title: Social network media exposure and adolescent eating pathology in Fiji.
abstract: BACKGROUND
  Mass media exposure has been associated with an increased risk of eating pathology. It is unknown whether indirect media exposure--such as the proliferation of media exposure in an individual's social network--is also associated with eating disorders.
  
  
  OBJECTIVE
  To test hypotheses that both individual (direct) and social network (indirect) mass media exposures were associated with eating pathology in Fiji.
  
  
  METHODS
  We assessed several kinds of mass media exposure, media influence, cultural orientation and eating pathology by self-report among adolescent female ethnic Fijians (n=523). We fitted a series of multiple regression models of eating pathology, assessed by the Eating Disorder Examination Questionnaire (EDE-Q), in which mass media exposures, sociodemographic characteristics and body mass index were entered as predictors.
  
  
  RESULTS
  Both direct and indirect mass media exposures were associated with eating pathology in unadjusted analyses, whereas in adjusted analyses only social network media exposure was associated with eating pathology. This result was similar when eating pathology was operationalised as either a continuous or a categorical dependent variable (e.g. odds ratio OR=1.60, 95% CI 1.15-2.23 relating social network media exposure to upper-quartile EDE-Q scores). Subsequent analyses pointed to individual media influence as an important explanatory variable in this association.
  
  
  CONCLUSIONS
  Social network media exposure was associated with eating pathology in this Fijian study sample, independent of direct media exposure and other cultural exposures. Findings warrant further investigation of its health impact in other populations.
authors.affiliation: Department of Global Health and Social Medicine, Harvard Medical School, and Department of Psychiatry, Massachusetts General Hospital, 641 Huntington Ave, Boston, MA 02115, USA. anne_becker@hms.harvard.edu
authors.forename: Anne E
authors.initials: AE
authors.lastname: Becker
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Fay
authors.forename: Jessica
authors.initials: J
authors.lastname: Agnew-Blais
authors.forename: A Nisha
authors.initials: AN
authors.lastname: Khan
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Striegel-Moore
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Gilman
mesh_terms: D000293:Adolescent; D001828:Body Image; D015992:Body Mass Index; D001068:Feeding and Eating Disorders / Q000208:ethnology* / Q000523:psychology*; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006801:Humans; D008297:Male; D008402:Mass Media; D010379:Peer Group; D012044:Regression Analysis; D057566:Self Report; D012922:Social Change; D013334:Students / Q000706:statistics & numerical data; D013690:Television / Q000706:statistics & numerical data; D055815:Young Adult