Social media and eating disorder psychopathology: A systematic review



The relationship between socialization through social media (SM) and eating disorders (EDs) is a serious problem for public health, largely affecting the mental health of younger people. This work aimed to identify scientific works addressing ED psychopathologies, studying their relationship with SM usage. In this systematic review, we analyze the available scientific evidence, thereby providing tools for intervention, prevention, and treatment. A systematic review and PRISMA analysis of narrative syntheses was carried out. Works were selected from the databases of Web of Science, Scopus, PubMed, and PsycINFO. Out of a total of 257 references, 19 articles were identified and selected; among them, correlational studies predominated. A growing interest in the subject matter was identified, as it is undergoing constant changes. The investigations found that EDs and SM usage are influenced by the time spent on SM, the type of interactions, and shared photographs, as well as gender and sociocultural context.

Systematic review, eating disorder psychopathology, social media, anorexia, bulimia

American Academy of Pediatrics. (2003). Identifying and treating eating disorders. Pediatrics, 111(1), 204–211.

American Academy of Pediatrics. (2016). Media and young minds. Pediatrics, 138(5), Article e20162591.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.

Anderson, C. B., & Bulik, C. M. (2004). Gender differences in compensatory behaviors, weight and shape salience, and drive for thinness. Eating Behaviors, 5(1), 1–11.

Becker, A. E., Fay, K. E., Agnew-Blais, J., Khan, A. N., Striegel-Moore, R. H., & Gilman, S. E. (2011). Social network media exposure and adolescent eating pathology in Fiji. The British Journal of Psychiatry, 198(1), 43–50.

Ben-Tovim, D. I., & Walker, M. K. (1991). The development of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new measure of women's attitudes towards their own bodies. Psychological Medicine, 21(3), 775–784.

Black, D. W., & Grant, J. E. (2014). DSM-5® guidebook: The essential companion to the diagnostic and statistical manual of mental disorders. American Psychiatric Publishing, Inc.

Blood, S. K. (2005). Body work: The social construction of women’s body image. Routledge.

Brichacek, A., Neill, J., & Murray, K. (2018). The effect of basic psychological needs and exposure to idealised Facebook images on university students’ body satisfaction. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 12(3), Article 2.

Briggs, J. (2020) JBI’s critical appraisal tools assist in assessing the trustworthiness, relevance and results of published papers. Retrieved March 3, 2020, from

Brotsky, S. R., & Giles, D. (2007). Inside the “pro-ana” community: A covert online participant observation. Eating Disorders, 15(2), 93–109.

Butkowski, C. P., Dixon, T. L., & Weeks, K. (2019). Body surveillance on Instagram: Examining the role of selfie feedback investment in young adult women’s body image concerns. Sex Roles, 81(5–6), 385–397.

Carter A., Forrest J. I., Kaida A. (2017). Association between Internet use and body dissatisfaction among young females: Cross-sectional analysis of the Canadian Community Health Survey. Journal of Medical Internet Research, 19(2), Article e39.

Chesney, E., Goodwin, G. M., & Fazel, S. (2014). Risks of all‐cause and suicide mortality in mental disorders: A meta‐review. World Psychiatry, 13(2), 153–160.

Clark, J. L., Algoe, S. B., & Green, M. C. (2018). Social network sites and well-being: The role of social connection. Current Directions in Psychological Science, 27(1), 32–37.

Cohen, R., Newton-John, T., & Slater, A. (2017). The relationship between Facebook and Instagram appearance-focused activities and body image concerns in young women. Body Image, 23, 183–187.

Eurostat. (2020). Individuals using the Internet for participating in social networks. Retrieved May 20, 2020, from

Fairburn, C. G. & Cooper, Z. (1993). The eating disorder examination. In C. G. Fairburn, & G. T. Wilson G. (Eds.), C.G. Binge eating: Nature, assessment, and treatment (pp. 317-360). Guilford Press.

Fairburn, C. G., Cooper, Z., & O’Connor, M. (1993). The eating disorder examination. International Journal of Eating Disorders, 6, 1–8.

Fallon, E. A., Harris, B. S., & Johnson, P. (2014). Prevalence of body dissatisfaction among a United States adult sample. Eating Behaviors, 15(1), 151–158.

Fardouly, J., Pinkus, R. T., & Vartanian, L. R. (2017). The impact of appearance comparisons made through social media, traditional media, and in person in women’s everyday lives. Body Image, 20, 31–39.

Ferguson, C. J., Muñoz, M. E., Garza, A., & Galindo, M. (2014). Concurrent and prospective analyses of peer, television and social media influences on body dissatisfaction, eating disorder symptoms and life satisfaction in adolescent girls. Journal of Youth and Adolescence, 43(1), 1–14.

