Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jul 4:17:2587-2601.
doi: 10.2147/PRBM.S410600. eCollection 2024.

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review

Suzanne E Mazzeo  1   2 , Madison Weinstock  1 , Taylor Nadine Vashro #  1 , Taryn Henning #  1 , Karly Derrigo  1
Affiliations
Review

Mitigating Harms of Social Media for Adolescent Body Image and Eating Disorders: A Review

Suzanne E Mazzeo et al. Psychol Res Behav Manag. .

Abstract

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

Keywords: adolescent; body image; eating disorders; review; social media.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work. References1.BrownBBLarsonJ, LernerRM, SteinbergL. Handbook of Adolescent Psychology: Contextual influences on adolescent development. Vol. 2. 3rd ed. (John Wiley & Sons Inc.) 2009Available From: https://onlinelibrary.wiley.com/doi/10.1002/9780470479193.adlpsy002004.2.MittmannG, WoodcockK, DörflerS, KrammerI, PollakI, SchrankB. “TikTok is my life and snapchat is my ventricle”: a mixed-methods study on the role of online communication tools for friendships in early adolescents. J Early Adoles. 2022;42(2):172–203. doi:10.1177/027243162110203683.DahlgrenCL, Sundgot-BorgenC, KvalemIL, WennersbergAL, WistingL. Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents. J Eat Disord. 2024;12(1):34. doi:10.1186/s40337-024-00992-3384245794.HollandG, TiggemannM. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image. 2016;17:100–110. doi:10.1016/j.bodyim.2016.02.008269951585.SaiphooAN, VahediZ. A meta-analytic review of the relationship between social media use and body image disturbance. Comput Human Behav. 2019;101:259–275. doi:10.1016/j.chb.2019.07.0286.VandenboschL, FardoulyJ, TiggemannM. Social media and body image: recent trends and future directions. Curr Opin Psychol. 2022;45:101289. doi:10.1016/j.copsyc.2021.12.002350304607.WellsG, HorwitzJ, SeetharamanDFacebook knows Instagram is toxic for teen girls, company documents show. Wall Street Journal; Available from: https://www.wsj.com/articles/facebook-knows-instagram-is-toxic-for-teen-girls-company-documents-show-11631620739. Accessed March13, 2024.8.NetworkTLWhat students are saying about how social media affects their body image. The New York Times. 2024.9.WilkschSM, O’SheaA, HoP, ByrneS, WadeTD. The relationship between social media use and disordered eating in young adolescents. Int J Eating Disord. 2020;53(1):96–106. doi:10.1002/eat.2319810.PolaninJR, EspelageDL, GrotpeterJK, et al. A systematic review and meta-analysis of interventions to decrease cyberbullying perpetration and victimization. Prev Sci. 2022;23(3):439–454. doi:10.1007/s11121-021-01259-y3415950611.DayS, BusseyK, TrompeterN, MitchisonD. The impact of teasing and bullying victimization on disordered eating and body image disturbance among adolescents: a systematic review. Trauma Violence Abuse.2022;23(3):985–1006. doi:10.1177/15248380209855343346143912.BerneS, FrisénA, KlingJ. Appearance-related cyberbullying: a qualitative investigation of characteristics, content, reasons, and effects. Body Image. 2014;11(4):527–533. doi:10.1016/j.bodyim.2014.08.0062519430913.KelesB, McCraeN, GrealishA. A systematic review: the influence of social media on depression, anxiety and psychological distress in adolescents. Int J Adolesc Youth. 2020;25(1):79–93. doi:10.1080/02673843.2019.159085114.McCraeN, GettingsS, PurssellE. Social media and depressive symptoms in childhood and adolescence: a systematic review. Adolesc Res Rev. 2017;2(4):315–330. doi:10.1007/s40894-017-0053-415.BarakatS, McLeanSA, BryantE, et al. Risk factors for eating disorders: findings from a rapid review. J Eat Disord. 2023;11(1):8.3665057216.SpindlerA, MilosG. Links between eating disorder symptom severity and psychiatric comorbidity. Eating Behav. 2007;8(3):364–373. doi:10.1016/j.eatbeh.2006.11.01217.TiggemannM. Digital modification and body image on social media: disclaimer labels, captions, hashtags, and comments. Body Image. 2022;41:172–180. doi:10.1016/j.bodyim.2022.02.0123525965518.KrayerA, IngledewDK, IphofenR. Social comparison and body image in adolescence: a grounded theory approach. Health Educ Res. 2008;23(5):892–903. doi:10.1093/her/cym0761815614819.KleemansM, DaalmansS, CarbaatI, AnschützD. Picture perfect: the direct effect of manipulated Instagram photos on body image in adolescent girls. Media Psychol. 