. 2019 Oct 3;77(1):19–40. doi: 10.1111/1747-0080.12581

Table 2.

Study characteristics and results of social media engagement and exposure to image‐related content on body image and food choice outcomes in healthy young adults

References	Country	Design	Participant characteristics	Channel	Exposure measure	Outcome measure	Key findings
Howard et al57	USA	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	922(100) College 21 ± 2.8 Caucasian 25 ± 5.8, African American 28.24 ± 6.1 Caucasian (51) African American (48)	Facebook Instagram Twitter	Frequency of SNS use Reassurance Seeking Scale (a)	Body Shape Questionnaire (BSQ‐16) Eating Disorder Examination Questionnaire (EDE‐Q)	African American women used Facebook less but had the same Twitter and Instagram use compared to white women. African American women experienced lower body dissatisfaction and disordered eating than white women. Frequency of Facebook use associated with body dissatisfaction but not Twitter or Instagram (no differences between ethnicity). Engaging in higher reassurance seeking increased body dissatisfaction and disordered eating (no differences between ethnicity).
Hummel et al58	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	185 (78) College Students 18.73 ± 1.2 NR Caucasian (73.2)	Facebook	Maladaptive Facebook Questionnaire Status updates and comments coded for positive and negative emotions.	Body Image Eating Disorder Examination Questionnaire (EDEQ‐4) Food choices Eating Disorder Examination Questionnaire (EDEQ‐4) Subscales Restraint, and Eating Concern.	Participants who wrote revealing status updates with negative comments had greater shape and eating concerns. Participants with a feedback seeking style and high number of comments were more likely to report eating restraint. Receiving negative comments from personal status updates predicted eating concerns.
Smith et al62	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	232(100) College Students 18.72 ± 1.6 NR Caucasian (76.3)	Facebook	Maladaptive Facebook Usage Scale	Body Image Body Dissatisfaction Subscale (EDI) Shape Concern Subscale (EDEQ‐4). Reassurance Seeking Subscale (DIRI‐RS) Food choice Bulimia Subscale (EDI) Eating Disorder Examination Questionnaire (EDEQ‐4).	Maladaptive Facebook use predicted increased body dissatisfaction and shape concern. Body dissatisfaction partially mediated the relationship between maladaptive Facebook use and increased bulimic symptoms. Maladaptive Facebook usage predicted increased bulimic symptoms and over‐eating episodes.
Feltman et al54	USA	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	492(100) College 18.5 ± 0.85 NR Caucasian (84)	Instagram	Passive Use Active Use	Body Surveillance Subscale (OBCS) Internalisation Subscale (SATAQ‐3) Upward and Downward Appearance Comparison Scale Appearance‐Related Commentary (RD) Social Networking Appearance‐Related Commentary Scale (SNARCS) (RD) Self‐Objectification Questionnaire (SOQ)	Active and passive Instagram use positively correlated with self‐objectification, body surveillance, upward and downward appearance comparisons and positive appearance commentary. The internalisation of cultural beauty standards and engaging in upward appearance comparisons mediated the association between Instagram use with body surveillance and self‐objectification. Positive and negative commentary and downward appearance comparisons did not mediate the association between Instagram, use, self‐objectification and body surveillance.
Hanna et al55	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	1104 (62.5) College students F19.11, M19.43 NR Caucasian (>70)	Facebook	Time spent using Facebook minutes‐hours Passive Facebook Use Active Facebook Use	State Self‐Esteem Scale (SSES) Iowa Netherlands Comparison Orientation Measure Body Surveillance subscale (OBC‐Y) Enjoyment of Sexualisation Scale (ESS) Sexual Appeal Self‐Worth Scale	Time spent on Facebook was inversely associated with self‐esteem, and positively associated with social comparison, depression, anxiety and body shame. Social comparison and self‐objectification mediated relationship between Facebook use and body shame.
Kim et al59	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	186 (64) College students 19.75 ± 2.06 NR Caucasian (74.1)	Facebook	Utz and Beukeboom's SNS use for Grooming Scale^a Time spent on Facebook/day	Drive for Thinness (EDI) Drive for Muscularity (DMS) Physical Appearance Comparison Scale (PACS)	Men reported greater drive for muscularity than women. Women reported greater drive for thinness, Women are more likely to engage in appearance comparisons. Social grooming behaviours positively associated with the drive for thinness and appearance comparisons. Appearance comparisons mediated Facebook use with social grooming and drive for thinness. Time spent on Facebook not associated with appearance comparison, drive for thinness or drive for muscularity.
Lee et al60	USA/Korea	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	USA 502(60.1) Korea 518(62.6) College USA 21.13 ± 4.5 Korea 22.35 ± 2.15 NR USA—Asian (48) Korea—all Korean	Social Media	Social media use for information (eg, fashion, exercise.) Social media use for status seeking Social media use for socialising (posting, comments)	Body‐Esteem Scale for Adolescents and Adults Rosenberg's Self‐esteem Scale Ryff's (1989) psychological wellbeing scale	Social media information seeking negatively affected body image in both US and Korean participants, but was not significant in the Korean cohort. Social media use for status seeking and socialising did not change body image in US participants. Social media use for status seeking positively affected body image in Korean participants with socialising having no effect.
