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The Disturbing Effects of Social Media on Eating Disorders

February 21-27 is National Eating Disorders Awareness Week, which aims to raise public awareness of disordered eating and encourage intervention and increased access to resources.

Social-media sites like Pinterest, Tumblr, Instagram and YouTube have come under fire for hosting content promoting eating disorders. Commonly known as "thinspiration," "thinspo," "pro-ana" and "pro-mia," searches on these terms return images of emaciated bodies and suggestions from users about how to develop or sustain an eating disorder.

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A 2010 Johns Hopkins Bloomberg School of Public Health study found that when pro-eating-disorder terms like "pro-anorexia" and "thin and support" were searched, 83 percent of the search-engine results were websites supporting eating-disorder behavior through images and text. Because this research was conducted in 2010, we have to assume that pro-eating-disorder content has only become more abundant and pervasive as social media continues to evolve both in the number of sites and their enhanced functionality for supporting connection and sharing information.

As a psychologist specializing in the treatment of eating disorders, I am troubled -- although not surprised -- by the emerging connection between social media and these complex illnesses. Several key characteristics of social media make it an ideal place to promote the pro-eating-disorder mentality, including:

1. Increased exposure to information related to dieting and weight loss. Dieting mentality has become normative in our culture, in part because people flock to social media to publicize their diet, weight-loss strategies and results. Anyone can post anything on social media, giving unhealthy ideologies like the pro-eating-disorder movement a faux legitimacy.

For example, "thigh gap" (a space between the upper thighs when standing with legs together) and "bikini bridge" (when hipbones protrude to create a gap between the stomach and the bikini bottoms) are two popular unhealthy body ideals discussed widely in pro-eating-disorder social-media sites.

[Read More: Filling in the Facts About Thigh Gaps]

2. A medium for social comparison. The literature tells us that social comparison affects deficits in self-esteem. Social media -- in both name and functionality -- is the ideal medium for social comparison, with many individuals using these platforms to share information about their unhealthy diets and body ideals.

The misguided hope of this content is to "inspire" thinness (hence the term "thinspiration"). In reality, this content results in feelings of inferiority, inadequacy and body dissatisfaction in otherwise normal women and can compel an urgent need to take action through restriction, purging or over-exercising to achieve greater thinness among those struggling with negative body image or an eating disorder.

3. The social-media paradox. Social media seeks to promote connection with others, but for many at risk for or suffering from eating disorders, it supports isolation and withdrawal from real-world relationships.

Eating disorders are lonely and isolating illnesses. For those already dealing with interpersonal difficulties and issues around self-esteem and confidence, spending too much time online in their social networks is a means of avoidance, passivity and minimizing direct communication with people. Social media can offer a sense of belonging and connection around a topic that feels safe, even if it is unhealthy.

4. Anonymity. Eating disorders thrive in secrecy. The high-achieving, perfectionistic, people-pleasing individuals who tend to suffer from these complex illnesses often go to great lengths to hide their intense body dissatisfaction and eating-disorder behaviors.

Social media allows for a sense of connection while maintaining relative anonymity through the use of pseudonyms and fictitious profile information. In this way, social media is attractive for pro-eating-disorder content because it allows people to discuss their eating disorders while at the same time keeping them a secret.

While certain aspects of social media can contribute to the development and maintenance of an eating disorder, it can also be a powerful tool to support and sustain recovery when used responsibly. Social media enables peer support and fosters connection with others. For individuals struggling with interpersonal skills, it can be a great place to start generating relationships and connections.

[Read More: Habits of Compulsive Exercisers]

While pro-eating-disorder content is increasingly common, so, too, is meaningful recovery-focused content, communities, groups and blogs. In an effort to foster healthy use of social media among individuals touched by eating disorders, consider the following best practices:

1. Avoid pro-eating-disorder content altogether, no matter your stage of recovery. Despite administrative efforts by various social-media sites to eliminate "thinspiration" content, there will always be unhealthy content and opinions somewhere online. Simply put, avoid this content because engaging with pro-eating-disorder mentality reinforces body dissatisfaction and challenges recovery.

2. Engage with recovery-focused eating-disorder content and communities. Seek out communities and resources to help you and your loved ones understand these complex illnesses and garner support from those at similar stages of the recovery journey. Personal narratives of recovery are particularly common and powerful in social media.

3. Consider blogging or sharing your story. Writing, along with most other forms of creative expression, can be healing for those struggling with eating disorders. Commit to sharing your story in recovery-focused communities in a way that feels comfortable to you. Start a blog that is visible and inspiring to anyone, or just share updates related to your recovery progress with friends and followers.

4. Limit your time on social media. Several studies have found a correlation that as social-media usage increases, so does body dissatisfaction. While social media can provide a supportive community, establishing real-world connections and nurturing relationships with friends, loved ones and colleagues are equally important in the recovery journey.

5. Report pro-eating-disorder content to site administrators. It's important that social-media administrators continue to receive feedback about dangerous pro-eating-disorder content in their communities and the potential impact it has on users. While previous efforts to remove, contain or limit access to unhealthy content have been largely ineffective in stunting the reach of this dangerous mentality, unified voices calling for action can only compel sites to do more to protect their users.

--Dr. Solomon

Readers -- Have you or anyone you know struggled with an eating disorder? Do you think social media can have a negative or positive affect on people’s diet choices? Have you seen pro-eating-disorder content on a social-media channel? Leave a comment below and let us know.

Ashley Solomon, Pys.D., is the program and clinical director at Eating Recovery Center of Ohio. A licensed clinical psychologist specializing in the treatment of anorexia, bulimia, binge-eating disorder and compulsive over-exercise as well as mood, substance and other psychological concerns, Dr. Solomon also serves as a co-chair of the Academy for Eating Disorders' Social Media Committee.

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