10. Social media & eating disorder


Struggles with body image create internal conflicts in adolescents… Social media exposes adolescents to millions of users with variations in body appearance…


The Impact of Social Media on Disordered Eating in Adolescents

Caitlin L Hoeing, Kelsey L Smith, Maria G Aramburu de La Guardia, Hatim A Omar

Lehigh Valley Reilly Children’s Hospital, Lehigh Valley Health Network, Allentown, PA

Correspondence: Caitlin Hoeing. Email: caitlin.hoeing@lvhn.org

Received: 10/11/2023; Revised: 20/11/2023; Accepted: 25/11/2023

Key words: adolescents, social media, disordered eating, body dissatisfaction, body image, media literacy

[citation: Hoeing, Caitlin; Smith, Kelsey; Guardia, Maria; and Omar, Hatim (2023). The impact of social media on disordered eating in adolescents. DHH, 10(1):https://journalofhealth.co.nz/?page_id=2981].

Introduction

Social media has gained popularity in all age groups throughout the past decade (Bozzola, 2022). As a whole, modern society adopted the idea that ceaseless social media usage is acceptable (Wilksch, 2020). Many individuals report that they utilize various social media platforms during the day, accruing multiple hours of screen time on their cell phones alone (Bozzola, 2022). Besides cell phone use, exposure to media occurs via televisions, tablets, and other smart devices. Social media consumption continues to rise, and applications now target the adolescent population for increased success (Wilksch, 2020).

Social media provides adolescents with instant connections to their network of friends. The majority of children want a cell phone so they can communicate with their peers on a daily basis (Wilksch, 2020). In addition to communication, adolescents utilize social media applications to put their lives on display via posts comprised of photos, videos, or text. Parents are handing their children a device that can place the entire Internet and every social network at their fingertips (Bozzola, 2022).

Now that children are receiving smartphones at younger ages, social media applications are easily accessible to them (Wilksch, 2020). The minimum age requirement for most social media platforms is 13 years old (Bozzola, 2022). At this age, adolescents may not fully understand the consequences of increased screen time and lack of face-to-face interactions (Wilksch, 2020). Younger generations have not received proper education on social media and its risks. Parents are commonly the source of education and guidance for children on this topic. However, it is difficult for parents to monitor all of the social media their child uses, as each platform serves a different purpose, and many parents are not familiar with the applications (Rounsefell, 2020).

Research has shown that increased social media usage in adolescents is linked to disordered eating (Wilksch, 2020). Exposure to thousands of users each day introduces new ideas and concepts to a child. Adolescents begin to compare themselves to peers, or even strangers, as they see others’ lives through the lens of social media (Aparicio-Martinez, 2019). This comparison can lead to dissatisfaction with one’s body, distortions in body image, and ultimately the development of disordered eating habits (Aparicio-Martinez, 2019).

Definitions

Body Image: An individual’s subjective mental image, thoughts, or conceptions of their own body. Body image is multidimensional and influenced by environmental and social factors (Aparicio-Martinez, 2019).

Body Dissatisfaction: An individual’s negative attitude towards their physical appearance. A discrepancy between actual physical appearance and the perceived physical appearance due to a desire for one’s body to appear different (Cataldo, 2021).

Disordered Eating: A term used to describe a spectrum of eating habits considered abnormal, which may include symptoms and behaviors of an eating disorder, such as restrictive eating, compulsive eating, or inflexible eating habits. An individual with disordered eating habits does not need to meet criteria for the diagnosis of an eating disorder (Chung, 2021).

Social Media: Mobile applications, networks, and websites that allow users to create, share and view content posted by others. Social media posts can include photos, videos, animated graphics, or free text (Chung, 2021).

Media Literacy: One’s ability to comprehend and analyze topics presented in mass media or social media. The skill of understanding the accuracy and/or credibility of sources that present media to the public (Wilksch, 2020).

Discussion

The widespread use of social media by adolescents generates concerns regarding mental health and self-esteem (Cataldo, 2021). The majority of adolescents feel a need to be involved with social media platforms to maintain their social status (Bozzola, 2022). Sharing their lives on social networks, as well as viewing friends’ posts, may provoke anxiety and distress in those who lack self-confidence. Individuals that struggle with self-esteem and confidence are vulnerable to sensitive topics discussed on social media (Cataldo, 2021). Adolescents are quick to judge their appearance and compare themselves to what they believe society discerns as beautiful. These comparisons cause adolescents to take drastic measures in order to meet society’s beauty standards (Aparicio-Martinez, 2019). Research into the cause of disordered eating has shifted its focus onto social media usage in adolescent populations (Aparicio-Martinez, 2019).

