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Social Media Influence and Symptom Severity in Those Diagnosed with Anorexia Nervosa

Info: 2411 words (10 pages) Nursing Case Study
Published: 29th Jan 2021

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Tagged: social media


Ways in which young woman, and now even young girls, view their bodies has been a topic of interest for many decades. Social media and the possible repercussions of subscribing to social media is what will be examined in this study. How do those who suffer from Anorexia Nervosa or AN, utilize social media to coincide with their illness? Does having a regular presence on social media influence the individual’s level of self-esteem and reliance on symptom usage when experiencing distress? 20 female participants who have been diagnosed with AN by a psychologist and are between the ages of 14-18 were obtained for this study. A clinical interview is mandatory for all participants. The clinical interview is necessary to collect crucial information regarding the participants upbringing, family medical history, and individual medical history that led up to having AN. Regular users of the popular social media app Instagram is operationally defined as logging at least 10 hours per week. The participants were divided into two groups of ten. The control group was instructed to continue their normal use of the app Instagram while the experimental group was instructed to not use the app for one year. At the beginning of the first month and every month thereafter, each participant was given an Eating Disorder Questionnaire that asks specific questions regarding body image, self-esteem, and overall satisfaction with oneself to determine the severity of symptoms experienced throughout the duration of the study. At the end of the study, the results from the questionnaire are then quantified to see if there is any correlation between social media use and severity of the eating disorder symptoms.


 According to The Oxford Handbook of Eating Disorders, AN holds the highest mortality rate of any other psychiatric disorder (Hoek, 2006). This reason alone is why AN can strongly be considered a public health concern. Research conducted by Verma and Avgoulas (2015) on the matter of eating disorders found that the perception the individual holds of themselves physically has become distorted in terms of their weight and body shape. Those struggling have a difficult time seeing their bodies for how they look. Body dysmorphia is extremely prevalent and can hinder someone struggling with AN to connect with reality, thinking one is fat when they are, in fact, dangerously thin (2015).

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 A considerable amount of research has uncovered many interesting secrets of eating disorders. Social media and prevalence of anorexia type symptoms in individuals who have been pre-diagnosed with the disorder is the aim of this study. What Verma and Avgoulas (2015) uncovered in their research are the attitudes that the individuals have towards themselves is a huge indicator of the type of content being consumed via social media. To take it a step further, Instagram, as a major social media platform for young women all over the world, will be incorporated into an experiment where participants will be assigned to one of two groups. Group A, participants will be instructed to log into their Instagram accounts as they normally would and in group B, participants will refrain from using Instagram. This will continue over the duration of one year. At the beginning of each month, the participants will be given an Eating Disorder Examination Questionnaire in order to measure if there is any adjustment in attitudes towards themselves throughout the experiment.

Literature Review

 Anorexia Nervosa is an eating disorder characterized by weight loss, difficulty maintaining an appropriate weight for age, height and stature according to the National Eating Disorder Association (NEDA, 2018). Distortion of body image, calorie restriction, and purging (over exercising, laxatives, diuretics or vomiting) are typically found in those diagnosed with AN.  According to NEDA (2018), AN can affect people of any age, race, religion and sexual orientation. Although AN typically occurs in adolescence, many children and adults have also been diagnosed with the mental disorder. A common misconception is that one needs to be emaciated in order to have the disorder. On the contrary, cannot be diagnosed by looking at the individual solely. Unfortunately, those who are deemed normal or even overweight often get misdiagnosed because of cultural stigma around the disorder (2018).

  A study by Verma (2015), looked to access how young women conceptualize eating disorders in comparison to how the media discusses and portrays eating disorders (Verma, 2015). This qualitative research used in-depth interviews and social media to create a detailed understanding to how eating disorders are perceived among young woman and those who are in recovery from or currently live with an eating disorder (2015). Similarly, this study aims to look at young who have a current diagnosis of Anorexia Nervosa and see how the presence of regular social media use influences severity of AN symptoms.

 Furthermore, a larger overview of Social Media and Body Image Concerns published by Williams and Ricciardelli (2014) discussed the prevalence of social media and similar technologies in the lives of youths and how it influences and shapes the perceptions, attitudes, and self-esteem of its users (Williams, 2014). This fact stresses the importance of studies performed to investigate how forms of social media are impacting the youth. Williams (2014) reports that as demonstrated in other studies; social media has penetrated the lives of many Westerners that past forms of mass media simply could not amount to.


Anorexia Nervosa is an eating disorder characterized by extreme weight loss and inability to maintain an ideal body weight in conjunction with height, age, and body type. Typically, individuals with AN have limited social spontaneity highly restrictive food intake and rigid exercise regimens in desperate attempts to maintain an unrealistic low body weight (NEDA, 2019). Social media is form of electronic communication in which its users can create online communities to share ideas, messages, information, and personal content (Webster, 2019).


The participants for this study are females ranging in age from 14-18. All the participants have had a confirmed diagnosis of Anorexia Nervosa. The participants were recruited through a partnership with a therapeutic clinic specializing in eating disorders (TBD). Participants and legal guardian are asked if they would like to participate in the study after a formal diagnosis was made for the client. If so, a consent form is given. After consent has been granted, by either legal guardian or client if the client is legally able to do so, the participants are assigned into one of two groups at random.


