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

The Impact of Social Media on Disordered Eating: Insights from Israel

BACKGROUND

Social media platforms have become integral to daily life and increasingly disseminate health, nutrition, and food information. While these platforms can offer evidence-based nutrition education and meal planning guidance, a significant portion of content promotes unrealistic beauty standards and unhealthy weight-loss practices, potentially contributing to disordered eating behaviors. The increasing prevalence of disordered eating, characterized by abnormal eating behaviors and attitudes, has become a global public health concern. This study examines whether social media consumption correlates with disordered eating symptoms in Israeli college students.

METHODS

A cross-sectional study was conducted among college students at Ashkelon Academic College in Israel. The questionnaire assessed demographics, social media usage (platforms used, frequency, and content followed), body satisfaction, and disordered eating symptoms, measured via the Eating Attitudes Test (EAT-26).

RESULTS

The study sample comprised 580 students (73% were female and 27% were male) with a mean age of 27.87 years. Participants predominantly used multiple social media platforms, with a majority following food-, eating-, and health-related content. Despite having a normal BMI, a substantial number of participants reported body dissatisfaction. The results indicated a positive correlation between social media use and disordered eating symptoms. Individuals who frequently engaged with food-related content on social media exhibited higher levels of disordered eating. Moreover, body satisfaction emerged as a significant mediator in the relationship between social media use and disordered eating symptoms.

CONCLUSIONS

The findings of this study support the growing body of evidence linking social media use to disordered eating behaviors among young adults. Developing targeted interventions that promote media literacy and foster body positivity is essential. Additionally, future research should explore the long-term effects of social media on eating behaviors and the effectiveness of different prevention strategies.

Diet pills and deception: A content analysis of weight-loss, muscle-building, and cleanse and detox supplements videos on TikTok

The promotion of harmful dieting-related products, including weight-loss, muscle-building, and cleanse/detox supplements, is pervasive across TikTok. Use of these products has been associated with eating pathology, and in some instances, increased risk of an eating disorder diagnosis. To inform eating disorders prevention and public health intervention, a content analysis was conducted to analyze the promotional features of the most viewed videos as of June 2022 in the U.S. across popular dieting product-related hashtags (#dietpills, #preworkout, #detox) (N = 233 videos). Investigators watched and coded videos using a codebook that captured details about featured individuals, product claims and details, and other video elements (e.g., language, use of popular music). Descriptive statistics were obtained to analyze trends within and across product hashtags. A total of 78 #dietpills, 86 #preworkout, and 69 #detox videos met study criteria. Videos promoting weight-loss and cleanse/detox products overwhelmingly featured feminine-presenting (70.5 % and 71 %, respectively) and thin (35.9 % and 44.9 %) individuals, while #preworkout video subjects were mostly masculine-presenting (73.3 %) and muscular (61.6 %). Most did not disclose their credentials (93.6 %) nor identify whether the promotion of the product was sponsored by the retailer (95.7 %). The vast majority of videos (97 %) did not provide any scientific evidence to support health- and appearance-related claims. The most popular videos promoting dieting-related supplements on TikTok overwhelmingly make unsubstantiated health claims, posing substantial risks for social media users who are vulnerable to their usage and associated health risks, including engagement in disordered eating.

Negative Affect as a Mediator Between Exposure to Fitspiration and Thinspiration and Disordered Eating Behaviors: An Ecological Momentary Assessment Study

OBJECTIVE

Although social media use, such as Instagram, has been associated with ED pathology, mechanisms connecting social media use to disordered eating behaviors (DEBs) remain largely unevaluated. Based on Dual Process, Tripartite, and Affect Regulation models of ED pathology, we proposed a moderated mediation model evaluating impacts of exposure to fitspiration/thinspiration on Instagram.

METHOD

We evaluated a hypothesized pathway from exposure to fitspiration/thinspiration (i.e., ED-salient content) on Instagram to disordered eating mediated by negative affect and tested individual differences in weight bias internalization, trait self-esteem, and trait self-comparison as moderators. We recruited 173 undergraduate women who reported engaging in DEBs on average at least once per week over the past 3 months. Participants completed a seven-day ecological momentary assessment protocol, during which they reported their ED-salient content exposure on Instagram, affect, and engagement in DEBs.

RESULTS

Multilevel modeling was used to assess moderated mediation. Negative affect partially mediated associations between viewing ED-salient content and subsequent engagement in objective binge eating and restricting but did not mediate the pathway to purging or excessive exercise. Higher weight bias internalization intensified the association between viewing ED-salient content and negative affect.

DISCUSSION

The association between viewing ED-salient content and engaging in objective binge eating and restricting may be a partial consequence of elevated negative affect; however, effects were small. Individuals with higher weight bias internalization may be more vulnerable to negative consequences from viewing ED-salient content. Findings suggested that reducing negative affect responses (e.g., via emotion regulation) could reduce negative consequences of viewing ED-salient content.

Mindful eating and orthorexia nervosa: How do they interact?

