"I aspire to look and feel healthy like the posts convey": engagement with fitness inspiration on social media and perceptions of its influence on health and wellbeing

Understanding Fitness Trends in the Virtual Age: A Content Analysis of TikTok Workout Videos

The purpose of this study was to examine the content of workout videos on TikTok. A sample of 297 TikTok workout videos was coded for demographic factors and body shape of content creators, as well as the presence of body positivity messaging, appearance-related messaging, and other relevant themes. The results suggest that TikTok workout content is often presented in a time-lapse format with little verbal instruction, which may make it difficult for viewers to perform the exercises. The majority of the videos depicted young women with athletic bodies and other characteristics associated with culturally based beauty ideals, and approximately half of the videos included non-White content creators. Approximately a quarter of the videos in the sample included objectification and a smaller proportion of the sample included messages about inner positivity. Overall, the TikTok platform may provide underrepresented individuals opportunities to seek out workout content from a more diverse group of instructors; however, the fact that many of these videos including objectifying depictions of the content creators is concerning. Further experimental work is needed in order to more fully elucidate the effects of TikTok workout videos on viewers.

Rationalising a spectrum of problematic exercise: A qualitative study

Whilst a substantial body of evidence supports the benefits of exercise for physical and mental health, the overfocus on the benefits of exercise could result in harmful behaviours in some individuals. Conceptualised as a behavioural addiction, research often dichotomises the behaviour through a medical diagnostic model. The present qualitative study explored the meaning of problematic behaviour from the exerciser's perspective. Nineteen UK-based frequent exercisers were interviewed regarding their experiences. Thematic analysis described three themes: 'relentlessly pushing the limits' of their personal best and comparing to others; 'an enabling community' which could promote problematic behaviours; and 'the complexity of the ideal body' focussing on perceptions of weight maintenance. Transcending these themes was the notion of 'rationalising choices'. The results indicate that participants felt that the benefits outweighed the costs, encouraging them to continue, even when causing harm. These findings support the notion of problematic exercise as a continuum, rather than dichotomous.

'I've learned a lot about myself this year': Young student women's perceptions of their cumulative use of digital fitness technologies across the Covid-19 pandemic

Many young women turned to digital fitness technologies (DFT) to support their health and wellbeing during the covid-19 pandemic. The present study explores young student women's retrospective perceptions of their cumulative engagement with DFT, across periods of restriction and easing (March 2020-2021). Seventeen UK-based women (Age M = 20.29, SD = 1.72); Ethnicity White = 94.12% participated in one-on-one interviews using an adapted scroll-back technique. Data was analysed using narrative-informed reflexive thematic analysis. Three themes were developed: My lockdown #fitnesstransformation: DFT as information and inspiration, My unrealistic expectations: DFT as a source of comparison and concern and My new body positive and resilient self: DFT as a catalyst to self-development. Themes highlight how perceptions of DFT changed over time as a consequence of repeat engagement, sociocultural context and psychological meaning-making. Crucially, findings underscore the importance of examining the collective and cumulative effects of DFT engagement on health and wellbeing, both positive and negative.

Development and psychometric assessment of the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire

OBJECTIVES

This research aimed to construct and psychometrically test a measure of multiple sociocultural dimensions (i.e. family, peers, media) theoretically associated with exercise behaviours/attitudes in adolescents; the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire (SIEBAQ).

METHODS AND MEASUREMENT

Part 1 of this study focused on measure construction and psychometric testing, involving item generation and exploratory factor analysis (EFA) to refine the item pool, with 905 adolescents (Mage 13.66 years (SD = 0.94); girls = 442). Part 2 sought to explore the convergent validity of the SIEBAQ (n = 846; n = 414 girls).

RESULTS

EFA resulted in a 47-item measure with a nine-factor structure (including social media modelling, parent exercise expectations, peer co-participation; α = 0.72-0.92). Correlations revealed weak-moderate significant relationships between the SIEBAQ and related constructs (e.g. compulsive exercise, sociocultural attitudes towards appearance). Regression analyses with the SIEBAQ identified social media modelling of exercise as a significant predictor of compulsive exercise in boys and girls. Proving exercise ability to significant others also significantly predicted compulsive exercise outcomes.

CONCLUSION

This newly developed measure holds promise. Further psychometric testing and validation of the SIEBAQ is the recommended next step to confirm the measure's nine-factor structure identified through EFA.

Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown

Background

Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults.

Methods

A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information.

Results

A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory.

Conclusion

This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.

Effect of Social Media on Diet, Lifestyle, and Performance of Athletes: A Review of Current Evidence

PURPOSE OF REVIEW

Social media (SM) plays an important role in providing diet and health advice to athletes, but it also carries with it a risk of credibility in the information sought for and received. The objective of this review is to assess the knowledge gap on how SM influences dietary and lifestyle practices in athletes.

RECENT FINDINGS

For this, relevant literature was searched in three leading databases with appropriate keywords, which were subjected to proper scrutiny that led to inclusion of 22 articles (original research papers, reviews, viewpoints, and commentaries). The current era of digitalization has seen an over-reliance on internet and SM for nutrition and lifestyle advice for an athlete. SM has become a powerful tool in athlete's choice of food, nutrition information, healthy living, and performance, with merits and demerits. Their role in choosing dietary supplements and particular food types (e.g., ketogenic diet), body image, self-esteem and eating disorders, and in lifestyle and performance are discussed. SM should be used with caution and should not be used alone as a source of information for nutrition related pieces of advise by athletes. Any food type and supplements trending in SM should be discussed with a sports nutritionist before consumption. SM influencers having a big follower base may not always be disseminating the right knowledge on food and nutrition, thus caution should be exercised. For optimal benefit to the athlete, SM information should be in alignment with recommendations provided by sports nutrition and coaches.

Recent insights in the correlation between social media use, personality traits and exercise addiction: a literature review

Introduction and aim

The excessive involvement in physical activity without stopping in between sessions despite injuries, the continuous thinking to exercise feeling insane thoughts and experiencing withdrawal symptoms are all characteristics of the Exercise Addiction (EA), an addictive behavior. While the primary exercise addiction is directly caused by compulsive exercise, many studies highlighted the relationship between Eating Disorders (ED) and EA, defining the secondary EA. The correlation between EA, social media use (SMU) and other individual traits remains a relatively underexplored domain. Therefore, this review aimed to examine the latest evidence on the relationship between EA, SMU, and some personality traits such as perfectionism and body image.

Methods

Electronic databases including PubMed, Medline, PsycARTICLES, Embase, Web of Science were searched from January 2019 to October 2023, following the PRISMA guidelines.

Results

A total of 15 articles were examined and consolidated in this review. EA was found to be related to different individual traits such perfectionism, body dissatisfaction, depression, obsessive-compulsive personality disorders. While controversial results were found regarding the relationship between EA and SMU.

Conclusion

The interaction between mental health, exercise addiction and social media use is complex. Excessive engagement in these latter may result in negative mental health consequences despite their potential benefits. Understanding individual differences and developing effective interventions is crucial to promoting healthy habits and mitigating the EA risks, ultimately enhancing mental well-being. Further research should focus on the identification of risks and protective factors with the eventual aim of developing and implementing effective prevention strategies.

