Children as young as five now suffering from "image anxiety".

It’s now become the norm to be unhappy with the way you look. As adults, between 70 and 80 per cent of us are dissatisfied with the reflection staring back at us in the mirror.

But disturbingly, the figures are much the same for young people, with research from the Centre for Appearance Research (CAR) at the University of West England showing children as young as five years old are suffering from image anxiety.

In fact, appearance psychologist and the co-director of the centre, Professor Nichola Rumsey, told Mamamia body self-consciousness is actually likely to begin even earlier, but it’s simply too difficult to measure in younger children.

“Even the toys that kids use seem to influence levels of appearance dissatisfaction, or at least awareness of appearance at a very young age. So they’ll make judgements and start talking about things like, ‘Being fat isn’t good’, and they’ll be assimilating those messages early on,” she said.

For school-age children, this usually presents itself as low-self esteem, higher levels of self-consciousness, concern about social interactions, concern that people are judging them on basis of their looks, and even disordered eating.

“That’s a particular concern,” Professor Rumsey said. “It’s quite common now for children to have competitions in school for who can eat the fewest calories in a day or a week.”

The implications of this kind of behaviour, she argues, aren't just physical and psychological, they're academic, too.

"There's research to show that the higher the level of appearance dissatisfaction the greater the likelihood is that they'll have poorer grades," Professor Rumsey said.

So where does it come from?

The big three influences on a person's body image, Professor Rumsey argued, are parents, peers and media, with one giving way to the next as the child ages.

"Parents are particularly important up to the age of around 11, 12, 13. So quite a lot of the influencing goes on at that stage," she said.

And often it's not intentional.

"If adults are dissatisfied with the way they look, and they're talking about diet and exercise and whether or not they should have cosmetic procedures, even if they don't direct their comments directly to the children, the kids are still getting the rhetoric," Professor Rumsey said.

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How can parents help?

Avoiding appearance talk is one way parents can be a positive influence, Rumsey argued: "Still compliment them, but not in a way that makes them feel that love is conditional on that in any way, or that that's going to make them happy."

The key, she said, is to promote the idea that self-esteem is multi-faceted, that it comes from more than just appearance. Paying particular attention to what the child is good at - be it sport, school, making others happy - is crucial here.

As are discussions that encourage them to have a more rounded view of those around them.

"Engage in conversations with them about their friendships and their relationships, and the qualities that they value in their friends - usually it isn't appearance," Professor Rumsey said. "So engage in some myth-busting, and challenge the messages out there in social media and advertising. That's very helpful."

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With those messages more pervasive and extreme than ever, intervention at an early age is crucial.

"The levels of dissatisfaction with appearance seem to have got more prevalent," Professor Rumsey said. "Things have changed over the last 10 to 15 years because of a number of influences. A lot to do with media, social media, particularly."

Of course it's not that simple. A lot of complex factors are at play when it comes to image anxiety, and CAR is working to tease those out. To help groups who may part of the problem play a role in developing solutions.

Just last week, Professor Rumsey addressed the biennial conference for the Australian Society of Plastic Surgeons about developing tools to help health practitioners to better assess a patient’s psychological needs and their expectations of their procedure, and also to consider the development of a self-esteem outreach program targeting adolescents.

"[It's about] trying to orient them to promote resilience in their patients rather than contributing to the myth that, 'Oh yeah, let's do this procedure, you'll look amazing afterwards and I'm sure you'll feel much better.' It's not a helpful message."