Adolescent Exposure to Weight Loss Imagery on Instagram: A Content Analysis of "Top" Images

Obesity: Post-Pandemic Weight Management

Societal changes secondary to the coronavirus disease 2019 pandemic led to increased prevalence of adolescents with obesity and heightened awareness of weight stigma and size bias. During this time the American Academy of Pediatrics published its first clinical practice guidelines, and the Food and Drug Administration approved new weight loss drugs for adolescents, but insurance coverage is largely unavailable.

Emotional Distress and Body Dissatisfaction: The Mediating Role of Social Media and Emotional Regulation

BACKGROUND

Body dissatisfaction is defined as a negative attitude towards one's body, characterized by emotional disorders. Currently, problematic use of social media seems to be associated with an increase in body dissatisfaction and emotional distress. Therefore, the present study examined the relationship between emotional distress (i.e., depression, anxiety, and stress) and body dissatisfaction, as well as the mediating role of emotional regulation and problematic social media use in this relationship. In addition, the study aims to identify sex differences in the four research variables.

METHODS

Measures of the four variables mentioned above were administered to 2520 participants over 18 (M = 48.35; SD = 16.56, 51% females).

RESULTS

The results reveal that women reported higher levels of emotional regulation, emotional distress, body dissatisfaction, and problematic use of social media. Emotional distress correlated with problematic use of social media, emotion regulation strategies (i.e., rumination and catastrophizing), and body dissatisfaction. The relationship between emotional distress and body dissatisfaction was mediated by the problematic use of social media and emotional regulation.

CONCLUSIONS

These findings underscore the relevance of educating social media users on strategies for emotional regulation. The results highlight the clinical importance of including the emotion regulation approach to a comprehensive understanding of body dissatisfaction.

What adolescents see on Instagram: Content analysis of #intermittentfasting, #keto, and #lowcarb

AIM

To describe popular diet content visible on #intermittentfasting, #keto, and #lowcarb on adolescent social media accounts.

METHODS

An adolescent Instagram profile captured 200 'top' images from three popular diet hashtags (#intermittentfasting, #keto, and #lowcarb) across two timepoints. Images were coded using a pre-determined ontology as food (core or discretionary; common foods/food groups), people (group, individual, before/after), or informative. Descriptive statistics were used to summarise these categories across hashtags.

RESULTS

At the time of first data collection, there were 3.8 million #intermittentfasting, 19 million #keto, and 22 million #lowcarb posts on Instagram. At the second timepoint there were 4.3 million #intermittentfasting, 21.5 million #keto, and 24.3 million #lowcarb posts. Images tagged #intermittentfasting were categorised as 44% food, 39% people, 10% information; #keto were 64% food, 28% people, 5% information; and #lowcarb were 69% food, 14% people, 16% information. Food images mostly depicted animal proteins (58.6% of #intermittentfasting; 62.9% of #keto; and 40.1% of #lowcarb). Images of people were individual (44%) or before/after (39%); mostly female (77%), of white (53%) ethnicity. Across all posts, 12.5% were linked to a commercial product/program, and 2.3% provided nutrition information.

CONCLUSION

Diet-related images visible when adolescents search #intermittentfasting, #keto, and #lowcarb on Instagram promote animal-based foods with or without vegetables. These diet hashtags on Instagram do not provide nutrition information and are not helpful for young people searching for diet information online.

Relationship of Objectified Short-Form Videos Exposure to Satisfaction and Objectification in Relationships Among Chinese Women: A Pilot Study

Studies have indicated the impact of exposure to objectifying media on objectification and relationship satisfaction from a romantic context. This study examined the association between viewing objectified short-form videos and self-and partner-objectification (i.e., objectifying one's partner), as well as relationship satisfaction among Chinese women. The study participants comprised 241 Chinese women in romantic relationships who were recruited online. Participants completed measures of viewing objectified male and female videos, self-objectification (SO), partner-objectification (PO), and relationship satisfaction. The results showed a significant association between exposure to objectified female videos and SO, but not with relationship satisfaction. Exposure to objectified male videos was associated significantly with PO. The indirect effect of objectified male videos exposure on relationship satisfaction via PO was significant. This implies that PO plays an important role in relationship satisfaction as opposed to SO.

Participant recruitment for paediatric research using social media: A practical 'how-to' guide for researchers

AIM

Social media platforms are being increasingly used to support participant recruitment into paediatric health-related research. This study aimed to develop a multi-phase approach for using social media as a recruitment strategy for paediatric research studies.

METHODS

The process was informed by the authors' prior experiences recruiting for paediatric obesity-related research studies, expertise in social media marketing and digital participant/ patient recruitment. Reflection on these experiences resulted in the iterative creation of a draft process which was further refined. A narrative literature review using a structured search was conducted to refine and augment the content and finalise the process.

