Currently, the effects of social media on one’s mental health is heavily debated, especially its correlations to the rise in eating disorder cases worldwide. As of 2019, the prevalence of eating disorders has risen from 3.5 percent of the world population to 7.8 percent (“Body Image and Eating Disorders”). The most common age for eating disorder onset is 18-21 (Rehman), however, there has been a 42% rise in women over 35 seeking treatment (Howard), and a 119% rise in children under 12 in inpatient care for eating disorders (Pike), both in the last decade. Generally, the amount of inpatient admissions for treatment has more than doubled (“Body Image and Eating Disorders”). There are three most common types of eating disorders that will be discussed; anorexia nervosa, bulimia nervosa, and binge eating disorder. Anorexia is caused by a psychological rejection of food (Forgacs et al.), leading to a weight loss of 15-60% of the patient’s body weight (Zoltan). Individuals with Bulimia consume large amounts of food, then attempt to eliminate it by self-induced vomiting, otherwise known as purging (Forgacs et al.). These two variations of disordered eating are extremely dangerous since they often lead to the malnourishment of the body, which can cause dangerously low levels of blood pressure and in the worst cases, heart failure (Howard). Analogous to bulimia, in cases of binge eating disorders, large amounts of food are consumed during a “binge” often associated with feelings of guilt, but there is no behavior of purging afterward (Zoltan). BEDs can be related to obesity, equally as dangerous, and is also commonly referred to as a repeated and more extreme form of emotional eating. Although significantly more women struggle with disordered eating than men, the illness is often diagnosed much later in men and is, therefore, more deadly (Rehman). Additionally, BIPOC, people in the LGBTQ community, people with disabilities, people in larger bodies, athletes, veterans, substance abusers, people who have other mental illnesses, and people who have traumatic experiences are all more likely to develop eating disorders than the average woman (“Statistics and Research on Eating Disorders”) (“Eating Disorder Statistics”). The United States has 30 out of 70 million of the current reported cases globally, however, it is estimated that the actual number of total cases is much higher, especially in other countries, due to a lack of resources, treatment, and overwhelming stigma (“Body Image and Eating Disorders”). Over 70 percent of individuals who suffer from disordered eating do not seek treatment because of stigma (Pike).
The earliest documentation of eating disorders are ones of anorexia, from as early as the 1300s (Zoltan). These cases were later referred to as “holy anorexia”, a practice of self-starvation by female members of the clergy as a means of self-discipline and attempt to achieve spiritual and religious purity along with “independence from physical needs.” One particular saint, Catherine of Siena (1347-1380), said her anorexic behavior was a “look into [her]self to understand [her] infirmity and [the goodness of] God who by a most singular mercy allowed [her] to correct the vice of gluttony.” She viewed self-starvation and inability to eat as both a consequence of God for her sins and a method of redemption (Griffin and Berry). British Physician Sir William Whitney Gull (1816-1890) and French contemporary, Charles Lasègue (1816–1883) were the first to identify and record eating disorders as illnesses during the Victorian era. They observed acts of self-starvation in female teenage patients and as well as purging, which Lasègue then named “cynorexia” (Zoltan). Throughout this period, eating disorders became more prevalent due to the popular culture pressures of extreme femininity on women, both spiritually and physically. An emphasis was placed on the size of a woman’s waist, as slender waists appeared as a sign of illness, weakness, and etherealness, signs associated with angles. This suggested the femininity and spiritual purity of a woman. At this time, corsets were extremely common and used as a means of concealing the appetite. Victorian women also heavily regulated their diets due to a belief that self-control and placing the “body with constant conflict with the soul” were superior demonstrations of femininity (Silver 44-45, 48), which is distinctively similar ideologically to the pursuit of religious purity in practices of “holy anorexia”. In addition to corsets and food restriction, a new form of dieting was popularized; the tapeworm diet. Ingestion of intestinal parasites was a way to maintain a slender figure, but in many cases, ended fatally. In more recent years, during the 19th century, the influence of media became more prevalent, and food advertising grew common as food companies filled the gap mothers and housewives left after their contributions to the workforce. These corporations promoted unintuitive, unhealthy, eating habits and a dependence on artificially produced foods, causing a spike in obesity in the 1960s, accompanied by the popularization of beauty pageants and exceptionally thin and young models such as Twiggy as the beauty standard for women. Simultaneously, men also saw a surfacing of bodybuilding competitions and male models who were highly muscular with a similarly unattainable body shape. Many developed “muscle dysmorphia”, comparable to “body dysmorphia,” which causes an unhealthy fixation on muscular and bodily flaws, leading to a lack of self-confidence closely correlated with the development of eating disorders (Forgacs et al.). Despite evidence of negative and heavy impacts of media on the rise in eating disorders throughout history, research has also shown the influences of genetics, environment, and trauma.
