Eating Disorders in ‘Millennials’: Risk Factors and Treatment Strategies in the Digital Age

  • Cassandra LenzaEmail author
Original Paper


Social media applications, known colloquially as “apps,” have quickly impacted the lives of young adults. There is evidence to support that suicide risk and social media use are correlated, which is of particular concern for individuals who struggle with body image, body dysmorphia, and eating disorders. These populations are already at a higher-risk for self-injurious behaviors and thoughts of suicide. In the treatment of eating disorders among emerging adults, known as Millennials, clinicians can feel disconnected to their clients when discussing and intervening in these new socialization structures that demand “perfection”. Understanding this population and its unique subset of challenges is essential in the digital age. This paper will explore common risk factors that precipitate eating disorder symptomology among this cohort, as well as offer a new perspective on treating the emerging adult population utilizing a values-based approach derived from Acceptance and Commitment Therapy (ACT).


Eating disorders Millennials Young adults Adolescent psychology Social media Acceptance and Commitment Therapy ACT 


Compliance with Ethical Standards

Conflict of interest

Author declares that she has no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. Ackard, D. M., Richter, S., Egan, A., & Cronemeyer, C. (2014). Poor outcome and death among youth, young adults, and midlife adults with eating disorders: An investigation of risk factors by age at assessment. The International Journal of Eating Disorders,47(7), 825–835.CrossRefGoogle Scholar
  2. Boyd, D. (2014). It’s complicated: The social lives of networked teens. New Haven, CT: Yale University Press.Google Scholar
  3. Carlyle, K. E., Guidry, J. P. D., Williams, K., Tabaac, A., & Perrin, P. B. (2018). Suicide conversations on Instagram: Contagion or caring? Journal of Communication in Healthcare,11(1), 12–18.CrossRefGoogle Scholar
  4. Errasti, J., Amigo, I., & Villadangos, M. (2017). Emotional uses of facebook and twitter: Its relation with empathy, narcissism, and self-esteem in Adolescence. Psychological Reports,120(6), 997–1006.CrossRefGoogle Scholar
  5. Fairburn, C. G. (2008). Eating disorders: The transdiagnostic view and the cognitive behavioral theory. In C. G. Fairburn (Ed.), Cognitive behavior therapy and eating disorders (pp. 7–22). New York: Guilford.Google Scholar
  6. Fardouly, J., Diedrichs, P. C., Vartanian, L. R., & Halliwell, E. (2015). Social comparisons on social media: The impact of Facebook on young women’s body image concerns and mood. Body Image,13, 38–45.CrossRefGoogle Scholar
  7. Foerde, K., Steinglass, J. E., Shohamy, D., & Walsh, B. T. (2015). Neural mechanisms supporting maladaptive food choices in anorexia nervosa. Nature Neuroscience,18(11), 1571–1573.CrossRefGoogle Scholar
  8. Goldschmidt, A. B., Wall, M., Loth, K. A., & Neumark-Sztainer, D. (2015). Risk factors for disordered eating in overweight adolescents and young adults. Journal of Pediatric Psychology,40(10), 1048–1055.CrossRefGoogle Scholar
  9. Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavior therapy. Behavior Therapy,35, 639–665.CrossRefGoogle Scholar
  10. Hayes, S. C., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: Guilford.Google Scholar
  11. Juarascio, A., Forman, E. M., & Herbert, J. (2010a). Acceptance and commitment therapy versus cognitive therapy for the treatment of comorbid eating pathology. Behavioral Modification,34(2), 175–190.CrossRefGoogle Scholar
  12. Juarascio, A., Shaw, J., Forman, E., Timko, C. A., Herbert, J., Butryn, M., et al. (2013). Acceptance and commitment therapy as a novel treatment for eating disorders: An initial test of efficacy and mediation. Behavioral Modification,37, 459–489.CrossRefGoogle Scholar
  13. Juarascio, A. S., Shoaib, A., & Timko, C. A. (2010b). Pro-eating disorder communities on social networking sites: A content analysis. Eating Disorders,18, 393–407.CrossRefGoogle Scholar