Manago et al61	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	815 (n = 467) Psychology students 19.07 ± 0.82 NR Caucasian (74.3)	Facebook	Facebook Involvement: Time spent/day Facebook Intensity Scale Passive Use (viewing stories, liking) Active Use (posting, status updates)	Objectified Body Consciousness: Gordon and Ward Self‐Worth Measure Body Shame Subscale (OBC‐Y) Body Surveillance Subscale (OBC‐Y) Enjoyment of Sexualisation Scale	Women reported higher levels of Facebook involvement, body shame and appearance self‐worth than men. Women and men with high Facebook involvement (passive/active use) reported greater objectified body consciousness. Objectified body consciousness predicted greater body shame in women and men.
Fardouly et al52	AUS	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	146 (100) Psychology Students 19.24 ± 2.24 21.74 ± 3.71 Caucasian (39.6)	Social Media	Participants periodically asked by text message if they made appearance comparisons, and their context (eg, Social Media).	Body Image Body Dissatisfaction Subscale (EDI) Appearance Subscale (SSES) Appearance Comparisons: Frequency/Nature/Direction^b Food choices 2 adapted questions from (EDEQ) on restraint and diet behaviour.	10% appearance comparisons made through social media. Participants reported more upward social media comparisons than lateral or downward comparisons. Engaging in upward social media comparisons associated with less appearance satisfaction. Social media comparisons associated with more dieting thoughts and diet‐related behaviours.
Cohen et al49	AUS	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	259(100) College 22.97 ± 3.25 22.45 ± 3.89 Caucasian (77.5)	SNS	Time spent SNS/day Selfie Activities (taking/sharing) Photo Investment Scale Photo Manipulation Scale	Body Image: Internalisation Subscale (SATAQ‐3) Appearance Evaluation Subscale (MBSRQ) Body Surveillance Subscale (OBCS) Drive for Thinness (EDI) Eating Behavior Bulimia Subscales (EDI)	64% use SNS 2 hours/day. 48.7% take selfies at least once /fortnight. 62.2% edit photos. 80.7% do not edit photos. Selfie posting negatively correlated with body satisfaction. Photo investment positively correlated with thin‐ideal internalisation, drive for thinness and bulimia symptoms. Photo investment negatively correlated with body satisfaction. Selfie behaviours did not predict drive for thinness. Self‐objectification mediated photo investment and bulimia symptoms.
Ahadzadeh et al45	Malaysia	CS, OS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	273 (62.3) College 20.09 ± 1.12 21.05 (3.53) Chinese (83.9)	Instagram	Time (minute, hour) Following celebrities (yes/no) Number/type of pictures posted	Body Areas Satisfaction Scale (BASS) Body Image Ideals Questionnaire (BIQ) Appearance Schemas Inventory (ASI‐R) Rosenberg Self‐Esteem Scale (RSES)	Instagram use was inversely associated with body satisfaction.
Barry et al47	USA	CS, S, SMO	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	100(80) College 19.93 ± 1.35 NR Caucasian (77)	Instagram	30‐day Content Analyses (posts, followers, following) Coding included (selfie, non‐selfie, photo of participant [posie], no participant)	Rosenberg Self‐Esteem Scale (RSES) Physical Appearance Comparison Scale (PACS) Sociocultural Attitudes Toward Appearance (SATAQ3).	Greater selfies and posies not significantly associated with preoccupation with physical appearance standards. Physical appearance selfies not significantly associated with physical appearance concerns or self‐esteem.
Fardouly et al51	AUS/USA	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	276(100) College 22.83 ± 3.57 24.37 ± 6.52 Caucasian (USA 71.5, AUS 54.8)	Instagram	Instagram checked/day Time Spent/day How often fitspiration images viewed Frequency comparisons to female groups (family, friends, acquaintances, strangers, celebrities, themselves)	Internalisation Subscale (SATAQ‐3) Upward and Downward Appearance Comparison Scale Body Dissatisfaction Subscale (EDI) Drive for Thinness subscale (EDI) Self‐Objectification Questionnaire (SOQ)	Instagram checked 1× daily—every few hours. Approx. 30 minutes spent on Instagram. Comparisons made mostly to friends and celebrities. Instagram use positively correlated with self‐objectification and internalization of beauty ideal (not body dissatisfaction, drive for thinness or appearance comparison). Viewing fitspiration images positively correlated to comparison tendencies, body dissatisfaction and drive for thinness (not self‐objectification). Appearance comparison mediated frequency of viewing fitspiration images with body dissatisfaction and drive for thinness. Frequency of comparison to fitspiration images mediated frequency of viewing fitspiration images and body dissatisfaction.
Fardouly et al53	AUS	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	227 (100) Psychology students 19.13 ± 2.21 21.41 ± 3.93 Caucasian (46.3)	Facebook	Times spent checking Facebook Physical Appearance Comparison Scale (PACS)^a Comparison direction for family members, close friends, Facebook friends, friends of friends, celebrities.	Body Dissatisfaction Subscale (EDI) Drive for Thinness Subscale (EDI) Physical Appearance Comparison Scale (PACS)^a	Greater frequency of checking and Facebook use positively associated with body dissatisfaction and drive for thinness. Appearance comparisons mediated these relationships. Body rated most negatively after comparing to female celebrities followed by close friends and distant peers.