2018;21(1):93–110. doi:10.1080/15213269.2016.125739220.MoormanEL, WarnickJL, AcharyaR, JanickeDM. The use of internet sources for nutritional information is linked to weight perception and disordered eating in young adolescents. Appetite. 2020;154:104782. doi:10.1016/j.appet.2020.1047823254446721.CustersK. The urgent matter of online pro-eating disorder content and children: clinical practice. Eur J Pediatr. 2015;174(4):429–433. doi:10.1007/s00431-015-2487-72563358022.CarrotteER, VellaAM, LimMSC. Predictors of “liking” three types of health and fitness-related content on social media: a cross-sectional study. J Med Internet Res. 2015;17(8):e205. doi:10.2196/jmir.48032629768923.JerónimoF, CarraçaEV. Effects of fitspiration content on body image: a systematic review. Eat Weight Disord. 2022;27(8):3017–3035. doi:10.1007/s40519-022-01505-43640108224.Urgent responsibility to reduce harms posed by social media on risk for eating disorders: an open letter to Facebook, Instagram, TikTok, and Other Global Social Media Corporations. Available From: https://www.newswise.com/articles/urgent-responsibility-to-reduce-harms-posed-by-social-media-on-risk-for-eating-disorders. Accessed March13, 2024.25.HuddlestonJWould new legislation actually make kids safer online? analyzing the consequences of recent youth online safety proposals. Cato Institute Briefing Paper. 2023;(150).26.MarlattGA, WitkiewitzK. Update on harm-reduction policy and intervention research. Ann Rev Clin Psychol. 2010;6(1):591–606. doi:10.1146/annurev.clinpsy.121208.1314382019279127.HawkM, CoulterRW, EganJE, et al. Harm reduction principles for healthcare settings. Harm Reduct J. 2017;14(1):1–9. doi:10.1186/s12954-017-0196-42805699028.HendlinYH, VoraM, EliasJ, LingPM. Financial conflicts of interest and stance on tobacco harm reduction: a systematic review. Am J Public Health. 2019;109(7):e1–e8. doi:10.2105/AJPH.2019.30510629.LevengoodTW, YoonGH, DavoustMJ, et al. Supervised injection facilities as harm reduction: a systematic review. Am J PrevMed. 2021;61(5):738–749. doi:10.1016/j.amepre.2021.04.01730.KellyY, ZilanawalaA, BookerC, SackerA. Social media use and adolescent mental health: findings from the UK millennium cohort study. EClinical Med. 2018;6:59–68. doi:10.1016/j.eclinm.2018.12.00531.Massarat EAV Risa Gelles Watnick and Navid. Teens, social media and technology 2022. pew research center: internet, science & tech, 2024. Available from: https://www.pewresearch.org/internet/2022/08/10/teens-social-media-and-technology-2022/. August10, 2022.32.ZuairAA, SoporyP. Effects of media health literacy school-based interventions on adolescents’ body image concerns, eating concerns, and thin-internalization attitudes: a systematic review and meta-analysis. Health Commun. 2022;37(1):20–28. doi:10.1080/10410236.2020.18139543287308233.McLeanSA, WertheimEH, MastersJ, PaxtonSJ. A pilot evaluation of a social media literacy intervention to reduce risk factors for eating disorders. Intl J Eating Disord. 2017;50(7):847–851. doi:10.1002/eat.2270834.BellBT, TaylorC, PaddockD, BatesA. Digital Bodies: a controlled evaluation of a brief classroom‐based intervention for reducing negative body image among adolescents in the digital age. Br J Educ Psychol. 2022;92(1):280–298. doi:10.1111/bjep.124493435059435.MahonC, HeveyD. Pilot trial of a self-compassion intervention to address adolescents’ social media-related body image concerns. Clin Child Psychol Psychiatry. 2023;28(1):307–322. doi:10.1177/135910452210992153554946236.KusinaJR, Exline JulieJ. Beyond body image: a systematic review of classroom-based interventions targeting body image of adolescents. Adolesc Res Rev. 2019;4(3):293–311. doi:10.1007/s40894-019-00121-137.Sundgot-BorgenC, FriborgO, KolleE, et al. The healthy body image (HBI) intervention: effects of a school-based cluster-randomized controlled trial with 12-months follow-up. Body Image. 2019;29:122–131. doi:10.1016/j.bodyim.2019.03.0073092868138.GordonCS, JarmanHK, RodgersRF, et al. Outcomes of a cluster randomized controlled trial of the SoMe social media literacy program for improving body image-related outcomes in adolescent boys and girls. Nutrients. 2021;13(11):3825. doi:10.3390/nu131138253483608439.DiedrichsPC, AtkinsonMJ, GarbettKM, LeckieG. Evaluating the “Dove Confident Me” five-session body image intervention delivered by teachers in schools: a cluster randomized controlled effectiveness trial. J Adolesc Health. 2021;68(2):331–341. doi:10.1016/j.jadohealth.2020.10.0013324372340.GuestE, JarmanH, SharrattN, et al. ‘everybody’s different: the appearance game’. A randomised controlled trial evaluating an appearance-related board game intervention with children aged 9–11 years. Body Image. 