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Body image is hard enough for kids and teens right now. Between social media, changing bodies, and a culture that rewards looking a certain way, most young people are already navigating a complicated relationship with how they look. And that’s long before a diagnosis or a medical device ever enters the picture.
So when a child or teen also has a central line, a feeding tube, an ostomy bag, a cochlear implant, or any other visible medical device, that struggle doesn't start from zero. It starts from a baseline that's already a little bit shaky, and the device adds a layer most of their peers won’t ever have to think about.
A 2025 meta-analysis in Clinical Nutrition, pooling data from 28 studies and over 2,400 young patients (ages 0–25) with vascular access devices for parenteral nutrition, found that roughly one in three had clinically significant anxiety, and nearly one in four had depression, both well above rates in the general pediatric population. Devices were also linked to a moderate negative effect on body image and a real, if smaller, dip in overall quality of life.
One detail stood out: visibility mattered. Kids and teens with externally visible devices, like central lines, reported significantly more anxiety and body image distress than those with fully implanted ports. Girls and adolescents were affected more than younger children and boys. And the effect wasn't about vanity; it showed up as kids skipping sports, changing what they wore, and avoiding situations where the device might be seen or questioned.
This tracks with what's understood more broadly about body image and illness. A widely cited case discussion in Primary Care Companion to the Journal of Clinical Psychiatry (Bolton, Lobben & Stern) makes a point worth sitting with: body image is typically established by around age six, and external factors like trauma, medical conditions, how other people react to a visible difference can shape it long-term. For example, a scar that becomes barely noticeable can still carry the same weight it did the day it appeared. The authors also note that visible conditions and external devices, from ostomy bags to prosthetics, consistently cause more body image distress than things that are hidden.
Put together, these two pieces of research say something clinicians are increasingly building into care plans: a device's medical function and its psychological weight aren't separate questions. Both deserve attention.
For families new to this, it helps to understand your child’s devices, since not all devices carry the same visibility, and visibility is exactly what the research flags as the biggest driver of body image impact.
Tunneled catheters, feeding tubes, peritoneal dialysis catheters, and other external medical hardware share the same basic challenge of being at least partially on the outside. These devices serve important medical purposes, but their visibility can introduce challenges that go beyond the clinical setting.
For example, a line may be visible beneath clothing. A child may worry about classmates asking questions. A teenager may think twice about what they wear or whether they want to participate in an activity. In other words, a device that is medically necessary can become something a young person has to think about socially, emotionally, and physically throughout the day.
The research doesn't suggest that concealing a device erases the psychological impact of a chronic condition, and no product should claim it does. But a few of the following findings are worth taking seriously:
That last point is where securement and concealment tools can genuinely contribute to the bigger picture. A pilot study out of UPMC Children's Hospital of Pittsburgh tested this directly. In it, 23 pediatric patients with intestinal failure were randomized to Gus Gear’s Central Line Vest or standard dressing as a form of line securement. The Vest group had lower rates of line trauma during the study period, and several quality-of-life measures, including questions about daily activity and body image, scored better in the Vest group than the control group. These results demonstrate a real, measured signal that a more secure, less disruptive device can move the needle on both medical outcomes and how kids experience living with a line day to day.
This is the thinking behind Gus Gear’s LOCK 2000 Vest and LOCK 3000 Belt. Both are designed to be low-profile and concealable under clothes, specifically because research shows how big of an influence visibility has on body image for kids and teens with medical devices.
To be clear about what that does and doesn't mean, a more discreet securement product isn't going to resolve an individual's relationship with their body, and it shouldn't be marketed as if it could. But it can mean one less thing to explain at school. It can mean a child is able to participate in their line care. It can mean playing without worrying the device will catch, snag, or show. Over time, those small moments of freedom and control are exactly the kind of thing the research points to as protective, contributing to how a young person comes to feel about living with a device long-term.
Body image work for kids and teens with medical devices isn't a single intervention. It's screening, family support, peer connection, and yes, thoughtful design that gives kids back some of the freedom their diagnosis might have taken away.