Abstract:
This extended project aims to explore whether or not Instagram plays a role in the rising cases of eating disorders amongst teenage girls in the UK. It has been shown that the main cause of eating disorders stems from the development of low self-esteem and low self-worth (Spettigue, 2021). Previous research analysed government data to provide evidence of this growing issue. It was found that there was a 46% increase in referrals of under-18s with eating disorders, since 2019 (Jayanetti, 2021).
For this EPQ some primary research was completed in the form of a qualitative and quantitative questionnaire. A total of 18 participants completed the survey. From this, it was concluded that whilst many people did not feel Instagram negatively affected them, over a third of people did state that Instagram had triggered them. There was also a link made between the higher usage of Instagram and lower confidence levels amongst participants. This demonstrates that people may not be fully aware of the impacts Instagram has on them. A high number of users were also found to be under the age of 18 which should be highlighted due to the high susceptibility of this age range to poor self-image and eating disorders. To conclude whilst Instagram has been shown to positively change some people's lifestyles it also has been shown to potentially impact some peopleâs diet and exercise behaviours in an unhealthy way.
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Introduction:
This extended project will investigate the question To what extent does Instagram encourage the development of anorexia for teenage girls in the UK?. The aim of this is to assess the impacts of Instagram on teenage girls in the UK and to discover if the platform is the main cause of eating disorders amongst this age category. An eating disorder is a mental health condition in which a person develops unhealthy eating patterns. In the UK, there are three main eating disorders, anorexia nervosa, bulimia and binge eating disorder (BED) (NHS, 2021). Anorexia will be the focus of this EPQ as it is most commonly associated with being brought on by social media usage.
Around 10% of those diagnosed with eating disorders in the UK are suffering from anorexia which is most common amongst girls aged 15-19 (Schoen Clinic, 2021). Anorexia nervosa or anorexia is the development of eating minimal amounts of food and is often connected to low self-esteem and negative self-image (NHS, 2021). It can lead to loss of enjoyment in day-to-day activities, fear of eating or even putting on weight and even suicidal tendencies and depression. Furthermore, as the sufferer isn't eating enough this can cause other health problems such as weakness, fragile bones, rapid weight loss and difficulty concentrating (Mind, 2021). All of these symptoms can massively impact a person's daily life especially with the majority of suffers being aged 15-19, as this can influence their education and daily routines.
Along with the increase of eating disorders, the use of Instagram is also increasing rapidly. Over the past few years, Instagram users have increased from 100 million monthly users, recorded in 2013, (Dean, 2021) to over 1.074 billion users as of 2021, (Mohsin, 2021) with 32.05 million of these users being from the United Kingdom. One study was also carried out to estimate that around 32.1% of UK users are aged between 13-24 (Tankovska, 2021). Therefore, it can be assumed that many of them are exposed to the platform's harmful and impactful content shared, at such a young age, many can develop eating disorders like anorexia, as they don't fully understand the impacts and side effects of social media on their mental health. This is significant as a common cause for the development of anorexia is low self-esteem (NHS, 2021), which is easily developed through social media.
This essay will specifically investigate how Instagram is argued to have caused an increase in anorexia and how truthful these allegations really are, as well as the benefit and detriments to mental health when using social media.
Impact of Advertisement
One feature of Instagram is the ability to have targeted adverts for the user. This can be based on the audience's location, age and gender (Instagram, 2016). As a result of this, companies will tailor their adverts for those who are most likely to purchase the product. This can have negative impacts as marketers will often target buyers who are searching for solutions to their insecurities and ailments (Viraj J, 2018). Consequently, anyone who may be feeling insecure or is struggling with their food intake could receive several dieting or food-related advertisements which could significantly impact their mental and physical health.
A recent incident occurred whereby Instagram was found to be mistakenly promoting harmful diet content which many found to be triggering (Criddle, 2021). Lauren Black, an Instagram influencer who is recovering from Anorexia said in an interview with the BBC (Black, 2021) that people often turn to Instagram to find support for their illness. However, when researching for eating disorder recovery it can customize harmful and triggering content which is related to the topic. Black also stated that this can cause people to suffer further and even relapse. This shows first-hand how impactful these targeted adverts can have on teenagers who are exposed to them. Therefore, any teenager girls who are exposed to these adverts as a result of their previous searches could be triggered with unwanted topics and content, possibly causing relapse for recoverees or creating symptoms for new sufferers.
