Does Social Media Drive Eating Disorders?
Although social media is a relatively new phenomenon — Facebook isn’t yet 20 years old — it is now an integral part of the daily life of more than 80% of Americans. Like other media sources, the information shared on social media platforms can have a significant influence on a person’s thoughts, feelings, behaviors, and overall mental health and wellbeing. That’s especially true when it comes to self-image, self-esteem, and a person’s relationship with food. This begs the question: Does social media drive eating disorders?
Social Comparison and Eating Disorders: A Complicated Relationship
Before the 20th century, Americans had a relatively small community of neighbors and friends within their spheres of social influence. The latest information took longer to filter through to the general population. The media, though, brought new ideas — and ideals — into American homes. Readers and viewers now knew what other people were wearing, going, doing, watching, and enjoying, and pressures to “keep up with the Joneses” increased, even when the “Joneses” weren’t anything like themselves. This influence and subsequent persuasion were evident in the way people, especially women, saw themselves in comparison to the body weight, body shape, and physical appearance of those featured in newspapers, magazines, and television.
In a study published in 2004 (incidentally, the same year Mark Zuckerburg launched Facebook from his Harvard dorm room), researchers concluded that the media played a significant role in the development of eating and food-related disorders. They found “plenty of evidence demonstrating that the media glorify slenderness and weight loss and emphasize the importance of beauty and appearances.” This evidence, researchers added, supported their conclusion that “exposure to slender media images of women and perceived pressure from the media to be thin negatively affects female body image and emotional wellbeing.” Additionally, it has a “significant negative impact on body satisfaction, weight preoccupation, eating patterns, and the emotional wellbeing of women in the western culture.”
Today, the popularity and pervasiveness of social networking sites have made these “slender media images” difficult to escape, and the pressures on people to look a certain way seems to have increased. Additional factors have emerged, too. First, the audience for social media is much younger than it was for traditional media. A 2018 CNN Health poll found that about 56% of United States adolescents had accounts on at least one social media platform, and the average age for adding their first account was 12. By young adulthood, more than 90% of Americans will be actively using an average of seven social networking sites daily. According to Johns Hopkins Medicine, the most common age of onset of an eating disorder is between 12 and 25.
What is an eating disorder?
The American Psychiatric Association (APA) defines eating disorders as “illnesses in which the people experience severe disturbances in their eating behaviors and related thoughts and emotions.” Eating disorders are both a medical condition and a mental health condition. They often occur with other mental disorders like anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and substance use disorders.
The most common types of eating disorders are anorexia nervosa, bulimia, and binge-eating disorder.
Anorexia, according to the APA, is characterized by limited food intake, an intense fear of “being fat,” problems with body self-image, and denial of low body weight. The condition is diagnosed when patients weigh at least 15% less than the recommended body weight for their height.
Bulimia patients are also obsessed with being overweight, but their actual weight can range from slightly below average weight to overweight or obese. Instead of not eating like anorexia patients, bulimia patients will binge on large amounts of food frequently. After binge eating, a person with bulimia will attempt to purge their bodies of the food through vigorous exercise, using laxatives, or inducing vomiting to “counteract” their behavior.
Binge eating disorder includes similar thoughts about self-image and binge behaviors with large amounts of food, but without the attempts to get rid of the food through purging.
Other less common eating or food-related disorders include avoidant restrictive food intake disorder, or ARFID (dramatic weight loss accompanied by rapidly worsening picky eating), PICA (persistently eating non-food substances), rumination disorder (repeated regurgitation of food).
The implications of an eating disorder to a person’s physical health can be tremendous, and the most severe cases may result in death. Eating disorders have the highest mortality rate of any mental illness. Sometimes, though, it’s difficult for family and friends to detect the symptoms of an eating disorder in a loved one because their eating or purging behaviors usually take place in private, and the emotional and mental symptoms happen gradually. However, at least 30 million people in the United States are currently suffering from an eating disorder. And even though most people think eating disorders impact only young women or people in their teen years, this condition is shared among all ages and genders.
Social Media and the Development of Eating Disorders
The National Alliance on Mental Illness (NAMI) calls eating disorders a “very complex” condition, citing experts’ beliefs that food-related disorders like anorexia nervosa, bulimia, and binge-eating disorder (BED) are caused by “people attempting to cope with overwhelming feelings and painful emotions by controlling food.” There is no exact cause of eating disorders. They may be spurred by a multitude of factors, including genetics, cultural pressures, emotional health, and peer pressure. Media, social media, and the people within someone’s in-person and online social networks can play a significant role in three of those four circumstances.