Analysis of Actual Fitness Supplement Consumption among Health and Fitness Enthusiasts

With the rising popularity of fitness supplements, understanding the factors driving their consumption behaviors is crucial. This study investigated the actual consumption of fitness supplements utilizing the Theory of Planned Behavior (TPB), Health Belief Model (HBM), and the Theory of Effort Minimization in Physical Activity (TEMPA) frameworks. The TPB provided insights into how attitudes, subjective norms, and perceived behavioral control influence individuals' intentions to consume fitness supplements. Additionally, the HBM sheds light on perceived effectiveness, benefits, barriers, and health motivation related to supplement consumption. Integrating the TEMPA framework further investigated the role of effort minimization in physical activity contexts. Through an online questionnaire, data were collected from a sample of 250 fitness supplement-consuming respondents. SEM analysis revealed significant associations between behavioral intentions and attitudes, perceived behavioral control, health motivation, and controlled precursors. However, it was seen that subjective norms, perceived effectiveness, perceived benefits, and automatic precursors were deemed insignificant. The findings contribute to a comprehensive understanding of the factors shaping actual consumption behaviors, offering valuable implications for marketers, health professionals, and policymakers seeking to promote informed and responsible supplement use among health and fitness enthusiasts.

Communicating Extremity: Fitness Efficacy and Standards Relate to Using Extreme Imagery and Messaging to Create Fitness-Related Media

Health-related social media increasingly competes with other forms of health communication for public attention. To advance understanding of the genesis of health-related social media communicating extreme fitness standards, we investigated women's creation of fitspiration, social-media content combining fitness images with effortful messages. In a pre-registered study, we hypothesized that creating extreme fitspiration content would relate positively to fitness fantasizing and to exercise self-efficacy, fitness perfectionism, physical activity, thin- and muscular-ideal internalizations, and self-objectification. Undergraduate women (N = 277) created their own fitspiration content by selecting from fitness images and messages that varied in extremity. Fitness fantasizing related positively to creating more extreme fitspiration. When controlling statistically for all other individual-difference variables, exercise self-efficacy and perfectionistic strivings emerged as key variables associated with creating extreme fitspiration content. Results suggest that women who are confident and strive toward challenging goals may create fitspiration content that communicates extreme standards. This work has implications for understanding a potential disconnect between fitspiration creators and consumers, which may illuminate ways to promote healthy fitness communications online.

Risk of low energy availability and nutrition knowledge among female team sport athletes

BACKGROUND

Nutrition knowledge influences adequate dietary intake in athletes. Inadequate dietary intakes can result in low energy availability (LEA) which can lead to relative energy deficiency in sport (RED-S). To date, there is little information on the relationship between nutrition knowledge and the risk of LEA in female team sport athletes. This study investigates if general and sports nutrition knowledge are associated with the risk of LEA in female team athletes.

METHODS

A cross-sectional design was used. Female athletes (>16 years) who participate in team sports in New Zealand were asked to complete an online questionnaire. The LEA in Females Questionnaire and the Abridged Sport Nutrition Knowledge Questionnaire were included. LEA risk and general/sports nutrition knowledge were assessed. The relationship between LEA risk and knowledge was analyzed using the Kruskal-Wallis Test of independent variables and χ2 tests.

RESULTS

Among 100 female athletes, 53% were at-risk for LEA, and 70% (N.=67) had poor nutrition knowledge. Athletes who were "at-risk" for LEA and those who were "not at-risk" for LEA did not differ statistically in terms of age (P=0.350) or BMI (P=0.576). Of those "not at risk" 54% had an A-NSK score between 50 and 60% (i.e., average knowledge), whereas 54% of the athletes who were "at risk" for LEA had poor nutrition knowledge. There was no statistical difference between the groups (P=0.273).

CONCLUSIONS

The poor nutrition knowledge and the high rates of those "at risk" of LEA among team sports athletes indicates the need for more nutrition education in this population.

College students' attitudes about ways family, friends, significant others and media affect their eating and exercise behaviors and weight perceptions

Objective: This study examined college students' perceptions of how parents, family, friends, significant others, and the media influenced eating and exercise behaviors and weight perceptions. Participants: Forty-one college students, mostly female, participated in interviews. Methods: A Grounded Theory approach, using open coding and memoing, was used to uncover key themes. Results: Healthy cooking and exercise role models at home were viewed as positive, encouraging healthy eating and exercise. Criticism was perceived as negative for healthy habits and weight perceptions. Friends and significant others who practiced positive health habits and were body accepting were uplifting. Cultural transmission of the thin ideal could occur through the media. Some noted that media messages were becoming more positive. Conclusions: Using peers, especially friends, as collaborators in interventions, and discussing parental influences on eating, exercise, and weight perceptions may positively impact obesity prevention programs and interventions for college students.

Flex Friday: A content analysis of men's fitspiration on Instagram

Fitspiration is a social media trend that utilizes images and quotes to promote and inspire physical health and fitness. However, research has shown Fitspiration reinforces the rigidly defined appearance ideal, particularly in women, which can lead to negative body image. There remains limited understanding of the characteristics and impact of men's Fitspiration. The purpose of this content analysis was to investigate the nature, presentation, and text-based messages of male-focused Fitspiration on Instagram. Hashtags (#) were used to collect 1,000 random images from Instagram. Content codes for images included body type, objectification, activities, and messages conveyed. Results showed most images consisted of men accentuating their highly muscular upper bodies with low body fat, consistent with the male appearance ideal. Also, men were often shown engaging in activities irrelevant to health or fitness (i.e., passive modeling) that emphasized their physical appearance. Consistent with research examining female-focused Fitspiration, male-focused Fitspiration reinforces a glamorized appearance ideal with low focus on health and fitness.

Exploring the perceived influence of social media use on disordered eating in nutrition and dietetics students

BACKGROUND

Social media use (SMU) is increasingly widespread. More recently, SMU has been associated with increases in disordered eating; however, few qualitative studies have explored this issue in nutrition and dietetics students specifically, where susceptibility to disordered eating may be particularly high. The present study therefore aimed to investigate the perceived impact of SMU on disordered eating in nutrition and dietetics students.

METHODS

One-to-one, in-depth, semi-structured interviews were conducted with nutrition and dietetics students from universities across the UK. Interviews explored students' views on the potential influence of SMU on their eating-related thoughts, feelings and behaviours. Data were thematically analysed to identify key themes.

RESULTS

The findings suggested that SMU may provide students with a useful tool for the exploration of new recipes, ingredients and health-related information, thus enabling them to improve their eating behaviour and diet quality. However, students also showed high levels of objective awareness regarding the problems associated with SMU, including the presence of misinformation, body image dissatisfaction, social pressures and disordered eating. Interestingly, despite enabling them to detect sources of misinformation, students also discussed the negative impact that their course had on their eating habits, suggesting course content may be an additional risk factor for the development of disordered eating for this particular group.

CONCLUSIONS

Future research should investigate ways to mitigate the negative impact of SMU and course content on disordered eating in nutrition and dietetics students.

Prospectively predicting naturalistic exposure to fitspiration and thinspiration in young women with disordered eating by leveraging an ecological momentary assessment design

OBJECTIVE

Although a growing body of research has examined the impacts of ED-salient content, such as fitspiration and thinspiration, on eating disorder (ED) symptoms, there is less known about the characteristics of who may be at risk for accessing this content on Instagram. Current research is limited by cross-sectional and retrospective designs. This prospective study used ecological momentary assessment (EMA) to predict naturalistic exposure to ED-salient content on Instagram.

METHODS

Female university students with disordered eating (N = 171, Mage = 20.23, SD = 1.71, range = 18-25) completed a baseline session, followed by a seven-day EMA protocol, in which they reported on Instagram use and exposure to fitspiration and thinspiration. Mixed-effects logistical regressions were used to predict exposure to ED-salient content on Instagram from four principal components (e.g., behavioral ED symptoms and trait social comparison) controlling for duration of Instagram use (i.e., dose) and day of study.

