Abstract
This study aimed to compare the scope, internet use patterns, and degree of online need satisfaction of girls and women with and without a lifetime eating disorder (ED) diagnosis. Participants were 122 females aged 12–30, 53 with a lifetime ED diagnosis recruited via a hospital-based treatment program, and 69 age-matched controls recruited via normative social media sites. Participants completed questionnaires assessing disordered eating, body image, positive and negative affect, general distress, and life satisfaction, and completed an online survey about the scope of their internet use, the frequency of watching and posting pictures and videos, online friendships and social comparison, fulfillment of needs online, and mood after internet use. All questionnaire scores differed significantly between groups in the expected directions. Whereas overall, ED and control groups spent similar amounts of time online (6.21, SD = 5.13), they spent this time differently. ED participants reported devoting 56.7% of their online time to eating, weight and body image, versus 29.1% for controls, and spent significantly more time than controls on forums and blogs (t = -5.3, p < 0.0001, Cohen’s d = 0.87). They also engaged more often in social comparison (t = 3.6, p < 0.005, Cohen’s d = 0.65), had a higher online–offline friend ratio (t = 3.7, p < 0.0001, Cohen’s d = 0.65), and more online friends with ED (t = 5.4, p < 0.0001, Cohen’s d = 0.89). In comparison to controls, ED participants reported that their use of forums and blogs gave them more eating- and weight-related advice, and a greater sense of belonging, social support, and safety resulting from anonymity, with effect sizes of 0.63–0.96. However, they also reported more negative affect after posting online. Most online behaviors and patterns correlated positively with measures of symptomatology and negatively with measures of psychological health, in both groups. Internet use was rarely addressed in therapy. Professionals, families and friends should help people with disordered eating and EDs to broaden the scope of their internet use. They should invest less in food- and weight-related forums/blogs, expand their “real life” social lives and develop their interpersonal skills, so that their legitimate needs can be satisfied face-to-face, rather than virtually. Clinicians should address the online lives of their ED clients in therapy.
Highlights
Today’s young adults are “digital natives” (Prensky, 2001), who use the internet as a major information source, and conduct much of their social life online
To test hypothesis no. 1, scores on the Eating Attitudes Test-26 (EAT-26), BSQ, I-PANASSF and Satisfaction With Life Scale (SWLS) were compared between groups using t-tests
Eating disorder participants were asked to rate how often their internet use had been raised in therapy between 1 and 5
Summary
Today’s young adults are “digital natives” (Prensky, 2001), who use the internet as a major information source, and conduct much of their social life online. This study aimed to characterize the online lives of girls and young women with and without eating disorders (EDs). A major focus of shopping, fashion, celebrity, and magazine websites targeting adolescent girls and young women, is appearance, and internet exposure is associated with internalization of the thin ideal, body surveillance, and drive for thinness in adolescents (Tiggemann and Slater, 2013). A recent meta-analysis suggests that the link between social media use and the internalization of the thin ideal in girls and women is explained by online appearance-related features (Mingoia et al, 2017). Readily available online, are associated with body dissatisfaction, and people with EDs frequently compare their bodies to others’ (FitzsimmonsCraft, 2017)
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