With increasing eating disorder prevalence, attention has turned to the growth of social media. Eating disorders are associated with health consequences. Exploratory research suggests that social media usage may be triggering body image concerns and heightening eating disorder pathology amongst young people. Still, the topic is under-researched as a global public health issue.
Body image dissatisfaction and eating disorder pathology amongst young people are rising. An estimated 13% of young people experience an eating disorder by the age of 20, and 15–47% endorse disordered eating cognitions and behaviors. Exploratory evidence indicates that social media usage may be partly to blame.
Is social media a plausible risk factor for the development of body image concerns and recent rise in eating disorders? If so, is it a global or western phenomenon?
Scientists noted, “For the study, we used Arksey and O’Malley’s framework and the updated PRISMA checklist for scoping reviews to guide their approach. They searched MEDLINE, PyscINFO, and Web of Science databases in May 2021 and updated our search on 20th July 2021. They then identified appropriate search terms through preliminary reading and listing relevant Medical Subject Headings.”
“Keywords were related to four principal concepts: social media, body image, eating disorders, and young people. We entered keywords manually and used the “?” symbol to capture all potential word-endings.”
The search results were then exported from each database to the reference manager Zotero. After removing duplicates, scientists screened titles and abstracts and eliminated irrelevant papers. Any discrepancies were resolved by enlisting the help of additional reviewers who were not part of the study but had a relevant background in global health and nutrition.
To allow for sufficient depth of analysis and documentation of individual differences, scientists included studies involving young people (aged 10–24 years). They had studied any social media platform but not those focusing on mass media and/or internet use. The studies exploring social media interventions and body image/ disordered eating outcomes were excluded as they were beyond the scope of the review.
Across studies, reasons for social media usage included: identity management, fitting in with friends, posting content for peer feedback, and seeking out weight loss, fitness, or pro-eating disorder material.
Evidence from 50 studies in 17 countries indicates that social media usage leads to body image concerns, eating disorders/disordered eating, and poor mental health via the mediating pathways of social comparison, thin/fit ideal internalization, and self-objectification.
Specific exposures (social media trends, pro-eating disorder content, appearance-focused platforms, and investment in photos) and moderators (high BMI, female gender, and preexisting body image concerns) strengthen the relationship. In contrast, other moderators (high social media literacy and body appreciation) are protective, hinting at a ‘self-perpetuating cycle of risk.’
Scientists concluded, “Social media usage is a plausible risk factor for the development of eating disorders. Research from Asia suggests that the association is not unique to traditional western cultures. Based on the scale of social media usage amongst young people, this issue is worthy of attention as an emerging global public health issue.”