Back in 2005, the world was a different place. YouTube had only just been invented, Green Day were still topping the album charts, and only 10% of young adults used social media. Now, however, that figure is at least 90%. The ubiquity of social media has had many benefits, but there’s also a dark side that can’t be ignored. A recent study has linked increased Instagram use with increased symptoms of orthorexia nervosa, an eating disorder associated with obsessive healthy eating. Social media isn’t going anywhere any time soon, so we need to understand more about how it may exacerbate eating disorders, but also how it might be a positive influence.
The study conducted by researchers at University College London, looked at Instagram usage among members of the ‘healthy eating’ community on Instagram. They found that the more time users spent on Instagram, the more likely they were to display a tendency towards orthorexia. “It’s a sliding scale,” says Pixie Turner, nutritionist and lead author of the study. “The greatest tendency was shown with use of 60+ minutes per day.” In the general population orthorexia is thought to affect about 1% of people, whereas 49% of those in the study showed symptoms. “Based on the research around orthorexia, I would say that females, those with a history of eating disorders, and individuals who are under pressure to look a certain way for their job (yoga instructors, athletes, nutritionists and dietitians, etc.) are at greater risk,” she adds.
Despite this, the new NICE guidelines on treating eating disorders published last month only mention social media once in passing, and orthorexia isn’t even mentioned as a separate disease because it doesn’t yet have a clinical diagnosis. “I absolutely think it should be, and I believe it to be separate from other eating disorders, such as anorexia,” says Turner. She notes that it does, however, often develop following anorexia, perhaps as a more socially acceptable way of controlling food intake, so experts must know how to treat it.
Whilst the UCL study doesn’t show that Instagram causes an eating disorder, there’s no doubt that it can exacerbate it. “They are being overloaded with lots more information and are saturated with it. It’s not very normal to be looking at food accounts all the time,” says Yvonne Green, a British Association for Counselling and Psychotherapy accredited therapist specialising in eating problems. It’s not just followers who are at risk; influencers are equally vulnerable. Singer Ming Bridges, who developed orthorexia as her career took off and her Instagram following subsequently grew, has first-hand experience of this. “Suddenly I had a mass of followers and over 100 comments on my Instagram account saying how pretty I was and how skinny I looked and everything, and I freaked out. At that time I was following a lot of Instagram accounts of bikini models and healthy accounts,” she remembers. “It made me feel like everyone around the world has a bikini body and everyone is eating this way, and it’s not normal for me to want to have burger and chips – that didn’t even become an option to me.”
According to Bridges, most of the health bloggers she personally knows have some form of eating disorder. “I don’t think many health bloggers exist who don’t have some history of disordered eating,” agrees Turner. Part of the problem is that orthorexia is hard to diagnose. “People who have got orthorexia probably won’t think they need any help,” says Green. “From my experience it’s only when they start to lose weight that it’s flagged up.”
Instagram is here to stay, so taking it into consideration as part of eating disorder treatment and prevention is important. Bridges says: “My eating disorder therapist made me unfollow every account that had body inspo or healthy eating inspo, which helped me so much because without seeing it, it didn’t provoke that urge in me to want to be like them.” However, Green has had cases where Instagram has helped patients recover. “When they see pictures of themselves, it actually makes them see themselves in reality rather than this perceived perception of themselves. So it can be a positive thing.” There is also a strong body positivity community which celebrates being happy and healthy over any particular look or lifestyle, and this is the approach Bridges now takes towards her own Instagram.
“In the end it’s also up to consumers to consume social media responsibly, question what they’re being told, and unfollow people who make them feel worse about themselves,” says Turner. Green also thinks that influencers can do more: “I think it does need to be monitored, and I think maybe they need to come with a health warning that, you know, this advice is only given from an amateur perspective.”
Increased recognition of orthorexia is needed to protect those who are vulnerable to it. Instagram may be a double edged sword, but as a society we can try to shift the focus towards being healthy mentally as well as physically, and recognise when nutritional advice may not be legitimate.
Helena Spooner is studying for an MSc in Science Communication at Imperial College London
Banner image: healthy eating, JN-chantalao