Cyberbullying
One clear issue of platforms such as Instagram is the lack of censoring. Inappropriate and upsetting content can easily become widespread with Instagram failing to remove much of it. Eating disorders can stem from bullying, especially cyberbullying, due to individuals developing low self-esteem and anxiety from the constant targeting of body image. It is estimated that nearly 60% of teenagers have been bullied on social media (Anderson, 2018). This staggering statistic affirms that the majority of Instagram users have been cyberbullied which is a cause of low self-esteem, possibly aggravating the increase of anorexia. Furthermore, recent studies (Scott, 2020) have identified perfectionism, the need to appear perfect by setting unrealistic standards, as being a major influence on eating disorders, self-harm and obsessive-compulsive disorder (OCD) (Limburg, et al., 2016). Perfectionism has also been expedited due to social media as people are constantly comparing themselves or being compared to others forming a sense of imperfection. Therefore, as Instagram exacerbates cyberbullying, due to messages and comments being spread anonymously, without the tormentor facing any consequences, many can develop low self-esteem and a matter of perfectionism. The lack of accountability through social media platforms also allows cyberbullying to escalate, which has an impact on young teenagers using the platform. Consequently, teenage girls using Instagram can develop anorexia whilst using the platform as constant comparisons and distressing comments made by others on the platform can create lowered self-esteem.
Impact of Images
Instagram has a high engagement with the average time spent on the platform is 32 minutes a day (Agrawal, 2021). Continuous exposure to social media has been shown to have an impact on mental health (RSPH, 2017), with the constant images and messages of how to look better, it is easy to fall into a spiral of harmful content. Whilst many of the images shared on Instagram can portray unrealistic standards there is also the issue of influencers advertising products and diets. Often companies use celebrity figures on social platforms like Instagram to reach a wider audience in order to boost their sales. By getting a celebrity to post a few images using the product it can reach thousands if not millions of teenagers worldwide. This can have an impact on mental health for teenagers as they will see their idols promoting these products, encouraging them to try the product in order to obtain a standard of beauty. However, most often the item doesn't do as advertised. This can have serious detriment to eating disorders as teenagers may assume that no product can make them appeal to modern-day beauty standards potentially leading to them resorting to an unhealthy diet as a way to feel achieve this ideal image. This development of an eating disorder can be especially harmful as often teenagers aren't even aware of its impacts as they may just see it as dieting or developing a healthier lifestyle. However, on most occasions, this can lead to anorexia, especially if the sufferer is also using strict rules to control their exercise and becoming hyper-aware of their weight and eating times (Mind, 2021). These are very common symptoms of anorexia which from another's point of view could just appear as a lifestyle choice or way of dieting, but it can be far more damaging. Therefore, the use of Images on Instagram can lead young girls aspiring to unachievable beauty standards disfiguring their self-esteem and self-worth.
Over-exposure to food
In a recent study (Larson, et al., 2014) it was discovered that repeated exposure to photographs and images of food can decrease enjoyment of eating. This has been an issue linking to eating disorders as people can be constantly shown photographs and adverts of food on their Instagram page which can cause disinterest when it comes to mealtimes. This disinterest can start to snowball into more serious issues like anorexia, whereby the sufferer can persistently refuse to eat and potentially lose their appetite completely. The study, (Larson, et al., 2014) further discusses the idea of satiation which suggests that repeated consumption, whether it be regularly eating or participating in other assignments, can result in decreased enjoyment. By constantly being visually exposed to foodstuff, a person's stimulus can associate the visual experience to that of a real one, consequently diminishing their appetite. Consequently, teenage girls who might have an interest in recipes and food-related content could start to see a decrease in their participation at mealtimes as they may start to develop satiation towards their food, as a result of over-exposure to food.
Pro-an Content
One way Instagram can spread impactful content related to eating disorders is through accounts that post pro-ana content. These are accounts that focus on promoting anorexia. Most often they are set up by those who are also suffering from eating disorders to share photos of themselves and their unhealthy practises (Borzekowski, et al., 2010). The reason these sites are harmful is that they can often be used to encourage others to embrace eating disorders, and they are also criticised as not promoting eating disorders as mental health conditions, but rather as lifestyle choices. Suggesting eating disorders are controllable and brought on purposefully to diet or change one's appearance, can cause further impacts for those who have fought and are still fighting the extreme struggles of an eating disorder. These accounts can also be triggering or initiate relapses of those in recovery. Although these accounts on Instagram can be hurtful, one interview for The Independent (Burton, 2013) suggests pro-ana sites and content can't be fully to blame. Burton discussed that more than often comments are made on how celebrities or users of Instagram are either too thin or too fat, amongst other things, and this is more reason for impacting anorexia than Instagram's platform. These unnecessary remarks often fuel the encouragement of disorders more than pro-ana accounts as they lambast the individual rather than offering them support. Nonetheless, pro-ana accounts on Instagram are still very deleterious for young sufferers as although they might not directly inflict eating disorders, they are still criticised for lowering self-esteem and self-perception, which can considerably impact one's mental health (The Meadowglade, 2020).
Access
Many see the ability for Instagram Images and comments to be accessed globally as a negative due to the effortless ability to share unrealistic Images or hurtful comments. Meanwhile, alternative arguments suggest that Instagram's accessibility also enables movements and campaigns to be created allowing those who have been subject to eating disorders to come forward and share their stories with others. One successful movement for eating disorders that has been spread across Instagram is the #edrecovery, this is a platform for those who were suffering from an eating disorder to show their journey to recovery. Currently, there are over 4 million posts on Instagram (Instagram, 2021) using the hashtag which can also help people feel less isolated as they can share their experiences and learn from others.