Ferreira González, I., Urrútia, G., & Alonso-Coello, P. (2011). Systematic reviews and meta-analysis: Scientific rationale and interpretation. Revista Española de Cardiología, 64(8), 688–696.

Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117–140.

Frederick, D. A., Daniels, E. A., Bates, M. E., & Tylka, T. L. (2017). Exposure to thin-ideal media affect most, but not all, women: Results from the Perceived Effects of Media Exposure Scale and open-ended responses. Body Image, 23, 188–205.

Frederickson, B. L., & Roberts, T.-A. (1997). Objectification theory: Toward understanding women's lived experiences and mental health risks. Psychology of Women Quarterly, 21(2), 173–206.

Garner, D. M. (2004). Eating Disorder Inventory-3 (EDI-3): Professional manual. Psychological Assessment Resources.

Garner, D. M., Olmsted, M. P., Bohr, Y. & Garfinkel, P. E. (1982). The eating attitudes test: Psychometric features and clinical correlates. Psychological Medicine, 12(4), 871–878.

Gavin, J., Rodham, K., & Poyer, H. (2008). The presentation of “pro-anorexia” in online group interactions. Qualitative Health Research, 18(3), 325-333.

Goldstein, A., & Gvion, Y. (2019). Socio-demographic and psychological risk factors for suicidal behavior among individuals with anorexia and bulimia nervosa: A systematic review. Journal of Affective Disorders, 245, 1149–1167.

Grabe, S., Ward, L. M., & Hyde, J. S. (2008). The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychological Bulletin, 134(3), 460–476.

Griffiths, S., Murray S. B., Krug I., & McLean S. A. (2018). The contribution of social media to body dissatisfaction, eating disorder symptoms, and anabolic steroid use among sexual minority men. Cyberpsychology, Behavior, and Social Networking, 21(3), 149–156.

Grogan, S. (2016). Body image: Understanding body dissatisfaction in men, women and children. Routledge.

Gruzd, A., Jacobson, J., Mai, P., & Dubois, E. (2018). The state of social media in Canada 2017 (Version 1.0). Ryerson University Social Media Lab.

Gündüz, U. (2017). The effect of social media on identity construction. Mediterranean Journal of Social Sciences, 8(5), 85–85.

Hendrickse, J., Arpan, L. M., Clayton, R. B., & Ridgway, J. L. (2017). Instagram and college women's body image: Investigating the roles of appearance-related comparisons and intrasexual competition. Computers in Human Behavior, 74, 92–100.

Hilbert, A., Pike, K. M., Goldschmidt, A. B., Wilfley, D. E., Fairburn, C. G., Dohm, F.-A., Walsh, B. T. & Weissman, R. S. (2014). Risk factors across the eating disorders. Psychiatry Research, 220(1–2), 500–506.

Hogue, J. V., & Mills, J. S. (2019). The effects of active social media engagement with peers on body image in young women. Body Image, 28, 1–5.

Holland, G., & Tiggemann, M. (2016). A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image, 17, 100–110.

Horton, D. & Wohl, R. R. (1956). Mass communication and para-social interaction: Observations on intimacy at a distance. Psychiatry, 19(3), 215–229.

Hou, Y., Xiong, D., Jiang, T., Song, L., & Wang, Q. (2019). Social media addiction: Its impact, mediation, and intervention. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 13(1), Article 4

Howard, L. M., Heron, K. E., MacIntyre, R. I., Myers, T. A., & Everhart, R. S. (2017). Is use of social networking sites associated with young women’s body dissatisfaction and disordered eating? A look at Black–White racial differences. Body Image, 23, 109–113.

Hummel, A. C., & Smith, A. R. (2015). Ask and you shall receive: Desire and receipt of feedback via Facebook predicts disordered eating concerns. International Journal of Eating Disorders, 48(4), 436–442.

Jin, S. V. (2018). Interactive effects of Instagram foodies' hashtagged #foodporn and peer users' eating disorder on eating intention, envy, parasocial interaction, and online friendship. Cyberpsychology, Behavior, and Social Networking, 21(3), 157–167.

Kaewpradub, N., Kiatrungrit, K., Hongsanguansri, S., & Pavasuthipaisit, C. (2017). Association among Internet usage, body image and eating behaviors of secondary school students. Shanghai Archives of Psychiatry, 29(4), 208–217.

Keski-Rahkonen, A., & Mustelin, L. (2016). Epidemiology of eating disorders in Europe: Prevalence, incidence, comorbidity, course, consequences, and risk factors. Current Opinion in Psychiatry, 29(6), 340–345.

Kim, M. (2020). Instagram selfie-posting and young women’s body dissatisfaction: Investigating the role of self-esteem and need for popularity. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 14(4), Article 4.