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In present-day society, social media is universal and a substantial part of many people’s lives, especially those of adolescents. 95% of US teens have a smartphone. Globally, teens spend an average of 7 hours per day on screens, mainly consuming content on social media. Adolescents at this age are most prone to developing insecurities, low self-esteem, and anxiety due to high rates of media consumption and conflicting messages about the body. For instance, popular media idealizes a thin yet still curvy physique for women, and a lean and muscular build for men to a great extent. Such images of the socially desirable body are often digitally manipulated to make the subject match the “beauty standard”, however, this widespread practice creates unrealistic standards for women and men around the world. Movements to “break the beauty standards” have also emerged on a greater scale in recent years, spreading messages of body positivity such as; “beautiful at any size”, “eat what you want”, and “fat acceptance”. Despite these affirmations, this movement is seen as equally problematic by some as it reinforces beauty standards inadvertently. It boosts confidence momentarily, but beauty standards that have stood for centuries are not so easily ignored. Many studies show social media continues and will continue to kindle body dissatisfaction and eating disorders for all sexes of all ages (McBride et al.). In parallel, many of the Victorian ideologies of femininity were displayed in books, which in the present can be equated to social media, and categorized as media influence on body image and cultivation for disordered eating.
Experts recognize that claims of heavy media impact on eating disorders are highly methodological, and quantitative evidence with direct correlations are lacking. Such quantitative data regarding media and mental illnesses are incredibly difficult to obtain because external factors affect everyone to different extents. As a result, many studies rely on theories, principles, and inferences from professionals that could have biased opinions. Furthermore, different methods of data collection and analysis are utilized, making it difficult to form a general conclusion (Ferguson). The argument that social media does not play the most significant role in the development of disordered eating stands. Individuals with relatives suffering from anorexia nervosa are 4 times more likely to develop it themselves. Twin studies show the impact of genetics is up to 74% for anorexia, 62% for bulimia, 46% for binge eating disorders. Living environments can also play a role in the onset of eating disorders. Individuals vulnerable to obesity genetically who can easily access high-fat, high-carb foods, have increased risks of becoming overweight and binge eating. Likewise, individuals who live in an environment where thinness is highly valued are more prone to exhibiting behaviors of food restriction and weight control (Yilmaz et al.). Athletes, and individuals who identify as LGBTQ are similarly more susceptible to disordered eating because of stereotypes within the community to be a certain size (“Eating Disorder Statistics”). Evidence demonstrates the effects of traumatic and potentially traumatic events on eating disorders also debate the extent of media influence. Almost all patients with an eating disorder of any kind have experienced at least one event throughout their life that could be potentially traumatizing, according to a US study. The nature of mental illnesses related to eating also supports the theory of significant impacts of trauma. Binging and purging behaviors can be related to traumatic experiences and emotional distress. Binges, also known as emotional eating, can be soothing, stress-relieving, and can make problems temporarily forgotten, with effects comparable to alcohol or substances (Backholm et al.). Accordingly, patients with restrictive forms of eating often report a lack of control in their past regained by highly regulating their diet (Zoltan). A 2014 study enumerates this and revealed that 97% of those struggling with disordered eating have one or more other coexisting mental illnesses, such as anxiety, depression, PTSD, alcohol or substance abuse, borderline personality disorder, or OCD (“Statistics and Research on Eating Disorders”).
Although evidence is abundant on the correlations of genetics, environment, and trauma on eating disorders, it can be seen as lacking to reason the steady rise of cases globally. These factors have all existed throughout history, and should not impact the prevalence of mental illness more now than they did in the past, though it can be argued that decreasing stigma could cause the increase of reported cases and diagnoses. Media, on the other hand, can justify this rise to a greater extent due to its rapid popularization and commoditization.