Struggles with body image create internal conflicts in adolescents (Jiotsa, 2021). Social media exposes adolescents to millions of users with variations in body appearance (Cataldo, 2021). As adolescents scroll through their applications each day, they are introduced to people they have never interacted with in person. At this age, they are impressionable and open to ideas spread by strangers they connect with online (Chung, 2021). This poses a risk to adolescents who lack confidence in themselves and struggle with their own body image (Jiotsa, 2021).  Adolescents are quick to compare their appearance to others (Choukas-Bradley, 2022). When they perceive someone as “skinnier”, “thinner”, or “prettier” than themselves, a long-term internal conflict starts. This struggle may lead the adolescent down a path of disordered eating in efforts to attain a body type they see online (Choukas-Bradley, 2022).

Adolescents who are dissatisfied with their looks are vulnerable to posts that discuss dieting, exercise, and appearance (Jiotsa, 2021). As they consistently click on these posts, applications tailor future content to the topics that they interact with most (Jiotsa, 2021). This creates a string of posts related to the same topics that is difficult to remove themselves from. Continuous exposure to posts by those struggling with diet and weight result in distortions in the adolescent’s body image and body dissatisfaction (de Vries, 2019). 

Body dissatisfaction results from social media when a adolescent thinks that they should look like people they see on their feed (de Vries, 2019). Adolescents are susceptible to believing that online posts are accurate and compare themselves to what they see (de Vries, 2019). As they continue to have negative attitudes towards their appearance, they will take drastic steps to alter the way they look. Research suggests that most adolescents believe that losing weight will improve their body image (de Vries, 2016). As a result, adolescents adopt disordered eating habits in order to attain their desired body image (de Vries, 2016).

Engaging in social media on a daily basis places adolescents at risk for distortions in their body image (Choukas-Bradley, 2022). Any negative change in body perception can alter their eating habits. Once disordered eating begins, the adolescent’s confidence and self-esteem become increasingly damaged (Ho, 2016). This puts them at risk for progression to other mental health disorders – most commonly anxiety, depression, or an eating disorder (Ho, 2016).

Adolescents turn to disordered eating in an effort to cope with body dissatisfaction (Ho, 2016). Disordered eating can occur in various forms, such as restricting or purging behaviors (Aparicio-Martinez, 2019). Adolescents may develop obsessive thoughts about food or suppress their appetite to achieve their ideal body image (Rounsefell, 2020). Persistent changes in eating and body perception puts the adolescent at risk of developing an eating disorder (Aparicio-Martinez, 2019). Social media usage can lead to decreased self-esteem, body dissatisfaction, negative body image, and disordered eating in susceptible adolescents (Rounsefell, 2020).

Current Recommendations

Research into the treatment of disordered eating as a result of social media usage is limited. Most studies agree that providers should tailor treatment to each adolescent’s unique mental health struggles (Jiotsa, 2021). Preventing adolescents from developing body distortions and body dissatisfaction is the best way to combat this growing dilemma (Yael, 2015). 

Significant risk factors for developing disordered eating habits are low self-esteem and lack of self-confidence (Cataldo, 2021). Empowering adolescents from an early age has been shown to decrease these risk factors (Yael, 2015). Parents should instill in their children that positive outcomes are under their personal control. This requires encouragement that they are loved, they are beautiful, and they do not need to change their appearance. Adolescents respond well to positive feedback, which directly affects perceived body image and boosts confidence (Yael, 2015). Complimenting adolescents on non-physical qualities increases self-esteem and can be protective against body focus (Yael, 2015).

Increasing adolescents’ awareness about the dangers of social media is another way to prevent disordered eating (Ho, 2016). One of the best ways to increase their knowledge is by teaching media literacy, which is the skill of determining what is credible and accurate in the media (Wilksch, 2020). Media literacy can be taught through open discussion. It is normal for adolescents to compare themselves to others online, but they should recognize that they do not need to act on these comparisons (Yael, 2015). Empowering adolescents to have confidence in their appearance can significantly help them identify their self-doubts and provide them with insight into mental well-being (Wilksch, 2020).

Adolescent empowerment requires strong, healthy relationships with a parent or guardian (de Vries, 2019). Consistent positive feedback and reassurance conveys optimistic messages to vulnerable adolescents (Yael, 2015). Compliments focused on non-physical characteristics, such as the adolescent’s personality or skills, instill confidence in their personal attributes rather than their appearance (de Vries, 2019). With this encouragement, adolescents will be less inclined to take drastic measures to change their appearance in response to body dissatisfaction (Yael, 2015).

