Social media are increasingly becoming part of our daily routine, and catching up with the latest social media used by both adolescents and young adults is not a piece of cake.
What we know for sure is that most of us spend a considerable amount of time posting our life on online networks where friends can “like” and comment on it as they please. Is it any wonder why our desire to look perfect intensifies when we get more and more used to the idea of leading more public lives?
Unsurprisingly, if we had to look for an association between social media and body image, we would find a remarkable amount of papers confirming the existence of an association (Holland & Tiggemann, 2016).
However, what is not completely clear is the relationship between social media and disordered eating (Howard et al., 2017). Given that disordered eating can be a risk factor for developing a clinical diagnosis of eating disorder (Stice et al., 2010), and more and more young people are able to access social media, it is worth understanding this relationship further.
This study (Wilksch et al., 2020) aimed to investigate rates of disordered eating and social media usage (specifically Facebook, Instagram, Snapchat, and Tumblr), and the relationship between these two, in a sample comprising both young adolescent boys and girls.
The authors recruited 996 Australian participants (534 girls and 462 boys) with an average age of 13 years (Grade 7-8) and who completed the questionnaires online.
Information about socioeconomic status and body mass index (BMI) were collected, but information on ethnicity was not captured as the majority of the sample was White.
- Disordered eating cognitions: measured by Eating Disorder Examination Questionnaire (EDE-Q) as a continuous measure examining subscales that cover shape concern, weight concern, restraint, and eating concern, and a total Global score
- Disordered eating behaviours: measured by the Project EAT (Eating Among Teens) questionnaire examining behaviours including skipping meals, eating very little food, following a strict eating and exercise plan, and making themselves vomit, over the last 12 months
- Social media use: measured by items previously used in body image research including questions on type of account, parent as friend/follower, public/private mode, time spent on an account, and content of photo posting.
While ANOVAs (analysis of variance) were used to investigate the relationship between number of social media accounts and mean EDE-Q Global scores, logistic or linear regressions were used for the comparison between girls and boys on both the frequency of individual disordered eating behaviours and social media account usage.
Overall, girls reported having higher disordered eating cognitions and behaviours than boys.
Instagram and Tumblr were more commonly used platforms among girls, whereas more boys reported having Facebook. While girls were more likely to post pictures of themselves, friends, and food on Instagram and Snapchat, boys were more likely to post pictures of Memes and possessions.
For both boys and girls, as the number of social media accounts increased, so did the frequency of disordered eating behaviours. Girls were more likely to report these behaviours if they spent more time using Instagram (OR = 1.56, 95% CI [1.20 to 2.03]) or Snapchat (OR = 1.33, 95% CI [1.02 to 1.73]), while boys would report them if they posted pictures of themselves or friends taken by others on Instagram (OR = 2.15, 95% CI [1.15 to 4.01]).
Finally, disordered eating cognitions tended to increase as the number of social media accounts increased. Higher cognitions were found in girls posting pictures of themselves or friends taken by others on Instagram (M = 1.63, SD = 1.35) and Memes/Quotes on Snapchat (M = 2.11, SD = 1.54), and in boys posting pictures of possessions on Instagram (M = 1.44, SD = 1.25) and selfies on Snapchat (M = 1.31, SD = 1.13).
- In this study, disordered eating and social media usage, particularly when focusing on image posting and viewing, were common and significantly associated in boys and girls aged 12-13 years
- Specifically, having more social media accounts was associated with increased disordered eating cognitions and behaviours.
Strengths and limitations
Overall, this is a well-designed study that focuses on a timely and relevant topic that can have important implications. However, the study presents with some limitations.
Firstly, this was a cross-sectional study, so it is not possible to disentangle the causality of the relationship between social media usage and disordered eating. Nonetheless, this type of design could have been used to explain this relationship more in depth by elucidating how socioeconomic status and BMI can affect disordered eating, or by considering how other mental health conditions can impact this relationship. Moreover, it is not clear whether parent followers play a role in influencing this association, nor whether a relationship between disordered eating cognitions and behaviours exists.
While the authors used validated and reliable measures to collect data on disordered eating cognitions and behaviours, currently there is no commonly agreed social media use measure that can be used to compare different studies. For the same reason, the authors were limited in the number of variables they could explore: besides posting of fitness-related images, types of accounts followed by the participants, and content of written posts, it is probably worth adding filters and camera effects to this already extensive list.
Furthermore, the authors could only refer to those social media accounts that were used at the time of the writing of the paper, leaving behind new and popular social media such as TikTok, hence confirming the high variability in the use of social media.
Finally, the authors recognised that the sample might not be representative of the Australian socioeconomic diversity, as all the teenagers were recruited in private schools, and there was a lack of ethnic diversity.
Implications for practice
This study brings attention to the social era, where teenagers start using social media at an even younger age than previously seen in other studies. Moreover, it highlights that those who use social media might present with both disordered eating behaviours and cognitions, and not just body image disturbance. I personally think that this can have extremely useful implications for practice, as new interventions targeting eating disorders could be tailored to include social media usage.
In addition, this research is likely to create the pathway for new studies to emerge on this topic, with the authors calling for more prospective research to better assess the causality of this association. As the minimum required age to access social media is 13 years, it would be interesting to investigate whether disordered eating is present before that age and see how it develops after the encounter with social media, in particular with the newest platforms such as TikTok.
Finally, this study has implications in terms of prevention. The authors suggest a couple of strategies that are particularly important: parental control over time spent on social media; and media literacy to help young people understand their current and future relationship with social media. However, these strategies can work only when parents and educators act prior to the encounter of teenagers with social media, as the addictive power of these platforms should not be underestimated (Griffiths & Kuss, 2017). With the appropriate knowledge of these technologies, I believe that young people can take advantage of the benefits of this rapidly-changing world.
Statement of interests
Wilksch, S. M., O’Shea, A., Ho, P., Byrne, S., & Wade, T. D. (2020). The relationship between social media use and disordered eating in young adolescents (PDF). International Journal of Eating Disorders, 53(1), 96-106.
Holland, G., & Tiggemann, M. (2016). A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes (PDF). Body image, 17, 100-110.
Howard, L. M., Heron, K. E., MacIntyre, R. I., Myers, T. A., & Everhart, R. S. (2017). Is use of social networking sites associated with young women’s body dissatisfaction and disordered eating? A look at Black-White racial differences (PDF). Body image, 23, 109-113.
Stice, E., Ng, J., & Shaw, H. (2010). Risk factors and prodromal eating pathology (PDF). Journal of Child Psychology and Psychiatry, 51(4), 518-525.
Griffiths, M. D., & Kuss, D. (2017). Adolescent social media addiction (revisited) (PDF). Education and Health, 35(3), 49-52.