RESULTS

Duration of use was positively associated with all types of exposure. Purging/cognitive restraint and excessive exercise/muscle building prospectively predicted access to any ED-salient content and fitspiration only. Restricting positively predicted thinspiration only access. Purging/cognitive restraint positively predicted accessing fitspiration and thinspiration (dual exposure). Day of study was negatively associated with any exposure, fitspiration only, and dual exposure.

CONCLUSIONS

Baseline ED behaviors were differentially associated with exposure to ED-salient Instagram content; however, duration of use was also a significant predictor. Limiting use of Instagram may be important for young women with disordered eating to reduce probability of encountering ED-salient content.

Effect of source on trust of pulse nutrition information and perceived likelihood of following dietary guidance

OBJECTIVE

The purpose of the present study was to examine how information source (control-no source, U.S. Department of Agriculture (USDA), fictitious hospital, or fictitious social media) impacts perceptions of diet information.

METHODS AND MEASURES

Participants (N = 537) completed an online survey in which they viewed one flyer containing dietary information and guidance on consuming pulses. The purported source of the flyer information was manipulated to create the 4 conditions. Participants rated the flyer in terms of perceived accuracy, trustworthiness, reliability, desirability for learning more from the source, and likelihood of following the advice. Attitudes, perceived control and norms, and past behavior were used to measure components of the Theory of Planned Behavior (TPB).

RESULTS

ANOVA results indicated that the USDA and hospital sources were perceived as more accurate, trustworthy, reliable, and more desirable to learn more from relative to control and social media. There were no differences in likelihood of following guidance depending on source. Multiple regression showed that measures of the TPB were predictors of likelihood of following advice.

CONCLUSION

Overall, these findings suggest that trust in the source of information does not influence perceived likelihood of following dietary recommendations for pulses.

[Health goals amongst patients with Crohn's disease.]

INTRODUCTION

Inflammatory bowel diseases, including Crohn's disease, have a significant impact on patients' lifestyle, requiring lifelong attention to health behavior.

OBJECTIVE

The aim of our study was to investigate health-related goals, emotions related to health goals, the use of infocommunication tools and their associations.

METHOD

79 patients with Crohn's disease (59.5% female, mean age 40.7 years, SD = 11.89) participated in the study. They answered demographic and health behaviour questions and completed the Personal Health Plans Questionnaire, which assessed their personal health goals, positive and negative emotions about health goal(s), support for personal health goals from their physician, negative and positive effects (barriers/support) of achieving health goals, and digital technology and internet use.

RESULTS

70% of patients had at least 1 health goal. The health goals were classified into four categories: physical activity (43.6%), stress management (25.4%), nutrition (18%) and smoking cessation (7%). 71% of participants experienced at least average levels of positive emotions related to the health goal, but about 50% also experienced negative emotions. 51% of those with a health goal regularly use the internet and apps on smartphones. Infocommunication device use showed a medium-strength correlation with perceived health goal-related barrier/support (ρ = 0.55, p<0.01), support from the person's doctor (ρ = 0.45, p<0.05) and physical activity (ρ = 0.40, p<0.01).

DISCUSSION

More than two-thirds of patients had a health goal; most of the goals were related to health behaviours that are also relevant to Crohn's disease, but few had healthy eating and smoking cessation as health goals. Half of those with a health goal regularly use the internet and apps on smartphones. Among health behaviours, physical activity was associated with infocommunication device use.

CONCLUSION

It is recommended to investigate patients' health goals and infocommunication device use in the care of patients with Crohn's disease. This would allow the development of specific interventions to improve their health behaviour, which could increase the quality of life and disease prognosis. Orv Hetil. 2023; 164(28): 1102-1110.

Who is your Fitspiration? An Exploration of Strong and Weak Ties with Emotions, Body Satisfaction, and the Theory of Planned Behavior

Physical inactivity has become an increasingly important concern for public health. "Fitspiration" social media posts may influence attitudes and intentions toward exercising. An online survey (N = 485) was conducted to examine the potential for fitspiration content from weak and strong ties to shape user emotions, attitudes, norms and behaviors related to exercising. Guided by the theory of planned behavior (TPB) and social cognitive theory (SCT), the results show that exposure to fitspiration content from both strong ties and weak ties were significant predictors of particular attitudes, norms, intentions, actual exercise frequency. However, our path analyses reveal significant indirect paths between exposure to fitspiration content and outcomes for weak ties through negative emotions (guilt), but only through positive emotions (hope and curiosity) for strong ties. Additionally, we found evidence that body satisfaction levels do matter in shaping the interrelationships between exposure to fitspiration content, emotions, and our outcome variables. In light of our results, we encourage researchers to consider the inclusion of emotional responses as antecedents to TPB outcomes and for practitioners to consider the role of source in campaign design.

Patients' perception of changes and consequences after tumor resection : A qualitative study in Austrian patients with musculoskeletal malignancies

OBJECTIVE

The aim of this study was to investigate the effects and consequences of surgical treatment of patients with musculoskeletal malignancies on everyday life.

METHODS

A modified form of grounded theory was used for data collection and analysis. Data collection was systematic and analyzed simultaneously and 16 interviews were conducted: 2 narrative, 11 guided and 3 expert interviews (surgeon, physical therapist, support group). Data collection and analysis alternated until no new codes could be found. Once theoretical saturation was achieved, the main category was formed and described using the literature.

RESULTS

The main category results from the combination of all categories and leads to the core category. In the center is the affected person and in the immediate environment are the patient's relatives/partners. In the next instance the primary care physician is necessary to establish a sense of normalcy. This depends on the individuality of the person and the restored possibilities of movement.

CONCLUSION

Based on the results, the necessity of implementing psychosocial care involving the social environment is shown. The importance of relatives/partners for recovery is emphasized. Furthermore, the communication between the specialists and family physicians should be simplified.

Health education and promotion of #PhysicalActivity on Twitter before and during COVID-19

Objective

Twitter, a microblogging service, allows users to post short messages (tweets) and link posts through hashtags, creating online communities to enable dissemination of health education. The objective of this descriptive study was to examine Twitter's #PhysicalActivity health education and promotion efforts, including differences in response before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic.

Design setting and methods

A codebook was developed to conduct a quantitative content analysis of #PhysicalActivity tweets before and during the COVID-19 pandemic. Twitter's Advanced Search parameters included minimum 1 reply, 25 likes and 5 retweets. Tweets were double-coded for user characteristics, community response, tweet elements (video, photo, link, questions, events, original text, survey/response, journal article, infographic) and intended audience. T-tests examined differences in researcher-generated NET response (replies + retweets + likes) between COVID-19 and comparison years.

Results

Data were collected from 400 tweets. Eighty percent of tweets were from personal accounts, with over half indicating the possession of a health professional degree. Twenty-nine percent of tweets gave behavioural recommendations of which 56.8% provided a rationale. Nearly all used at least two components, text and photos most common. The general public was the most intended audience with health professionals second. While the NET response was greater during COVID-19 (M = 139.6, SD = 156.8) than prior to it (M = 116.8, SD = 105.1), the difference was not statistically significant (p = .091).

Conclusion

Twitter platform provided an opportunity to disseminate health education, specifically for the promotion of physical activity, while adhering to public health recommendations to #StaySafeStayHome. Our findings provide insights into engaging this online community to inform future physical education and promotion dissemination.

The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people

Background

Eating disorders are a group of heterogenous, disabling and deadly psychiatric illnesses with a plethora of associated health consequences. Exploratory research suggests that social media usage may be triggering body image concerns and heightening eating disorder pathology amongst young people, but the topic is under-researched as a global public health issue.

Aim

To systematically map out and critically review the existing global literature on the relationship between social media usage, body image and eating disorders in young people aged 10–24 years.