Conclusion

As reported above,  a review of the literature between 2015 and 2022 suggested that social media usage has a detrimental effect on self-esteem and confidence in adolescents. Social media communicates false notions to adolescents about beauty standards. Adolescents find themselves dissatisfied with their body image after comparing themselves to those they see on social media. Disordered eating results from adolescents’ desires to change their appearance and conform to what society holds as beautiful. With the rise in social media usage, there has been an increase in disordered eating and subsequent mental health struggles. Based on the evidence reviewed in the literature, current recommendations focus on empowering adolescents in efforts to improve their self-esteem and confidence in their body image. Future research should focus on developing tools to monitor the relationship between social media use and mental health events in adolescents. Additionally, future longitudinal studies about the effects of social media may provide insight into long-term effects, such as disordered eating, body dysmorphia, anxiety, and depression. Teaching media literacy may potentially prevent adolescents from comparing themselves to the carefully edited photos posted on social media.

References

Aparicio-Martinez, P., Perea-Moreno, A. J., Martinez-Jimenez, M. P., Redel-Macías, M. D., Pagliari, C., & Vaquero-Abellan, M. (2019). Social Media, Thin-Ideal, Body Dissatisfaction and Disordered Eating Attitudes: An Exploratory Analysis. International journal of environmental research and public health, 16(21), 4177. https://doi.org/10.3390/ijerph16214177.

Bozzola, E., Spina, G., Agostiniani, R., Barni, S., Russo, R., Scarpato, E., Di Mauro, A., Di Stefano, A. V., Caruso, C., Corsello, G., & Staiano, A. (2022). The Use of Social Media in Children and Adolescents: Scoping Review on the Potential Risks. International journal of environmental research and public health, 19(16), 9960. https://doi.org/10.3390/ijerph19169960.

Cataldo, I., Lepri, B., Neoh, M. J. Y., & Esposito, G. (2021). Social Media Usage and Development of Psychiatric Disorders in Childhood and Adolescence: A Review. Frontiers in psychiatry, 11, 508595. https://doi.org/10.3389/fpsyt.2020.508595.

Choukas-Bradley, S., Roberts, S. R., Maheux, A. J., & Nesi, J. (2022). The Perfect Storm: A Developmental-Sociocultural Framework for the Role of Social Media in Adolescent Girls’ Body Image Concerns and Mental Health. Clinical child and family psychology review, 25(4), 681–701. https://doi.org/10.1007/s10567-022-00404-5.

Chung, A., Vieira, D., Donley, T., Tan, N., Jean-Louis, G., Kiely Gouley, K., & Seixas, A. (2021). Adolescent Peer Influence on Eating Behaviors via Social Media: Scoping Review. Journal of medical Internet research, 23(6), e19697. https://doi.org/10.2196/19697.

de Vries, D. A., Peter, J., de Graaf, H., & Nikken, P. (2016). Adolescents’ Social Network Site Use, Peer Appearance-Related Feedback, and Body Dissatisfaction: Testing a Mediation Model. Journal of youth and adolescence, 45(1), 211–224. https://doi.org/10.1007/s10964-015-0266-4.

de Vries, D. A., Vossen, H. G. M., & van der Kolk-van der Boom, P. (2019). Social Media and Body Dissatisfaction: Investigating the Attenuating Role of Positive Parent-Adolescent Relationships. Journal of youth and adolescence, 48(3), 527–536. https://doi.org/10.1007/s10964-018-0956-9.

Ho, S. S., Lee, E. W. J., & Liao, Y. (2016). Social Network Sites, Friends, and Celebrities: The Roles of Social Comparison and Celebrity Involvement in Adolescents’ Body Image Dissatisfaction. Social Media + Society, 2(3). https://doi.org/10.1177/2056305116664216.

Jiotsa, B., Naccache, B., Duval, M., Rocher, B., & Grall-Bronnec, M. (2021). Social Media Use and Body Image Disorders: Association between Frequency of Comparing One’s Own Physical Appearance to That of People Being Followed on Social Media and Body Dissatisfaction and Drive for Thinness. International journal of environmental research and public health, 18(6), 2880. https://doi.org/10.3390/ijerph18062880.

Rounsefell, K., Gibson, S., McLean, S., Blair, M., Molenaar, A., Brennan, L., Truby, H., & McCaffrey, T. A. (2020). Social media, body image and food choices in healthy young adults: A mixed methods systematic review. Nutrition & dietetics: the journal of the Dietitians Association of Australia, 77(1), 19–40. https://doi.org/10.1111/1747-0080.12581.

Wilksch, S., O’Shea, A., Ho, P., Byrne, S., Wade, T. (2020) The relationship between social media use and disordered eating in young adolescents. Int J Eat Disord, 53: 96–106. https://doi.org/10.1002/eat.23198.

Yael, L., Zohar, S., & Ruth, K. (2015) Disordered eating and media exposure among adolescent girls: the role of parental involvement and sense of empowerment. International Journal of Adolescence and Youth, 45(1), 375-391. https://doi.org/10.1080/02673843.2015.1014925.