Connectivity:
As well as accessibility, Instagram also allows for positive platforms to be formed which allows people to connect with others through personal interests. Instagram's platform allows for communities to develop which can have positive effects on teenagers who may struggle to talk and make friendships in person. This can help boost an individual's self-esteem and self-worth. These communities also enable those who may be experiencing symptoms of eating disorders to learn about what they are going through and how to improve their wellbeing. Often, by participating in these online communities people can make connections with those who have previously suffered from eating disorders and can reach out and receive guidance and honest experiences. By surrounding sufferers with motivating communities, they are able to feel less isolated.
Instagram's Platform Policies:
Although harmful content can be spread rapidly and effortlessly, Instagram also has many policies to ensure this content can be prevented. Whilst using the platform, users are able to report abusive comments and posts. There are also ways for accounts that continuously spread hate to be suspended if they violate the community guidelines (Instagram, 2021). Furthermore, some content has been forbidden, meaning any content mentioning these banned words or content will be immediately taken down. This includes messages encouraging self-hate, violence and threats (Instazood, 2020). These policies are all used with the aim of protecting the community on the platform. These policies are beneficial for those suffering from eating disorders as they can protect messages of harassment and threat, which can both participate in lowering one's self-esteem.
However, there are some limitations to these policies. Whilst messages containing the banned content are taken down, it is possible to bypass them simply by misspelling words or replacing letters with symbols or numbers, people are able to avoid their contents from getting flagged up for being harmful. Despite the fact that it is still possible for other users to report these messages distributed, they can still have caused an impact, especially on teenagers who aren't fully aware of the long-term effects of becoming exposed to this content.
In full, whilst not all messages can be easily picked up as being harmful, overall by having these restrictions in place it does ensure that for the most part, that these topics are censored which is very beneficial for those struggling with low self-esteem and eating disorders.
Positive Eating:
As mentioned previously, Instagram allows connectivity and the development of communities which can promote beneficial eating routines and more positive eating. Instagram is often used by teenagers to learn new skills and recipes through watching videos or reading posts, this information was highlighted through the questionnaire carried out for this extended project. Three of the participants discussed Instagram influencing their lifestyle by recommending new recipes for them to try out. This showcases that many people receive information from Instagram which promotes healthy eating rather than harmful diets. This also allows many of those who could be potentially suffering from eating disorders to discover new foods and recipes, inspiring them to try new ways to eat healthily.
Primary Research:
For this EPQ some primary research was completed in the form of a qualitative and quantitative questionnaire. The purpose of this was to gather realistic evidence from teenage girls in the UK and see how they compare to statistics gathered from journals and online pages. To obtain the data I wrote up a survey comprised of 14 questions (Appendix 1) and asked 20 people to fill it out. The questionnaire was distributed with a link to clarify that it was voluntary. When distributing the link, Information regarding the themes of the questionnaire were provided to ensure informed consent could be obtained. As the questionnaire had some potential trigger topics such as dieting, and exercise, participants were warned not to carry out the questionnaire if they were affected by these topics. Overall, 18 participants completed the survey and from this, it was concluded that whilst many people did not feel Instagram directly affect them, over a third of people did state that Instagram had triggered them. Another element that should be highlighted was that 72.2% of the participants felt that Instagram didn't boost their self-esteem. This provides information to suggests that whilst many are aware Instagram doesn't boost their self-esteem, they still use it often, which could be introducing mental health issues without the user's awareness. There was also seen to be a link between higher usage of Instagram and lower confidence levels amongst participants. This suggests that increased usage of Instagram can cause a higher likelihood of poor mental health, particularly eating disorders if self-esteem and self-worth are damaged.
Another key element to note from this study is the high number of users being under the age of 18. Previous studies (NHS, 2015) have shown this age range to be highly susceptible to poor self-image and the development of eating disorders, demonstrating the importance of Instagram controlling adverts and product placement for this age range to prevent possible triggers and users buying products due to the adverts purposely aiming to appeal to younger users.
Discussion
A common theme for the main cause of eating disorders for young adults is development of low self-esteem and self-worth. This is the reason why Instagram is often the target of disapproval, especially when discussing the causation of eating disorders. With teenage girls commonly comparing themselves to the glamour and ideal looks presented online, it is seen as an easy way to feel more self-conscious and self-aware. This ongoing view of the impacts of social media has been supported by many studies. From the statistics gathered in the questionnaire carried out, this point can be supported as 72.2% of the study felt that Instagram didn't boost their mental health. In support of these findings, some articles suggest the link between the level of engagement on social networking sites like Instagram, as lower self-esteem (Pantic, 2014). This is also showcased in the survey carried out as those findings also linked increased Instagram usage to low self-esteem.
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