1. Introduction
Body image disturbance is a significant psychological concern among young women, particularly those aged 18-24, who are at a crucial stage for establishing long-term health behaviors [
1]. The pervasive influence of social media has been identified as a critical factor in shaping negative body perceptions by promoting unrealistic beauty standards [
2]. This phenomenon has led to increased dissatisfaction with body shape and size, resulting in heightened awareness of perceived body imperfections and a greater risk of developing body image disturbances [
2,
3,
4,
5,
6,
7,
8,
9].
Studies suggest that body image is closely linked to eating behavior and diet quality, with positive body image and autonomous exercise motivations leading to healthier eating outcomes, while body dissatisfaction and restrained eating are associated with poorer diet quality and lower dietary diversity [
10,
11,
12,
13,
14,
15,
16,
17,
18,
19]. While some studies suggest that poor diet quality may exacerbate body dissatisfaction [
20], others indicate that the connection may be more complex, with factors such as social media exposure playing a more significant role [
21].
Social media has been increasingly recognized as a significant factor in shaping body image perception across various age groups and settings [
22]. Numerous studies have documented the pervasive influence of platforms like Instagram, Facebook, and TikTok on body image dissatisfaction, especially in younger populations. Adolescents and young adults are particularly vulnerable due to their high engagement with social media, frequent exposure to idealized body images, and the prominence of peer comparison. A recent systematic review highlights the correlation between social media usage and body image disturbance, particularly among women aged 18-25, with Instagram showing the strongest link due to its image-centric nature [
22]. In contrast, older adults show less impact, as suggested by a meta-analysis, which posits that body image concerns in middle-aged adults may be influenced more by real-life social networks than by social media [
23]. Settings also play a role, with Westernized cultures reporting higher rates of body dissatisfaction compared to non-Western countries [
24]. Despite these findings, there remains a gap in longitudinal studies that explore how social media exposure affects body image over time and whether these effects differ in non-Western settings or among older populations.
Given the critical role of both nutrition and psychosocial factors in shaping body image, this study aims to explore the relationship between body image disturbance among young women, diet quality, as measured by Australian Recommended Food Scores (ARFS) [
25] and eating behaviors using the Three-Factor Eating Questionnaire [
26] (TFEQ-R18). By combining qualitative insights from focus group discussions with quantitative analysis through the Body Image Disturbance Questionnaire [
27] (BIDQ), ARFS and TFEQ-R18, this research seeks to provide a comprehensive understanding of how these factors interact, particularly in the context of social media exposure. Social media exposure can shape perceptions of healthy eating and body image, but more research is needed to understand its long-term effects on eating behaviors and dietary intake [
22,
23]. By focusing on social media’s role in influencing not just body image but also eating behaviors and diet quality, this research fills a pertinent gap that could inform interventions aimed at promoting healthier eating habits in the digital age [
9]. The findings will contribute to the development of targeted interventions that address both dietary behaviors and the psychological impacts of media on body image.
4. Discussion
While previous research has established a connection between social media exposure and negative body image, the impact of this exposure on dietary behaviors, specifically diet quality and disordered eating patterns, remains underexplored. This study addresses these gaps by examining the relationships between social media influence, body image disturbance, eating behaviors and diet quality in young women aged 18–24, a demographic particularly susceptible to social pressures regarding appearance.
The study found that while body image disturbance did not significantly correlate with diet quality, social media familiarity was significantly associated with higher body image disturbance. Additionally, a considerable proportion of participants exhibited disordered eating behaviours, with a notable relationship between uncontrolled eating and body image concerns. However, such behaviours were only weakly associated with social media use. However, the focus group discussions revealed that social media remains a significant context where young women navigate their body image and eating habits, often leading to unhealthy comparisons and increased dissatisfaction with their appearance.
A noteworthy proportion of participants indicated low diet quality and mild body image disturbance. It is becoming frequently apparent that extended social media use can have damaging effects on the self-perception of young women [
2,
3,
4,
5,
7,
8,
21]. Several sub-themes were identified via focus group discussions which illuminated the potential and harms of social media use for nutrition purposes. Participants frequently experienced negative body image perceptions influenced by unrealistic beauty standards propagated on social media. Many expressed feelings of guilt and pressure to conform to idealized images, which exacerbated disordered eating behaviors.
Social media noise likely results in confusion rather than informed users due to excessive and low-quality information [
41]. A probable contributor to this is algorithms which favor popularity, and therefore beauty standards; algorithms do not promote, or push based on quality of evidence or professional credentials [
42]. It is left to the user to discern fact from fiction when consuming nutrition information, a task which is difficult without an education in health or nutrition.
The social contagion of disordered eating behaviours may permeate via social media, from one’s inner circle to highly influential encounters online, leading to an overt “social pressure to be thin” [
43,
44]. Instagram is saturated with weight-loss messaging and harmful dietary advice, which fosters poor body image and nutrition misinformation (37). For example, social media commonly reinforces one-dimensional diet messaging through body ideals (i.e., “
she eats this way, therefore her body is this way” or “
she achieves the standard of beauty, therefore her commentary on dietary intake must be correct”). There is little nuanced discussion of genetics, environmental, and other pertinent external influences on nutrition status. The omission of these influences in “Insta norms” such as “fitspiration” can lead to an inflated sense of personal responsibility and, subsequently, a harmed perception of self [
9,
43].