2021;36:34–44. doi:10.1016/j.bodyim.2020.09.0103316025641.Smolak, L, Cash, TFCashTF, SmolakLBody Image: A Handbook of Science, Practice, and Prevention2nd (New York: Guilford Press)2011. editors. Future challenges for body image science, practice, and prevention.. xxi, 490-xxi. 471–47842.YagerZ, DiedrichsPC, RicciardelliLA, HalliwellE. What works in secondary schools? A systematic review of classroom-based body image programs. Body Image. 2013;10(3):271–281. doi:10.1016/j.bodyim.2013.04.0012368361143.Lewis-SmithH, GarbettKM, ChaudhryA, et al. Evaluating a body image school-based intervention in India: a randomized controlled trial. Body Image. 2023;44:148–156. doi:10.1016/j.bodyim.2022.12.0063660843444.GarbettKM, Lewis-SmithH, ChaudhryA, et al. Acceptability and preliminary efficacy of a school-based body image intervention in urban India: a pilot randomised controlled trial. Body Image. 2021;37:282–290. doi:10.1016/j.bodyim.2021.02.0113381334545.CraddockN, GarbettKM, HaywoodS, et al. ‘Dove Confident Me Indonesia: Single Session’: study protocol for a randomised controlled trial to evaluate a school-based body image intervention among Indonesian adolescents. BMC Public Health. 2021;21(1):2102. doi:10.1186/s12889-021-11770-03478491646.GarbettKM, HaywoodS, CraddockN, et al. Evaluating the efficacy of a social media–based intervention (Warna-Warni Waktu) to improve body image among young Indonesian women: parallel randomized controlled trial. J Med Internet Res. 2023;25(1):e42499. doi:10.2196/424993701091147.MathesonEL, SmithHG, AmaralACS, et al. Using chatbot technology to improve Brazilian adolescents’ body image and mental health at scale: randomized controlled trial. JMIR Mhealth Uhealth. 2023;11(1):e39934. doi:10.2196/399343733560448.GarbettKM, DiedrichsPC. Improving uptake and engagement with child body image interventions delivered to mothers: understanding mother and daughter preferences for intervention content. Body Image. 2016;19:24–27. doi:10.1016/j.bodyim.2016.07.0042758047549.LothKA, MacLehoseR, BucchianeriM, CrowS, Neumark-SztainerD. Predictors of dieting and disordered eating behaviors from adolescence to young adulthood. J Adolesc Health. 2014;55(5):705–712. doi:10.1016/j.jadohealth.2014.04.0162492549150.FrederickDA, SandhuG, ScottT, AkbariY. Reducing the negative effects of media exposure on body image: testing the effectiveness of subvertising and disclaimer labels. Body Image. 2016;17:171–174. doi:10.1016/j.bodyim.2016.03.0092708511251.Cohen, R, Newton-John, T, Slater, AThe case for body positivity on social media: Perspectives on current advances and future directions. J Health Psychol.202126132365–2373. doi:10.1177/13591053209124503219113252.RodgersRF, WertheimEH, PaxtonSJ, TylkaTL, HarrigerJA. #Bopo: Enhancing body image through body positive social media- evidence to date and research directions. Body Image. 2022;41:367–374. doi:10.1016/j.bodyim.2022.03.0083552515553.LazukaRF, WickMR, KeelPK, HarrigerJA. Are we there yet? Progress in depicting diverse images of beauty in Instagram’s body positivity movement. Body Image. 2020;34:85–93. doi:10.1016/j.bodyim.2020.05.0013253426954.SmithAC, AhuviaI, ItoS, SchleiderJL. Project body neutrality: piloting a digital single-session intervention for adolescent body image and depression. Int J Eating Disord. 2023;56(8):1554–1569. doi:10.1002/eat.2397655.Wood-BarcalowNL, TylkaTL, Augustus-HorvathCL. “But I Like My Body”: Positive body image characteristics and a holistic model for young-adult women. Body Image. 2010;7(2):106–116. doi:10.1016/j.bodyim.2010.01.0012015399056.TylkaTL, Wood-BarcalowNL. What is and what is not positive body image? Conceptual foundations and construct definition. Body Image. 2015;14:118–129. doi:10.1016/j.bodyim.2015.04.0012592165757.ZavattaroSM. Taking the social justice fight to the cloud: Social media and body positivity. Public Integrity. 2021;23(3):281–295. doi:10.1080/10999922.2020.178210458.AffulAA, RicciardelliR. Shaping the online fat acceptance movement: talking about body image and beauty standards. J Gend Stud. 2015;24(4):453–472. doi:10.1080/09589236.2015.102852359.BaconL. Health at Every Size: The Surprising Truth About Your Weight. BenBella Books; 2010.60.CohenR, ShikoraS. Fighting weight bias and obesity stigma: a call for action. Obes Surg. 2020;30(5):1623–1624. doi:10.1007/s11695-020-04525-03219374261.PiranN. New possibilities in the prevention of eating disorders: the introduction of positive body image measures. Body Image. 