Niu et al65	China	CS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	886(100) College 20.14 ± 1.09 20.26 ± 2.57 Chinese	WeChat	Selfie posting frequency Verbal Commentary on Physical Appearance Scale (VCOPAS)	Body objectification Objectified Body Consciousness Scale (OBCS) Food choice Restrained Eating subscale from the Dutch Eating Behaviour Questionnaire (DEBQ)	Selfie posting frequency positively correlated with commentary on appearance and self objectification. Selfie posting was positively correlated with restrained eating. Commentary on appearance and self objectification both mediated the relationship between selfie posting frequency and restrained eating.
Veldhuis et al67	Netherlands	CS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	179(100) College 21.54 ± 2.05 21.95 ± 2.73 NR	Facebook Instagram Twitter Pinterest Tumblr	The photo subscale from Facebook photo‐activity scale^a Photo Selection Scale Editing of selfies^a Deliberate selfie posting^b	Body Dissatisfaction Subscale (EDI)^a Body Appreciation Scale‐2 Objectified Body Consciousness Scale (OBCS) Rosenberg Self‐Esteem Scale (RSES)	Facebook most popular SNS. Average 1‐2 selfies posted per week. Selfie selection was non‐significantly associated with increased body appreciation.
Wagner et al63	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	130(100) College Students 19.9 ± 1.62 21.59 ± 3.17 NR	Instagram	Number of solo selfies taken and posted in a month.	Body Dimensions (BIAS‐BD)	Average of 17 selfies taken and 0.34 selfies were posted during a month. Participant's actual body size positively related to level of body dissatisfaction. Actual body size and body dissatisfaction predicted the number of selfies taken. Low BMI or greater body dissatisfaction predicted more selfies taken. Actual body size and body dissatisfaction not related to number of selfies uploaded.
Xiaojing69	China	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	384 (52.9) Community 25.78 ± 3.09 NR NR	Facebook	Facebook photo‐activity scale Online appearance interactions Online appearance presentation	Internalisation Subscale (SATAQ‐3) Body Surveillance Subscale (OBCS) Physical Appearance Comparison Scale (PACS) Female Weight Satisfaction Subscale (BES) Muscularity and Body Fat subscales of (male body attitudes scale)	Social media appearance interaction positively associated with both men's and women's body dissatisfaction. Social comparison mediated the relationship between men's online appearance interaction and body dissatisfaction.
Arroyo et al46	USA	CS, OS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	488 (66.2) College students 20.51 ± 1.43 NR Caucasian (73.6)	SNS—Facebook, Instagram, Twitter Pinterest	Frequency of SNS exposure Viewing friends fitness posts (eg, food, before/after photos) Negative Body Talk Scale (NBT)^a	Body Image Body‐Esteem Scale for Adolescents and Adults (BESAA) Physical Appearance Comparison Scale (PACS) Body Surveillance Subscale (OBC‐Y) Food choice Exercise and Diet Subscale (HPS)^a	Friends' fitness posts negatively associated with body satisfaction. Friends' fitness posts positively associated with healthy eating and negative body talk. Social comparison moderates friends' fitness posts and negative body talk. Women engage in healthy eating behaviours and negative body talk more than men.
Butkowski et al70	International sample Researchers from USA	CS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	177(100) Online 18–30 25.09 ± 6.32 Caucasian (59.9) African American (11.86)	Instagram	Selfie feedback investment^a Frequency of Instagram use Frequency of selfie posting	Body Image Body Dissatisfaction Subscale (EDI) Drive for Thinness Subscale (EDI) Body Surveillance Subscale (OBCS) Food choice Bulimia Subscale (EDI)	Selfie feedback investment positively correlated with drive for thinness, body surveilance and selfie posting frequency. Selfie posting frequency negatively correlated with body dissatisfaction. Bulimia action tendencies positively correlated with body surveilance. Neither selfie feedback investment nor selfie posting frequency was correlated with bulimia action tendencies.
Eckler et al50	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	881 (100) College students 23.83 ± 7.26 NR Caucasian (87.4)	Facebook	Time spent checking, reading, posting, looking at photos. Frequency topics relating to weight, body image, diet topics are posted and commented on. Frequency of weight and body comparisons with friends Frequency attention is given to dress, body in others pictures	Body Image: Body Shape Questionnaire (BSQ) Researcher Question: “How often has looking at someone else's photos on Facebook made you feel negatively about your body in the last month?” Food choices: Food choice Test (EAT‐26)	20% time spent looking at photos. 8.51% posts on body, weight, diet, exercise. More time on Facebook related to feeling negatively after viewing photos. More time viewing/posting photos led to more attention to physical appearance of others and negative body attitudes. Increased Facebook exposure and weight loss desire increased disordered food choice.