Methods

A systematic search of MEDLINE, PyscINFO and Web of Science for research on social media use and body image concerns / disordered eating outcomes published between January 2016 and July 2021. Results on exposures (social media usage), outcomes (body image, eating disorders, disordered eating), mediators and moderators were synthesised using an integrated theoretical framework of the influence of internet use on body image concerns and eating pathology.

Results

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 internalisation, 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 pre-existing body image concerns) strengthen the relationship, while other moderators (high social media literacy and body appreciation) are protective, hinting at a ‘self-perpetuating cycle of risk’.

Conclusion

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 traditionally western cultures. Based on scale of social media usage amongst young people, this issue is worthy of attention as an emerging global public health issue.

Hashtag fitspiration: credibility screening and content analysis of Instagram fitness accounts

BACKGROUND

Fitspiration is a social media phenomenon purported to inspire viewers to lead healthier lifestyles but can result in negative psychological outcomes such as body dissatisfaction. This study aimed to develop a tool to audit Instagram fitspiration accounts and screen for content that could have potentially negative psychological effects.

METHODS

This study developed and implemented an audit tool to (1) identify credible fitspiration accounts (i.e., accounts that do not portray potentially harmful or unhealthy content) and (2) describe the content of identified accounts. The most recent 15 posts of 100 leading Instagram fitspiration accounts were audited. Accounts were deemed non-credible and were excluded if they contained fewer than four fitness-related posts or portrayed nudity or inappropriate clothing, sexualisation or objectification, extreme body types, "thinspiration", or negative messages.

RESULTS

Many accounts contained fewer than four fitness-related posts (n = 41), sexualisation or objectification (n = 26), nudity or inappropriate clothing (n = 22), and/or extreme body types (n = 15). Three accounts failed on all four criteria, while 13, 10 and 33 failed on three, two, or one criterion, respectively. Therefore, only 41% of accounts were considered credible. Inter-rater reliability (percentage agreement and Brennan and Prediger's coefficient κ_q) was high (Stage 1: 92% agreement [95% CI 87, 97], κ_q 0.84 [95% CI 0.73, 0.95]; Stage 2: 93% agreement [95% CI 83, 100], κ_q 0.85 [95% CI 0.67, 1.00]). Account holders of credible fitspiration accounts were predominantly female (59%), aged 25-34 (54%), Caucasian (62%), and from the United States (79%). Half held a qualification related to physical activity or physical health (e.g., personal trainer, physiotherapy; 54%). Most included accounts included an exercise video (93%) and example workout (76%).

CONCLUSION

While many popular Instagram fitspiration accounts offered credible content such as example workouts, many accounts contained sexualisation, objectification or promotion of unhealthy or unrealistic body shapes. The audit tool could be used by Instagram users to ensure the accounts they follow do not portray potentially harmful or unhealthy content. Future research could use the audit tool to identify credible fitspiration accounts and examine whether exposure to these accounts positively influences physical activity.

The Liver King Lie: Misrepresentation, justification, and public health implications

It is well-established that performance and image enhancing drugs (PIEDs) are effective in increasing muscle mass and strength. PIEDs are unique in that, while harm may result from use, there is little evidence of widespread individual or social harm comparable with other illicit substances. However, given the rapid growth of the online health and fitness industry, the digital consumption of hardcore fitness content represents a space ripe for indirect harms. A poignant example of this trend among the digital health and fitness community is the contestation around 'fake natty' users, who falsely claim to not use PIEDs. The non-disclosure of use has the potential to give individuals who are not enhanced the false impression that they too can achieve a bodily ideal which is similar, potentially resulting in psychological distress and risky behaviours. In this commentary, we discuss this harmful phenomenon using the case study of the fitness influencer Brian Johnson, more commonly known as Liver King. Employing a psycho-criminological lens, we use Social Identity Theories to understand the 'Primal' identity, before unpacking Johnson's disavowal of his PIED consumption through Sykes and Matza's (1957) techniques of neutralization. We conclude with an overview of the harms surrounding fake natural influencers and cognitive dissonance, before attempting to map a path towards emic harm reduction in collaboration with the digital fitness community.

#fitspiration: a comparison of the sport-related social media usage and its impact on body image in young adults

BACKGROUND

Following and posting sport-related content on social media is wide-spread among young people. To date, little is known about the interdependence between sport-related social media use and the thereby perceived personal body image.

METHODS

We conducted an online survey (N = 285) to examine how social media influences the sport-related body image.

RESULTS

In general, social media are frequently used for sport (n = 136, 47.7%). Resistance training correlated significantly with several motives of sport-related use of social media, and thus, represents the strong online presence of athletic sports. Less correlations could be found in team or other sports. Regarding the perception of body image, it was found that the group of rejecting (negative) body image significantly correlated with the emulation of social media mediated sport-related beauty and body ideals (r = 0.63, p = 0.001), as well as with increased body dissatisfaction when viewing sport-related posts on social media (r = 0.590, p = 0.001). Perceived social pressure and comparison were found to be mediators of the prevailing influence of social media usage.

CONCLUSIONS

These results reveal the importance of taking a closer look at socially shaped beauty and body ideals, especially in sport-related contents, striving for more educational campaigns such as Body Positivity and, above all, filtering information. Finally, future research is needed to gain deeper insight into young persons' usage behavior of social media and its impact on the individual's body image. Trial Registration The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of University of the Federal Armed Forces Munich, Germany (01/24/2022).

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.

Effects of fitspiration content on body image: a systematic review

PURPOSE

Fitspiration (also known as "fitspo") aims to inspire individuals to exercise and have healthy habits, but emerging research indicates that exposure to it can have a negative impact on body image. This study aims to analyze the relationship between individuals' exposure to fitspiration content and body image measures or associated variables (e.g., appearance comparison).

MATERIALS AND METHODS

A comprehensive search of peer-reviewed papers published in English between 2000 and August 2022 was conducted in PubMed, PsycINFO and Google Scholar, based on the PICOS model. To be included, studies had to analyze the relationship between exposure to fitspiration content (I) and body image or associated variables (O) in adolescents and adults (P). Study methodological quality was assessed using an adaptation of the EPHPP Quality Assessment Tool for Quantitative Studies. Outcome data were synthesized narratively and by vote counting.

RESULTS

Twenty articles met the eligibility criteria and were included. Nineteen studies analyzed the relationship between fitspiration and body image, twelve analyzed the association between exposure to fitspiration and physical appearance comparison tendencies, and nine analyzed the association between fitspiration content and mood. One study analyzed the association between frequency of viewing fitspiration content and motives for exercise. Results showed that exposure to "fitspiration" increased individuals' body dissatisfaction, physical appearance comparisons, and negative mood, especially in younger populations.

CONCLUSIONS

Fitspiration has been seen as a new and prolific digital trend, considered beneficial for health. However, our results showed that fitspo is associated with negative body image, especially in younger populations that are more exposed to this content. Most of the studies were conducted in females and young age participants, which limits the extrapolation of results by gender and age. Future studies are needed to confirm and extend these findings.

LEVEL OF EVIDENCE

Level 1, Systematic Review.

TikTok on the clock but the #fitspo don't stop: The impact of TikTok fitspiration videos on women's body image concerns

Fitspiration is a popular social media trend that aims to inspire individuals to improve their health and fitness through diet and exercise. However, viewing fitspiration content on Instagram has been identified as a contributor to negative body image, especially for young women. With the growing popularity of the video sharing platform TikTok and concerns over its content, the present study aimed to experimentally examine the effect of exposure to fitspiration TikTok videos on young women's body dissatisfaction, appearance comparison and mood. The roles of state appearance comparison as a mediator and trait fit ideal internalisation as a moderator were also considered. Young women (18-25, N = 120) from Australia were randomly allocated to view a set of fitspiration videos or a set of art control videos from TikTok. Results indicated that exposure to fitspiration TikTok videos increased state appearance comparison and state negative mood relative to art TikTok videos but did not directly increase state body dissatisfaction. State appearance comparison significantly mediated the effect of TikTok videos on body dissatisfaction and mood, however, there was no moderating effect of trait fit ideal internalisation. These findings highlight the importance of state appearance comparison in relation to viewing fitspiration content on TikTok.

