Understanding social, genetic and environmental risk factors across eating disorders

社交媒体为人们提供了不断的机会，让他们每天都能将自己与理想化的、过滤过的和经过修饰的人进行比较。也许这并不奇怪，使用社交媒体平台Facebook与饮食失调1和身体形象担忧2有关，研究表明这些影响可以持续长达18个月3。有趣的是，一项研究发现，虽然花在Facebook上的时间与关注身体形象和饮食失调无关，但在Facebook上参与基于照片的活动是4。这一发现，再加上图片比文字更容易被记住的发现，意味着探索研究较少的基于图像的Instagram对饮食失调的影响至关重要。事实上，Instagram是世界上快速增长的社交网络6，与“健康饮食运动”7联系最紧密，因此它可能在最近饮食失调症的上升中发挥了关键作用。为了表明Instagram帖子对食物和锻炼的痴迷程度，在撰写本文时，有6230万#fitspo（'fitspiration'）帖子，4240万#cleaneating帖子和2390万#wellness帖子。这些帖子的普遍性令人担忧，因为对标签#fitspiration下的照片进行分析后发现，绝大多数照片都包含瘦而健美的女性图像，这些照片都符合当前社会文化中的美丽趋势。这种对“适合”看起来像什么的有限和狭隘的观点表明，拥有更大的身体与健康不相容，因此破坏了#fitspiration促进健康和健身的承诺。相反，它并不比它更具破坏性的对手#thinspiration好多少;可以说，两者都有助于促进瘦身。与大众媒体不同，社交媒体使观众能够积极和被动地参与，这两种参与形式与健康相关行为之间的联系已经确定。研究发现，在Instagram上消费图片的时间（即被动参与）与神经性厌食症（一种与神经性厌食症症状重叠的进食障碍）之间存在显著关系。相比之下，Facebook、Pinterest和Tumblr没有发现相关性，Twitter实际上显示出了一种小的保护作用。此外，以前的研究表明，在Instagram上发布“fitspiration”图像，即积极参与，与饮食失调行为和强迫性运动有关。10总的来说，我建议这个项目利用这个机会检查参与者在Instagram上消费的特定内容及其与饮食失调诊断，严重程度和轨迹的联系。例如，个人遵循的“健身”、“清洁饮食”和“健康”账户的数量可以被视为潜在的社会风险因素和健康寻求行为。参与者可以被要求报告他们关注的账户中致力于这些领域的比例，并可以检查其与饮食失调严重程度的关系。该示例的自我报告性质及其可靠性相关的困难可以通过对事实样本的验证过程来解决。如果我们要创造减轻饮食失调个体风险的方法，这项研究至关重要。

Social media offers constant opportunities for individuals to compare themselvesto idealised, filtered, and airbrushed versions of people every day. Perhaps it is no surprise then, that use of the socialmedia platform Facebook is associated with both disordered eating1 and with body image concern2, with longitudinalstudies indicating that these effects can last up to 18 months3. Interestingly, one study found that, whilst time spent onFacebook was not associated with concern over body image and disordered eating, engagement with photo-basedactivities on Facebook was4. This finding, coupled with the discovery that pictures are remembered better than words5,means it is vital to explore the effects of the lesser-studied, image-based Instagram on the development of eatingdisorders. Indeed, Instagram is the fasting growing social network in the world6 and is most linked to the 'healthy eatingmovement'7, thus it may have played a key role in the recent rise in eating disorders.To indicate the extent of the food-and-exercise-obsessed nature of Instagram posts, at the time of writing, thereare 62.3 million #fitspo ('fitspiration') posts, 42.4 million #cleaneating posts and 23.9 million #wellness posts. Thepervasive nature of these posts is concerning, given that analyses of photos under the tag #fitspiration revealed anoverwhelming majority contained images of thin, toned women, all in line with current sociocultural trends of beauty8.This limited and narrow-minded view of what 'fit' looks like suggests that being in a larger body is not compatible withbeing fit, and thus undermines #fitspiration's promise to promote health and fitness. Instead, it is not much better than itsmore damaging counterpart #thinspiration; arguably, both serve to promote thinness.The consequences of such posts have been investigated. Social media, unlike mass media, enables viewers toparticipate both actively and passively, and links between both forms of participation and health-related behaviours havebeen identified. A significant relationship was discovered between time spent consuming images on Instagram, i.e.passive participation, and orthorexia nervosa9 (an eating disorder that has symptoms that overlap with anorexia nervosa).In comparison, no association was found with Facebook, Pinterest, and Tumblr, and Twitter actually showed a smallprotective effect. Further, previous research indicates that posting 'fitspiration' images on Instagram, i.e. activeparticipation, is associated with disordered eating behaviours and compulsive exercise.10Overall, I suggest this project takes the opportunity to examine the specific content participants consume onInstagram and its link with eating disorder diagnosis, severity, and trajectory. For example, the number of 'fitspiration','clean eating' and 'wellness' accounts an individual follows could be viewed as both a potential social risk factor and ahealth seeking behaviour. Participants could be asked to report the proportion of accounts they follow that are dedicatedto such domains, and its association with eating disorder severity could be examined. The self-report nature of thisexample and the difficulties associated with its reliability could be addressed through a verification process of a sample ofaccounts. This research is crucial if we are to create methods to mitigate individual risk of eating disorders.