Cultural pressures: Image-driven social media platforms like Facebook, Instagram, YouTube, Tik Tok, and Snapchat subject followers to a virtually endless stream of photos, videos, and messaging demonstrating supposed (yet often unrealistic) ideals of beauty, body shape, weight, diet, and weight loss. In most cases, people or companies who post this content associate these outcomes with happiness, popularity, or success.
Emotional health: Emotional and mental health problems like impulsive behavior or major depression, or personality tendencies like perfectionism, self-doubt, or low self-esteem can be underlying causes of food-related disorders. For someone with a real issue, posts about dieting, workouts, or unrealistic body size on social media can easily trigger disordered eating behaviors like excessive exercise or binge eating.
Peer pressure: The opinions of friends and family members can have a significant impact on a person’s thoughts, feelings, and behaviors. These voices can be an even more powerful force during the formative years of adolescence and early adulthood. Cyberbullying is an ugly and unfortunate offshoot of social media sites. This kind of bullying is often directed at a person’s appearance. According to the National Eating Disorders Association, as many as 65% of people with food-related disorders in the United States say bullying contributed to their condition.
Like the 2004 study of the effect of media on eating and food-related disorders, several recent research efforts have confirmed the same correlation with social media content. In 2011, the University of Haifa’s study of 248 girls aged 12 to 19 found that the “more time adolescent girls spend in front of Facebook, the more their chances of developing a negative body image and various eating disorders, such as anorexia, bulimia, and exaggerated dieting.”
A 2007 study published by the National Institutes of Health included 1765 participants aged 19 to 32 years and measured eating concerns and the use of social media sites (both volume and frequency). “Eating concerns” were defined as body dissatisfaction, negative or altered body image, and disordered eating in addition to diagnosed eating or feeding disorders. The results indicated a “strong and consistent association between social media use and eating concerns.”
Protecting Your Physical and Mental Health
These findings may be alarming, but they don’t necessarily mean that you should log off of all of your social media sites or delete every mobile app. There are a variety of ways you can escape the adverse effects of social media without abandoning your social networks.
Greta Gliessner, licensed clinical social worker and founder of Eating Disorder Recovery Specialists, suggests using social networks for empowerment by unplugging, unfollowing, and unwinding. She recommends engaging in activities that don’t involve a computer or mobile device, like going outside, calling a friend, or practicing meditation.
Ms. Gliessner also suggests unfollowing individuals who seem obsessed with appearance, food, or exercise, and blocking social media users who engage in body shaming. Lastly, she says unwinding, like replacing time on social media sites with mindfulness techniques or cooking healthy meals, allows you to live in the present moment and “release yourself from the stress caused by the digital world.”
Another option to counteract the potential eating-related mental health problems associated with popular social media sites is to use them as a place to promote positive change. Instead of altering your selfies or images to present an unrealistic version of yourself or your activities, share the real unfiltered you, curves and all. Post an inspirational message about acceptance, encouragement, and positive self-image. Join one of the many support groups on social media that support people struggling with food-related disorders or one that works to counteract cyberbullying. With the rapidly evolving digital world, there will always be new ways to make a positive difference with the very social media sites that could otherwise do so much harm.
Starting the Mental Health Recovery Process
Caring for your mental health is imperative if you’re dealing with an eating-related disorder. The National Institute of Mental Health (NIMH) suggests seeking mental health treatment early, even if you haven’t yet been diagnosed with a mental health condition or an eating disorder. A mental health professional can create a treatment plan to address your specific individual needs.
The most effective treatment plans for eating disorders will include a combination of psychotherapy, medical care and monitoring, nutritional counseling, and medications. Cognitive-behavioral therapy (CBT) and Dialectical Behavior Therapy (DBT) are some of the most promising psychotherapy approaches clinicians can use to improve the mental health of patients with eating-related disorders. CBT helps a person identify harmful or inaccurate thoughts and beliefs that lead to their unhelpful behavior. With a patient struggling with an eating or mental disorder stemming from cultural pressures on popular social media sites, for example, a therapist would use CBT to help them understand that the images that are influencing these feelings aren’t real. They may show real people, but they often aren’t authentic and shouldn’t be held up as an ideal for everyone else. DBT aids people to develop strengths as they cope with emotional ups and downs that do not involve disordered food or eating behaviors.
The first step to overcoming any mental health concern, whether it’s an eating disorder like binge eating or anorexia, substance abuse disorder, anxiety disorder, or major depression, is to find a therapist with whom you’re comfortable. Although we do not currently have eating disorder specialists in our practice, The Therapy Group of NYC can help you to find teletherapy and other treatment options for you to explore. There’s no time like the present to get to great mental health.