Social media platform, Instagram, is being utilized as the independent variable in the experimental group. The Eating Disorder Examination Questionnaire will be used as the constant, or dependent, variable among both the experimental and control group throughout the study to measure the severity of AN Symptoms of the participants in both groups. The EDEQ will be administered at the beginning of each month in the presence of a therapist in the facility where the participants had their initial diagnosis to evaluate any changes in symptom severity amongst participants throughout the duration of the study. The questionnaire consists of 28 questions pertaining to eating disordered symptoms and severity. Severity of symptoms are rated on a scale from 0-6, 0 being “Not at all” and 6 being “Markedly”. In addition, the participants current weight, height, and menstrual cycle pattern is recorded.

Social media platform, Instagram, will be acting as the independent variable in the experimental group. All participants have been undergone a clinical interview that included questioning regarding how many hours per week, on average, each participant spends on Instagram. It was decided by the experimenter that a base rate of 10 hours per week is operationally defined as “excessive” use of the platform. To assure an accurate log of use for the experimental group, participants were given an iPhone that logs data usage for the Instagram app.


Once the screening process is complete and the participants have been briefed about the study, each participant will be randomly assigned to either group 1 or group 2. Group 1 is instructed to utilize their personal Instagram accounts as they normally would on a day to day basis. Group 2 is instructed to refrain from using their Instagram account. This will go on over the duration of 12 months. The EDEQ is given at the beginning of each month as a baseline for symptom severity of each participant. The goal is to see if the severity of symptoms differs in the individual who does not look on Instagram compared to someone who does, given they both have Anorexia.


The results of this study will not be discussed. Please see ‘Discussion’.


This study will be looking at the relationship between social media use, specifically Instagram, and AN symptom severity. The goal of this study is to measure the difference between participants, who all share the same diagnosis of AN, while comparing their AN symptom severity by limiting the availability for half the participants in their social media use. Considering that eating disorders are a mental health issue and that the mind frame of individuals could be negatively impacted through seeking corresponding negative content (Verma, 2015), it is suspected that by limiting the use of Instagram, participants will experience alleviation of AN symptom severity.

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The strength of this study’s design allows the researcher to examine the types of AN symptoms that are negatively correlated with social media influence. Using the EDEQ, a rating scale questionnaire, the researcher was able to quantify the results and calculate an average. Through Pearson’s ‘r’ Correlation Coefficient, there is a visible representation between the relationship of Instagram and ED symptom severity among participants who did not look at Instagram versus those who did. The results of this data prove that 10 or more hours of Instagram shows a linear correlation whereas no Instagram shows a negative correlation. This means that the less Instagram used, the lower rate of symptom severity in patients over time. These results will give clinicians an insight into the impact social media can have on their client’s rate of recovery. Those suffering from AN will also be allotted more knowledge on the impact they have on their own recovery.

Limitations of this study are that it will not be applicable in countries where social media is not prevalent. In addition, cultures where vanity is not of value, and other AN symptom are stemmed from other life factors were not be calculated into the data of this study. Participations truthfulness on the answers of the EDEQ are also recognized as potential confounding variables. In order to limit falsified information, participants names will not be revealed on the questionnaire, rather a serial number will be assigned to each participant.

 The replication of this study using other types of social media will show which types of social media can have a negative impact on those suffering from AN. Looking at other forms of social media where vanity is not the main focus will give a broader understanding to what drives individuals to seek various forms of social media. This way, medical professionals can make improved recommendations to their patients as to how much social media input could be a hindrance to their recovery and well-being.

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  • Williams, R. J., & Ricciardelli, L. A. (2014). Social media and body image concerns: Further considerations and broader perspectives. Sex Roles, 71(11-12), 389-392. doi:http://dx.doi.org.libproxy.temple.edu/10.1007/s11199-014-0429-x
  • Verma, A. & Avgoulas, M. (2015). Eating Disorders: Perceptions of Young Wozmen and Social Media Portrayal. The International Journal of Health, Wellness, and Society, Vol. 5(4), 97-105. file:///C:/Users/Piper/Downloads/Psychological%20Research/article%20one.pdf
  • Dohnt, H. K., & Tiggemann, M. (2006). Body image concerns in young girls: The role of peers and media prior to adolescence. Journal of Youth and Adolescence, 35(2), 135-145. doi:http://dx.doi.org.libproxy.temple.edu/10.1007/s10964-005-9020-7
  • http://cedd.org.au/wordpress/wp-content/uploads/2014/09/Eating-Disorder-Examination-Questionnaire-EDE-Q.pdf
  • Hoek, H. “Incidence, Prevalence and Mortality of Anorexia Nervosa and Other Eating Disorders.” Current Opinion in Psychiatry, 2006: 389-394.
  • Anorexia Nervosa. (2018, February 28). Retrieved March 14, 2019, from https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
  • Social Media. (n.d.). Retrieved March 26, 2019, from https://www.merriam-webster.com/dictionary/social media
  • Regressions and Correlations: Pearson's r. (n.d.). Retrieved April 11, 2019, from
  • https://erc.barnard.edu/spss/pearsons_r


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