Juvenile Arthritis and Body Image

By Emily Delzell

At some point almost all kids struggle with their body image. They wrestle with thoughts and feelings about how they and others view their bodies.

Juvenile arthritis (JA) often means extra challenges, says Lauren Cox, PhD, a pediatric psychologist at Texas Scottish Rite Hospital for Children in Dallas. She notes that swollen, painful joints can change how children can use their bodies. And psoriatic arthritis can mark the skin with red and silver scales. Side effects of arthritis medications can include fatigue, hair loss and weight gain. All of this means kids with JA may look and function differently than their peers — and they know it.

“Children become more aware of themselves in relation to other people as they grow and develop,” says Cox. “Most school-age children and teenagers are really motivated to fit in, and they do not want to be seen as different.”

When Body Image Issues Take Over

Struggles with JA and body image take place in a society where people are valued by idealized appearance and physical skills. Both younger children and teens can have a hard time accepting themselves. Adolescent sensitivity about looks is very common, says Cox. But in kids with JA, she notes, concerns seem more tied to how arthritis impacts the child.

“For a teenager with very little disease or treatment-related impact, the effect on body image may be minimal,” she says. “Conversely, an 8-year-old with significant impairment may have a very hard time adapting to the ways arthritis has impacted her body. It’s very child-specific.”

When children with JA absorb negative feelings and messages, they can feel sad, anxious and lonely, says Cox.

“Unchecked, this could potentially turn into more clinical-level impairment, like depression or anxiety disorders,” she says. Warning signs include

• Withdrawing from activities.
• Dressing differently to hide signs of disease.
• Sleeping poorly.
• Becoming irritated.
• Becoming unmotivated.

Help Build Acceptance

Work closely with your doctors to ensure your child has as few symptoms and medication side effects as possible. “Achieving adequate disease control with minimal side effects reduces negative effects,” Cox says.

First, be proactive about disease control. Bring up concerns in medical visits rather than waiting for the doctor to do it. Cox offers these other suggestions:

• Teach your child that everyone has differences and issues to deal with; some are just more obvious than others.
• Help your child nurture interests that are doable when disease is flaring.
• Praise your child for non-physical traits, such as persistence, honesty and kindness.
• Connect children with peers who understand what they’re going through. The Arthritis Foundation JA camps and national conferences are great ways for families to connect with people who “get” it.  
• Monitor your child’s peer group and social media; make a change if you’re uncomfortable with any interactions.

If your child’s body image concerns continue to be a problem, it may be time to seek help. Your doctor can refer you to a counselor, social worker, therapist or psychologist.