The present study explored the associations between orthorexia nervosa, social media addiction, emotion regulation difficulties, perfectionism and BMI with four facets of mindful eating, using path analysis to assess these relationships. A sample of 551 students (127 males, 424 females, mean age = 22.6 years) completed an online self-report questionnaire evaluating these constructs. Analyses revealed that mindful eating contributed to emotion dysregulation and orthorexia nervosa and was related to social media addiction. Significant indirect paths were identified from mindful eating, social media addiction and adaptive perfectionism through emotion dysregulation to maladaptive perfectionism. While no direct paths were observed between mindful eating and perfectionism, a direct path was found between adaptive perfectionism and orthorexia nervosa. These findings suggest a more nuanced understanding of eating behaviours is required. Individuals susceptible to eating disorders should approach mindful eating with caution and seek support from healthcare providers to ensure it is used in a way that supports overall wellbeing. Future research should aim to replicate and further clarify these associations to reveal the long-term effects of mindful eating.

Effects of Media Literacy Intervention on Weight-Control Products Digital Marketing Targeting Adolescents

This study aimed to evaluate the effects of a media literacy education intervention on adolescents' responses to digital marketing of weight-control products, focusing on media literacy, persuasion resistance efficacy, and purchase intention. Using a quasi-experimental design, the study involved 326 11th-grade students from a municipal high school in Kaohsiung City, Taiwan, with 189 students in the intervention group and 137 in the comparison group. Conducted in 2023, the intervention group participated in baseline and follow-up assessments and attended four 50 min media literacy sessions, while the comparison group completed only baseline and follow-up assessments with standard instruction. The results indicated that the media literacy intervention had positive effects on adolescents' conceptual, attitudinal, and critical media literacy, as well as their persuasion resistance efficacy in relation to digital marketing of weight-control products. However, no significant effect was observed on purchase intention. In conclusion, media literacy interventions can effectively enhance adolescents' media literacy and their ability to resist persuasion.

Body, image, and digital technology in adolescence and contemporary youth culture

The physical, psychological and social changes that occur during adolescence constitute a physiological crisis that is necessary for development and growth. The establishment of a suitable "self-image" is important for facilitating harmonious psychophysical development during this time. In the current era, digital technology (DT) serves as an extraordinary means of communication for young people, who make significant use of images as a mode of expression. Accordingly, there is growing interest in the relationship between physical development, self-image and use of DT. A review of the published literature on the topic was carried out in April 2024. Fourteen studies (n = 14) were inclused from search of electronic databases such as PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The aim of this study is to explore the influence of (DT) on cultural models of adolescent body image, and how this "social" culture can affect wellbeing and development. It was considered that the rise of DT and social media (SM) emphasized in young people the culture of appearance, adherence to ideal models (thinness ideal) and social comparison at an unprecedented level. It was estimated that the digital mechanism works on the adolescent's vulnerability and stimulates the desire for experimentation and amplifies cultural beliefs that expose the young to deviant or pathological behaviors on the body. The use of digital images emphasizes the perception of self by making it more real and alive but empty of content. Our framework highlights that the adolescent can defend himself if he leaves the homologation that the SM condition, regains his own experiences, fill with emotional content and real life the images and the representation of the body.

Associations Between Body Image, Eating Behaviors, and Diet Quality Among Young Women in New Zealand: The Role of Social Media

Background/Objectives: This study investigates the relationship between diet quality and body image disturbance among young women aged 18-24, a crucial period for establishing lifelong health behaviors. Given the increasing exposure to social media, which often promotes unrealistic beauty standards, this research aims to explore associations between eating behaviors, diet quality, and body image disturbance. Methods: A mixed-methods approach was employed, combining qualitative focus group discussions with quantitative analysis. Focus groups (n = 19) explored themes of body image dissatisfaction. The Body Image Disturbance Questionnaire (BIDQ) was administered to 50 participants (young women aged 18-24) to quantitatively assess body image disturbance, while diet quality was evaluated using the Australian Recommended Food Scores (ARFS). The Three-Factor Eating Questionnaire (TFEQ-R18) was also used to assess eating behaviors, including cognitive restraint, uncontrolled eating, and emotional eating. A social influence questionnaire (SIQ) was administered to measure the effect of social influence. Pearson's correlation coefficient was used to determine the relationship between ARFS, BIDQ, and TFEQ-R18 scores. Results: Qualitative findings revealed persistent dissatisfaction with body shape, largely influenced by social media. Quantitatively, 65% of participants scored above the clinical threshold for body image disturbance (mean BIDQ score = 4.2, SD = 0.8). The correlation between ARFS and BIDQ scores was weak and not statistically significant (r = 0.057, p = 0.711). However, a significant positive correlation was observed between time spent on social media and body image disturbance (r = 0.58, p < 0.01). Additionally, TFEQ-R18 results indicated that 45% of participants displayed moderate levels of uncontrolled eating, and 36.5% demonstrated moderate levels of emotional eating. Conclusions: While social media is associated with body image concerns, its effect on eating behaviors and diet quality shows weak correlations, suggesting that other factors may mediate these outcomes. These results suggest the complexity of the associations between body image, eating behaviors, and diet quality, indicating that interventions should consider psychological drivers behind these concerns alongside social media usage.

