Appearance Comparison Is the Strongest Independent Correlate of Eating Disorder Risk among Adolescents

Abstract

Background: Previous studies have demonstrated associations between social media use, body image, and the risk of eating disorders. However, it remains unclear whether these associations are attributable to social media use itself or to processes related to how users perceive and respond to the content encountered on these platforms. Methods: This cross-sectional study included 750 secondary school students aged 17–18 years. Participants completed an author-developed questionnaire assessing social media use, the perceived influence of social media content on body image, and com-parisons of their own body shape with those presented on social media, as well as the Eating Attitudes Test (EAT-26). Results: TikTok was the most frequently used social media platform. An elevated risk of eating disorders (EAT-26 ≥ 20) was identified in 9.7% of participants. Greater perceived influence of social media content on body im-age and more frequent body shape comparisons were independently associated with higher EAT-26 scores and a greater likelihood of scoring ≥20 on the EAT-26. Conclu-sions: Body image-related processes, particularly comparisons of one’s own body shape with those presented on social media, may be more relevant to eating disorder risk than the amount of time spent using social media itself. These findings highlight the importance of preventive interventions focused on media literacy and reducing maladaptive appearance comparisons.