RESULTS

A six-phase recruitment approach was developed that includes: (i) plan for social media use as a recruitment strategy, (ii) explore relevant ethical considerations to protect the wellbeing of potentially vulnerable groups and create an ethical management plan, (iii) identify and understand the different target audiences and develop the advertising strategy, (iv) develop and design campaign content, (v) implement, monitor and iteratively refine the recruitment campaign, (vi) evaluate the campaign success. Potential activities and key considerations relevant for paediatric research are presented within each phase.

CONCLUSION

Due to the widespread use and diverse characteristics of social media users, social media has the potential to disseminate details of research opportunities to community members who may otherwise not hear about, engage with, and potentially benefit from research participation. Researchers should collaborate with communication experts and target audiences to generate relevant and effective recruitment campaigns. Researchers should implement processes to protect vulnerable audiences' wellbeing at each stage of the process. Recruitment via social media may support wider community participation in research studies designed to improve young people's health.

Nutrition-Related Information on Instagram: A Content Analysis of Posts by Popular Australian Accounts

Social media is a popular source of nutrition information and can influence food choice. Instagram is widely used in Australia, and nutrition is frequently discussed on Instagram. However, little is known about the content of nutrition information published on Instagram. The aim of this study was to examine the content of nutrition-related posts from popular Australian Instagram accounts. Australian Instagram accounts with ≥100,000 followers, that primarily posted about nutrition, were identified. All posts from included accounts, from September 2020 to September 2021, were extracted and posts about nutrition were included. Post captions were analysed using Leximancer, a content analysis software, to identify concepts and themes. Text from each theme was read to develop a description and select illustrative quotes. The final sample included 10,964 posts from 61 accounts. Five themes were identified: (1) recipes; (2) food and nutrition practices; (3) body goals; (4) food literacy and (5) cooking at home. Recipes and practical information about nutrition and food preparation are popular on Instagram. Content about weight loss and physique-related goals is also popular and nutrition-related Instagram posts frequently include marketing of supplements, food and online programs. The popularity of nutrition-related content indicates that Instagram may be a useful health-promotion setting.

Obesity-Related Discourse on Facebook and Instagram Throughout the COVID-19 Pandemic: Comparative Longitudinal Evaluation

BACKGROUND

COVID-19 severity is amplified among individuals with obesity, which may have influenced mainstream media coverage of the disease by both improving understanding of the condition and increasing weight-related stigma.

OBJECTIVE

We aimed to measure obesity-related conversations on Facebook and Instagram around key dates during the first year of the COVID-19 pandemic.

METHODS

Public Facebook and Instagram posts were extracted for 29-day windows in 2020 around January 28 (the first US COVID-19 case), March 11 (when COVID-19 was declared a global pandemic), May 19 (when obesity and COVID-19 were linked in mainstream media), and October 2 (when former US president Trump contracted COVID-19 and obesity was mentioned most frequently in the mainstream media). Trends in daily posts and corresponding interactions were evaluated using interrupted time series. The 10 most frequent obesity-related topics on each platform were also examined.

RESULTS

On Facebook, there was a temporary increase in 2020 in obesity-related posts and interactions on May 19 (posts +405, 95% CI 166 to 645; interactions +294,930, 95% CI 125,986 to 463,874) and October 2 (posts +639, 95% CI 359 to 883; interactions +182,814, 95% CI 160,524 to 205,105). On Instagram, there were temporary increases in 2020 only in interactions on May 19 (+226,017, 95% CI 107,323 to 344,708) and October 2 (+156,974, 95% CI 89,757 to 224,192). Similar trends were not observed in controls. Five of the most frequent topics overlapped (COVID-19, bariatric surgery, weight loss stories, pediatric obesity, and sleep); additional topics specific to each platform included diet fads, food groups, and clickbait.

CONCLUSIONS

Social media conversations surged in response to obesity-related public health news. Conversations contained both clinical and commercial content of possibly dubious accuracy. Our findings support the idea that major public health announcements may coincide with the spread of health-related content (truthful or otherwise) on social media.

TikTok: a far-reaching opportunity for health professionals to address weight loss

OBJECTIVES

Recent behavioral research indicates that social media may be successfully integrated into weight loss interventions to mitigate the obesity epidemic that has been linked with type two diabetes, cardiovascular diseases, cancers, as well as poor psychological health. This study aimed to examine the content and characteristics of 100 most trending TikTok videos related to weight loss.

STUDY DESIGN

This was a cross-sectional, descriptive study.

METHODS

Videos were analyzed for source, predominant theme, and inclusion of specific content. Independent two-tailed t-tests assessed the effect of content on number of comments, likes, and forwards garnered by the videos.

RESULTS

More than 90% of the videos were consumer generated, indicating a missed opportunity by health professionals to use social media to provide accurate information regarding weight loss. Less than one-fifth of the videos were informational but significantly influenced the number of comments (P < .001) and likes (P = .002). Videos mentioning benefits ((P < .001) and speed of weight loss (P = .003) significantly influenced the number of forwards, whereas those that mentioned recipes (P = .005) and how to lose weight (P = .003) significantly affected the number of comments.