Social media delivered mental health campaigns and public service announcements: A systematic literature review of public engagement and help-seeking behaviours

Social media (SM) is increasingly utilised to disseminate mental health (MH) public service announcements (PSAs) and campaigns, connecting the public with support or resources. However, the effectiveness of MH campaigns/PSAs is often overlooked, and actions following exposure are rarely measured. We aimed to i) systematically review research on MH campaigns/PSAs disseminated via SM to determine their efficacy in eliciting engagement, help-seeking/behavioural change and ii) identify components that may facilitate engagement, help-seeking/behavioural change. The review followed PRISMA guidelines. Fourteen studies were eligible. The campaigns/PSAs targeted various MH concerns and country dissemination was diverse. Twitter/X was the most prevalent SM platform (n = 11), followed by Facebook (n = 8). All campaigns/PSAs generated engagement although engagement level benchmarks were inconsistent or absent, a proportion measured formal help-seeking behaviours (n = 1) or behavioural/language/knowledge change (n = 8). Components influencing engagement included videos/live streams, relatable content, the organisation/account disseminating the content, how information was conveyed, and external events. We highlight the heterogeneity of research in SM MH campaign/PSA evaluation and identify commonalities across studies potentially responsible for eliciting engagement, behavioural change and/or help-seeking in future campaigns/PSAs.

Trends in youth acute care hospital visits for anxiety and depression in Illinois

PURPOSE

This study analyzes the trajectory of youth emergency department or inpatient hospital visits for depression or anxiety in Illinois before and during the COVID-19 pandemic.

METHODS

We analyze emergency department (ED) outpatient visits, direct admissions, and ED admissions by patients ages 5-19 years coded for depression or anxiety disorders from 2016 through June 2023 with data from the Illinois Hospital Association COMPdata database. We analyze changes in visit rates by patient sociodemographic and clinical characteristics, hospital volume and type, and census zip code measures of poverty and social vulnerability. Interrupted times series analysis was used to test the significance of differences in level and trends between 51 pre-pandemic months and 39 during-pandemic months.

RESULTS

There were 250,648 visits to 232 Illinois hospitals. After large immediate pandemic decreases there was an estimated -12.0 per-month (p = 0.003, 95% CI -19.8-4.1) decrease in male visits and a - 13.1 (p = 0.07, 95% CI -27 -1) per-month decrease in female visits in the during-pandemic relative to the pre-pandemic period. The reduction was greatest for outpatient ED visits, for males, for age 5-9 and 15-19 years patients, for smaller community hospitals, and for patients from the poorest and most vulnerable zip code areas.

CONCLUSIONS

llinois youth depression and anxiety hospital visit rates declined significantly after the pandemic shutdown and remained stable into 2023 at levels below 2016-2019 rates. Further progress will require both clinical innovations and effective prevention grounded in a better understanding of the cultural roots of youth mental health.

Longitudinal Associations of (Un)popularity with Weight Perceptions and Dieting in Adolescence

Little is known about the unique effects of (un)popularity on body image and the characteristics influencing these effects. The goals of this study were to examine (1) the longitudinal associations of adolescents' (un)popularity with weight perception and dieting, (2) whether (dis)liking, self-esteem, and gender moderated these associations. Participants were 1697 Dutch adolescents (Mage = 14.18 years, SD = 1.29; 51% female), from a middle-class population. Participants completed peer nominations and self-reports in three consecutive school years. Mixed-effects models showed that (un)popularity did not predict weight perception and dieting over time. Concurrently, when liking was low, popularity predicted positive weight perception. Higher popularity predicted more dieting in females. This study highlighted that adolescents' body image varied in subgroups of social status.

Mirror, mirror on my screen: Focus on self-presentation on social media is associated with perfectionism and disordered eating among adolescents. Results from the "LifeOnSoMe"-study

BACKGROUND

Social media use, perfectionism, and disordered eating have all increased over the last decades. Some studies indicate that there is a relationship between self-presentation behaviors and being exposed to others' self-presentation on social media, and disordered eating. Studies also show that the relationship between focus on self-presentation and highly visual social media is stronger than for non-visual social media, hence facilitating upward social comparison. Nevertheless, no previous studies have investigated the link between adolescents' focus on self-presentation and upward social comparison on social media, and perfectionism and disordered eating, which is the aim of the present study.

METHOD

The present study is based on a cross-sectional survey from the "LifeOnSoMe"-study (N = 3424), conducted in 2020 and 2021. Respondents were high school students (mean age 17.3 years, 56% females) in Bergen, Norway. Multiple regression analysis was performed, where SPAUSCIS, a measure of self-presentation and upward social comparison, was the independent variable. Perfectionism and disordered eating were dependent variables. Self-reported age, gender, and subjective socioeconomic status were used as covariates, as well as frequency and duration of social media use. Regression models were performed to compare proportions across the median split of SPAUSCIS.

RESULTS

The multiple regression analysis showed that increased focus on self-presentation and upward social comparison on social media were positively associated with both perfectionism (standardized coefficient 0.28) and disordered eating. A stronger association for girls than boys was found for disordered eating (standardized coefficient 0.39 for girls and 0.29 for boys). There was no gender moderation for perfectionism.

