By Katie Olson

Social media has completely changed the way we engage with each other. Social media platforms allow us to communicate with anyone, anywhere, as much as we want. Although the increased communication is a wonderful development, the constant interaction and comparison can be overwhelming.

Previous research has found that media use is associated with disordered eating symptoms, such as worry about losing control over eating.¹ A focus on body image has increased in this social media age, specifically on photo-based social media accounts, including Facebook and Instagram. Additional research has found that engagement with photo-based social media sites is associated with negative body image.² A recent study in the International Journal of Eating Disorders by Lonergan and colleagues³ investigated appearance-related social media behaviors, specifically the association between selfie behaviors and eating disorders. The authors hypothesized that selfie behaviors would be associated with increased odds of meeting diagnostic criteria for an eating disorder and that the association between selfie behaviors and eating disorder diagnosis would not differ by gender.

The sample included 4,209 Australian adolescents, ages 11-19, 53% of whom were girls. For the purpose of this study, selfies were defined as images of oneself taken by anyone. Adolescents were asked questions regarding four appearance-related selfie behaviors: avoidance of posting selfies, photo investment (amount of effort put into choosing a photo to post and the level of monitoring of responses to a posted photo), photo manipulation (editing photos of oneself before posting to social media), and investment in others’ selfies (the extent to which one examines another’s selfie, including monitoring the number of “likes” and comments it gets). Multiple questionnaires were used to measure nine eating disorder diagnoses: clinical/subclinical anorexia nervosa, clinical/subclinical bulimia nervosa, clinical/subclinical binge-eating disorder, night eating syndrome, purging disorder, and unspecified feeding or eating disorder.

Results supported the first hypothesis—all four selfie behaviors were associated with increased likelihood of meeting criteria for at least one eating disorder. Photo investment specifically was associated with increased likelihood of meeting criteria for all nine eating disorders. The second hypothesis, that there would be no gender differences, was generally supported. One exception was that boys who reported avoidance of posting selfies were more likely than girls to meet criteria for anorexia nervosa. However, since there were only fourteen boys who met criteria for anorexia nervosa, this finding should be interpreted with caution. 

Results of this study were consistent with previous eating disorder research, including the idea that determining self-worth primarily based on weight and shape is associated with disordered eating. Although overvaluation of weight and shape is a consistent feature of eating disorders, this study is one of the first to demonstrate how this overvaluation is experienced in social media. For example, avoidance of posting selfies can reflect the body avoidance seen in anorexia nervosa and bulimia nervosa. Likewise, scrutinizing the likes and comments a selfie receives is a social media manifestation of heightened preoccupation with physical appearance.

The authors encourage future research to take a longitudinal perspective to explore whether photo-based social media behaviors can predict the development of an eating disorder. They also encourage exploration of whether these sorts of social media behaviors are associated with added psychological distress and quality of life impairment in individuals with eating disorders. Given the amount of time many individuals spend on social media, clinicians should consider whether to engage in discussions about the role of social media on health and well-being as an important component to psychotherapy for eating disorders.

References

1. Peat, C. M., Von Holle, A., Watson, H., Huang, L., Thornton, L. M., Zhang, B., Du, S., Kleiman, S. C., & Bulik, C. M. (2015). The association between internet and television access and disordered eating in a Chinese sample. The International Journal of Eating Disorders, 48(6), 663–669. https://doi.org/10.1002/eat.

2. Fardouly, J., Willburger, B. K., & Vartanian, L. R. (2018). Instagram use and young women’s body image concerns and self-objectification: Testing mediational pathways. New Media & Society, 20(4), 1380–1395. https://doi.org/10.1177/1461444817694499

3. Lonergan, A. R., Bussey, K., Fardouly, J., Griffiths, S., Murray, S. B., Hay, P., Mond, J., Trompeter, N., & Mitchison, D. (2020). Protect me from my selfie: Examining the association between photo-based social media behaviors and self-reported eating disorders in adolescence. The International Journal of Eating Disorders, 10.1002/eat.23256. Advance online publication. https://doi.org/10.1002/eat.23256