Cohen et al48	AUS	CS, S	n (%F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	259(100) College 22.97 ± 3.25 22.45 ± 3.89 Caucasian (77.5)	Facebook Instagram	Times accessed/day Time spent on Social Media The Facebook Questionnaire (FBQ) Instagram accounts followed (health, fitness, diet, celebrities, travel)	Internalisation Subscale (SATAQ‐3) Physical Appearance Comparison Scale (PACS) Appearance Evaluation Subscale (MBSRQ) Body Surveillance Subscale (OBCS) Drive for Thinness Subscale (EDI)	99.2% of participants had Facebook. 90.3% checked Facebook 3‐5 times daily 81.5% had an Instagram account. 57.5% checked Instagram 3‐5 times/day. Total time not associated with body image outcomes. Facebook appearance exposure positively correlated with thin‐ideal internalisation, and body surveillance. On Instagram: Following health and fitness accounts positively correlated with thin‐ideal internalisation and drive for thinness. Following celebrity accounts associated with thin‐ideal internalisation and body surveillance. Users reported greater body surveillance than non‐users.
Hayes et al68	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	241 (n57) Population 18‐29 years NR Caucasian (73.2)	Facebook	Time spent and accessed/day Facebook apps used over last 30 days (eg, pictures, posting, commenting)	3 Body image questions adapted from Centre for Eating Disorders survey.	29.5% of young adults reported looking at own photos more than twice per week. Young adults scored higher on negative Facebook body image scale than members of older cohorts. Age independently inversely associated with higher body image dissatisfaction.
Hendrickse et al56	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	185 (100) College students 21.04 ± 3.55 NR Caucasian (66.3)	Instagram	Instagram Photoactivity Index^a Passive exposure Physical Appearance Comparison Scale (PACS)^a	Body Dissatisfaction Subscale (EDI) Drive for Thinness Subscale (EDI)	Greater appearance comparisons associated with greater body dissatisfaction and drive for thinness. Appearance comparisons mediated Instagram photo activity with drive for thinness, and body dissatisfaction.
Strubel et al66	USA	CS	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	796(100) College 20.71 ± 3.25 NR Caucasian (51.5) Hispanic (23.6)	Facebook	General Social Media Usage subscale from Media & Technology Usage and Attitudes Scale^a	Internalisation Subscale (SATAQ‐3)^a Physical Appearance Comparison Scale (PACS) Body Parts Satisfaction Scale for Females (BPSS‐F) Rosenberg Self‐Esteem Scale (RSES)	No significant correlations between Facebook use and body image outcomes
Walker et al64	USA	CS, S	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity (%)	128(100) Undergrad students 18‐23 years 23.2 ± 4.48 Caucasian (81.3)	Facebook	Facebook Intensity Scale: Total number of friends Time spent on Facebook/day Physical appearance comparison scale (PACS) Online Fat Talk Scale	Eating Disorder Examination Questionnaire (EDEQ‐Q4) Multidimensional Perfectionism Scale (MPS) Beck Depression Inventory State‐Trait Anxiety Inventory General Self Efficacy Scale	Appearance comparison and online fat talk positively associated with disordered eating behaviors. Facebook intensity positively associated with appearance comparisons. Appearance comparison mediated the relationship between Facebook intensity and disordered eating. Online Fat Talk did not significantly mediate the relationship between Facebook Intensity and disordered eating. Time only (in the absence of appearance comparisons) was not associated with disordered appearance comparisons.
Baker et al72	USA	Qual, FG	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	27(100) College 20.00 ± 1.2 NR Caucasian (63)	Instagram	Research question 1: How do female college students use Instagram and what features (eg, posting, liking and commenting) are most important?	Research question 2: Does Instagram use impact female college students body image and in what ways?	Research question 1: Uses and features; (i) effortful posting, (ii) promotion of self, (iii) seeking engagement Research question 2: Body image; (i) responding to beauty ideals, (ii) comparing self with others, (iii) display of self
Barry et al44	USA	Qual, I	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	20(0) Urban 19‐29 years NR Caucasian (>60%)	Social Media	In‐depth Interviews	Explored cultural factors impacting body dissatisfaction. Participants were asked how dress and social media practices affect their body image.	Social media provides a platform for self‐objectification, body surveillance and to receive immediate appearance assessments. Social media exposure provokes men to analyze their self‐image and engage in comparison and competition among peers. Social media amplifies focus on visual self and critical analysis of clothing and bodies.
Grover et al71	USA	Qual, FG	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	73(100) College	Social Media	—	Open conversations exploring internalized thin‐ideal values. Origins of the thin‐ideal and understanding themes factors that promote being ultra‐thin.	Students focus on image of themselves portrayed online. Social media images of peers affect young women's self‐perceptions. The collective effect of thin‐ideal images may take precedence over individual body image attitudes.
Vateralus et al73	USA	Qual, FG, I	n (% F) Setting Age (M ± SD) BMI (kg/m²) Ethnicity	34(79) College 20.4 years 26% OW/OB Caucasian (82.4)	Social Media	Social media use and daily life	Explored the influences of social media on participants eating habits.	Participants felt some peers posts intend viewers to feel shame about their bodies. Viewing pictures of peers losing weight was a form of motivation and inspiration Social media increases food choices. Viewing pictures of food too frequently is irritating. Viewing food posts could lead to feeling hungry, eating more or restraint. Social media can distract during meal times and lead to poor food choices.