  14. Kaye, W. (2008). Neurobiology of anorexia and bulimia nervosa. Physiology & Behavior,94(1), 121–135.CrossRefGoogle Scholar
  15. Kendal, S., Kirk, S., Elvey, R., Catchpole, R., & Pryjmachuk, S. (2017). How a moderated online discussion forum facilitates support for young people with eating disorders. Health Expectations,20, 98–111.CrossRefGoogle Scholar
  16. Levallius, J., Clinton, D., Bäckström, M., & Norring, C. (2015). Who do you think you are? Personality in eating disordered patients. Journal of Eating Disorders,3, 3.CrossRefGoogle Scholar
  17. Liechty, J. M., & Lee, M. J. (2013). Longitudinal predictors of dieting and disordered eating among young adults in the U.S. The International Journal of Eating Disorders,46(8), 790–800.CrossRefGoogle Scholar
  18. Lin, L. Y., Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., et al. (2016). Association between social media use and depression among U.S. young adults. Depression and Anxiety,33(4), 323–331.CrossRefGoogle Scholar
  19. Loth, K. A., MacLehose, R., Bucchianeri, M., Crow, S., & Neumark-Sztainer, D. R. (2014). Predictors of dieting and disordered eating behaviors from adolescence to young adulthood. Journal of Adolescent Health,55(5), 705–712.CrossRefGoogle Scholar
  20. Neumark-Sztainer, D. R., Wall, M. M., Haines, J. I., Story, M. T., Sherwood, N. E., & van den Berg, P. A. (2007). Shared risk and protective factors for overweight and disordered eating in adolescents. American Journal of Preventive Medicine,33(5), 359–369.CrossRefGoogle Scholar
  21. Neumark-Sztainer, D., Wall, M., Larson, N. I., Eisenberg, M. E., & Loth, K. (2011). Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Journal of the American Dietetic Association,111(7), 004–1011.CrossRefGoogle Scholar
  22. Pew Research Center. (2007). A portrait of “generation next” 2007. Retrieved from
  23. Pratt, B. M., & Woolfenden, S. (2002). Interventions for preventing eating disorders in children and adolescents. Cochrane Database of Systematic Reviews,2, 1–10.Google Scholar
  24. Santarossa, S., & Woodruff, S. J. (2017). #SocialMedia: Exploring the relationship of social networking sites on body image, self-esteem, and eating disorders. Social Media + Society,3, 1–10.CrossRefGoogle Scholar
  25. Sonneville, K. R., Grilo, C. M., Richmond, T. K., Thurston, I. B., Jernigan, M., Gianini, L., et al. (2014). Prospective association between overvaluation of weight and binge eating among overweight adolescent girls. The Journal of Adolescent Health,56(1), 25–29.CrossRefGoogle Scholar
  26. Tempel, L. (2015). Danah Boyd: It’s complicated: The social lives of networked teens. Clinical Social Work Journal,43(2), 249.CrossRefGoogle Scholar
  27. Tiggemann, M. (2005). Body dissatisfaction and adolescent self-esteem: Prospective findings. Body Image,2(2), 129–135.CrossRefGoogle Scholar
  28. Tiggemann, M., & Miller, J. (2010). The internet and adolescent girls’ weight satisfaction and drive for thinness. Sex Roles,63(1–2), 79–90.CrossRefGoogle Scholar
  29. Tiggemann, M., & Slater, A. (2013). NetTweens: The internet and body image concerns in preteenage girls. The Journal of Early Adolescence,34(5), 606–620.CrossRefGoogle Scholar
  30. Tregarthen, J. P., Lock, J., & Darcy, A. M. (2015). Development of a smartphone application for eating disorder self-monitoring. The International Journal of Eating Disorders,48, 972–982.CrossRefGoogle Scholar
  31. van den Berg, P., Paxton, S. J., Keery, H., Wall, M., Guo, J., & Neumark-Sztainer, D. (2007). Body dissatisfaction and body comparison with media images in males and females. Body Image,4(3), 257–268.CrossRefGoogle Scholar
  32. Voelker, D. K., Reel, J. J., & Greenleaf, C. (2015). Weight status and body image perceptions in adolescents: Current perspectives. Adolescent Health, Medicine and Therapeutics,6, 149–158.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.New York UniversityNew YorkUSA

Personalised recommendations