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Idealized Body Images and Fitness Lifestyles on Social Media: A Systematic Review Exploring the Link Between Social Media Use and Symptoms of Orthorexia Nervosa and Muscle Dysmorphia

Cristina Vintró‐Alcaraz, Cristina Ballero Reque, G. Paslakis, Giulia Testa

European eating disorders review, 2025

17 participants · 15 citations

Abstract

ABSTRACT Objective Social media (SM) is a source of appearance‐focused content that promotes idealized bodies and appearances. It also spreads misinformation about nutrition and fitness practices. While SM use has been linked to attitudes toward eating disorders, its association with orthorexia nervosa and muscle dysmorphia—characterized by obsessive behaviors around diet and body image—remains underexplored. This study systematically reviewed quantitative research on the relationship between SM use and symptoms of orthorexia nervosa and muscle dysmorphia. Method The review was registered on PROSPERO and adhered to PRISMA guidelines. Twenty‐two studies (orthorexia nervosa: n = 17; muscle dysmorphia: n = 5) were included, primarily cross‐sectional and conducted on non‐clinical populations. Study quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Results Most studies found that higher SM use was associated with greater orthorexia nervosa and muscle dysmorphia symptoms, with specific contents –such as posts regarding nutrition, thinness, and exercise– particularly associated with orthorexia nervosa. Platforms like Instagram, Tumblr, and Grindr demonstrated stronger associations with orthorexia nervosa symptoms. Gender differences were also observed. Conclusions Findings suggest a link between SM use and orthorexia nervosa symptoms, with preliminary evidence also supporting an association with muscle dysmorphia symptoms.…

How strong is the evidence?

Evidence Hub reads this as a systematic review. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 17 participants or records.

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