Teenage girls who maintain a 'normal' body weight through constant dieting and exercise may look 'healthy' but should be seen as a vulnerable group according to new research from the University of Warwick.
The study, led by Dr Dimitra Hartas, finds that 17-year-old women of normal weight who closely manage their bodies through strict regimes of diet and exercise - focused on "clean eating", fitness, and constant self-monitoring rather than food deprivation - face heightened risks to their psychological health. Many reported experiences of weight stigma, high levels of anxiety-related traits, and thoughts of self-harm and suicide.
By the age of 20, these young women were more likely to experience symptoms associated with anxiety and depression, alongside psychological distress and poorer overall wellbeing.
The research challenges the widespread assumption that dieting and regular exercise are always markers of good health. Instead, it highlights how body management has become closely tied to identity, self-worth, and social acceptance - particularly for young women.
"In an image-saturated culture, young women are praised for being fit and slim," said Dr Dimitra Hartas, Reader at the University of Warwick. "But beneath this veneer of health lies a troubling reality. For many, managing body weight is not about wellbeing - it is about meeting cultural expectations and earning a sense of worth."
The study points to a broader societal shift in which personhood has become a project of constant self-optimisation, where the 'ideal body' is narrowly defined and weight is treated as a measure of personal worth.
In social media culture, body satisfaction has become a form of currency, with 'slim' increasingly seen as synonymous with 'worthy'. As a result, young women often work hard to look like the best version of themselves, rather than to feel or be well.
"This pressure for the female body to shrink is a form of social control," Dr Hartas said. "It restricts women's physical and symbolic space, shaping how they see themselves and how society permits them to exist. The mental health cost of this pressure is significant and too often overlooked."
The findings sit within a wider and worrying context. Recent studies show that one in three women aged 16-24 report experiencing mental ill health, with rates of self-harm among young women having quadrupled since 2000.
Dr Hartas argues that recognising young women of normal weight who engage in constant dieting and exercise as a vulnerable group is essential for improving mental health prevention, education, and support.
"Health messaging needs to move beyond weight and appearance," she said. "We need to ask not just how young women look, but how they are actually doing - psychologically, emotionally, and socially."
"These findings show that schools and colleges need to do much more to support young people's health," said Dr Michael C Watson from the Institute of Health Promotion and Education (IHPE). "We need to move beyond BMI and weight management towards promoting exercise, sleep and healthy eating, while also tackling body image and fat shaming. This is a complex challenge that won't be solved by one-off or isolated interventions."
The full research report is available here: https://tinyurl.com/2kfwpsm7