CONCLUSION

The results underscore the need for further research to elucidate the effectiveness of social media in impacting weight loss, as well as how they may supplement traditional health promotion and behavior interventions for weight loss.

Weight-normative messaging predominates on TikTok-A qualitative content analysis

Tiktok is a social media platform with many adolescent and young adult users. Food, nutrition, and weight-related posts are popular on TikTok, yet there is little understanding of the content of these posts, and whether nutrition-related content is presented by experts. The objective was to identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were downloaded and analyzed using template analysis. The one-hundred most viewed videos were downloaded from each of the ten chosen hashtags. Two coders then coded each video for key themes. Key themes included the glorification of weight loss in many posts, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to disordered eating behaviors and body dissatisfaction in the young people that are TikTok’s predominant users. Helping users discern credible nutrition information, and eliminate triggering content from their social media feeds may be strategies to address the weight-normative social media content that is so prevalent.

Content Analysis of #Postpartumbody Images Posted to Instagram

Understanding the imagery on social media targeting postpartum women is an important step in determining the utility of Instagram as a potential avenue for targeting public health messages to this group. This study (1) describes the content of images on Instagram tagged with #postpartumbody and; (2) compares images from ‘Top’ posts (‘trending’ or ‘popular’) with ‘Recent’ posts. 600 images tagged with #postpartumbody (300 ‘Top’ and 300 ‘Recent’) were systematically captured from Instagram and coded using a predefined framework. Images of women were coded for adiposity, muscularity, pose and attire. Chi-square tests were used to compare ‘Top’ and ‘Recent’ posts. Most (n = 409) images were of a woman who generally had low/average adiposity (91%) and little-to-none/some visible muscle definition (93%). Most women (52%) were posing in a non-specific manner, 5% were posing to accentuate a postpartum body feature and 40% were wearing fitness attire. Compared with ‘Recent’, ‘Top’ posts were less likely to be text-focused (p < 0.001), photos of food (p < 0.001) or linked to a product/program (p < 0.001). Women of lower adiposity are more likely to post images of themselves on Instagram tagged with #postpartumbody than women of higher adiposity, which may reflect increased body pride in this group, but could reduce body satisfaction for some viewers. Conveying health information on Instagram may be necessary to interrupt potentially harmful content.

Mindful and Intuitive Eating Imagery on Instagram: A Content Analysis

Non-dieting approaches, including mindful/intuitive eating, to health improvement are of increasing interest, yet little is known about young adults' social media exposure to them. Therefore, this study aimed to describe the imagery related to mindful/intuitive eating which is visible to young adult Instagram users. Images categorized under the hashtags 'mindfuleating' and 'intuitiveeating' were searched in September 2021 using the 'top posts' view. Screen captures of 1200 grid-view images per hashtag were used to construct coding frameworks and to determine saturation. Sample sizes for #mindfuleating and #intuitiveeating were 405 and 495 images, respectively. Individual images were coded collaboratively. Almost half of each sample depicted food or drink, of which 50-60% were healthy foods. Approximately 17% were single-person images, of which the majority were young, female adults with healthy weight. Approximately one-third of text suggested credibility through credentials, profession, or evidence. Messaging was similar for both hashtags, encompassing mindful/intuitive eating (~40%), nutrition/eating behaviours (~15%), physical/mental health (~20%), disordered eating (~12%), and body-/self-acceptance (~12%). Differences were observed between hashtags for weight-related concepts (20%/1%) and anti-diet/weight-neutral approaches (10%/35%). The representation on Instagram of mindful and intuitive eating portrays healthy lifestyles without a focus on weight but lacks demographical and body-type diversity. Instagram holds the potential for health professionals to disseminate culturally/demographically inclusive, evidence-based health/nutrition information to youth.

Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females

BACKGROUND

Instagram is one of the most popular social media platforms among young females. Idealized body images shared on the platform have been associated with lower levels of body satisfaction in this population, likely due to social comparison processes. In the present study, we tested a mediation model linking Instagram use (i.e., browsing through others' profiles, commenting on others' looks, posting one's own photos or stories) to body dissatisfaction (i.e., body image discrepancy and lack of body appreciation), mediated by upward social comparison with close peers, distant peers, and social media influencers.

METHODS

We applied structural equation modeling to self-report cross-sectional data collected from 291 female adolescents and young women (M_age = 19.8, SD = 4.6; 94.8% Italian).

RESULTS

Our final model results show that browsing on Instagram was associated with lower levels of body appreciation, fully mediated by upward social comparison with social media influencers, not close or distant peers. Commenting on others' looks and posting own content were not associated with body dissatisfaction. Being an adolescent female (compared to a young woman) and having a higher BMI were associated with worse body appreciation.

CONCLUSIONS

Our findings highlight the need for public health interventions to raise awareness about the posting practices of social media influencers and to strengthen a positive body image among young females susceptible to social comparison processes.