CONCLUSIONS

Findings suggest that focus on self-presentation and upward social comparison on social media is associated with perfectionism and disordered eating. We recommend promoting a healthy use of social media. This could be established by increasing adolescents' ability to reflect on and think critically about self-presentation and upward social comparison on social media.

Adapting an Online Guided Self-Help CBT Programme Targeting Disordered Eating for Students in Aotearoa New Zealand: A Qualitative Study

Disordered eating is a significant issue in university student populations. Currently, access to interventions is limited. Online interventions present an innovative way to increase accessibility to treatment for those in need. The current study explored how an online intervention for disordered eating (everyBody) could be modified to suit the needs of university students in Aotearoa New Zealand. Aotearoa New Zealand is a unique cultural context, with an indigenous population that has a high incidence rate of disordered eating, highlighting the need to adapt everyBody to the local context. Individual interviews were conducted with nine students currently at university in Aotearoa New Zealand, aged between 18 and 33 years old (five females, four males). Three first-order themes were identified using template analysis. The themes indicate that participants perceived the programme as acceptable and feasible for use with Aotearoa New Zealand's university student population. Furthermore, the themes provide insight into potential adaptions to the programme to facilitate engagement and uptake. The suggested changes were largely consistent with previous research on E-therapy design (e.g., content length, therapeutic alliance), and also highlight changes specific to fit Aotearoa New Zealand's cultural context. The findings have implications for universities and other funders deciding on services for students with disordered eating and eating disorders.

Longitudinal Impact of Disordered Eating Attitudes on Depression, Anxiety, and Somatization in Young Women with Anorexia and Bulimia

Background/Objectives: Eating disorders, characterized by severe disturbances in eating behavior, are a public health concern, particularly among young women. This longitudinal study aimed to investigate the relationship between disordered eating attitudes and mental health outcomes, including depression, anxiety, and somatization, among individuals with eating disorders. Methods: A total of 471 young German women hospitalized with anorexia nervosa or bulimia nervosa participated in this study. Assessments were conducted at two points over a two-month interval using the Eating Disorder Inventory-2 (EDI-2) and the Patient Health Questionnaire. Regression analyses were performed to determine predictors of depression, anxiety, and somatization. The study controlled for socio-demographic segmentation using Sinus-Milieus, a social classification system, as a covariate. Results: Regression analyses revealed that interpersonal distrust and impulse regulation were significant predictors of subsequent depression. Impulse regulation strongly predicted subsequent anxiety, while both impulse regulation and social insecurity were strong predictors of subsequent somatization. The Neo-Ecological Milieu emerged as the most prevalent socio-demographic group (34.4% of participants). The Sinus-Milieus segmentation, however, did not significantly impact the health outcomes, suggesting consistent mental health issues across socio-demographic groups. Conclusions: This study's findings underscored the role of disordered eating attitudes in predicting mental health outcomes among young women with eating disorders. Addressing these attitudes in therapeutic settings may help mitigate symptoms of not only the primary condition but also depression, anxiety, and somatization.

Body dissatisfaction and dieting among Finnish adolescents: a 20-year population-based time-trend study

Body image has an important role in the health and development of adolescents. Body dissatisfaction and dieting can become chronic and continue into adulthood. There is a lack of recent, comprehensive studies on ongoing trends on body dissatisfaction. This study assessed time-trend changes in self-reported body dissatisfaction and dieting among Finnish adolescents at four assessment points. Representative samples of adolescents (N = 6660) aged 13-16 years participated in school-based, cross-sectional studies in 1998 (N = 1458), 2008 (N = 2044), 2014 (N = 1809), and 2018 (N = 1349), respectively. The studies were similar in design, methodology, and geographical recruitment areas. Body dissatisfaction and dieting were assessed with a questionnaire including items derived from the DSM-IV criteria for anorexia and bulimia nervosa. From 1998 to 2018, dieting and fears related to gaining weight decreased among females. Body dissatisfaction reduced among females, and their wishes to become thinner became less prevalent. Consuming large amounts of food at one time consistently decreased among females and males and there were no changes in the rates of willful vomiting. The number of females in the 90th percentile with the most severe symptoms decreased. The results indicate that body dissatisfaction and disturbed dieting improved among females during the 20-year study. Despite these positive developments, the overall level of symptoms among females remained substantial, indicating that females have much higher levels of body dissatisfaction and dieting than males.

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors

This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.

