title: Instagram use is linked to increased symptoms of orthorexia nervosa.
abstract: OBJECTIVE
  Social media use is ever increasing amongst young adults and has previously been shown to have negative effects on body image, depression, social comparison, and disordered eating. One eating disorder of interest in this context is orthorexia nervosa, an obsession with eating healthily. High orthorexia nervosa prevalence has been found in populations who take an active interest in their health and body and is frequently comorbid with anorexia nervosa. Here, we investigate links between social media use, in particularly Instagram and orthorexia nervosa symptoms.
  
  
  METHODS
  We conducted an online survey of social media users (N = 680) following health food accounts. We assessed their social media use, eating behaviours, and orthorexia nervosa symptoms using the ORTO-15 inventory.
  
  
  RESULTS
  Higher Instagram use was associated with a greater tendency towards orthorexia nervosa, with no other social media channel having this effect. In exploratory analyses Twitter showed a small positive association with orthorexia symptoms. BMI and age had no association with orthorexia nervosa. The prevalence of orthorexia nervosa among the study population was 49%, which is significantly higher than the general population (<1%).
  
  
  CONCLUSIONS
  Our results suggest that the healthy eating community on Instagram has a high prevalence of orthorexia symptoms, with higher Instagram use being linked to increased symptoms. These findings highlight the implications social media can have on psychological wellbeing, and the influence social media 'celebrities' may have over hundreds of thousands of individuals. These results may also have clinical implications for eating disorder development and recovery.
authors.affiliation: Division of Medicine, UCL, London, WC1E 6BT, UK.
authors.forename: Pixie G
authors.initials: PG
authors.lastname: Turner
authors.affiliation: Centre for Behaviour Change, Department of Clinical, Education and Health Psychology, UCL, London, WC1E 7HB, UK. c.lefevre@ucl.ac.uk.
authors.forename: Carmen E
authors.identifier: http://orcid.org/0000-0003-1640-7262
authors.initials: CE
authors.lastname: Lefevre
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image / Q000523:psychology; D005247:Feeding Behavior / Q000523:psychology*; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D061108:Social Media; D063189:Symptom Assessment; D055815:Young Adult
keywords: Eating disorder; Instagram; Orthorexia nervosa; Social media