Kwon, M. (2020) Media influences on body image & eating behaviors in adolescents. In Y. N. Evans & A. Dixon Docter (Eds.), Adolescent nutrition (pp. 177–235). Springer.

Lewinsohn, P. M., Seeley, J. R., Moerk, K. C., & Striegel‐Moore, R. H. (2002). Gender differences in eating disorder symptoms in young adults. International Journal of Eating Disorders, 32(4), 426–440.

Ljungberg, T., Bondza, E., & Lethin, C. (2020). Evidence of the importance of dietary habits regarding depressive symptoms and depression. International Journal of Environmental Research and Public Health, 17(5), Article 1616.

Loth, K. A., MacLehose, R., Bucchianeri, M., Crow, S., & Neumark-Sztainer, D. (2014). Predictors of dieting and disordered eating behaviors from adolescence to young adulthood. Journal of Adolescent Health, 55(5), 705–712.

Mabe, A. G., Forney, K. J., & Keel, P. K. (2014). Do you “like” my photo? Facebook use maintains eating disorder risk. International Journal of Eating Disorders, 47(5), 516–523.

McCormack, A., & Coulson, N. S. (2009). Individuals with eating disorders and the use of online support groups as a form of social support. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 3(2), Article 5.

Meier, E. P., & Gray, J. (2014). Facebook photo activity associated with body image disturbance in adolescent girls. Cyberpsychology, Behavior, and Social Networking, 17(4), 199–206.

Mills, J. S., Musto, S., Williams, L., & Tiggemann, M. (2018). “Selfie” harm: Effects on mood and body image in young women. Body Image, 27, 86–92.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Journal of Clinical Epidemiology, 62(10), 1006–1012.

Morgan, J. F., Reid, F., & Lacey, J. H. (1999). The SCOFF questionnaire: Assessment of a new screening tool for eating disorders. BMJ, 319(7223), 1467–1468.

Morgan, R. L., Whaley, P., Thayer, K. A. & Schünemann, H. J. (2018). Identifying the PECO: A framework for formulating good questions to explore the association of environmental and other exposures with health outcomes. Environment International, 121(Part 1), 1027–1031.

Murray, M., Maras, D., & Goldfield, G. S. (2016). Excessive time on social networking sites and disordered eating behaviors among undergraduate students: Appearance and weight esteem as mediating pathways. Cyberpsychology, Behavior, and Social Networking, 19(12), 709–715.

Napolitano, F., Bencivenga, F., Pompili, E., & Angelillo, I. F. (2019). Assessment of knowledge, attitudes, and behaviors toward eating disorders among adolescents in Italy. International Journal of Environmental Research and Public Health, 16(8), Article 1448.

Pantic, I. (2014). Online social networking and mental health. Cyberpsychology, Behavior, and Social Networking, 17(10), 652–657.

Pertegal-Vega, M. Á., Oliva-Delgado, A., & Rodríguez-Meirinhos, A. (2019). Systematic review of the current state of research on Online Social Networks: Taxonomy on experience of use. Comunicar, 27(60), 81–91.

Pew Research Center. (2019). Social Media Fact Sheet. Retrieved January 4, 2020 from

Pike, K. M., & Dunne, P. E. (2015). The rise of eating disorders in Asia: A review. Journal of Eating Disorders, 3, Article 33.

Probst, M., Vandereycken, W., Van Coppenolle, H., & Vanderlinden, J. (1995). The Body Attitude Test for patients with an eating disorder: Psychometric characteristics of a new questionnaire. Eating Disorders, 3(2), 133–144.

Quick, V. M., & Byrd-Bredbenner, C. (2014). Disordered eating, socio-cultural media influencers, body image, and psychological factors among a racially/ethnically diverse population of college women. Eating Behaviors, 15(1), 37–41.

Quiroz, S. I., & Mickelson, K. D. (2021). Are online behaviors damaging our in-person connections? Passive versus active social media use on romantic relationships. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 15(1), Article 1.

Rodgers, R. F. (2016). The relationship between body image concerns, eating disorders and internet use, part II: An integrated theoretical model. Adolescent Research Review, 1, 121–137.

Santarossa, S., & Woodruff, S. J. (2017). # SocialMedia: Exploring the relationship of social networking sites on body image, self-esteem, and eating disorders. Social Media+ Society, 3(2).

Saunders, J. F., & Eaton, A. A. (2018). Snaps, selfies, and shares: How three popular social media platforms contribute to the sociocultural model of disordered eating among young women. Cyberpsychology, Behavior, and Social Networking, 21(6), 343–354.