Looking at me, looking at you: The mediating roles of body surveillance and social comparison in the relationship between fit ideal internalisation and body dissatisfaction

Understanding the mechanisms through which internalisation of societal body standards lead to negative outcomes for women is important to inform prevention and treatment strategies targeting female body image issues and problematic eating and exercise behaviours. This study investigated the mediating roles of body surveillance and social comparison on the relationship between fit-ideal internalisation and a range of negative eating and body image related outcomes. Participants were 448 females, aged 16-25 years who completed self-report measures of fit-ideal internalisation, body surveillance, social comparison, body dissatisfaction, dieting, bulimic behaviours and compulsive exercise. Consistent with hypotheses, the results of parallel mediation analyses suggested that both body surveillance and social comparison mediated the relationship between fit-ideal internalisation and body dissatisfaction, dieting and bulimic behaviours. However, only social comparison was found to mediate the relationship between fit-ideal internalisation and compulsive exercise. The results suggest both body surveillance and social comparison are mechanisms by which fit internalisation detriments women's body image, making them potentially useful treatment targets for future research.

Because Follower Experience Matters: The Continuance Intention to Follow Recommendation of the Influencer

In harnessing social media, for the follower to keep following recommendations from the influencer, the concerns are primarily focused on the influencer side only. However, the follower’s experience, in fact, is equally crucial as, at the end of the day, that is the follower who decides to continue following or not the recommendation from the influencer over all the influences. Therefore, this paper examines the follower experience determining the follower to keep following the influencer’s recommendation. In particular, the psychological aspects imbued by the experience that promotes well-being and inspiration affect the follower’s intention to continue to follow. A total of 292 screened respondents were gathered and analysed. The findings reveal that the psychological factors: emotional design, functionalities, and hedonism perceived by the follower enhance well-being and inspire them to continue following the influencer’s recommendation. Theoretically, this research demonstrates how well-being and inspiration are the determinants and sheds more light on how the follower experience contributes to understanding the continuance intention to follow the influencer’s recommendation. Practically, this research informs the influencer and the brand that understanding the follower experiences is also crucial for more effective influence. The limitation and future research directions are also discussed.

"In-between orthorexia" profile: the co-occurrence of pathological and healthy orthorexia among male and female non-clinical adolescents

BACKGROUND

The profile of adolescents with orthorexic eating behaviors remains to be explored. This study is the first to explore the typology of Lebanese adolescents from a large non-clinical sample based on orthorexia nervosa (ON) and healthy orthorexia (HO).

METHOD

A total of 555 adolescents (aged between 15 and 18 years) completed a set of questionnaires assessing orthorexic behaviors, self-esteem, stress, depressive and anxiety symptoms. Cluster analysis based on ON and HO scores was used to identify the typology of the sample. More precisely, this analysis was used to reveal and distinguish between naturally occurring subgroups of individuals with different orthorexic eating profiles, within the studied sample. Further, a series of one-way ANOVA was used to compare observed clusters based on their scores on used questionnaires. This analysis was used to capture the behavioral and psychological differences between previously yielded subgroups of individuals.

RESULTS

Cluster analysis based on ON and HO scores yielded 3 distinct groups: "Low orthorexia", "Moderate in-between orthorexia" and "High in-between orthorexia". While the first group represented individuals with no particular (healthy or pathological) interest in healthy eating, the two latter groups represented those with respectively moderate and high degrees of an interest in healthy eating that has both pathological and healthy aspects. Significant differences between clusters regarding their levels of stress, depression, anxiety and self-esteem was observed, yet they were found to be negligible due to poor effect sizes.

CONCLUSION

Findings from this study suggest that ON and HO can indeed co-occur among adolescents, that this co-occurrence can be experienced at different severity levels. Low effect sizes for ANOVA comparisons may suggest the possibility of the co-occurrence of ON and HO reducing the negative effects of ON behavior to some degree. The potential role of confusion around what constitutes "healthy eating" in the emergence of these "in-between orthorexia" profiles is put forward.

Interactive communication in the process of physical education: are social media contributing to the improvement of physical training performance

The development of modern technologies and the use of social networks create an environment for the exchange of information, interactive communication, learning, and optimization of various processes. The study describes the results of the effectiveness of using various social media tools to increase the level of physical activity in people of different ages (12-35 years old). Effective tools for increasing the level of physical activity that can be used on social media have been considered. A survey created in Google forms was conducted to select research participants and group them; the pedagogical experiment is the introduction of social media tools to encourage users to do sports. The experiment involved 148 people of different age groups: adolescents, students, adults. After the experiment with the experimental group, there were 59.20% of participants with an average level of physical activity and 22.37% of participants with a high level of physical activity; in the control group, 31.58% of participants had a low level of physical activity, 48.70%-average, 10.53%-high. Most participants of all ages (88.16%) refrained from posting videos of their achievements on social media, while nine participants (5 pupils and 4 students) posted their achievements in the form of short video exercises or screenshots, and reports of exercises in mobile applications in their groups. The research results are applicable to various social groups and can be used to create private groups on social media to encourage physical activity. The data obtained can be used for further development of specialized training programs using digital technology and social networks.

"Eat clean, train mean, get lean": Body image and health behaviours of women who engage with fitspiration and clean eating imagery on Instagram

The present study examined the relationship between posting or viewing fitspiration and clean eating imagery in relation to body image, disordered eating, and compulsive exercise among women. Participants (269 women aged 18-30 years) who posted and/or viewed fitspiration, clean eating or travel imagery on Instagram completed an online cross-sectional questionnaire. Results showed engaging with fitspiration and clean eating material (either posting or viewing) was significantly positively associated with increased levels of compulsive exercise and athletic-ideal internalization. However, only viewing (not posting) fitspiration and clean eating content was significantly related to thin-ideal internalization and disordered eating symptomatology. Athletic-ideal internalization mediated the relationships between posting fitspiration/clean eating and disordered eating symptomatology and compulsive exercise. Both thin-ideal internalization and athletic-ideal internalization mediated the relationship between viewing fitspiration/clean eating material and disordered eating and compulsive exercise. Overall, the findings suggest that viewing fitspiration and clean eating content on Instagram is negatively associated with thin-ideal internalization and disordered eating symptomatology, however the same relationships do not exist for people who frequently post these types of material. The mediational pathways provide a nuanced understanding of how engaging with fitspiration and clean eating material on social media influences female users' body image and health behaviour.

Exploring the Linkages of Digital Food Communication and Analog Food Behavior: A Scoping Review

The linkages of digital food communication on social media platforms and analog food behavior of social media users are widely discussed in media and research, but less differentiated. Due to the interdisciplinary nature of the research field, the scientific studies are characterized by great heterogeneity in approaching the role of communication and modelling of food behavior, and thus also the conclusions on how digital food communication might be linked to analog food behavior. There is still much uncertainty regarding the relationship and underlying assumptions between digital communication and analog action. The rationale of this scoping review is to systematically summarize the findings of this heterogeneous body of knowledge. The importance and originality of this review are that it focuses explicitly on studies that provide insights into the nexus of digital food communication and analog food behavior, be it in the theoretical foundation, the results, or their interpretation. It draws on a socio-ecological model of food behavior that depicts food behavior variables in different domains and uses a differentiated categorization of food behavior (food choice, dietary intake, and eating behavior) to synthesize the results. Using the Web of Science and PubMed databases, 267 abstracts were identified and screened, of which 20 articles met the inclusion criteria and were selected for full-text analysis. The review offers some important insights on how different variables of the socio-ecological model of food behavior are related to digital food communication and different areas of analog food behavior. This review provides a more discerning understanding of which aspects of analog food behavior may be linked to social media food communication and in which ways. Implications are derived to reflect the role of communication in previous models of food behavior by adding a more nuanced and cross-cutting understanding of food communication.

