Family, friends, partners, teachers, coaches, and the media are all huge environmental influences when it comes to shaping our perceptions of where we fit in the world - and whether we measure up.

But the old adage, "It's what's inside that counts', is the one we need to model and teach our children if we want them to build body confidence and healthy attitudes to eating, a parent forum hosted by The Scots School Albury was told this week.

Ah yes, of course, many parents nod sagely.

And yet, even unwittingly, our language around food and beauty, the attitudes to our own bodies, good-natured "teasing" and even compliments from family and friends, coupled with continuous exposure to appearance-focused messaging in the media are wreaking havoc on our children and teenagers' self-esteem.

Research consistently shows body image is ranked among the top concerns for Australian teens, clinical psychologist Suzie Rhydderch told attendees at the Butterfly Foundation presentation.

A 2018 Mission Australia youth survey reports 30.4 per cent of 15-19-year-olds are "extremely" or "very" concerned about body image, she revealed.

Further are the worrying figures that show 50 per cent of girls and 20 per cent of boys (14-15 years) are "afraid" of putting on weight with many of them restricting food intake to control this.

It appears young people are buying into unrealistic beliefs that self-worth and success are determined by your size, weight and shape.

Ms Rhydderch explained that eating and body attitudes ranged across a spectrum from healthy through to more unhealthy attitudes and practices that could include dieting, increasing body dissatisfaction and "disordered eating through to severe mental illlness with clinical - and life-threatening - eating disorders.

She warned puberty was a particularly high-risk stage for body dissatisfaction and it was important for children and teenagers to understand weight gain and shape change were part of that process.

She urged parents to be "alert but not alarmed" in observing changes to their child's behaviour that could flag "disordered eating" including: restricting food intake or food groups; excessive exercising; and high levels of body dissatisfaction.

One of the big concerns currently is a fixation with "righteous eating" (orthorexia), according to Ms Rhydderch.

"It starts as an innocent attempt to eat more healthily but can move to a fixation on food purity/quality and self punishment if they are not 'good'," she explained.

"Under the mask of wellbeing, good choices become restrictive, health suffers and it can impair relationships and social activities."

She said it was imperative parents, teachers and adult influencers were aware of warning signs, triggers and positive modelling to prevent the "curve ball" of a severe eating disorder.

"We know early intervention can reduce the severity and duration of an eating disorder," Ms Rhydderch said, before advising parents not to be afraid to talk with their children about their thoughts and feelings.

"It's important not to be dismissive about unhealthy thoughts but try to re-direct or re-frame the conversation.

"Find five things, for example, they can do to make themselves feel better - a hug, writing in a journal, music, colouring-in - a tool-kit if you like when they are not feeling good.

"It all builds resilience.

"Explain to your child their body is capable of incredible things - no matter what the shape or size."

FURTHER READING: From pizza to perfection - how the digital world shapes our thinking

Under-reporting of eating disorders and body image issues in boys and young men can have devastating consequences, an Albury forum heard this week.

Overshadowed by stigma and besieged by stereotypes that equate muscles with manliness, males do not seek the help they need, clinical psychologist Suzie Rhydderch said at the session on developing body confidence in children and teens.

Over-exercising and the pursuit of muscle growth were often seen as healthy - even applaudable - behaviours for males, she explained

Big biceps, a big chest and a six-pack were qualities valued by society, young men revealed in an emotion-laden video aired during the session hosted by The Scots School Albury on May 7.

"If you're not tall enough, or muscular enough, you're not good enough - it gets in your head," one boy admitted.

A 2018 Mission Australia survey of youth between the ages of 15 and 19 revealed 30.4 per cent of respondents were "extremely" or "very concerned" about body image.

The Butterfly Foundation has further stated two-thirds of adolescent boys report making specific changes to their diet to gain muscle.

Almost an equal number of males and females experience binge eating disorder.

And the 2018 Australian Institute Family Studies annual report reveals 1 in 2 girls and 1 in 5 boys are "afraid of gaining weight".

Body image concerns in boys can lead to supplementation/steroid use and body dysmorphia disorder, Ms Rhydderch revealed.

In October, 2018, the Butterfly Foundation launched Australia's first digital body image program for adolescent boys called RESET.

The program aims to start a "deeper conversation about body dissatisfaction and eating disorders which are unfortunately increasing in boys".

Researcher Dr Scott Griffiths said conversations about body image needed to be normalised with all genders to minimise risks.

"Evidence tells us males are consistently under-represented in messaging and interventions in relation to body dissatisfaction and eating disorders which can have a devastating impact on boys' help seeking," he said.