Adolescents and young adults engaged with pro-eating disorder social media: eating disorder and comorbid psychopathology, health care utilization, treatment barriers, and opinions on harnessing technology for treatment

  • Ellen E. Fitzsimmons-CraftEmail author
  • Melissa J. Krauss
  • Shaina J. Costello
  • Glennon M. Floyd
  • Denise E. Wilfley
  • Patricia A. Cavazos-Rehg
Original Article



The purpose of this study was to examine exposure (i.e., seeing, following, posting) to body image content emphasizing a thin ideal on various social media platforms and probable eating disorder (ED) diagnoses, ED-related quality of life, and psychiatric comorbidities (i.e., depression, anxiety) among adolescents and young adult females recruited via social media who endorsed viewing and/or posting pro-ED online content. We also investigated health care utilization, treatment barriers, and opinions on harnessing technology for treatment.


Participants were 405 adolescent and young adult females engaged with pro-ED social media. We reported on study constructs for the sample as a whole, as well as on differences between age groups.


Eighty-four percent of participants’ self-reported symptoms were consistent with a clinical/subclinical ED, and this was slightly more common among young adults. Participants endorsed reduced ED-related quality of life, as well as comorbid depression and anxiety. Among those with clinical/subclinical EDs, only 14% had received treatment. The most common treatment barriers were believing the problem was not serious enough and believing one should help themselves. The majority of participants approved of harnessing technology for treatment.


Results provide support for engagement with pro-ED online content serving as a potential indicator of ED symptoms and suggest promise for facilitating linkage from social media to technology-enhanced interventions.

Level of evidence

V, cross-sectional descriptive study.


Feeding and eating disorders Adolescent Young adult Social media Cross-sectional studies 



This study was funded by the National Institute of Mental Health [Grant Numbers R21 MH112331 and K08 MH120341].

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study was reviewed and approved by the Washington University Institutional Review Board.

Informed consent

Participants consented to participate online.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PsychiatryWashington University School of MedicineSt. LouisUSA

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