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J Acad Nutr Diet. Author manuscript; available in PMC 2017 September 01.
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Published in final edited form as:

J Acad Nutr Diet. 2016 September ; 116(9): 1465–1472. doi:10.1016/j.jand.2016.03.021.

The Association between Social Media Use and Eating Concerns

among U.S. Young Adults
Jaime E. Sidani, PhD, MPHa,b, Ariel Shensa, MAa,b, Beth Hoffman, BSb, Janel Hanmer, MD,
PhDa, and Brian A. Primack, MD, PhDa,b,c
aDivisionof General Internal Medicine, Department of Medicine, University of Pittsburgh School of
Medicine, Pittsburgh, PA
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bCenterfor Research on Media, Technology, and Health, University of Pittsburgh School of

Medicine, Pittsburgh, PA
cDivisionof Adolescent and Young Adult Medicine, Department of Pediatrics, University of
Pittsburgh School of Medicine, Pittsburgh, PA

Abstract
Background—Although the etiology of eating concerns is multi-factorial, exposure to media
messages is considered to be a contributor. While traditional media, such as television and
magazines, have been examined extensively in relation to eating concerns risk, the influence of
social media has received relatively less attention.

Objective—To examine the association between social media use and eating concerns in a large,
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nationally representative sample of young adults.

Design—Cross-sectional survey.

Participants/setting—Participants were 1765 young adults ages 19-32 years, who were
randomly selected from a national probability-based online non-volunteer panel.

Outcome measures—An eating concerns scale was adapted from two validated measures: the
SCOFF Questionnaire and the Eating Disorder Screen for Primary Care (ESP). Social media use
(including Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine,
Snapchat, and Reddit) was assessed using both volume (time per day) and frequency (visits per
week).

Statistical analyses—To examine associations between eating concerns and social media use,
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ordered logistic regression was used, controlling for all covariates.

*
Corresponding Author: Jaime E. Sidani, PhD, MPH, Center for Research on Media, Technology, and Health, 230 McKee Place, Suite
600, Pittsburgh, PA 15213, [email protected]; 412-864-3192 (phone); 412-692-4838 (fax).
CONFLICT OF INTEREST DISCLOSURE
The authors of the manuscript entitled “The Association between Social Media Use and Eating Concerns among U.S. Young Adults”
have no conflicts of interest to disclose.
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our
customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of
the resulting proof before it is published in its final citable form. Please note that during the production process errors may be
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 Sidani et al. Page 2

Results—Compared to those in the lowest quartile, participants in the highest quartiles for social
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media volume and frequency had significantly greater odds of having eating concerns (adjusted
odds ratio [AOR] = 2.18, 95% CI = 1.50 - 3.17 and AOR = 2.55, 95% CI = 1.72 - 3.78,
respectively). There were significant positive overall linear associations between the social media
use variables and eating concerns (P < 0.001).

Conclusions—The results from this study indicate a strong and consistent association between
social media use and eating concerns in a nationally-representative sample of young adults ages 19
to 32 years. This association was apparent whether social media use was measured as volume or
frequency. Further research should assess the temporality of these associations. It would also be
useful to examine more closely the influence of specific characteristics of social media use—
including content-related and contextual features.

INTRODUCTION
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Feeding and eating disorders, known more colloquially as eating disorders, represent an
important clinical and mental health issue in the U.S., especially among adolescents and
young adults. Estimates based on the most recent Diagnostic and Statistical Manual of
Mental Disorders (DSM-V) definitions suggest lifetime prevalence by age 20 of
approximately 0.8% for anorexia nervosa (AN), 2.6% for bulimia nervosa (BN), 3% for
binge eating disorder (BED), and 11.5% for feeding or eating disorder not elsewhere
classified (FEDNEC).1,2 Eating disorders can have serious medical complications,3 and
meta-analyses suggest an increased mortality rate—including an increased risk of suicide—
for individuals with anorexia nervosa.4,5 However, subclinical eating concerns have
prevalence rates substantially higher than those of diagnosed eating disorders.6,7 Body
dissatisfaction, negative or altered body image, and disordered eating represent a wide
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spectrum of eating concerns, all of which are significant precursors to the development of a
diagnosable eating disorder.8-11 Even when they do not lead to an eating disorder, these
conditions can contribute to a long-lasting period of continued disordered eating.9,12

