Too Much Social Media Could Raise Risk for Eating Disorders

THURSDAY, March 23, 2023 (HealthDay News) -- Curated images of perfect bodies -- often highly filtered and unrealistic -- are common on TikTok, Twitter, Instagram and Pinterest.

And a broad new review of 50 recent studies across 17 countries finds that relentless online exposure to largely unattainable physical ideals may be driving up the risk for eating disorders, particularly among young girls.

This study, said co-author Komal Bhatia, is “significant because it tells us how social media can lead to body image concerns, through constant social comparison, internalization of thinness and self-objectification.”

Girls and others with weight challenges and/or concerns about body image are among those most vulnerable to the “self-perpetuating cycle of risk” highlighted by the research review, she added.

Bhatia, a research fellow in adolescent health at University College London, pointed out that even though roughly of half of the world’s population -- about 4 billion people -- has access to social media, social media platforms “are largely unregulated.”

And many users are young; researchers noted that more than 90% of American and British teens regularly engage with such platforms. Fully half are believed to jump online at least once an hour.

The studies covered in this review were conducted between 2016 and 2021.

Most took place in wealthy countries, with the United States and Australia accounting for nearly half. Studies from Canada, Italy, Singapore, United Kingdom, Spain, Ireland, Belgium, Germany, France, Sweden, Sri Lanka, China, Malaysia and Thailand were also reviewed.

They included people between 10 and 24 years of age. Half focused solely on girls; most of the others included both boys and girls. In about three-quarters of the studies, the majority of participants were white.

The takeaway: Social media use has normalized a super thin and/or super fit body-type ideal.

In comparison to this ideal, young people may feel inferior, giving rise to body image concerns and damaged self-esteem. And this could trigger poor eating habits and potentially dangerous eating disorders, researchers said.

Such disorders include anorexia, an intense fear of weight gain and/or a distorted sense of self that leads to severely restrictive eating. Other concerns are binge eating, in which compulsive food intake gives rise to anxiety and distress, and bulimia, in which binges are accompanied by forced vomiting.

Bhatia noted that the study did not quantify how much social media use drives up body image problems and/or eating disorder risk.

She also acknowledged that there’s a chicken-and-egg question that remains unanswered: Are young people are being directly harmed by a distorted social media landscape, or are those with preexisting body image and eating issues seeking out idealized social media content?

“We need more follow-up,” Bhatia said.

Her team did find that young people who have more confidence in their appearance and/or a more sophisticated grasp of how social media work appear to be less vulnerable to the downsides.

An open discussion of body image and social media is needed to protect young people from the unhealthy influences it can have, Bhatia said.

Lauren Smolar is vice president of mission and education for the U.S. National Eating Disorders Association in New York City.

While social media can promote a sense of community, it can also exert "a lot of pressure" on users, she said.

“What people on social media are portraying are their best selves, and everyone -- especially kids -- who engages with this information is bound to feel a lot of pressure to look like that all the time or to behave like that all the time,” Smolar said.

Parents can help reinforce the fact that the images online are often not a realistic representations, she said.

“With [editing] filters, we know it’s sometimes not even really what people look like at all," Smolar said. "It’s a very curated perspective on someone’s life.”

That means parents need to be role models and show kids how to critically analyze what they see.

“Social media is not reality,” Smolar said. “It’s a very small curated piece of life. You’re not seeing what’s going on in the background, the complex dynamic of life, and that’s really important for kids to know.”

Smolar suggested parents also use technology to their advantage. Many platforms offer parents ways to limit how often, and for how long, their kids are allowed to access social media, as well as which content they can and cannot engage with, she pointed out.

"Check in with your child," Smolar said. “Pay attention to how they’re doing after they’re online. And ask them how being online made them feel. And if a child is struggling with how to navigate these spaces, parents should not be afraid to reach out to us for support with connecting to a professional for help.”

The findings were published March 22 in PLOS Global Public Health.

More information

Visit the National Eating Disorders Association for more on support and information.

SOURCES: Komal Bhatia, PhD, MSc, research fellow, adolescent health, Institute for Global Health, University College London; Lauren Smolar, vice president, mission and education, National Eating Disorders Association, New York City; PLOS Global Public Health, March 22, 2023