References

Country

Design

Participant characteristics

Channel

Exposure measure

Outcome measure

Key findings

Howard et al57

USA

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

922(100)

College

21 ± 2.8

Caucasian 25 ± 5.8, African American 28.24 ± 6.1

Caucasian (51)

African American (48)

Facebook

Instagram

Twitter

Frequency of SNS use

Reassurance Seeking Scale (a)

Body Shape Questionnaire (BSQ‐16)

Eating Disorder Examination Questionnaire (EDE‐Q)

African American women used Facebook less but had the same Twitter and Instagram use compared to white women.

African American women experienced lower body dissatisfaction and disordered eating than white women.

Frequency of Facebook use associated with body dissatisfaction but not Twitter or Instagram (no differences between ethnicity).

Engaging in higher reassurance seeking increased body dissatisfaction and disordered eating (no differences between ethnicity).

Hummel et al58

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

185 (78)

College Students

18.73 ± 1.2

Caucasian (73.2)

Facebook

Maladaptive Facebook Questionnaire

Status updates and comments coded for positive and negative emotions.

Body Image

Eating Disorder Examination Questionnaire (EDEQ‐4)

Food choices

Eating Disorder Examination Questionnaire (EDEQ‐4) Subscales Restraint, and Eating Concern.

Participants who wrote revealing status updates with negative comments had greater shape and eating concerns.

Participants with a feedback seeking style and high number of comments were more likely to report eating restraint.

Receiving negative comments from personal status updates predicted eating concerns.

Smith et al62

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

232(100)

College Students

18.72 ± 1.6

Caucasian (76.3)

Facebook

Maladaptive

Facebook

Usage Scale

Body Image

Body Dissatisfaction Subscale (EDI)

Shape Concern Subscale (EDEQ‐4).

Reassurance Seeking Subscale (DIRI‐RS)

Food choice

Bulimia Subscale (EDI)

Eating Disorder Examination Questionnaire (EDEQ‐4).

Maladaptive Facebook use predicted increased body dissatisfaction and shape concern.

Body dissatisfaction partially mediated the relationship between maladaptive Facebook use and increased bulimic symptoms.

Maladaptive Facebook usage predicted increased bulimic symptoms and over‐eating episodes.

Feltman et al54

USA

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

492(100)

College

18.5 ± 0.85

Caucasian (84)

Instagram

Passive Use

Active Use

Body Surveillance Subscale (OBCS)

Internalisation Subscale (SATAQ‐3)

Upward and Downward Appearance

Comparison Scale Appearance‐Related Commentary (RD)

Social Networking Appearance‐Related Commentary Scale (SNARCS) (RD)

Self‐Objectification Questionnaire (SOQ)

Active and passive Instagram use positively correlated with self‐objectification, body surveillance, upward and downward appearance comparisons and positive appearance commentary.

The internalisation of cultural beauty standards and engaging in upward appearance comparisons mediated the association between Instagram use with body surveillance and self‐objectification.

Positive and negative commentary and downward appearance comparisons did not mediate the association between Instagram, use, self‐objectification and body surveillance.

Hanna et al55

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

1104 (62.5)

College students

F19.11, M19.43

Caucasian (>70)

Facebook

Time spent using Facebook minutes‐hours

Passive Facebook Use

Active Facebook Use

State Self‐Esteem Scale (SSES)

Iowa Netherlands Comparison Orientation Measure

Body Surveillance subscale (OBC‐Y)

Enjoyment of Sexualisation Scale (ESS)

Sexual Appeal Self‐Worth Scale

Time spent on Facebook was inversely associated with self‐esteem, and positively associated with social comparison, depression, anxiety and body shame.

Social comparison and self‐objectification mediated relationship between Facebook use and body shame.

Kim et al59

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

186 (64)

College students

19.75 ± 2.06

Caucasian (74.1)

Facebook

Utz and Beukeboom's SNS use for Grooming Scale^a

Time spent on Facebook/day

Drive for Thinness (EDI)

Drive for Muscularity (DMS)

Physical Appearance Comparison Scale (PACS)

Men reported greater drive for muscularity than women. Women reported greater drive for thinness,

Women are more likely to engage in appearance comparisons.

Social grooming behaviours positively associated with the drive for thinness and appearance comparisons.

Appearance comparisons mediated Facebook use with social grooming and drive for thinness.

Time spent on Facebook not associated with appearance comparison, drive for thinness or drive for muscularity.

Lee et al60

USA/Korea

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

USA 502(60.1)

Korea 518(62.6)

College

USA 21.13 ± 4.5

Korea 22.35 ± 2.15

USA—Asian (48)

Korea—all Korean

Social Media

Social media use for information (eg, fashion, exercise.)

Social media use for status seeking

Social media use for socialising (posting, comments)

Body‐Esteem Scale for Adolescents and Adults

Rosenberg's Self‐esteem Scale

Ryff's (1989) psychological wellbeing scale

Social media information seeking negatively affected body image in both US and Korean participants, but was not significant in the Korean cohort.

Social media use for status seeking and socialising did not change body image in US participants.

Social media use for status seeking positively affected body image in Korean participants with socialising having no effect.

Manago et al61

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

815 (n = 467)

Psychology students

19.07 ± 0.82

Caucasian (74.3)

Facebook

Facebook Involvement:

Time spent/day

Facebook Intensity Scale

Passive Use (viewing stories, liking)

Active Use (posting, status updates)

Objectified Body Consciousness:

Gordon and Ward Self‐Worth Measure

Body Shame Subscale (OBC‐Y)

Body Surveillance Subscale (OBC‐Y)

Enjoyment of Sexualisation Scale

Women reported higher levels of Facebook involvement, body shame and appearance self‐worth than men.