Let's (Tik) Talk About Fitness Trends

Several factors that follow the development of society affect physical inactivity, which primarily includes the development of technology and digitalization and the increasing choice of unhealthy lifestyle habits. However, certain shifts in the fitness industry have been noted in the last decade. The development of wearable technologies and artificial intelligence is one of the leading fitness trends and undoubtedly represents the future of the fitness industry. On the other hand, the significant influence of social media and networks affects the development and attitudes of people related to physical activity. Therefore, this review paper evaluates the advantages and disadvantages of wearable technologies and artificial intelligence, the positive and negative effects of social networks, and points out the problems accompanying these new fitness trends. The development of fitness trends follows humanity's needs, and one of the biggest challenges is incorporating these novelties in a mission to improve physical activity levels worldwide.

Investigating the effects of fit-normative and weight-inclusive Instagram images on women's exercise motivations

Exposure to "fitspiration" may promote exercising for maladaptive weight and appearance reasons in young women. Fitness content depicting higher-weight bodies could promote exercise for adaptive non-appearance motives, and body compassion might protect against the negative effects of "fitspiration" exposure. Two pre-registered experimental studies examined (i) the effects of exposure to fit-normative vs. weight-inclusive Instagram images on young women's exercise intentions and motivations, and (ii) tested trait body compassion as a moderator of the relationships between image exposure and psychosocial exercise outcomes. Using an online experimental paradigm, young adult women were randomized to view Instagram images representing fit-normative, weight-inclusive, or control conditions and completed state measures of exercise intention and motivation. Study 1 (n = 228) employed a post-test design and found no significant effects of condition on exercise outcomes, nor an effect of body compassion. Using a pre- and post-experimental design in Study 2 (n = 797), participants in the weight-inclusive condition exhibited significantly greater increases in exercise intention and fitness/health motivation, while those in the fit-normative condition exhibited greater increases in weight/appearance motivation, compared to controls. Body compassion was not a significant moderator of the associations between exposure to weight-inclusive vs. fit-normative images and exercise outcomes. Exposure to fit-normative Instagram content may encourage dysfunctional exercise motives in young women. Weight-inclusive imagery may more effectively inspire adaptive exercise intentions and motivations, and future research should investigate how it may be leveraged to improve psychosocial exercise outcomes.

Associations between Body Image and Self-Perceived Physical Fitness in Future Spanish Teachers

Body image is a complex construct related to how each person perceives their own body and how they value it. Physical fitness and physical activity are factors that can influence the perception of a better or worse body image. This study aimed to identify the potential associations between body image and physical fitness self-perception in future Spanish teachers, analysing possible sex-related differences. A total of 278 Spanish university students answered the Multidimensional Body Self Relations Questionnaire and the International Fitness Scale, having an average age of 22 years, of which 40% were men and 60% were women. Nonparametric techniques (Spearman's Rho test) were used as the data did not fit normality. The findings showed associations between body image and perceived physical fitness, confirming differences between the sexes. Correlations were found between the first three dimensions of the Multidimensional Body Self Relations and the International Fitness Scale, with sex-related differences being more significant in women than in men, and between the physical abilities self-assessed by the International Fitness Scale (except flexibility) and the dimensions of the Multidimensional Body Self Relations (except Dimension 4). Since body image influences well-being and conditions the time spent exercising, public health organisations and universities should design supports to improve master students' body image through physical activity programmes, education and sex-specific individualised attention.

The Use of Social Media as a Persuasive Platform to Facilitate Nutrition and Health Behavior Change in Young Adults: Web-Based Conversation Study

Background

Globally, suboptimal dietary choices are a leading cause of noncommunicable diseases. Evidence for effective interventions to address these behaviors, particularly in young adults, is limited. Given the substantial time young adults spend in using social media, there is interest in understanding the current and potential role of these platforms in shaping dietary behavior.

Objective

This study aims to explore the influence of social media on young adults’ dietary behaviors.

Methods

We recruited 234 young adults aged 18-24 years and living in Australia, using market and social research panels. We applied a digital ethnography approach to collect data from web-based conversations in a series of forums, where participants responded to different health-themed questions related to health behavior change and persuasion on social media. We conducted a qualitative thematic analysis.

Results

Participants described how social media influenced their decisions to change their health behaviors. Access to social support and health information through web-based communities was juxtaposed with exposure to highly persuasive fast-food advertisements. Some participants expressed that exposure to web-based health-focused content induced feelings of guilt about their behavior, which was more prominent among women. Fast-food advertisements were discussed as a contributor to poor health behaviors and indicated as a major barrier to change.

Conclusions

Young adults reported that social media is highly persuasive toward dietary behavior through different pathways of social influence. This suggests that social norms on the web are an important aspect of changing young adults’ health behaviors. The commercialization of social media also encourages poor health behaviors, largely through fast-food advertisements. Future social media–delivered dietary interventions should acknowledge the social and environmental factors that challenge the ability of young adults to make individual health behavior improvements. Care should also be taken to ensure that future interventions do not further elicit guilt in a way that contributes to poor mental health within this community.

Physical Activity and Exercise Addiction During the Covid-19 Pandemic in Italy

Severe restrictive measures were implemented globally to limit the spread of the Covid-19 pandemic leading to significant lifestyle changes and impacting on both the physical and the mental health of citizens. Caught by the fear of getting sick, some individuals have adopted behaviors which favored the development of exercise addiction (EA). Our aim was to evaluate physical activity habits and the risk of EA in the general Italian population during phase 1 of the lockdown. The role of appearance anxiety (AA), self-compassion, and use of performance and image enhancing drugs (PIEDs) as predictors of EA development were investigated. A comparison between physically active subjects with the inactive ones was also included. Between April and May 2020, an online survey was conducted across Italy. Nine hundred thirty-six answers were collected. The rate of EA in the physically active sample (782 subjects) was 4.1%. The physically active group showed higher SCS scores and a greater use of PIEDs. Of the physically active participants, 84.2% reported variations in their fitness routine. Perceived benefit of exercising resulted significantly higher in those with EA. Subjects with EA reported stronger motivation in engaging in physical activity as for "physical wellness," "psychological well-being," and "sexual attractiveness and confidence in relationship." A higher level of AA, a lower level of self-compassion, and a higher perceived benefit of exercising during lockdown were all significant predictors for the presence of EA. Our findings suggest that the fear of getting sick from Covid-19, combined with radical changes in the lifestyles induced by the lockdown and individual personological characteristics, can favor the development of EA and related phenomena in the general population.

An Instagram Hashtag Fostering Science Education of Vulnerable Groups during the Pandemic

Scientific literature presents young people as a vulnerable group at risk of poverty and social exclusion. One of the elements that have the most significant impact on reducing their vulnerability is promoting education. Little is known about how social networks can promote the education of young people. To address this, the present study aims to analyse how social networks, specifically Instagram, which is one of the most used by young people, has promoted, among other aspects, the scientific education of young people during the COVID-19 pandemic. This study analyses 5000 education-related Instagram posts made during the COVID-19 pandemic (March 2021) European research project ALLINTERACT. We have analysed those posts that show, on the one hand, how citizens benefit from scientific research and, on the other hand, citizens’ awareness of the impact of scientific research. Through the analysis of the posts, it has been observed how Instagram has been a social network that has provided information and scientific advances in various branches of knowledge, created knowledge networks, and provided a channel for information about the pandemic. Through the analysis of the 5000 posts, it is evident how Instagram has provided spaces for scientific learning, fostering access to scientific education for young people.