Schaumberg, K., Welch, E., Breithaupt, L., Hübel, C., Baker, J. H., Munn‐Chernoff, M. A., Yilmaz Z., Ehrlich, S., Mustelin, L., Ghaderi, A., Hardaway, A., Bulik-Sullivan, E. C., Hedman, A. M., Jangmo, A., Nilsson, I. A. K., Wiklund, C., Yao, S., Seidel, M., & Bulik, C. M. (2017). The science behind the Academy for Eating Disorders' nine truths about eating disorders. European Eating Disorders Review, 25(6), 432–450.

Schilder, P. (1950). The image and appearance of the human body. International Universities Press.

Slater, A., & Tiggemann, M. (2015). Media exposure, extracurricular activities, and appearance-related comments as predictors of female adolescents’ self-objectification. Psychology of Women Quarterly, 39(3), 375–389.

Šmahelová, M., Čevelíček, M., Nehybková, E., Šmahel, D., & Čermák, I. (2019). Is it important to talk about technologies with eating disorder clients? The health-care professional perspective. Health Communication, 34(1), 31–38.

Soh, N. L.-W., & Walter, G. (2013). Publications on cross-cultural aspects of eating disorders. Journal of Eating Disorders, 1, Article 4.

Sowles, S. J., McLeary, M., Optican, A., Cahn, E., Krauss, M. J., Fitzsimmons-Craft, E. E., Wifley, D. E., & Cavazos-Rehg, P. A. (2018). A content analysis of an online pro-eating disorder community on Reddit. Body Image, 24, 137–144.

Statista. (2020). The statistics portal. Web site: Número mundial de usuarios de redes sociales 2016–2021. Retrieved January 7, 2020, from

Statista. (2021). The statistics portal. Global social network penetration rate as of January 2021, by region. Retrieved March 8, 2021, from

Stice, E., Marti, C. N., & Durant, S. (2011). Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behaviour Research and Therapy, 49(10), 622–627.

Tan, T., Kuek, A., Goh, S. E., Lee, E. L., & Kwok, V. (2016). Internet and smartphone application usage in eating disorders: A descriptive study in Singapore. Asian Journal of Psychiatry, 19, 50–55.

Tao, X., Huang, W., Mu, X., & Xie, H. (2016). Special issue on knowledge management of web social media. Web Intelligence, 14(4), 273–274.

Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the Bulimia Test: The BULIT—R. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(1), 119–124.

Thompson, J. K., Burke, N. L., & Krawczyk, R. (2012) Measurement of body image in adolescence and adulthood. In T. F. Cash (Ed.), Encyclopedia of body image and human appearance (pp. 512–520). Academic Press.

Tiggemann, M., Hayden, S., Brown, Z., & Veldhuis, J. (2018). The effect of Instagram “likes” on women’s social comparison and body dissatisfaction. Body Image, 26, 90–97.

Tiggemann, M., & Slater, A. (2014). NetTweens: The Internet and body image concerns in preteenage girls. The Journal of Early Adolescence, 34(5), 606–620.

Tiggemann, M., & Slater, A. (2017). Facebook and body image concern in adolescent girls: A prospective study. International Journal of Eating Disorders, 50(1), 80–83.

Tiggemann, M., Slater, A., Bury, B., Hawkins, K., & Firth, B. (2013). Disclaimer labels on fashion magazine advertisements: Effects on social comparison and body dissatisfaction. Body Image, 10(1), 45–53.

van den Berg, P., Thompson, J. K., Obremski-Brandon, K., & Coovert, M. (2002). The tripartite influence model of body image and eating disturbance: A covariance structure modeling investigation testing the mediational role of appearance comparison. Journal of Psychosomatic Research, 53(5), 1007–1020.

Walker, M., Thornton, L., De Choudhury, M., Teevan, J., Bulik, C. M., Levinson, C. A., & Zerwas, S. (2015). Facebook use and disordered eating in college-aged women. Journal of Adolescent Health, 57(2), 157–163.

Westmoreland, P., Krantz, M. J., & Mehler, P. S. (2016). Medical complications of anorexia nervosa and bulimia. The American Journal of Medicine, 129(1), 30–37.

Worell, J., & Todd, J. (1996). Development of the gendered self. In L. Smolak, R. H. Striegel-Moore, & M. P. Levine, (Eds.), The developmental psychopathology of eating disorders: Implications for research, prevention, and treatment (pp. 135–156.). Routledge.

World Health Organization. (2019). Press release adolescent mental health.

Yan, Y., & Bissell, K. (2014). The globalization of beauty: How is ideal beauty influenced by globally published fashion and beauty magazines? Journal of Intercultural Communication Research, 43(3), 194–214.

Yellowlees, R., Dingemans, A. E., Veldhuis, J., & de Vaate, A. J. D. B. (2019). Face Yourself(ie): Investigating selfie-behavior in females with severe eating disorder symptoms. Computers in Human Behavior, 101, 77–83.





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