The etiology of eating concerns is multi-factorial and includes biological, psychological,

intrapersonal, and environmental influences.6 One environmental influence—exposure to
media such as fashion magazines and television—has been associated with the development
of these issues, which is likely mediated by thin-ideal internalization.13,14 Newly emerging
social media, however, combine many aspects of traditional media with technologically-
facilitated peer interaction.15 This combination of visual media and propagation of
stereotypes among peers may be linked to increased risk for eating concerns. For example,
an analysis of the video-sharing social media site YouTube found that one-third of anorexia-
related videos could be classified as “pro-anorexia,” and these videos were more likely to
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receive higher viewer ratings than “informative” videos, such as those highlighting the
health consequences of eating disorders.16 Similarly, studies of Facebook have found that
maladaptive use, such as comparing one’s self to others, is associated with greater
disordered eating and body dissatisfaction in college women.17,18 However, studies have
found that even non-maladaptive use of Facebook may be associated with both disordered
eating and body image concerns.19,20

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The majority of the research on social media and eating concerns has focused on a specific
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platform, such as Facebook or YouTube. Additionally, much of this research has been
limited to specific groups of individuals, such as college students, women, and those with
eating disorder diagnoses. To our knowledge, there are no published studies exploring the
links between broader social media use (i.e., studies examining more than one platform) and
eating concerns among a general, nationally-representative population of young adults.
Therefore, this study aimed to determine if there was an association between two different
measures of social media use—volume and frequency—and eating concerns, and to assess
the potential linearity of the association between each social media use measure and eating
concerns. The two hypotheses for this study were: (1) two different measures of social media
use—volume and frequency—would be independently associated with eating concerns and
(2) there would be a significant linear association between the two different measures of
social media use and eating concerns.
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MATERIALS AND METHODS

Participants and Procedures
Participants were recruited from a nationally-representative probability-based online non-
volunteer access panel known as the KnowledgePanel®. This panel, which consists of
approximately 55,000 members ages 18 years and older, is recruited and maintained by a
company called Growth from Knowledge (GfK). GfK populated this panel through both
address-based sampling and random digit dialing, resulting in a sampling frame that
represented approximately 97% of U.S. households.21 The data for this study were collected
as part of a follow-up wave of a longitudinal survey about health behaviors. From March -
April 2013, a total of 3254 GfK panel members ages 18 to 30 years completed an Internet-
based survey as a baseline assessment. Any panel member in this age group was eligible for
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this study; there were no specific exclusion criteria. In October 2014, GfK sent a follow-up
survey to those who had completed the baseline survey, who were then ages 19 to 32 years.
Those participants were asked additional questions regarding social media use and eating
concerns, and this represented the sample for the current study.

Those who completed the follow-up survey were given a $15 cash-equivalent incentive.
With data delivery, GfK personnel provided sampling weights in order to facilitate
adjustment of results to be generalizable to the U.S. population. This study was approved by
the University of Pittsburgh Institutional Review Board and was granted a Certificate of
Confidentiality from the National Cancer Institute at the National Institutes of Health. All
participants provided written informed consent before participation.
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Measures
Eating Concerns (Dependent Variable)—Participants were presented with five items
that were adapted from the SCOFF assessment tool, which is an acronym representing five
items measuring eating disorders,22 and the Eating Disorder Screen for Primary Care (ESP),
both of which were designed as brief screening assessments to identify primary care patients
at risk for eating disorders and in need of more specialized care.23,24 Specific items were:
“Losing control over how much I eat concerns me;” “Food dominates my life;” “Someone

