The Role of Social Media in Eating Disorder Recovery

So many people with new eating disorders or relapses had nowhere to turn for help during the pandemic. Society shut down as we know it and access to any mental health care was severely curtailed. The eating disorder treatment world, like all health care, became instantaneously virtual with no warning and no plan. Assessment, treatment planning, residential care and outpatient treatment programs scrambled to adjust but left patients minimal options for true care.

The incidence of new eating disorders skyrocketed, but patients couldn’t find help. Clinicians had endless waitlists. Virtual programs struggled to function because eating with people in a safe setting is central to the effectiveness of treatment. Residential programs had trouble even staying open and accepting new people safely.

So many people stayed home, trapped by the coronavirus, trapped by their eating disorder, alone and scared.

Home as well, clinicians, coaches and recovered people looked for new ways to attempt to help. The plethora of Instagram dietitians, body positivity influencers and recovered people had already had an enormous impact on the vocabulary and approach to eating disorder treatment. That burgeoning world exploded during the pandemic and added TikTok as an equally powerful platform.

But the increased exposure to recovery oriented content came with the algorithms intended to push people, especially teenagers, towards posts that encourage extreme dieting, low self-esteem and thereby increased the risk of eating disorders. Research data presented to Congress this week by a former Facebook executive provides incontrovertible evidence about the destructive effects of Facebook and Instagram.

The lay of the land in the eating disorder treatment world has been forever changed.

These social media voices express a varied, powerful and resonant chorus about eating disorders, body image and recovery which all clinicians must now heed. The messages previously attributed to older media outlets are no longer easily avoidable but instead in our hands and on our screens all day long. Ignoring this new reality means missing the basic understanding of how eating disorders now exist in our culture.

Let’s hope that the experience accelerated by the pandemic and by the exposure of Facebook’s destructive business decisions help avoid an even larger uptick in eating disorders. As clinicians, we need to discuss social media as a realistic outlet to aid in recovery. Focusing on the ways to use content to encourage recovery, reinforce positive messages about body image and self-esteem and avoid triggering images and diet advice is crucial. It’s imperative for clinicians to work with this powerful tool and not demonize it or ignore it.

The next post will venture into trickier territory. What is the role of clinical work in the social media universe? Where are the boundaries between helping people get better and self-promotion?