Young people on social media in a globalized world: self-optimization in highly competitive and achievement-oriented forms of life

Research investigating young people's social media use has been criticized for its limited theoretical foundations and scope. This paper elaborates young people's social media activity from a socio-ecological evolutionary perspective (SEE), where young people's online exchanges cannot be divorced from the highly competitive and achievement-oriented modern market cultures in which they live. In highly competitive and achievement-oriented forms of life, young people's social media environments are often constituted as dynamic and evolving extrinsically oriented ecological niches that afford for status and identity enhancement while also affording for peer approval, belongingness, and self-worth nested within, and subordinate to, these higher-order affordances. The extrinsic value organization of social media platforms that serve young people's status and identity-enhancement are embodied by a community of mutually interdependent criteria that are evolutionary-based, developmentally salient, and market-driven: physical attractiveness, high (educational and extracurricular) achievements, and material success. Young people's online signaling of these interdependent extrinsic criteria affords for status-allocation and self-enhancement, where each criteria becomes an arena for social competition and identity formation, enabling young people to build personal and optimal models of social success congruent with their own interests and abilities. Young people's status and identity enhancing signaling of these extrinsic criteria is moving toward increasingly idealized or perfect embodiments, informed by accelerating, short-term positive feedback processes that benefit from the technological affordances and densely rewarding peer environments instantiated on social media.

Issues Related to the Use of Visual Social Networks and Perceived Usefulness of Social Media Literacy During the Recovery Phase: Qualitative Research Among Girls With Eating Disorders

BACKGROUND

The patient-centered approach is essential for quality health care and patient safety. Understanding the service user's perspective on the factors maintaining the health problem is crucial for successful treatment, especially for patients who do not recognize their condition as clinically relevant or concerning. Despite the association between intensive use of visual social media and body dissatisfaction and eating disorders, little is known about the meanings users assign to posting or searching for edited photos and the strategies they use to protect themselves from digital risks.

OBJECTIVE

This study aims to examine how young women recovering from eating disorders in Northern Italy perceive the health risks and potential benefits associated with visual social networks (ie, Instagram and Snapchat). The literature has found these platforms to be detrimental to online body comparisons. It also explores the perceived usefulness, willingness, and personal interest in coconstructing social media literacy programs with girls recovering from eating disorders.

METHODS

A total of 30 semistructured interviews were conducted with adolescent girls aged 14-17 years at the end of their treatment for eating disorders. The following areas of research were addressed: (1) the meanings associated with the use of Instagram and Snapchat; (2) the investment in the photographic dimension and feedback; (3) the impact of visual social networks on body experiences; (4) the potential and risks perceived in their use; (5) the importance of supporting girls undergoing treatment for eating disorders in using social networks; and (6) the usefulness and willingness to co-design social network literacy programs. Content analysis was applied.

RESULTS

A total of 7 main contents emerged: active or passive role in using social networks, the impact of online interactions on body image, investment in the photographic dimension, effects on self-representation, perceived risks, self-protective strategies, and potential benefits. The findings highlight a strong awareness of the processes that trigger body comparisons in the virtual context, creating insecurity and worsening the relationship with oneself. The self-protective behaviors identified are the development of critical thinking, the avoidance of sensitive content, increased control over social networking site use, and a certain skepticism toward developing antagonistic ideologies. All these topics were considered fundamental.

CONCLUSIONS

The findings provide important insights for health professionals working with youth in preparing media literacy programs. These programs aim to reduce potential risks and amplify the positive effects of online resources. They underscore the importance of addressing this issue during hospitalization to develop skills and critical thinking aimed at changing small habits that perpetuate the problem in everyday life. The inherent limitations in current service practices, which may not adequately address individual needs or impact posttreatment life, must also be considered.

Improvements in Quality of Life and Readiness for Change After Participating in an Eating Disorder Psychoeducation Group: A Pilot Study

Psychoeducation groups are an integral part of eating disorder treatment in community programs, yet research on their efficacy remains limited. This study examines the impact of participating in a 10-week psychoeducation group on changes in quality of life and in readiness and motivation. Seventy-five adults who had eating disorders were included in the study. We administered the Eating Disorder Quality of Life Scale (EDQLS) and Readiness and Motivation Questionnaire (RMQ) before and after the group. After participation, respondents reported an 11-point increase in the EDQLS score and 9-, 8-, and 9-point increases, respectively, in the total action, confidence, and internality components of the RMQ score. In group exit evaluations, participants reported that the psychoeducation group improved their quality of life and their readiness and motivation to recover.

Predictive Model of the Relationship between Appearance, Eating Attitudes, and Physical Activity Behavior in Young People amid COVID-19

This cross-sectional study conducted in Poland explored the relationship between the fear of negative appearance evaluations, eating disorders, and physical activity objectives, particularly during the COVID-19 pandemic. The Fear of Negative Appearance Evaluation Scale (FNAES), the Eating Attitude Test (EAT-26), and the Physical Activity Goals Inventory (IPAO) were administered to 644 participants (455 males with a mean age of 35.2 ± 6.2 years and 189 females with a mean age of 30.18 ± 5.7 years). This study explored the effects of gender, age, and body mass index (BMI) on FNAES, EAT-26, and IPAO scores. The results of this study demonstrated that females scored higher on fear of negative appearance, peaking at 41-50 years of age. Distinct BMI categories were associated with different negative appearance fear scores, eating attitudes, and physical activity objectives. Significant correlations were also found between the fear of negative appearance, dietary attitudes, and physical activity goals. Eating attitudes completely moderated the relationship between the fear of negative appearance and physical activity objectives. A significant interaction effect of age and body mass index on physical activity objectives was also revealed. These results highlight the relevance of considering gender, age, and body mass index when examining the associations between the fear of negative appearance, eating attitudes, and physical activity objectives.