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(such as a health professional, a family member, or friend) has expressed concerns about my
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eating patterns;” “My weight negatively affects the way I feel about myself;” and “I am
satisfied with my eating patterns.” When necessary, items were altered to assess broader,
subclinical eating concerns. Although the SCOFF and ESP instruments present their items as
questions, for this study items were formatted as statements with a 5-point Likert-type
agreement scale with response categories of definitely no, probably no, don’t know,
probably yes, and definitely yes. The summed raw score ranged from zero to twenty because
there were five items, each of which was scored from zero to four. Based on the non-normal
distribution of the data, these scores were collapsed into tertiles. “Low” eating concerns
consisted of scores ranging from 0-3; “medium” ranged from 4-9; “high” ranged from
10-20. These cut points were not based on established clinical definitions or intended for
diagnostic purposes. Instead, they helped form distinctions based on the natural distribution
of the data.
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Social Media Use (Independent Variables)—Social media use was assessed with
multiple items that were used to create two distinct social media use measures. First,
participants were asked to estimate their volume (time per day, in hours and minutes) of
social media use. Text associated with this item specifically instructed participants not to
include work-related use. The second set of items assessed frequency of use by asking
participants to indicate how often they visited the following social media platforms each
week: Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine,
Snapchat, and Reddit. These platforms were selected based on prior research documenting
their popularity with this age group.25 Seven response categories for each of these items,
based on a framework established by the Pew Research Center, included I don’t use this
platform (0), less than once a week (1), 1-2 days a week (2), 3-6 days a week (3), about once
a day (4), 2-4 times a day (5), and 5 or more times a day (6).25 These data were used to
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estimate participants’ summary frequency (visits per week) by converting the response
categories into numeric averages. For example, “1-2 days a week” was recoded as “1.5” and
“2-4 times a day” was recoded as “21 (three times per day, or 21 times per week).” Each of
these two independent variables (volume and frequency) was collapsed into quartiles for
primary analyses. This was done both to improve the interpretability of results and to be
consistent with similar studies in this area.26 However, all analyses were also conducted with
independent variables as continuous to ensure robustness of results.

Socio-demographic Factors (Covariates)—GfK maintains socio-demographic

information on its panel members. Based on their potential for having associations with
eating concerns and/or social media use,25,27-30 it was decided a priori to include seven
socio-demographic variables in multivariable analyses: age, gender, race/ethnicity,
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household income, relationship status, living situation, and educational attainment. Based on
the distribution of the data, age was collapsed into three categories (19-23; 24-26; 27-32).
Although eating concerns are typically thought to be issues of adolescence, prevalence in the
young adult age range is substantial.12,31 Race/ethnicity was collapsed into four categories,
including White, non-Hispanic; Black, non-Hispanic; Hispanic; and Other, which included
multi-racial individuals. Household income was divided into three categories, including low
(under $30,000), medium ($30,000-74,999), and high ($75,000 and above). Relationship

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status was categorized as single or in a committed relationship. Living situation was

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categorized as with parent/guardian; with significant other; and all other responses. Finally,
education level was categorized as high school or less; some college; or bachelor’s degree or
higher. All socio-demographic data were obtained via participant self-report.

Data Analysis
Weighted descriptive statistics were calculated for the dependent variable (eating concerns),
two independent variables (social media volume and frequency), and each of the seven
covariates.

Exploratory Factor Analysis using Principal Components Analysis (PCA) with varimax
rotation was performed to assess the underlying structure of the eating concerns items, and
Cronbach’s α was used to examine the internal consistency reliability of the eating concerns
items.
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Chi-square tests were used to determine bivariable associations between each of the
independent variables and covariates and the dependent variable. Additionally, bivariable
associations between each of the covariates and independent variables were assessed using
chi-square tests.

