Understanding social, genetic and environmental risk factors across eating disorders

Social media offers constant opportunities for individuals to compare themselves
to idealised, filtered, and airbrushed versions of people every day. Perhaps it is no surprise then, that use of the social
media platform Facebook is associated with both disordered eating1 and with body image concern2
, with longitudinal
studies indicating that these effects can last up to 18 months3
. Interestingly, one study found that, whilst time spent on
Facebook was not associated with concern over body image and disordered eating, engagement with photo-based
activities on Facebook was4
. This finding, coupled with the discovery that pictures are remembered better than words5
,
means it is vital to explore the effects of the lesser-studied, image-based Instagram on the development of eating
disorders. Indeed, Instagram is the fasting growing social network in the world6 and is most linked to the 'healthy eating
movement'7
, thus it may have played a key role in the recent rise in eating disorders.
To indicate the extent of the food-and-exercise-obsessed nature of Instagram posts, at the time of writing, there
are 62.3 million #fitspo ('fitspiration') posts, 42.4 million #cleaneating posts and 23.9 million #wellness posts. The
pervasive nature of these posts is concerning, given that analyses of photos under the tag #fitspiration revealed an
overwhelming majority contained images of thin, toned women, all in line with current sociocultural trends of beauty8
.
This limited and narrow-minded view of what 'fit' looks like suggests that being in a larger body is not compatible with
being fit, and thus undermines #fitspiration's promise to promote health and fitness. Instead, it is not much better than its
more damaging counterpart #thinspiration; arguably, both serve to promote thinness.
The consequences of such posts have been investigated. Social media, unlike mass media, enables viewers to
participate both actively and passively, and links between both forms of participation and health-related behaviours have
been identified. A significant relationship was discovered between time spent consuming images on Instagram, i.e.
passive participation, and orthorexia nervosa9 (an eating disorder that has symptoms that overlap with anorexia nervosa).
In comparison, no association was found with Facebook, Pinterest, and Tumblr, and Twitter actually showed a small
protective effect. Further, previous research indicates that posting 'fitspiration' images on Instagram, i.e. active
participation, is associated with disordered eating behaviours and compulsive exercise.10
Overall, I suggest this project takes the opportunity to examine the specific content participants consume on
Instagram and its link with eating disorder diagnosis, severity, and trajectory. For example, the number of 'fitspiration',
'clean eating' and 'wellness' accounts an individual follows could be viewed as both a potential social risk factor and a
health seeking behaviour. Participants could be asked to report the proportion of accounts they follow that are dedicated
to such domains, and its association with eating disorder severity could be examined. The self-report nature of this
example and the difficulties associated with its reliability could be addressed through a verification process of a sample of
accounts. This research is crucial if we are to create methods to mitigate individual risk of eating disorders.