Mounting research documents the harmful effects of social media use on mental health, including body image and development of eating disorders

Media influences and conventional beauty standards have long plagued society.

This issue took on new urgency in May 2023 when the U.S. surgeon general issued a major public advisory^[1] over the links between social media and youth mental health^[2].

Research shows that images of beauty as depicted in movies, television and magazines can lead to mental illness^[3], issues with disordered eating and body image dissatisfaction^[4].

These trends have been documented in women^[5] and men^[6], in the LGBTQ+ community^[7] and in people of different racial^[8] and ethnic backgrounds.

Experts have long suspected that social media may be playing a role in the growing mental health crisis in young people^[9]. However, the surgeon general’s warning is one of the first public warnings supported by robust research^[10].

Social media can be toxic

Body dissatisfaction among children and adolescents is commonplace and has been linked to^[11] decreased quality of life, worsened mood and unhealthy eating habits.

As an eating disorder and anxiety specialist^[12], I regularly work with clients who experience eating disorder symptoms, self-esteem issues and anxiety related to social media^[13].

I also have firsthand experience with this topic^[14]: I am 15 years post-recovery from an eating disorder, and I grew up when people were beginning to widely use social media. In my view, the impact of social media on diet and exercise patterns needs to be further researched to inform future policy directions, school programming and therapeutic treatment.

The mental health of adolescents and teens has been declining for the past decade^[15], and the COVID-19 pandemic contributed to worsening youth mental health^[16] and brought it into the spotlight. As the mental health crisis surges, researchers have been taking a close look at the role of social media^[17] in these increasing mental health concerns.

The pros and cons of social media

About 95% of children and adolescents in the U.S. between the ages of 10 and 17 are using social media almost constantly^[18].

Research has shown that social media can be beneficial^[19] for finding community support^[20]. However, studies have also shown that the use of social media contributes to social comparisons, unrealistic expectations and negative mental health effects^[21].

In addition, those who have preexisting mental health conditions^[22] tend to spend more time on social media. People in that category are more likely to self-objectify^[23] and internalize the thin body ideal^[24]. Women and people with preexisting body image concerns^[25] are more likely to feel worse about their bodies and themselves after they spend time on social media.

A breeding ground for eating disorders

A recent review found that, as with mass media, the use of social media is a risk factor for the development of an eating disorder^[26], body image dissatisfaction and disordered eating. In this review, social media use was shown to contribute to negative self-esteem, social comparisons, decreased emotional regulation and idealized self-presentation that negatively influenced body image.

Another study, called the Dove Self-Esteem Project^[27], published in April 2023, found that 9 in 10 children and adolescents ages 10 to 17 are exposed to toxic beauty content on social media and 1 in 2 say that this has an impact on their mental health.

Eating disorders are complex mental illnesses^[28] that develop because of biological, social and psychological factors. Eating disorder hospitalizations and the need for treatment have dramatically increased during the pandemic^[29].

Some reasons for this^[30] include isolation, food scarcity, boredom and social media content^[31] related to weight gain, such as the “quarantine15^[32].” That was a reference to the weight gain some people were experiencing at the beginning of the pandemic, similar to the “freshman 15” belief that one will gain 15 pounds in the first year of college. Many teens whose routines were disrupted by the pandemic turned to eating disorder behaviors for an often-false sense of control^[33] or were influenced by family members who held unhealthy beliefs around food and exercise.

Researchers have also found that increased time at home during the pandemic led to more social media use by young people^[34] and therefore more exposure to toxic body image and dieting social media content.

While social media alone will not cause eating disorders, societal beliefs about beauty^[35], which are amplified by social media, can contribute to the development of eating disorders.

‘Thinspo’ and ‘fitspo’

Toxic beauty standards online include the normalization of cosmetic and surgical procedures and pro-eating-disorder content, which promotes and romanticizes eating disorders. For instance, social media sites have promoted trends such as “thinspo,” which is focused on the thin ideal, and “fitspo,” which perpetuates the belief of there being a perfect body that can be achieved with dieting, supplements and excessive exercise.

Research has shown that social media content encouraging “clean eating^[36]” or dieting through pseudoscientific claims can lead to obsessive behavior around dietary patterns. These unfounded “wellness” posts can lead to weight cycling, yo-yo dieting^[37], chronic stress, body dissatisfaction and higher likelihood of muscular and thin-ideal internalization^[38].