After confirming that the proportional odds assumption was met for each analysis, ordered
logistic regression was used to assess bivariable and multivariable associations between each
independent variable and the dependent variable, which was an ordered categorical variable.
It was decided a priori to include all covariates in multivariable models. Additionally, tests
for interaction effects between each independent variable and all covariates were performed.
The presence of an overall linear trend between each ordered categorical independent
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variable and the dependent variable was tested using an established method.32

Two sets of sensitivity analyses were conducted to confirm the robustness of the results.
First, auxiliary analyses were conducted that modeled the dependent variable (eating
concerns) as dichotomous and in quartiles. Second, analyses were conducted that modeled
the independent variables (social media volume and frequency) as continuous.

Study-specific post-stratification weights provided by GfK were used to perform all

descriptive statistics and analyses. These weights were computed to adjust for non-response
as well as non-coverage, under-, or over-sampling resulting from the sample design.
Statistical analyses were performed with Stata 12.1,33 and two-tailed P-values < 0.05 were
considered to be significant.
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RESULTS
Participants
The final sample consisted of the 1,765 individuals with complete data for the dependent
variable (response rate = 59%). Only 31 (1.7%) individuals were omitted due to missing
data. Approximately half of respondents were female (49.7%) and 57.2% were White, non-
Hispanic (Table 1).

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Eating Concerns
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PCA revealed that all items assessing eating concerns loaded onto a single factor (eigenvalue
= 2.83) which explained 57% of the variance. The lowest loading factor was 0.66. The
internal consistency of the 5 items was high (α = 0.81). The mean summary score was 6.9
with a standard deviation of 5.0. A total of 9.7% of the respondents had a score of zero
(minimum) and 0.2% of the respondents had a score of twenty (maximum).

When the dependent variable was collapsed into tertiles and accounting for survey weights,
the “medium” eating concern group consisted of the greatest number of respondents (36.1%)
and the “low” group consisted of 30.6% of respondents. The “high” group consisted of the
remaining 33.3% (Table 1).

Social Media Use

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Median volume was 61 minutes per day (interquartile range [IQR] = 30 - 135), while median
frequency was 30 visits per week (IQR = 8.5 - 56.5).

Bivariable Analyses
Bivariable analyses showed significant associations between the two social media use
variables, three of the covariates (gender, race/ethnicity, and household income) and eating
concerns (P ranging from < 0.001 to 0.03) (Table 1). Additionally, bivariable analyses
demonstrated significant associations between age, gender, and education level and social
media volume (P ranging from < 0.001 to 0.004) (Table 2). Age and household income were
significantly associated with frequency (P ranging from < 0.001 to 0.05) (data not shown).

Multivariable Analyses
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In fully adjusted models, participants in the highest quartile of social media volume had
significantly greater odds of having eating concerns compared to those in the lowest quartile
(adjusted odds ratio, AOR = 2.18, 95% CI = 1.50 - 3.17) (Table 3). Compared to those in the
lowest quartile, participants in the highest quartile of frequency (AOR = 2.55, 95% CI = 1.72
- 3.78) reported significantly greater eating concerns (Table 3). No significant interaction
effects were found between either of the social media use variables and any of the
covariates. Additionally, there were significant positive overall linear associations between
the social media use independent variables and eating concerns (P < 0.001 for all) (Table 3).
All sensitivity analyses demonstrated consistent results—in terms of both significance and
magnitude—regardless of the way that dependent and independent variables were
operationalized (data not shown).
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DISCUSSION
The results from this study indicate a strong and consistent association between social media
use and eating concerns in a nationally-representative sample of young adults ages 19 to 32
years. This association was apparent whether social media use was measured using volume
(time per day) or frequency (visits per week), supporting the first hypothesis that two
different measures of social media use would be independently associated with eating

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concerns. Additionally, the second hypothesis that there would be a significant linear
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association as the volume and frequency of social media use increased was supported.