2015;14:146–157. doi:10.1016/j.bodyim.2015.03.0082588671162.CohenR, IrwinL, Newton-JohnT, SlaterA. #bodypositivity: a content analysis of body positive accounts on Instagram. Body Image. 2019;29:47–57. doi:10.1016/j.bodyim.2019.02.0073083133463.HarrigerJA, EvansJA, ThompsonJK, TylkaTL. The dangers of the rabbit hole: reflections on social media as a portal into a distorted world of edited bodies and eating disorder risk and the role of algorithms. Body Image. 2022;41:292–297. doi:10.1016/j.bodyim.2022.03.0073537833864.BarronAM, Krumrei-MancusoEJ, HarrigerJA. The effects of fitspiration and self-compassion Instagram posts on body image and self-compassion in men and women. Body Image. 2021;37:14–27. doi:10.1016/j.bodyim.2021.01.0033355691465.StevensA, GriffithsS. Body Positivity (#BoPo) in everyday life: an ecological momentary assessment study showing potential benefits to individuals’ body image and emotional wellbeing. Body Image. 2020;35:181–191. doi:10.1016/j.bodyim.2020.09.0033306889366.OgdenJ, GoslingC, HazelwoodM, AtkinsE. Exposure to body diversity images as a buffer against the thin-ideal: an experimental study. Psychol Health Med. 2020;25(10):1165–1178. doi:10.1080/13548506.2020.17342193211599867.RankinSTPortrait Positive: Changing the way you see. United Kingdom: Portrait Positive; 2018.68.BurnetteCB, KwitowskiMA, MazzeoSE. “I don’t need people to tell me I’m pretty on social media:” A qualitative study of social media and body image in early adolescent girls. Body Image. 2017;23:114–125. doi:10.1016/j.bodyim.2017.09.0012896505269.RodgersRF, LavewayK, ZalvinoJ, CardoneW, WangL. #BodyPositive: a qualitative exploration of young people’s responses to body positive social media content. Body Image. 2023;47:101613. doi:10.1016/j.bodyim.2023.08.0053765924770.RodgersRF, PaxtonSJ, WertheimEH. #Take idealized bodies out of the picture: a scoping review of social media content aiming to protect and promote positive body image. Body Image. 2021;38:10–36. doi:10.1016/j.bodyim.2021.03.0093379880071.HendrickseJ, ClaytonRB, RayEC, RidgwayJL, SecharanR. Experimental effects of viewing thin and plus-size models in objectifying and empowering contexts on Instagram. Health Commun. 2021;36(11):1417–1425. doi:10.1080/10410236.2020.17610773240105872.CohenR, FardoulyJ, Newton-JohnT, SlaterA. BoPo on Instagram: an experimental investigation of the effects of viewing body positive content on young women’s mood and body image. New Media Soc. 2019;21(7):1546–1564. doi:10.1177/146144481982653073.ReesA. Beyond Beautiful: A Practical Guide to Being Happy, Confident, and You in a Looks-Obsessed World. Clarkson Potter/Ten Speed; 2019.74.MAF. What if body positivity doesn’t work? how about body neutrality? everyday feminism. 2016; Available from: https://everydayfeminism.com/2016/02/body-positivity-vs-neutrality. Accessed March13, 2024.75.PuhlRM, HeuerCA. The stigma of obesity: a review and update. Obesity. 2009;17(5):941–964. doi:10.1038/oby.2008.6361916516176.SharpG, GerrardY. The body image “problem” on social media: novel directions for the field. Body Image. 2022;41:267–271. doi:10.1016/j.bodyim.2022.03.0043533900177.CostelloN, SuttonR, JonesM, et al. ALGORITHMS, ADDICTION, AND ADOLESCENT MENTAL HEALTH: an interdisciplinary study to inform state-level policy action to protect youth from the dangers of social media. Am J Law Med. 2023;49(2–3):135–172. doi:10.1017/amj.2023.253834478278.DanthinneES, GiorgianniFE, RodgersRF. Labels to prevent the detrimental effects of media on body image: a systematic review and meta‐analysis. Intl J Eating Disord. 2020;53(5):647–661. doi:10.1002/eat.2324279.BuryB, TiggemannM, SlaterA. Disclaimer labels on fashion magazine advertisements: impact on visual attention and relationship with body dissatisfaction. Body Image. 2016;16:1–9. doi:10.1016/j.bodyim.2015.09.0052649872880.PuhlRM. Weight stigma, policy initiatives, and harnessing social media to elevate activism. Body Image. 2022;40:131–137. doi:10.1016/j.bodyim.2021.12.0083495338781.LessardLM, PuhlRM. Adolescents’ exposure to and experiences of weight stigma during the COVID-19 pandemic. J Pediatr Psychol. 2021;46(8):950–959. doi:10.1093/jpepsy/jsab0713431372782.RobertsonA. Court blocks California’s online child safety law. The Verge. 2023; Available From: https://www.theverge.com/2023/9/18/23879489/california-age-appropriate-design-code-act-blocked-unconstitutional-first-amendment-injunction. Accessed March13, 2024.