Some social media posts feature pro-eating-disorder content^[39], which directly or indirectly encourages disordered eating. Other posts promote deliberate manipulation of one’s body, using harmful quotes such as “nothing tastes as good as thin feels.” These posts provide a false sense of connection, allowing users to bond over a shared goal of losing weight, altering one’s appearance and continuing patterns of disordered eating.

While young people can often recognize and understand^[40] toxic beauty advice’s effects on their self-esteem, they may still continue to engage with this content. This is in part because friends, influencers and social media algorithms^[41] encourage people^[42] to follow certain accounts.

How policy changes could help

Legislators across the U.S.^[43] are proposing different regulations for social media sites^[44].

Policy recommendations include increased transparency from social media companies, creation of higher standards of privacy for children’s data^[45] and possible tax incentives and social responsibility initiatives^[46] that would discourage companies and marketers from using altered photos.

Phone-free zones

Small steps at home to cut down on social media consumption can also make a difference. Parents and caregivers can create phone-free periods^[47] for the family. Examples of this include putting phones away while the family watches a movie together or during mealtimes.

Adults can also help by modeling healthy social media behaviors and encouraging children and adolescents to focus on building connections and engaging in valued activities^[48].

Mindful social media consumption is another helpful approach. This requires recognizing what one is feeling during social media scrolling. If spending time on social media makes you feel worse about yourself or seems to be causing mood changes in your child, it may be time to change how you or your child interact with social media.

References

1. ^{^} U.S. surgeon general issued a major public advisory (www.hhs.gov)
2. ^{^} links between social media and youth mental health (www.nytimes.com)
3. ^{^} can lead to mental illness (doi.org)
4. ^{^} body image dissatisfaction (doi.org)
5. ^{^} in women (doi.org)
6. ^{^} and men (doi.org)
7. ^{^} LGBTQ+ community (doi.org)
8. ^{^} people of different racial (www.hsph.harvard.edu)
9. ^{^} mental health crisis in young people (www.nytimes.com)
10. ^{^} public warnings supported by robust research (www.nytimes.com)
11. ^{^} has been linked to (doi.org)
12. ^{^} eating disorder and anxiety specialist (som.cuanschutz.edu)
13. ^{^} related to social media (news.cuanschutz.edu)
14. ^{^} have firsthand experience with this topic (doi.org)
15. ^{^} declining for the past decade (www.cdc.gov)
16. ^{^} COVID-19 pandemic contributed to worsening youth mental health (doi.org)
17. ^{^} close look at the role of social media (cuanschutz360.buzzsprout.com)
18. ^{^} using social media almost constantly (www.hhs.gov)
19. ^{^} social media can be beneficial (www.commonsensemedia.org)
20. ^{^} community support (doi.org)
21. ^{^} negative mental health effects (doi.org)
22. ^{^} preexisting mental health conditions (www.apa.org)
23. ^{^} self-objectify (doi.org)
24. ^{^} internalize the thin body ideal (doi.org)
25. ^{^} people with preexisting body image concerns (doi.org)
26. ^{^} the development of an eating disorder (doi.org)
27. ^{^} Dove Self-Esteem Project (www.dove.com)
28. ^{^} complex mental illnesses (theconversation.com)
29. ^{^} increased during the pandemic (doi.org)
30. ^{^} Some reasons for this (doi.org)
31. ^{^} social media content (doi.org)
32. ^{^} quarantine15 (doi.org)
33. ^{^} an often-false sense of control (doi.org)
34. ^{^} led to more social media use by young people (www.luriechildrens.org)
35. ^{^} societal beliefs about beauty (www.hsph.harvard.edu)
36. ^{^} social media content encouraging “clean eating (doi.org)
37. ^{^} can lead to weight cycling, yo-yo dieting (doi.org)
38. ^{^} muscular and thin-ideal internalization (doi.org)
39. ^{^} pro-eating-disorder content (doi.org)
40. ^{^} can often recognize and understand (www.dove.com)
41. ^{^} social media algorithms (doi.org)
42. ^{^} encourage people (doi.org)
43. ^{^} Legislators across the U.S. (scrippsnews.com)
44. ^{^} regulations for social media sites (www.pbs.org)
45. ^{^} privacy for children’s data (www.apa.org)
46. ^{^} possible tax incentives and social responsibility initiatives (doi.org)
47. ^{^} create phone-free periods (www.luriechildrens.org)
48. ^{^} on building connections and engaging in valued activities (www.dove.com)