Despite the obvious pitfalls of platforms like Instagram, this study found limited associations between social media use and diet quality, unlike some studies that suggest social media influences eating behaviors more directly [
3,
4,
5]. No significant relationship was found between social media influence or use and actual diet quality or disordered eating. Conversely, studies by Holland & Tiggemann (2016) and Fardouly et al. (2015) identified social media as a significant factor in body dissatisfaction, leading to unhealthy eating behaviors [
23,
24]. This may indicate that while social media significantly affects perceptions of body image, its direct impact on eating behaviors may be mediated by other factors such as individual psychological traits or external support systems [
24]. The nature of social media content consumed by participants or the possibility that other factors, such as personality traits or environmental influences, mediate the relationship between social media exposure and eating behaviors, is likely [
45,
46,
47,
48,
49].
Additionally, our findings could reflect the growing awareness of media literacy and body positivity movements, which may buffer the negative impact of social media [
50,
51,
52]. The social cognitive theory suggests that behaviors are influenced by personal, environmental, and behavioral factors, including observational learning from media. This posits that individuals are becoming more adept at critically evaluating the content they consume, which reduces its direct influence on their eating behaviors [
53]. As the focus group results demonstrated, some participants were able to critically evaluate the unrealistic standards set by social media and resist conforming to harmful dietary trends. Several participants in this study acknowledged the growing awareness of media manipulation and unrealistic portrayals on social media, which may have allowed some individuals to develop resilience against the harmful effects of these platforms.
A significant body of research, including systematic reviews and meta-analyses, has highlighted how social media exacerbates body image issues and disordered eating behaviors, particularly among young women [
9,
22]. Studies have demonstrated that increased exposure to idealized body images on social media platforms correlates with body dissatisfaction, restrictive eating, and binge eating behaviors [
9]. However, this study’s findings challenge these findings, indicating that the relationship might be context dependent. The Body Image Dissatisfaction Model suggests that the internalization of media ideals is not universal and may depend on individual differences in self-esteem, media literacy, and societal attitudes towards body image [
54]. Our findings suggest that social media may no longer universally dictate body dissatisfaction and disordered eating behaviors in this demographic, possibly due to these mediating factors.
Cultural or geographical factors, for example, might attenuate how social media influences body image and eating behaviors [
4]. Cultural values, societal norms, and exposure to different types of content can vary greatly between regions. For example, New Zealand culture places a significant emphasis on body diversity, health, and fitness, which could promote more positive attitudes toward body image and less susceptibility to disordered eating behaviors [
55]. Conversely, studies conducted in other countries with stronger "thin ideal" cultural norms, such as the US or Western Europe, may find a more pronounced relationship between social media influence and eating behaviors [
4]. In countries like New Zealand, where this study took place, a greater emphasis on healthy eating campaigns and critical media consumption may mitigate the negative effects of social media [
32,
56]. Several participants in this study acknowledged the growing awareness of media manipulation and unrealistic portrayals on social media, which may have allowed some individuals to develop resilience against the harmful effects of these platforms.
One limitation of the study is the relatively small sample size, which may limit the generalizability of the findings. The sample size of 50 participants, while appropriate for a feasibility RCT [
32], may have limited the power to detect significant relationships, and a larger sample may yield different results. Secondly, the cross-sectional design of the study restricts the ability to draw causal conclusions about the relationships between social media exposure, body image disturbance, and eating behaviors. We cannot conclusively determine whether social media influences body image and eating behaviors or if individuals predisposed to these issues are more likely to engage with certain types of social media content. The specific social media platforms and content consumed by participants were not deeply explored, which could account for the differences between our findings and those of other studies. Another potential limitation is the reliance on self-reported data, which can be subject to biases such as social desirability. The dietary intake assessment questionnaire selected for the quantitative phase of the research, the short-form food frequency questionnaire, asks participants to recall intake over a preceding three-month period [
34]. Food frequency questionnaires are notoriously prone to recall and underreporting bias, which may preclude the validity of results [
57,
58].
Future research should explore these relationships longitudinally to better understand the directionality of these associations. It would be valuable to investigate the specific types of social media content consumed (e.g., fitness influencers versus body-positive content) and their differential impacts on eating behaviors and diet quality [
59]. Furthermore, exploring the role of cultural and geographical factors in shaping the relationship between social media, body image, and eating behaviors could provide more insights. For example, investigations into potential moderating factors, such as the role of social support or individual psychological resilience, in mediating the impact of social media on both body image and eating behaviors is needed; as well as larger and more diverse samples to provide a broader perspective on how these relationships manifest in different demographic groups.
Finally, for dietitians and healthcare providers, future studies could focus on interventions aimed at increasing media literacy and promoting positive body image to mitigate any potential negative effects of social media [
32,
56,
60]. The fostering of these skills would likely be beneficial to clinical work with young people, whereby the provision of social media advice alongside general nutrition guidance could act to build confidence in content quality discernment and protection against harmful body ideals.
It is vital to gain a richer understanding of how social media algorithms and their influential users impact the nutrition status of young women. Beyond comprehension, it is important to investigate how best to utilise social platforms to improve the body image and dietary intake of young people. This study may inform future research attempting to achieve such objectives. The Daily Health Coach feasibility trial is a pilot RCT evaluating the impact of a 3-month healthy lifestyles program on Instagram for young women in Aotearoa, NZ. We call for similar research to be undertaken with distinct population groups in order to collectively map how best to navigate social apps from the practitioner and research perspective.