Evaluation of the Consumption of Junk Food Products and Lifestyle among Teenagers and Young Population from Romania

BACKGROUND

The long-term consumption of junk food products can lead to nutritional and metabolic imbalances, especially when it is associated with a lack of physical activity and the consumption of alcohol or other high-calorie products.

METHODS

The evaluation of junk food consumption among teenagers and young people in Romania was carried out with the help of a cross-sectional study based on a questionnaire.

RESULTS

A total number of 1017 respondents participated in this study, comprising 470 males and 547 females aged between 16 and 25 years. Although the majority of young people fell into the normal-weight category (607 of them, p < 0.0001), some aspects can be noted that in the long term can produce a series of nutritional imbalances: an increased tendency toward sedentarism, with 553 (p = 0.613) of the respondents declaring that they performed sports rarely or not at all, and a tendency toward relatively high consumption of foods high in calories (fast food products and especially fried potatoes, hamburgers, shawarma, pastries, and snacks, along with sweetened drinks and even alcoholic beverages). The respondents participating in this study even indicated a perceived addiction to the consumption of certain products: coffee (50.48%), fried potatoes (38.9%), hamburgers (37.05%), shawarma (31.65%), and snacks (30.08%). Many of these products are rich in calories, saturated fat, and even trans fat.

CONCLUSIONS

This study highlights a series of aspects that can have long-term negative effects related to the excess weight associated with other imbalances: consumption preferences among young people for hypercaloric fast food products, sweetened drinks associated with reduced physical activity, and even the development of some forms of food addictions for a series of hypercaloric foods.

Out of the loop: Taking a one-week break from social media leads to better self-esteem and body image among young women

This study experimentally tested the effects of taking a one-week break from social media (SM) on body image and self-esteem among young women. Female undergraduate students (N = 66) were randomly assigned to either take a one-week break from SM or continue their normal use (control condition). State self-esteem and body satisfaction were measured at baseline (Time 1) and one week later (Time 2). As predicted, participants in the break condition reported higher body satisfaction and higher state self-esteem (total, performance, social, and appearance domains) at Time 2 than did those in the control condition, controlling for Time 1 scores. The benefits of taking a break from SM on body satisfaction were especially pronounced for women with higher baseline levels of thin-ideal internalization. The findings demonstrate the short-term benefits of taking a break from SM for one week on self-esteem and body image among young women.

#WhatIEatInADay: The effects of viewing food diary TikTok videos on young adults' body image and intent to diet

The rise of short-form video content has prompted research into its impact on body image; however, little remains known regarding the effects of exposure to food-related content of this type. The present study aimed to fill this gap in the literature by conducting a between-subjects experiment (N = 316) examining the effects of exposure to low-calorie versus high-calorie "What I Eat in A Day" food diary TikTok videos on young adults' body appreciation, body dissatisfaction, and diet intentions. Additionally, this study sought to explore how social comparison and mood might affect participants' responses to these videos. Results indicate that social comparison mediated the relationship between video type (low- vs high- calorie) and positive mood, such that low-calorie videos increased upward social comparison and decreased positive mood, and high-calorie videos increased downward social comparison and increased positive mood. Positive direct effects of positive mood on body appreciation and diet intentions occurred, and a negative direct effect on body dissatisfaction was found. Additionally, positive mood mediated the path from social comparison to diet intentions. These findings highlight the importance of further research into the nuanced impacts of food diary social media content on young adults' body image and behaviors.

Social media & subjectivity: Adolescent lived experiences with social media in a Southern California middle school

The widespread use of social media (SM) platforms among adolescents has raised concerns over its role in increased adverse physical and mental health conditions. However, current research linking SM use with adolescent health relies on tenuous correlational associations, disproportionately focuses on harmful effects of its use, and seldom examines the perspectives of youth themselves (Odgers and Jensen, 2020; Schønning et al., 2020). This article examines adolescent lived experience in relation to SM platform engagement. Drawing from ethnographic fieldwork conducted in 2018-2019 and 2021-2022 among 75 middle-school adolescents living in an ethnically diverse and low-income Southern California community, we examine adolescent subjective experiences with SM platforms that illuminate adolescent concerns during this developmental stage. By attending to adolescent subjectivity, this article reveals the ways in which engagement with SM platforms is inextricable from cultural, social, political, and socio-emotional milieu.

Eating Disorders Risk Assessment and Body Esteem among Amateur and Professional Football Players

BACKGROUND

The purpose of this study was to assess the risk of eating disorders and attitudes toward one's own body among football players at amateur and professional levels.

METHODS

The study included 90 players from football clubs located in the Upper Silesia Metropolitan Area, participating in the 4th and 5th leagues in Poland. A survey questionnaire was used to conduct the study, which consisted of a metric section, an Eating Attitudes Test, and Body Esteem Scale questionnaires. The players were divided into two groups according to their sports level.

RESULTS

Results showed that 24.4% of players were overweight, while 75.6% had a normative body weight. Approximately 16.7% met the criteria indicating susceptibility to an eating disorder. Body Esteem Scale interpretations revealed moderate body appraisal among players.