Which are the Effects of Body-Objectification and Instagram-Related Practices on Male Body Esteem? A Cross-Sectional Study

OBJECTIVE

According to the objectification framework, media pressure toward body models promotes the internalization of beauty ideals that negatively influence individuals' body image and self-esteem. Historically, women have been the main target of sociocultural pressures. However, research has recently suggested that self-objectification is a male phenomenon as well, which can be inscribed in men's body experiences. Nevertheless, fewer studies have specifically focused on the male experience and general consequences of body-objectification are yet to be extensively analyzed regarding males' body image features. The current cross-sectional study explores the consequences of body-objectification on male body esteem, specifically testing the predictive role of exercising/dietary habits, body-objectification features, and SNS-related practices on male body esteem.

METHOD

A total of 238 male participants (mean age = 24.28 years, SD = 4.32) have been involved in an online survey. Three hierarchical analyses were performed to test the influence of objectified body consciousness and social networking-related experiences (i.e. Instagram intensity use, photo manipulation, selfie feedback investment) on young men's body esteem with specific reference to the weight, appearance, and attribution features of the Body Esteem Scale.

RESULTS

Findings highlighted that body shame played an interesting key role, influencing negatively all the body esteem dimensions, thus highlighting that attention needs to be deserved on this feature of OBC regarding males' experience. On the contrary, appearance control-related dimensions positively influenced body esteem. Overall, findings confirmed that objectification theory can adequately mark a pathway by which media imagery is internalized also by men and may negatively affect their body esteem.

CONCLUSIONS

Despite some limitations, this study may contribute to enlarging our knowledge on male body image and self-objectification experience and support literature shattering the stereotype that body dissatisfaction is a "female-exclusive" issue. Likewise, beyond some questioning positions, these findings also encourage further exploration of a healthier "control dimension", including body appearance-related activities and beliefs.

Young Adults' Use of Different Social Media Platforms for Health Information: Insights From Web-Based Conversations

Background

Social media–delivered health promotion has demonstrated limited uptake and effectiveness among young adults. Understanding how young adults interact with existing social media platforms for health might provide insight for future health promotion interventions.

Objective

The aim of this study is to describe how young adults interact with different social media platforms for health and health information.

Methods

We used a web-based conversation methodology to collect data from 165 young adults aged 18 to 24 years. Participants participated in an extended conversation with moderators and other participants about health and social media. They were prompted to discuss how they find health information, how they use different social media platforms, and how they evaluate the trustworthiness of information. A thematic qualitative analysis was applied to the data.

Results

Young adults spent a lot of time scrolling through Facebook newsfeeds, which often resulted in seeing health-related content either from their friends, news sources, or advertisements. Some actively sought out information about specific health areas by joining groups or following relevant pages. YouTube was considered a useful source for learning about everything and was often the go-to when searching for information or advice (after Google). Young adults found the video format easy to learn from. They stated that they could identify accurate YouTube health content by cross-checking multiple videos, by feeling that the presenter was real and relatable, or just through instinctively judging a video’s credibility. Instagram was a source of inspiration for health and wellness from those whose lives were dedicated to healthy lifestyles and fitness. Twitter, Tumblr, and Snapchat were rarely used for health information.

Conclusions

Most young adults obtain health information from social media, both actively and through passive exposure. Participants indicated looking to social media influencers for health and lifestyle inspiration and judged the credibility of sources by appearance and instinct. Health experts should try to use the channels in the way that young adults already use them; use relatable role models on Instagram and YouTube, eye-catching headlines and support groups on Facebook, and easy to follow instruction videos via YouTube.

International Registered Report Identifier (IRRID)

RR2-10.1111/1747-0080.12448

Acceptance of Digital Sports: A Study Showing the Rising Acceptance of Digital Health Activities Due to the SARS-CoV-19 Pandemic

In pandemic times, the possibilities for conventional sports activities are severely limited; many sports facilities are closed or can only be used with restrictions. To counteract this lack of health activities and social exchange, people are increasingly adopting new digital sports solutions—a behavior change that had already started with the trend towards fitness apps and activity trackers. Existing research suggests that digital solutions increase the motivation to move and stay active. This work further investigates the potentials of digital sports incorporating the dimensions gender and preference for team sports versus individual sports. The study focuses on potential users, who were mostly younger professionals and academics. The results show that the SARS-CoV-19 pandemic had a significant negative impact on sports activity, particularly on persons preferring team sports. To compensate, most participants use more digital sports than before, and there is a positive correlation between the time spent physically active during the pandemic and the increase in motivation through digital sports. Nevertheless, there is still considerable skepticism regarding the potential of digital sports solutions to increase the motivation to do sports, increase performance, or raise a sense of team spirit when done in groups.

How Do Social Network Sites Influence Workout Intentions: A Social Norm Approach

People share their workout experiences on social network sites (SNSs). The present study examined how perceived exposure to these workout-related SNS posts may affect individuals' engagement in physical activities through perceived descriptive and injunctive norms of workout in their network, and how self-efficacy in workout moderated the effect of perceived descriptive norm on their workout intention, which was measured in general and specific ways. An online survey was conducted with a convenience sample of 807 responses in China. Results show that perceived descriptive norm of workout in one's network mediated the relationship between perceived exposure to workout-related SNS posts and perceived injunctive norm. In addition, self-efficacy in workout moderated the effect of perceived descriptive norm on workout intention-both general and specific-but the normative influence was stronger at a low level of self-efficacy compared to a high level. Furthermore, perceived injunctive norm only predicted the general rather than specific workout intention, suggesting that the perception of most people's approval might not be priority when people consider details about workout. These findings develop the theory of normative social behavior by illustrating the relationship between perceived descriptive and injunctive norm and shed light on the relative strength of the motivating factors of workout in different situations.

Changes in Digital Media Use and Physical Activity in German Young Adults under the Covid-19 Pandemic - A Cross-Sectional Study

Many studies observed a reduction of physical activity (PA) and an increase in digital media use in young adults during the COVID-19 pandemic. However, few studies have been conducted in Europe or looked at changes in the association between both behaviors. Hence, this study aims at investigating the changes in digital media use/social media use and PA as well as in its association among young adults in Germany. Cross-sectional data of 884 German young adults (mean age 22.36 (±1.99), 76% female) collected via an online questionnaire between August 1 and September 30, 2020 were analyzed. Participants reported on digital media use (smartphone, television, computer, gaming console), social media use (Facebook, Instagram, Snapchat, Twitter, YouTube, TikTok) and PA (days/week of ≥30 min. PA) separately for the period of strict infection control measures in Germany (March - end of May 2020) and for normal times (before March 2020). Descriptive statistics of digital media use, social media use and PA were compared between both periods. Linear regression adjusted for sociodemographic and work-related characteristics were conducted for both periods with total media use, the various media devices and social media use, respectively, as independent and PA as dependent variables. Whereas PA did not differ between both periods, mean total digital media use increased by 1 hour during the period of strict infection control measures. Digital media use and social media use were negatively associated with PA in both time periods. Differences in these associations by sex could be found for some digital media devices. However, 60% of respondents did not comply with the WHO recommendations for PA. Under consideration of possible recall bias, young adults' digital media use, but not PA, seemed to have changed under the strict infection control measures. However, interventions are needed to increase PA and to prevent its reduction in the course of the pandemic.