The undeniable social costs of eating disorders are extremely substantial, taking one life every 52 minutes, which means it is the most deadly mental illness (Rehman). Individuals who suffer from disordered eating are also five times more likely to abuse substances, and 3 times more likely to self-harm, which can lead to an abundance of other health issues (“Statistics and Research on Eating Disorders”). Ten percent of patients will die within ten years of the onset of their disorder, either from suicide or other complications (“Body Image and Eating Disorders”). Despite the extremely dangerous nature of eating disorders, the rate of treatment is extremely low because of the huge influence of stigma. Only 70% of sufferers choose not to seek treatment due to stigma alone, and men, as well as larger individuals, are much less likely to receive a diagnosis, leading to an increased risk of mortality within these populations. Athletes are also a high-risk population because of stigma, but also their high levels of exercise (Rehman). Compulsive and excessive exercise is a strong marker of eating disorders frequently used to control weight. New subgroups like fatorexia, brideorexia, pregorexia, vigorexia, drunkorexia, stressorexia have evolved in recent years due to a general rise in cases (Forgacs et al.). Moreover, while eating disorders have been considered culturally bound illnesses only prevalent in countries with moderate to heavy Western influence and westernized beauty standards, there is an abundance of evidence that opposes this. Various diverse beauty standards, no matter where, influence people every day (Sharan and Sundar). In Africa, although rates of clinically diagnosed cases are low, more than 83% of adolescents express dissatisfaction with body image and weight. Many Asian countries have also reported rapidly rising rates of eating disorders, yet many struggle to find resources, treatment, or even official diagnoses due to stigma and lack of awareness on a large scale. A small population study in China and South Korea shows a prevalence higher than the United States (Pike and Dunne), which considering their populations, places the total number of eating disorder cases well above 70 million globally. Disordered eating is starting to target much younger individuals as well, and just below 25% of elementary students report active dieting, and even those who do not understand dieting yet express behaviors of weight control. However, dieting, especially at such a young age is extremely unhealthy, and those who do diet are more likely to binge, which can easily lead to a vicious cycle and develop into a serious eating disorder. Dieting also has various economic costs, though far less substantial to its social counterparts. An estimated 60 billion is spent on dieting and weight control products by Americans each year (“Statistics and Research on Eating Disorders”)
Many treatment methods have been developed throughout the years, such as psychotherapy, family-based therapy, and treatment centers dedicated to eating disorders. An emphasis has been placed not only on the treatment of disordered eating but coexisting mental illnesses that may simultaneously impact the patient. Nutritionists have developed informative diet plans, and physicians focus on resolving further health complications associated with disordered eating. One particular method of therapy is commonly utilized, called cognitive behavioral therapy. In this type of treatment, a focus is placed on helping the patient associate positive views of eating and weight that were previously considered negative or avoided, such as “fear foods” and weight gain in cases of anorexia and bulimia. In cases of binge eating disorders, the patient learns how to overcome difficult situations in a healthy manner without an over-involvement of food. Family-based therapy requires heavy involvement of the patient’s family and loved ones as assistance, and they are encouraged to face problems together. Eating disorders are often correlated with the internalization of fears, concerns, and emotions, thus the implementation of a support system has been proved to be highly effective and beneficial. Other procedures of treatments such as devices to regulate and stimulate magnetic waves in the areas of the brain which control eating behaviors have been researched, but are still in the early experimental stages and are not yet conclusive (“Body Image and Eating Disorders”). Despite various treatment methods, only 10% of those with eating disorders will seek and receive treatment, and only 60% of the 10% will make a full recovery (Rehman).
While eating disorders are becoming more and more of pressing concern, an adequate amount of research and funding has been dedicated in the United States specifically. In the Mental Health Parity Act of 1996, eating orders were categorized as a serious form of mental illness and deemed to receive equal health coverage, research, and funding as other medical and psychiatric conditions (“Statistics and Research on Eating Disorders”). However, stigma is still problematic among groups of the population and restricts many from seeking help. A large number of countries have yet to implement accessible forms of treatment, solutions, or even information regarding eating disorders. One example is Asia, where a significant amount of stigma is still a huge challenge for sufferers of any mental illness, and although there has been progress in media, lots of room for further normalization remains (Pike and Dunne). If the rate of those who seek treatment stays as low as they are in the present, and the number of cases continues to increase globally, a huge amount of lives will be lost. Prevention for eating and mental disorders should be emphasized at a young age as the onset of these illnesses have been lowering in recent years. Simultaneously, marginalized voices should be heard. In BIPOC and LGBTQ communities, as well as men, larger individuals, and older individuals, help and treatment is significantly less common despite higher risks and rapidly growing numbers (“Statistics and Research on Eating Disorders”). It should be known that eating disorders do not target specific people; rather it is a serious issue that threatens the health of the global population. While it is difficult to directly correlate this to the commoditization of media, education of healthy consumption of media should also be of importance. If a vulnerability to developing mental illnesses and eating disorders is identified in an individual or community, prevention and education should be easily accessible. An establishment of organizations for prevention and support is highly helpful and greatly encouraged globally. Clinical and non-clinical trials are also invaluable and provide research and statistics for the development of new and more effective forms of treatment.
Mental illness is a rapidly growing issue that has just been placed under the spotlight in recent years, and further research is essential and extremely valuable. Many factors contribute to the development of an eating disorder, and all of them should be heavily noted in resolving this heightening global issue. Regardless if media, genetics, environment, or trauma is at the forefront of causes for disordered eating, all populations affected should be considered, and treatment, as well as awareness, should be widespread and highly accessible.
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