Women and men with high Facebook involvement (passive/active use) reported greater objectified body consciousness.

Objectified body consciousness predicted greater body shame in women and men.

Fardouly et al52

AUS

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

146 (100)

Psychology Students

19.24 ± 2.24

21.74 ± 3.71

Caucasian (39.6)

Social Media

Participants periodically asked by text message if they made appearance comparisons, and their context (eg, Social Media).

Body Image

Body Dissatisfaction Subscale (EDI)

Appearance Subscale (SSES)

Appearance Comparisons: Frequency/Nature/Direction^b

Food choices 2

adapted questions from (EDEQ) on restraint and diet behaviour.

10% appearance comparisons made through social media.

Participants reported more upward social media comparisons than lateral or downward comparisons.

Engaging in upward social media comparisons associated with less appearance satisfaction.

Social media comparisons associated with more dieting thoughts and diet‐related behaviours.

Cohen et al49

AUS

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

259(100)

College

22.97 ± 3.25

22.45 ± 3.89

Caucasian (77.5)

SNS

Time spent SNS/day

Selfie Activities (taking/sharing)

Photo Investment Scale

Photo Manipulation Scale

Body Image: Internalisation Subscale (SATAQ‐3)

Appearance Evaluation Subscale (MBSRQ)

Body Surveillance Subscale (OBCS) Drive for Thinness (EDI)

Eating Behavior Bulimia Subscales (EDI)

64% use SNS 2 hours/day. 48.7% take selfies at least once /fortnight. 62.2% edit photos. 80.7% do not edit photos.

Selfie posting negatively correlated with body satisfaction.

Photo investment positively correlated with thin‐ideal internalisation, drive for thinness and bulimia symptoms.

Photo investment negatively correlated with body satisfaction.

Selfie behaviours did not predict drive for thinness.

Self‐objectification mediated photo investment and bulimia symptoms.

Ahadzadeh et al45

Malaysia

CS, OS

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

273 (62.3)

College

20.09 ± 1.12

21.05 (3.53)

Chinese (83.9)

Instagram

Time (minute, hour)

Following celebrities (yes/no)

Number/type of pictures posted

Body Areas Satisfaction Scale (BASS)

Body Image Ideals Questionnaire (BIQ)

Appearance Schemas Inventory (ASI‐R)

Rosenberg Self‐Esteem Scale (RSES)

Instagram use was inversely associated with body satisfaction.

Barry et al47

USA

CS, S, SMO

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

100(80)

College

19.93 ± 1.35

Caucasian (77)

Instagram

30‐day Content Analyses (posts, followers, following)

Coding included (selfie, non‐selfie, photo of participant [posie], no participant)

Rosenberg Self‐Esteem Scale (RSES)

Physical Appearance Comparison Scale (PACS)

Sociocultural Attitudes Toward Appearance (SATAQ3).

Greater selfies and posies not significantly associated with preoccupation with physical appearance standards.

Physical appearance selfies not significantly associated with physical appearance concerns or self‐esteem.

Fardouly et al51

AUS/USA

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

276(100)

College

22.83 ± 3.57

24.37 ± 6.52

Caucasian (USA 71.5, AUS 54.8)

Instagram

Instagram checked/day

Time Spent/day

How often fitspiration images viewed

Frequency comparisons to female groups (family, friends, acquaintances, strangers, celebrities, themselves)

Internalisation Subscale (SATAQ‐3)

Upward and Downward Appearance Comparison Scale

Body Dissatisfaction Subscale (EDI)

Drive for Thinness subscale (EDI)

Self‐Objectification Questionnaire (SOQ)

Instagram checked 1× daily—every few hours. Approx. 30 minutes spent on Instagram.

Comparisons made mostly to friends and celebrities.

Instagram use positively correlated with self‐objectification and internalization of beauty ideal (not body dissatisfaction, drive for thinness or appearance comparison).

Viewing fitspiration images positively correlated to comparison tendencies, body dissatisfaction and drive for thinness (not self‐objectification).

Appearance comparison mediated frequency of viewing fitspiration images with body dissatisfaction and drive for thinness.

Frequency of comparison to fitspiration images mediated frequency of viewing fitspiration images and body dissatisfaction.

Fardouly et al53

AUS

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

227 (100)

Psychology students

19.13 ± 2.21

21.41 ± 3.93

Caucasian (46.3)

Facebook

Times spent checking Facebook

Physical Appearance Comparison Scale (PACS)^a

Comparison direction for family members, close friends, Facebook friends, friends of friends, celebrities.

Body Dissatisfaction Subscale (EDI)

Drive for Thinness Subscale (EDI)

Physical Appearance Comparison Scale (PACS)^a

Greater frequency of checking and Facebook use positively associated with body dissatisfaction and drive for thinness.

Appearance comparisons mediated these relationships.

Body rated most negatively after comparing to female celebrities followed by close friends and distant peers.

