 17, according to the National Organization of Women (NOW). The same study reported that 66% of girls expressed the desire to lose weight, according to the NOW.

Liya said the lack of representation on social media contributed to her negative body image.

“When I scroll through TikTok, I often see these gorgeous thin girls who look so different from me,” Liya said. “And I know objectively they’re using touch-ups, but it still has an effect on me in the back of my mind. I would also see these transition videos where people ‘glowed up’ by becoming thinner. I had tried to lose weight through so many different methods and none of them worked, so seeing it work for them and not me was incredibly discouraging. It got so bad that I had to delete the app for a while even after I started on weight loss drugs to get my mental health back on track.”

Teenagers who reduced their smartphone usage by 50% saw significant decreases in their concerns about their weight, according to the American Psychology Association (APA).

Joyner said that judging individuals’ bodies and attractiveness based on their online presence can be detrimental to teenagers’ body image.

The images that we see all the time through social media are playing a significant role,” Joyner said. “There [are] particular standards of attractiveness, particular standards of what’s acceptable, what’s not, and that’s often what we see on these apps. There are trends of taking a camera, moving back from it and trying to see what others see. It’s disturbing because we can’t reduce ourselves to what our camera picks up two-dimensionally. We are such dynamic beings.”

Besides the negative effects of social media, daily experiences in certain extracurricular activities and cultures can have effects as well, according to the Mental Health Foundation. Sarah Parmet ’25 said she witnessed peers struggle with body image as a dancer and cheerleader.

“I’ve seen people quit dance because of body image,” Parmet said. “When I ask them why [they] quit, part of the reason is that it’s really installed a negative body image in them and they’ve gotten really shaming comments. The room is full of mirrors, and you’re very vulnerable, and the whole idea of ‘tuck your tummy in’ and ‘look smaller’ can really affect you, especially in ballet. I’m pretty short, and I’ve been told, ‘You’re short, so your lines won’t look great because you’re short.’ Some of that should change because these comments can really affect people.”

Joyner said that she also observed that the fashion industry was often tailored towards certain body types more than others, which can send a negative message to those who didn’t conform to what was conventionally accepted as the norm.

“Expression is so cool, and I love thinking about the way trends shift, cycle and evolve over time,” Joyner said. “But, there are some styles like the low-rise jeans that were very popular 13 years ago that are coming back or crop tops that make people think that they have to fit a standard to wear the style. Particularly, I feel that the stomach is a particularly vulnerable place where people have a lot of shame around.”

Clara Berg ’25 said that having conversations with her friends has increased her awareness of the unfair biases of fashion.

“At school, I’m so lucky to have friends that are so open to talking about [body image],” Berg said. “I hear them talk about how the fashion industry is designed for [the thin] body type and pretty much no one else’s. Being around so many people with different bodies and different experiences than me, I’ve been able to be more aware and make sure that I’m not asking people to do things that are pushing their boundaries or making them feel bad.”

Joyner said she feels that the school has a limited pool of body types and was designed with advantages given to those who are thinner.

“I don’t observe a lot of diversity of body size at the school,” Joyner said. “There’s a thinness to the norm. Even with the stairs at school, what message does that send to ourselves when everyday we’re struggling to go up the stairs? There can also be competitive components to body size and athleticism in general, which is normal for high school but potentially really harmful because it is such a pivotal time when we’re growing and developing. It can be a time where we’re looking to others for affirmation, and body image is such a big part of that.”

Liya said that she felt judged by her peers as a result of her body, further lowering her self-esteem.

“No one outright said that I looked fat or anything like that,” Liya said. “But when we’re getting food from the cafeteria, I felt very conscious reaching for the fries or chicken nuggets. I definitely also had the sense that my friends often assumed, ‘oh, she’s just unathletic,’ or ‘she must be lazy,’ neither of which were true. I felt misunderstood.”

Out of options, Liya turned to Wegovy, a drug similar to Ozempic which works slowly to make sure the user feels less hunger and full faster, resulting in weight loss. The medication, which is given through pre-filled injection pens on a weekly basis, comes with side effects like nausea, heartburn and fatigue, and rarely gallstones or acute pancreatitis, according to the WegovyWebsite.

Semaglutide has proven to be remarkably effective and has grown in popularity, with the number of prescriptions in the U.S. skyrocketing from none in 2018 to almost 3 million in 2023 for Wegovy and just over 2 million for Ozempic, according to Symphony Health.

Liya said that when she first started using the drug, she felt hesitant to share it because she felt like she was cheating her way to thinness.

“I always had this mindset that I had to work to deserve a thin body,” Liya said. “So now that I’m taking this drug, I feel like I’m taking a shortcut, and one that not everyone is able to afford.”

Joyner said the expensiveness of the drug and the willingness of people to pay for it reveals a societal attitude towards body image.

“I’ve heard people say, ‘I would pay hundreds of dollars for this’ because these drugs are very expensive, particularly for off-label use for weight loss,” Joyner said. “It reflects where our values are as a culture right now in terms of valuing thinness.”

Upper School Counselor Michelle Bracken said that many influencers online are promoting a medically-used drug as an easy weight loss drug. She said this misinformation could pose serious risks to teenagers.

“It’s very dangerous because people who take it who don’t really need to lose the weight put themselves at very high risks,” Bracken said. “There’s lots of things we don’t know because not many people who are not diabetic have taken the drugs. Anything on social media that is promoting something that is not being done by a medical professional or without research is irresponsible.”

Instead, Bracken said she encourages those who struggle with body image to accept themselves, regardless of their body type.

“I always start by working on somebody’s own self-confidence, letting them know that they’re enough,” Bracken said. “We get to control who we are inside, but there’s some genetics we can’t control. So, helping young people to feel better about themselves is crucial. It would be really great if social media and media in general normalized different body types.”

Parmet said making healthy choices and exercising has allowed her to maintain a healthy body image.

“My family has always prioritized taking care of ourselves and being healthy,” Parmet said. “So focusing on that has really helped. After a workout I feel so strong, accomplished and healthy. The body I’m in allows me to do so many amazing things, and I’m very grateful for that. I tell myself that I’m so grateful that I’m living in a body that can walk, run and dance.”

Although taking Wegovy had helped her superficially with body image, Liya said the process had more importantly taught her to embrace herself as she was.

“I’m certainly still not thin right now, but I’ve definitely learned so much on this journey,” Liya said. “I’m so proud of how far my body has gone and I’m beginning to learn to love it. I’ve never been happier.”

*Name has been changed.

This story was originally published on The Harvard-Westlake Chronicle on December 13, 2023.