References

    1. Brown BBLarson J, Lerner RM, Steinberg L. Handbook of Adolescent Psychology: Contextual influences on adolescent development. Vol. 2. 3rd ed. (John Wiley & Sons Inc.) 2009. Available From: https://onlinelibrary.wiley.com/doi/10.1002/9780470479193.adlpsy002004. - DOI
    1. Mittmann G, Woodcock K, Dörfler S, Krammer I, Pollak I, Schrank B. “TikTok is my life and snapchat is my ventricle”: a mixed-methods study on the role of online communication tools for friendships in early adolescents. J Early Adoles. 2022;42(2):172–203. doi:10.1177/02724316211020368 - DOI
    1. Dahlgren CL, Sundgot-Borgen C, Kvalem IL, Wennersberg AL, Wisting L. Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents. J Eat Disord. 2024;12(1):34. doi:10.1186/s40337-024-00992-3 - DOI - PMC - PubMed
    1. Holland G, Tiggemann M. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image. 2016;17:100–110. doi:10.1016/j.bodyim.2016.02.008 - DOI - PubMed
    1. Saiphoo AN, Vahedi Z. A meta-analytic review of the relationship between social media use and body image disturbance. Comput Human Behav. 2019;101:259–275. doi:10.1016/j.chb.2019.07.028 - DOI