Niu et al65

China

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

886(100)

College

20.14 ± 1.09

20.26 ± 2.57

Chinese

WeChat

Selfie posting frequency

Verbal Commentary on Physical Appearance Scale (VCOPAS)

Body objectification

Objectified Body Consciousness Scale (OBCS)

Food choice

Restrained Eating subscale from the Dutch Eating Behaviour Questionnaire (DEBQ)

Selfie posting frequency positively correlated with commentary on appearance and self objectification.

Selfie posting was positively correlated with restrained eating.

Commentary on appearance and self objectification both mediated the relationship between selfie posting frequency and restrained eating.

Veldhuis et al67

Netherlands

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

179(100)

College

21.54 ± 2.05

21.95 ± 2.73

Facebook

Instagram

Twitter

Tumblr

The photo subscale from Facebook photo‐activity scale^a

Photo Selection Scale

Editing of selfies^a

Deliberate selfie posting^b

Body Dissatisfaction Subscale (EDI)^a

Body Appreciation Scale‐2

Objectified Body Consciousness Scale (OBCS)

Rosenberg Self‐Esteem Scale (RSES)

Facebook most popular SNS.

Average 1‐2 selfies posted per week.

Selfie selection was non‐significantly associated with increased body appreciation.

Wagner et al63

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

130(100)

College Students

19.9 ± 1.62

21.59 ± 3.17

Instagram

Number of solo selfies taken and posted in a month.

Body Dimensions (BIAS‐BD)

Average of 17 selfies taken and 0.34 selfies were posted during a month.

Participant's actual body size positively related to level of body dissatisfaction.

Actual body size and body dissatisfaction predicted the number of selfies taken.

Low BMI or greater body dissatisfaction predicted more selfies taken.

Actual body size and body dissatisfaction not related to number of selfies uploaded.

Xiaojing69

China

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

384 (52.9)

Community

25.78 ± 3.09

Facebook

Facebook photo‐activity scale

Online appearance interactions

Online appearance presentation

Internalisation Subscale (SATAQ‐3)

Body Surveillance Subscale (OBCS)

Physical Appearance Comparison Scale (PACS)

Female Weight Satisfaction Subscale (BES)

Muscularity and Body Fat subscales of (male body attitudes scale)

Social media appearance interaction positively associated with both men's and women's body dissatisfaction.

Social comparison mediated the relationship between men's online appearance interaction and body dissatisfaction.

Arroyo et al46

USA

CS, OS

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

488 (66.2)

College students

20.51 ± 1.43

Caucasian (73.6)

SNS—Facebook, Instagram, Twitter

Frequency of SNS exposure

Viewing friends fitness posts (eg, food, before/after photos)

Negative Body Talk Scale (NBT)^a

Body Image

Body‐Esteem Scale for Adolescents and Adults (BESAA)

Physical Appearance Comparison Scale (PACS)

Body Surveillance Subscale (OBC‐Y)

Food choice

Exercise and Diet Subscale (HPS)^a

Friends' fitness posts negatively associated with body satisfaction.

Friends' fitness posts positively associated with healthy eating and negative body talk.

Social comparison moderates friends' fitness posts and negative body talk.

Women engage in healthy eating behaviours and negative body talk more than men.

Butkowski et al70

International sample

Researchers from USA

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

177(100)

Online

18–30

25.09 ± 6.32

Caucasian (59.9)

African American (11.86)

Instagram

Selfie feedback investment^a

Frequency of Instagram use

Frequency of selfie posting

Body Image

Body Dissatisfaction Subscale (EDI)

Drive for Thinness Subscale (EDI)

Body Surveillance Subscale (OBCS)

Food choice

Bulimia Subscale (EDI)

Selfie feedback investment positively correlated with drive for thinness, body surveilance and selfie posting frequency.

Selfie posting frequency negatively correlated with body dissatisfaction.

Bulimia action tendencies positively correlated with body surveilance.

Neither selfie feedback investment nor selfie posting frequency was correlated with bulimia action tendencies.

Eckler et al50

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

881 (100)

College students

23.83 ± 7.26

Caucasian (87.4)

Facebook

Time spent checking, reading, posting, looking at photos.

Frequency topics relating to weight, body image, diet topics are posted and commented on.

Frequency of weight and body comparisons with friends

Frequency attention is given to dress, body in others pictures

Body Image:

Body Shape Questionnaire (BSQ)

Researcher Question: “How often has looking at someone else's photos on Facebook made you feel negatively about your body in the last month?”

Food choices:

Food choice Test (EAT‐26)

20% time spent looking at photos. 8.51% posts on body, weight, diet, exercise.

More time on Facebook related to feeling negatively after viewing photos.

More time viewing/posting photos led to more attention to physical appearance of others and negative body attitudes.

Increased Facebook exposure and weight loss desire increased disordered food choice.

Cohen et al48

AUS

CS, S

n (%F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

259(100)

College

22.97 ± 3.25

22.45 ± 3.89

Caucasian (77.5)

Facebook Instagram

Times accessed/day

Time spent on Social Media

The Facebook Questionnaire (FBQ)

Instagram accounts followed (health, fitness, diet, celebrities, travel)

Internalisation Subscale (SATAQ‐3)

Physical Appearance Comparison Scale (PACS)

Appearance Evaluation Subscale (MBSRQ)

Body Surveillance Subscale (OBCS)

Drive for Thinness Subscale (EDI)

99.2% of participants had Facebook. 90.3% checked Facebook 3‐5 times daily 81.5% had an Instagram account. 57.5% checked Instagram 3‐5 times/day.

