Anyone who’s ever scrolled through social media (approximately 3.5 billion people) is likely aware that much of the content on platforms like Facebook, Instagram, and TikTok can be problematic or triggering to anyone struggling with body image let alone an eating disorder. But it wasn’t until this October of this year that the public confronted the fact that not only are these platforms failing to crack down on accounts with harmful, often extreme dieting and body image content — they’re actively promoting them, according to insiders.
Frances Haugen, a former product manager at Facebook who has become known as the “Facebook whistleblower” gathered internal documents from the company that indicate 13.5% of teen girls said Instagram makes thoughts of suicide worse, and 17% said Instagram makes eating disorders worse. "What's super tragic is Facebook's own research says as these young women begin to consume this eating disorder content, they get more and more depressed. It actually makes them use the app more," Haugen said. "They end up in this feedback cycle where they hate their bodies more and more."
The revelations were harrowing, but the findings aren’t exactly new — researchers have long-known that social media has a harmful, negative, and preventable impact on young people. In a 2006 paper titled “Body Image, Media, and Eating Disorders,” researchers examined changes in the “ideal” female body type over time and concluded that “throughout history, the ideal of beauty has been difficult to achieve and has been shaped by social context. Current mass media is ubiquitous and powerful, leading to increased body dissatisfaction”.
Jennifer Derenne MD, the study’s lead author and Equip’s senior psychiatric medical director, says she was interested in how current events shape ideal standards of beauty throughout time, and the first paper she wrote on the topic went on to become one of Academic Psychiatry’s most downloaded articles, so she was asked to update it ten years later. “It was really eye-opening to see the ways in which things had changed in that time — particularly with the widespread availability of social media platforms.”
As Derenne details in her updated paper, “the Internet remains the major source of health information for the vast majority of people, yet the information is not always accurate or regulated.” In addition to “self-proclaimed gurus touting the latest weight loss and exercise gimmicks,” social media users may also encounter “more blatantly pro-eating disorder messages and communities” that are difficult to moderate or shut down, despite efforts by Facebook and Instagram to filter and flag pro-eating disorder content.
“It is infuriating for me to learn that these companies know that the algorithms steer people to misleading and unhealthy content,” Derenne says. “At the same time, I appreciate the dilemma of not wanting to censor content. I’m hopeful that they’ll pivot and approach body image, eating disorders, and dieting content in the same manner that they use to approach suicidality and self-harm.”
Gillian Klein knows that social media is made up of many “split second depictions” of peoples’ lives — depictions that are often posed and edited. ”Given the time spent scrolling on these mass communication platforms, the underlying messages these images transmit manifest into our reality. Layer on the addition of likes and comments, which only feed our ideas of what’s ‘in’ or ‘accepted’ and suddenly the voice of an eating disorder is being hand-fed ‘facts’ to fight your voice of reason.”
Klein says social media — specifically Pinterest — is initially what piqued her interest in dieting. “I recall coming across colorful displays of low-sugar, no-carb diets claiming they were the solution,” she says. “Solution to what? That I did not know, but apparently they were the solution to a problem I’d not known existed.”
As a result of social media scrolling, Klein says weight loss practices and overexercise became integral habit’s in her daily life -“habits that were only further ingrained and encouraged with the posts I saw on my feed,” she adds. “I unintentionally created through my feed a world in which my ED could thrive”.
Dr. Derenne says she believes it’s important to consider subtlety and nuance when evaluating the effects of social media on eating disorders. “We are all exposed to media on a daily basis, but we don’t all develop eating disorders,” she says. “There really seems to be a ‘perfect storm’ of factors, including temperament, genetic vulnerability, co-occurring mental health conditions, and environmental or societal factors that contribute.”
But even with that ‘perfect storm’ in mind, Derenne says the media plays an undeniable role in the development of body image ideals and self perception. “I love the Becker Fiji study that illustrates the qualitative differences in body image resulted from television being introduced to the island between 1995 and 1998. It is really compelling — many of the people she spoke to did not have body image concerns until they were confronted with images of thin (usually white) television stars.” All of this, however, came before the advent and proliferation of social media and the landscape of influence we know today.
Derenne says the revelations are fascinating and has heard multiple people refer to this as social media’s ‘Big Tobacco’ moment, meaning many of the industry’s nefarious truths are coming to light in a major way.
“Most people were in agreement that smoking is not good for you and can lead to lung cancer, so it should not be marketed to young people and should be regulated,” Derenne says. “Social media is ubiquitous, and the outages on Facebook [in October] illustrate how dependent many people are on these platforms for communication and commerce. Honestly, being connected this way has many health benefits — personally, I’ve loved keeping up with people I had lost touch with over the years and enjoy seeing photos of kids and vacations and life events. There have been studies showing that social media groups can actually be supportive and beneficial to recovery.”
Derenne believes that to move forward in the fight against problematic content, it’s important to recognize that social media isn’t going anywhere. “We will need to find ways to help young people hone their skills as savvy consumers of digital content,” she says. “My opinion is that it is ideal for parents to be curious about what their children are watching or scrolling from an early age, and that they watch things together and encourage open conversation about difficult topics. While restricting access to social media may be necessary when an individual is in the throes of an eating disorder, most people will interact in the digital space at some point in their lives and benefit from learning to do that in a safe and gradual manner.”
Through the lens of her own experience, Klein says she hopes increased awareness of the potential pitfalls and risks of social media may help mitigate some of its risks. “These mass communication platforms tell us about our values as we continue taking and editing pictures to fit what we believe will perform well,” she says. “For those of us suffering from, or in recovery from, disordered eating behaviors, such platforms become a tool in which we may subconsciously construct worlds that uphold the values ED tells us are important. Reflecting upon and altering how important certain values are to social acceptance isn’t going to eliminate eating disorders; however, it will ease the pressures that often influence the relationships we, as a society, have to body image, exercise, and food.”
1. Sidani, Jaime E et al. “The Association between Social Media Use and Eating Concerns among US Young Adults.” Journal of the Academy of Nutrition and Dietetics vol. 116,9 (2016): 1465-1472. doi:10.1016/j.jand.2016.03.021
2. Derenne, Jennifer L, and Eugene V Beresin. “Body image, media, and eating disorders.” Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry vol. 30,3 (2006): 257-61. doi:10.1176/appi.ap.30.3.257
3. Derenne, Jennifer, and Eugene Beresin. “Body Image, Media, and Eating Disorders-a 10-Year Update.” Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry vol. 42,1 (2018): 129-134. doi:10.1007/s40596-017-0832-z