CONCLUSIONS

Both amateur and professional athletes showed no significant difference in eating disorder risk, but professionals rated their bodies higher. Social media use, particularly on Twitter and Instagram, is correlated with eating disorders, with longer daily use associated with lower body ratings.

The cost of the perfect body: influence mechanism of internalization of media appearance ideals on eating disorder tendencies in adolescents

BACKGROUND

Some studies have examined the relationship between internalization of media appearance ideals and eating disorders. However, few have discussed the relationship between eating disorder tendencies. To fill this research gap, this study was to explore the influencing mechanisms of internalization of media appearance ideals on adolescents' eating disorder tendencies in Chinese cultural context.

METHOD

The Sociocultural Attitudes Towards Appearance Questionnaire, Eating Attitude Test-26, Physical Self-Description Questionnaire, Body Image Depression Questionnaire and Multidimensional Scale of Perceived Social Support were employed in this study to investigate 1523 adolescents. The collected data were analyzed using SPSS 26.0 and AMOS 24.0.

RESULT

The results showed that: (1) internalization of media appearance ideals had a significant positive predictive effect on adolescents' eating disorder tendencies; (2) internalization of media appearance ideals significantly influenced adolescents' eating disorder tendencies through the mediating role of body esteem and body image disturbance respectively, and also influenced eating disorder tendencies through the chain mediating of both; and (3) social support played a moderating role between body image disturbance and eating disorder tendency.

CONCLUSION

Our findings suggest distinct pathways through which internalization of media appearance ideals may influence adolescents' eating disorder tendencies. It is suggested that reducing body image disturbance and enhancing social support can help reducing eating disorder tendency.

COVID-19-Related distress, body image, and eating behaviors: a cross-sectional explanatory model

BACKGROUND

The COVID-19 pandemic has been associated with increased body dissatisfaction and disordered eating behaviors in adolescents. To better understand these associations, this study tested an explanatory model in which appearance-focused social media use, internalization of social media pressure, and mindfulness abilities mediated the relationship between COVID-related distress and body dissatisfaction, which in turn was associated with dietary restraint and binge eating episodes.

METHODS

Adolescents (N = 493, Mage= 16.7; 47.5% girls) recruited within high schools completed online measures. We conducted model testing through path analysis in MPlus, using modification indices to derive a well-fitting model.

RESULTS

The initially hypothesized model was a poor fit for the data. The final well-adjusted model confirmed several significant paths and supported the parallel mediational roles of social media (specifically, the use of appearance-focused social media and internalization of social media pressure) along with mindfulness, on the relationship between COVID-19-related distress and body satisfaction. Model adjustments involved adding three paths, resulting in two additional significant indirect effects, and suppressing one path.

CONCLUSIONS

Findings suggest that mindfulness, media use and the internalization of social media pressure are potential key processes explaining body dissatisfaction and eating disorders among adolescents who experienced higher levels of COVID-related distress.

Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents

BACKGROUND

Few studies have investigated how the plethora of contemporary social media (SM) platforms relate to, and influence eating disorder (ED) pathology, appearance ideals and pressure to conform to these ideals in youth.

METHODS

In this study, 1558 girls (53%) and boys (47%), predominantly within the 16-19 age range, completed an online questionnaire assessing SM use and perceived influence on appearance, ED pathology, internalization of appearance ideals and perceived appearance pressure.

RESULTS

Results showed that ED pathology was common, particularly in girls, and that internalization of body ideals was gender specific, a thin ideal being more prevalent in girls, and a muscular ideal being more common in boys. Results also showed a strong association between ED pathology and perceived pressure to conform to these appearance ideals. One fourth of the participants reported spending four hours or more on SM daily, and 80% of girls reported that SM, particularly Instagram and TikTok, had a negative influence on how they felt about their appearance. These girls had significantly higher levels of ED pathology and reported higher levels of appearance pressure from the media.

CONCLUSION

A clear pattern of associations between photo- and video specific SM platforms, ED pathology, internalization of body ideals and perceived pressure was found in this study. Adolescent girls appeared to be particularly at risk. The results illustrate an imperative need to keep addressing the potential risks of SM use in adolescents, and to continue monitoring the effect of SM on young people's view of themselves, their appearance, and their eating habits. Future studies should attempt to identify aspects of SM use that may be particularly detrimental for girls and boys in their formative years, but also those that may enhance adolescents' satisfaction and appreciation of their body and appearance.

TRIAL REGISTRATION

The study is registered in the Open Science Framework (Identifier: 10.17605/OSF.IO/5RB6P https://doi.org/10.17605/OSF.IO/5RB6P ).

Health Misinformation on Social Media and Adolescent Health

This Viewpoint discusses strategies for dealing with health misinformation on social media.

A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians

AIM

The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic.

METHODS

This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13-18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported.

RESULTS

The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and "healthy eating"; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services.

CONCLUSION

During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.