Practice or performance? A content analysis of yoga-related videos on Instagram

Representations of yoga within media have become increasingly idealised, depicting typical practitioners as young, thin, and physically competent. While previous content analyses of yoga have focused on still images, social media platforms such as Instagram encourage the use of video to enhance viewer engagement. Video may contain features which reflect a more nuanced view of the body, and therefore the current study analysed 400 women in yoga-related videos on Instagram for appearance characteristics, body conceptualisation, yoga pose type, risk, and perceived intention. The vast majority of women were perceived to be in their 20s and thin or athletic. Only 13.2 % of women showed average visible levels of body fat, while more than a third displayed visible muscularity across multiple muscle groups. There was little presence of objectification with the majority of women in active poses, though more than 60 % of poses/sequences were advanced and potentially risky. The vast majority of videos appeared to be for the purpose of demonstrating skill rather than instructing the viewer. The findings show that videos on Instagram perpetuate unrealistic appearance ideals in yoga and also provide a platform for content creators to engage viewers by representing yoga as a highly performative, predominantly advanced physical activity.

The Relationship between Obligatory Exercise and Eating Attitudes, and the Mediating Role of Sociocultural Attitudes towards Appearance during the COVID-19 Pandemic

A strong sociocultural context could affect an individual's aesthetic standards. In order to achieve a socially recognized ideal appearance, obligatory exercisers might increase dieting behavior when exercise actions are disturbed, thereby placing the individual at risk of eating disorders. The current study mainly examined the relationship between obligatory exercise and eating attitudes during the COVID-19 pandemic, and considered the mediating role of externalized sociocultural attitudes towards appearance between the two. A total of 342 participants (175 females, 167 males) from various regions of China were invited to fill out the questionnaires including the Obligatory Exercise Questionnaire, the Sociocultural Attitudes Toward Appearance Questionnaire-3, and the Eating Attitudes Test. In total, 51.5% of the participants presented symptoms of an obligatory exercise behavior. Among them, males, young adults, and the participants with lower BMI had higher OEQ scores, whereas females and young adults had higher EAT-26 scores. Meanwhile, 9.4% of the participants might have had an eating disorder. The OEQ score was positively correlated with the EAT-26 total score as well as SATAQ-3 'Pressures' and 'Information' subscales. In addition, the EAT-26 total score was positively correlated with the SATAQ-3 'Pressures' and 'Information' subscales. Externalized sociocultural attitudes towards appearance served as a mediator between obligatory exercise behavior and eating attitudes, and the mediation effect accounted for 56.82% of the total effect. Obligatory exercise behavior may have an indirect effect on eating attitudes through sociocultural attitudes towards appearance. Given the sociocultural information and pressures, in order to maintain or pursue an ideal appearance, many people tend to keep a pathological diet. Thus, forming a positive and healthy social aesthetic orientation is beneficial in helping obligatory exercisers to develop reasonable eating habits.

Fitspiration on Instagram: Identifying Topic Clusters in User Comments to Posts with Objectification Features

This study aimed to examine features of objectified images in popular fitspiration accounts on social media, identify the most prevalent user discussion topics about these images, and investigate the linkages between specific objectification cues and discussion topics. We employed content analysis to identify gender-specific objectification elements in fitspiration images (N = 2,000) on Instagram and unsupervised topic modeling to uncover topics in user comments (N = 35,263). Multilevel regressions were conducted to examine how gender and objectification features associate with the topics. Results revealed that one-third of the images were objectified. Objectification features such as sexual posing and the presence of objectified chest or abdomen were associated with the occurrence of two out of the three most prominent topic clusters (inspiration, body, and image-related discussions). We concluded that objectified fitspiration may distract users from health goals.

Social media's influence on adolescents' food choices: A mixed studies systematic literature review

Over 90% of adolescents have at least one social media account, and their presence on social media continues to grow. Food and beverage brands capitalize on this trend by marketing their products on social media to adolescents. Depending on the nutrition value of the products being marketed, social media advertisements' influence may contribute to the risk of developing unfavorable health outcomes such as obesity, hypertension, and type 2 diabetes. This review aimed to investigate social media's food and beverage advertisements' role in influencing adolescents' food choices by appraising published literature. A systematic literature review was conducted reporting on social media's role in adolescents' food choices. Articles were searched through CINAHL and PubMed from scholarly journals between 2015 and 2020, using the search terms: social media use, food advertisements, adolescents, and food choices. Eligible articles were selected based on inclusion criteria. PRISMA guidelines were followed, and study quality was assessed using the Mixed Methods Appraisal Tool. The analysis was conducted using narrative analysis to identify key findings. Of the 234 records, six articles met inclusion criteria. The studies revealed two major findings: adolescents were more likely to recall unhealthy food and celebrity influence was a common component of the advertisements. This review suggests that food and beverage companies use social media for marketing their products by targeting the adolescent population. The use of celebrities and influencers and the promotion of "unhealthy" products appear to be commonly used tactics. With these findings, healthcare professionals should consider screening adolescents routinely for social media use and current eating habits and educating the adolescents, parents, and families about health risk. Additionally, implementing legislation and policies may be beneficial in preventing this exposure.

Young People's Experiences of Engaging With Fitspiration on Instagram: Gendered Perspective

Background

Fitness inspiration or fitspiration is a term used to describe web-based images of fit people, people in the gym, health foods, or inspirational quotes relating to diet and fitness being shared and consumed via visual social media. The popularity of this content is most notable via the Instagram platform. Currently, the majority of fitspiration research has focused on women’s experiences; however, increasingly, studies have pointed to the need to explore the gendered ways by which people engage with this content.

Objective

The aim of this study is to explore how young men and women engage in fitspiration content on Instagram and provide a gendered analysis of how and why they consume this content.

Methods

This study used a cross-sectional web-based survey (N=1213) of UK-based fitspiration users aged 18-24 years consisting of closed-ended questions to capture quantitative data.

Results

The majority actively using Instagram for fitspiration (therefore eligible participants) were women (826/1175, 70.30%). Men were more likely to view content posted by athletes (χ²_{1, N=1153}=71.8; P=.001) and bodybuilders (χ²_{1, N=1153}=32.8; P<.001), whereas women were more likely to view content related to weight loss (χ²_{1, N=1153}=36.8; P<.001), diet plans (χ²_{1, N=1153}=11.9; P<.001), and celebrities’ content (χ²_{1, N=1153}=33.5; P<.001). Men were more likely to use fitspiration as a source of inspiration to exercise to gain muscle or get stronger (χ²_{1, N=1147}=17.9; P<.001), whereas women were more likely to use fitspiration as inspiration for healthy eating (χ²_{1, N=1147}=37.7; P<.001), or to exercise to diet or lose weight (χ²_{1, N=1147}=13.5; P<.001). Women were more likely to engage in passive behaviors such as viewing content on their feed (χ²_{1, N=1139}=7.9; P=.005) or scrolling through accounts (χ²_{1, N=1139}=15.2; P<.001), whereas men were more likely to engage in active consumption by tagging fitspiration accounts in posts (χ²_{1, N=1139}=7.2; P=.007), commenting on posts (χ²_{1, N=1139}=8.1; P=.004), and posting fitspiration content (χ²_{1, N=1139}=6.4; P=.01).

Conclusions

Female fitspiration consumers engaged with content that reinforced the feminine thin but shapely ideal, whereas male users sought out content that reinforced the masculine muscular ideal. Male users were more likely to engage actively with content (eg, posting fitspiration content), while female users were more likely to engage passively (eg, scrolling through accounts, posts, or images). Future research should consider how fitspiration consumption reflects and reproduces oppressive gender ideology.