Total time not associated with body image outcomes.

Facebook appearance exposure positively correlated with thin‐ideal internalisation, and body surveillance.

On Instagram: Following health and fitness accounts positively correlated with thin‐ideal internalisation and drive for thinness.

Following celebrity accounts associated with thin‐ideal internalisation and body surveillance.

Users reported greater body surveillance than non‐users.

Hayes et al68

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

241 (n57)

Population

18‐29 years

Caucasian (73.2)

Facebook

Time spent and accessed/day

Facebook apps used over last 30 days (eg, pictures, posting, commenting)

3 Body image questions adapted from Centre for Eating Disorders survey.

29.5% of young adults reported looking at own photos more than twice per week.

Young adults scored higher on negative Facebook body image scale than members of older cohorts.

Age independently inversely associated with higher body image dissatisfaction.

Hendrickse et al56

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

185 (100)

College students

21.04 ± 3.55

Caucasian (66.3)

Instagram

Instagram Photoactivity Index^a

Passive exposure

Physical Appearance Comparison Scale (PACS)^a

Body Dissatisfaction Subscale (EDI)

Drive for Thinness Subscale (EDI)

Greater appearance comparisons associated with greater body dissatisfaction and drive for thinness.

Appearance comparisons mediated Instagram photo activity with drive for thinness, and body dissatisfaction.

Strubel et al66

USA

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

796(100)

College

20.71 ± 3.25

Caucasian (51.5)

Hispanic (23.6)

Facebook

General Social Media Usage subscale from Media & Technology Usage and Attitudes Scale^a

Internalisation Subscale (SATAQ‐3)^a

Physical Appearance Comparison Scale (PACS)

Body Parts Satisfaction Scale for Females (BPSS‐F)

Rosenberg Self‐Esteem Scale (RSES)

No significant correlations between Facebook use and body image outcomes

Walker et al64

USA

CS, S

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity (%)

128(100)

Undergrad students

18‐23 years

23.2 ± 4.48

Caucasian (81.3)

Facebook

Facebook Intensity Scale:

Total number of friends

Time spent on Facebook/day

Physical appearance comparison scale (PACS)

Online Fat Talk Scale

Eating Disorder Examination Questionnaire (EDEQ‐Q4)

Multidimensional Perfectionism Scale (MPS)

Beck Depression Inventory

State‐Trait Anxiety Inventory

General Self Efficacy Scale

Appearance comparison and online fat talk positively associated with disordered eating behaviors.

Facebook intensity positively associated with appearance comparisons.

Appearance comparison mediated the relationship between Facebook intensity and disordered eating.

Online Fat Talk did not significantly mediate the relationship between Facebook Intensity and disordered eating.

Time only (in the absence of appearance comparisons) was not associated with disordered appearance comparisons.

Baker et al72

USA

Qual, FG

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

27(100)

College

20.00 ± 1.2

Caucasian (63)

Instagram

Research question 1:

How do female college students use Instagram and what features (eg, posting, liking and commenting) are most important?

Research question 2:

Does Instagram use impact female college students body image and in what ways?

Research question 1: Uses and features; (i) effortful posting, (ii) promotion of self, (iii) seeking engagement

Research question 2: Body image; (i) responding to beauty ideals, (ii) comparing self with others, (iii) display of self

Barry et al44

USA

Qual, I

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

20(0)

Urban

19‐29 years

Caucasian (>60%)

Social Media

In‐depth Interviews

Explored cultural factors impacting body dissatisfaction.

Participants were asked how dress and social media practices affect their body image.

Social media provides a platform for self‐objectification, body surveillance and to receive immediate appearance assessments.

Social media exposure provokes men to analyze their self‐image and engage in comparison and competition among peers.

Social media amplifies focus on visual self and critical analysis of clothing and bodies.

Grover et al71

USA

Qual, FG

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

73(100)

College

Social Media

—

Open conversations exploring internalized thin‐ideal values.

Origins of the thin‐ideal and understanding themes factors that promote being ultra‐thin.

Students focus on image of themselves portrayed online.

Social media images of peers affect young women's self‐perceptions.

The collective effect of thin‐ideal images may take precedence over individual body image attitudes.

Vateralus et al73

USA

Qual, FG, I

n (% F)

Setting

Age (M ± SD)

BMI (kg/m²)

Ethnicity

34(79)

College 20.4 years

26% OW/OB

Caucasian (82.4)

Social Media

Social media use and daily life

Explored the influences of social media on participants eating habits.

Participants felt some peers posts intend viewers to feel shame about their bodies.

Viewing pictures of peers losing weight was a form of motivation and inspiration

Social media increases food choices.

Viewing pictures of food too frequently is irritating.

Viewing food posts could lead to feeling hungry, eating more or restraint.

Social media can distract during meal times and lead to poor food choices.

Abbreviations: BMI, body mass index; CS, cross‐sectional; Qual, qualitative; S, survey; FG, Focus Groups, I, interview; SMO, social media observation; NR, not reported; RD, researcher developed, SNS, social networking site.

Adapted.

Researcher developed.