Psychologically informed care of patients with anorexia nervosa on an acute medical ward

Anorexia nervosa is a challenging and highly distressing illness associated with significant and often debilitating symptoms that affect the person's physical and mental well-being, as well as their wider social networks. Although some patients can make important steps in their recovery in the community, many will become significantly unwell and require medical stabilisation and refeeding in an acute medical ward as a result of significant weight loss. This article describes some of the challenges experienced by adult nurses when caring for patients with anorexia nervosa on acute medical wards and explores how the patient's distress may manifest and complicate the recovery process. The article also discusses the principles of psychologically informed care and therapeutic interactions that nurses can use to promote recovery and ensure optimal practice.

Smartphone use and its association with body image distortion and weight loss behaviours among adolescents in Saudi Arabia

BACKGROUND

Concerns about the harmful effects of smartphone use on teenage development have been raised as the use of cell phones among adolescents has risen.

OBJECTIVE

This study aimed to examine the associations of smartphone usage patterns with Body Image Distortion (BID) and weight loss behaviors among adolescent smartphone users in Saudi Arabia.

METHODS

This population-based, cross-sectional study was conducted from July to October 2022. We assessed the mean daily length of smartphone use and classified it into quartiles using data from a self-reported survey and data on weekday and weekend use. Self-reported body weight and height were collected via an online survey. Out of the 11384 adolescents, the majority was females (65.7%) and was secondary school students (68.9%).

RESULTS

The prolonged smartphone use (301 min/d) was found in 36.4% of adolescents, 181-300 min/d in 27.6% of respondents, 121-180 min/d in 22.4% of respondents, while the modest smartphone use (1-120 min/d) was found only in 13.6% of participants. The duration of smartphone use was significantly associated with BID (P= 0.000); students with middle perceived stress levels (51.4%) and no depressive symptoms (68.9%) used smartphones 121-180 min/d sparingly. However, prolonged smartphone use was significantly associated with the presence of depressive symptoms (42.6%) and high perceived stress levels (21.5%). Weight loss behaviors were significantly associated with smartphone use duration. Modest smartphone use was significantly found in students with normal weight (P= 0.00, 71.9%); however, aerobic physical activity weight loss strategy (P= 0.00, 30.9%) was correlated with prolonged smartphone use.

CONCLUSION

Adequate parental advice is required to assist teenagers in developing healthy smartphone usage practices. Digital platform companies may increase their social responsibility for the information generated and delivered on their networks, boosting its beneficial effect.

Incels, autism, and hopelessness: affective incorporation of online interaction as a challenge for phenomenological psychopathology

Recent research has drawn attention to the prevalence of self-reported autism within online communities of involuntary celibates (incels). These studies suggest that some individuals with autism may be particularly vulnerable to the impact of incel forums and the hopelessness they generate. However, a more precise description of the experiential connection between inceldom, self-reported autism, and hopelessness has remained unarticulated. Therefore, this article combines empirical studies on the incel community with phenomenological and embodiment approaches to autism, hopelessness, and online affectivity. We analyze three interrelated aspects of online interactions in incel communities - worldview, bodily self-relation, and mutual dismissals - and examine how these elements contribute to the consolidation of the loss of significant life possibilities. By investigating the potential negative influence of specific online environments on affective dispositions, our approach contributes to the debate on current challenges to "situate" phenomenological psychopathology.

Virtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa

BACKGROUND

Normalizing the eating pattern and weight recovery are the main objectives in treating anorexia nervosa (AN). Eating accompaniment through shared mealtimes is a common strategy in eating disorder management programs. This study aims to examine the impact on weight gain of an internet-delivered meal support group on patients with AN who were under ambulatory treatment with the Eating Disorders Unit of the UC Christus Health Network, Chile.

METHODS

An observational study of 54 female patients with AN diagnosis who participated in Online Meal Support Groups (OMSGs) three times a week was performed. Their weight, BMI and BMI%, was reviewed at the beginning of the sessions and at 45- and 90-day follow-up.

RESULTS

Patients showed significant weight gain during follow-up. At the 90-day follow-up, patients had gained 4.41 (SD ± 2.82) kg with an effect size of -1.563.

CONCLUSIONS

Statistically significant differences were found between the weight at the beginning of the intervention and at the 45- and 90-day follow-up, meaning that eating support online groups may be an effective intervention for weight gain and maintenance in patients with AN. These findings highlight the viability of developing cost-effective and more accessible interventions for AN and thus help reduce the duration of untreated disease and its consequences.

Eating Disorders in Youth with Chronic Health Conditions: Clinical Strategies for Early Recognition and Prevention

Youth with chronic health conditions face an elevated risk of eating disorders and disordered eating behaviors. Contributors to this phenomenon may include the unique threats faced by this vulnerable population to their body image, their relationships with food and eating, and their mental health and self-esteem. However, youth with chronic health conditions may also experience more severe medical complications and mortality from eating disorder behaviors because of the additional risks conveyed by their underlying conditions. In this review, clinical strategies are provided to support youth with chronic health conditions through early recognition of eating disorder behaviors and prompt referral to treatment, which is important for a better prognosis. Suggestions are also given to mitigate their risk of developing eating disorders by proactively addressing risk factors and offering thoughtful anticipatory guidance that promotes a positive relationship with food and eating.