Table 1.
Perceived advantages of posting about/following thin-ideal content on social media (n = 566 participants responded to these open-ended items in the survey)
| Total (%) | Clinical ED (n = 138) |
Subclinical ED (n = 338) |
No ED (n = 90) |
p-value | Pairwise comparisons |
|
|---|---|---|---|---|---|---|
| n (%) | ||||||
| Motivation/Encouragement | 345 (60.95) | 76 (55.07) | 224 (66.27) | 45 (50.00) | 0.005 | Subclinical ED > Clinical ED, No ED |
| • “This allows me to stay motivated and remind myself of my goals.” • “Some people have the same views and are incredibly supportive/motivating.” • “It makes you feel motivated to do something about yourself and change things.” | ||||||
| Motivation to… | ||||||
| …be thin | 129 (37.39) | 33 (43.42) | 87 (38.84) | 9 (20.08) | 0.027 | Clinical ED, Subclinical ED > No ED |
| • “It gives me motivation to achieve my thinness related goals.” • “I use it to motivate myself to get skinnier.” • “It’s almost like I’m persuading myself to stick with losing more and more weight; it keeps me motivated.” | ||||||
| …get healthy | 82 (23.77) | 9 (11.84) | 51 (22.77) | 22 (48.89) | <0.001 | No ED > Subclinical ED > Clinical ED |
| • “It encourages me to keep up with healthy habits (e.g., exercise, nutritious eating, etc.) and reminds me of what is possible.” • “They can help motivate people to get healthy, when the activity or results being encouraged are healthy.” • “Motivation to have a more active and healthy lifestyle.” | ||||||
| …work out | 79 (22.90) | 9 (11.84) | 45 (20.09) | 25 (55.56) | <0.001 | No ED > Subclinical ED, Clinical ED |
| • It makes me want to work out in order to look more like the models or people in the photos/videos.” • “It gives me motivation to eat better and work out more. Working out can be fun if you do activities you enjoy.” • “I feel focused on my fitness goals and stops me from slacking off.” | ||||||
| …restrict, not eat, and/or diet | 38 (11.01) | 13 (17.11) | 25 (11.16) | 0 | 0.015 | Clinical ED, Subclinical ED > No ED |
| • “It helps me to remind myself that I should continue dieting.” • “when I get really hungry, I go in these sites to get a little extra motivation to not eat for just a bit longer” • “It makes it easier to not eat if I remind myself what I want my body to look like, and how I want to control my eating behaviors” | ||||||
| …recover/seek treatment/not engage in ED behavior | 10 (2.90) | 5 (6.58) | 5 (2.23) | 0 | 0.069 | -- |
| • “It helps motivate me to combat my binge eating disorder and makes me feel more comfortable and less alone with some harmful thoughts I have” • “Hearing others' ED struggles and recovery victories makes me believe that I might be able to recover too. Finding these online communities was the main push that actually got me to seek out help from a therapist and nutritionist.” • “Sometimes the bodies look really scary so it's like a warning to not go too far and it's a reminder that eating disorders aren't pretty.” |
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| Socializing | 211 (37.28) | 88 (63.77) | 111 (32.84) | 12 (13.33) | <0.001 | Clinical ED> Subclinical ED > No ED |
| • “Getting support from others who are struggling with similar issues, feeling less alone and isolated” • “Eating disorders and body dysmorphia can be isolating, being able to talk about things in a somewhat confidential environment helps me feel not as alone.” • “The advantages are that I can discuss the things I'm experiencing with others who relate. A lot of the discussions help me learn more about myself and understand myself better.” | ||||||
| Information giving/seeking | 138 (24.38) | 32 (23.19) | 79 (23.37) | 27 (30.00) | 0.400 | -- |
| • “Sometimes I feel like I am influencing people positively, to make better lifestyle choices.” • “I’ve learned a lot about calories and nutrition from ED communities, and despite my ED I feel like I have a lot of knowledge on those subjects now.” • “They give tips on how to become skinny.” |
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| Emotional outlet | 113 (19.96) | 46 (33.33) | 60 (17.75) | 7 (7.78) | <0.001 | Clinical ED> Subclinical ED > No ED |
| • I use it as a former of venting…I have high and low days regarding my self esteem, and on my low days it's nice to have somewhere I can let out how I feel and not hold it in.” • “It gets my feelings out and it helps me connect with others who feel the same way and we can help each other. It makes me feel less alone and it helps me to motivate myself to become prettier” • “It lets me speak my mind and get things off of my chest that I otherwise wouldn't be able to, as it's not something I can really discuss with friends or family.” | ||||||
| Self-status seeking | 91 (16.08) | 22 (15.94) | 52 (15.38) | 17 (18.89) | 0.723 | -- |
| • “It gives me attention thus temporarily making me feel better about my appearance.” • “It makes me feel better about my appearance when people validate me and my body type” • “I get more likes on my photos when I post a picture that accentuates a certain part of [my] face or body… I sometimes post about how unhappy I am with my appearance and people post nice things about me. When I post that I lost weight, people comment “yay!” with celebration emojis.” |
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| Entertainment | 32 (5.65) | 7 (5.07) | 19 (5.62) | 6 (6.67) | 0.878 | -- |
| • “Usually the posts are humorous and my friends can relate.” • “I just think it's pretty but there aren't really any advantages besides being something nice to look at when I'm bored looking at social media.” • “They're entertaining and 'trendy'.” |
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| No benefit | 36 (6.36) | 11 (7.97) | 21 (6.21) | 4 (4.44) | 0.559 | -- |
| • “I don't experience any advantages or positive feelings from posting about this content” • “there's really no rational advantage to following the accounts” • “There are no real advantages. As someone who has been hospitalized for my eating disorder… there is logically nothing positive about being encouraged or encouraging someone to engage in disordered behavior.” |
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Note: Pairwise comparisons listed were significant at least at p < 0.05.