The directionality of these associations cannot be ascertained due to the cross-sectional

study design. One possible explanation for the results of this study is that those individuals
who use more social media are exposed to more images and messages that present a risk for
the development of eating concerns. Some social media platforms, such as Instagram,
Snapchat, Pinterest, and Tumblr, are more visually-oriented, involving the sharing and
viewing of pictures and videos.34 According to the Pew Research Center (2014), 53% of
online adults 18-29 years use Instagram and 49% of Instagram users use the site daily.
Additionally, 42% of women online use Pinterest.25 These types of social media platforms
may expose users to influential visual material, including visuals that may promote the thin
ideal. Research suggests that individuals who use Facebook with higher frequency compare
themselves with others, potentially leading to body image concerns.17 Some social media
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platforms have attempted to mitigate this issue, such as Instagram banning the hashtags
“thinspiration” and “thinspo.”35 However, users have easily been able to circumvent these
barriers by spelling the words slightly incorrectly (e.g., “th1nspo”).36 Research has shown
that individuals tend to post images online that present themselves positively.37,38 Therefore,
users are likely to select from hundreds of more “accurate” photos the scant few which may
make the subject appear thinner and more attractive, in line with current social ideals. This
may result in users being exposed to unrealistic expectations for appearance.

Another explanation for the results of this study is that those individuals who develop eating
concerns may consequently use more social media. These individuals may seek out
information on social media to connect with other individuals who also have eating
concerns. Those who do so may encounter pro-eating disorder groups, such as the “pro-ana”
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and “pro-mia” communities that have a substantial presence on social media; there were at
least 500 of these groups on Facebook in 2010.39 Individuals report seeking out these
communities as a potential antidote to self-reported loneliness and social isolation.39
However, using these groups for social support may be problematic, as studies suggest that
these groups may lead to development of a shared social identity that inhibits authentic and
meaningful recovery from an eating disorder.40,41

While preliminary studies investigating the association between social media and eating
concerns focused on women in younger age groups,19,20,42 this study included men and
young adults ages 19 to 32 years. Interestingly, while there was a significant difference
between men and women for both social media use and eating concerns, no significant
interaction effect for social media use and gender on eating concerns was found.
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Additionally, while the younger age groups in this study reported significantly greater social
media volume, no significant interaction effect for social media use and age on eating
concerns was found. This suggests that the association between social media use and eating
concerns is an issue that is not confined to young women. Research has shown that men are
not immune to media images of “ideal” body shape, 43 and that use of Facebook may affect
mens’ body image.44 Likewise, disordered eating has a prevalence among older age
groups, 31 who are also increasing their presence on social media.25 Therefore, potential

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prevention messages concerning the association between social media use and eating
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concerns should be applicable to a broad population.

The results of this study should be considered with some important limitations. First, as
noted above, the cross-sectional design of this study limits the ability to make causal
inferences. Second, all data were self-reported. However, because respondents were assured
that their responses were confidential, it is unlikely that respondents would not be truthful.
Third, because this sample consisted of individuals ages 19-32 years, results cannot be
generalized to any other age groups. Fourth, response rate was 59%, and non-respondents
may have been different from respondents. However, the application of appropriate survey
weights allows for the generalization of these results based on the other socio-demographic
variables. Fifth, although the eating concerns measure was adapted from two validated
measures, it would be valuable to more closely align scale values with established clinical
cutoffs. Finally, the assessments of social media use in this study were limited to volume and
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frequency of use. Future studies should also examine other contextual factors around social
media use, such as whether use is generally alone or with peers.

CONCLUSIONS
In summary, a strong and consistent association between social media use and eating
concerns was found in a nationally-representative sample of young adults. This association
was apparent regardless of whether social media use was operationalized as volume or
frequency. These results suggest an important association that should be further explored in
longitudinal analyses to determine temporality.

Acknowledgments
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FUNDING DISCLOSURE

This work was supported by the National Cancer Institute at the National Institutes of Health (R01-CA140150).

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Table 1

Whole sample characteristics and bivariable associations between social media use and sociodemographic variables with eating concerns among a
nationally representative sample of young adults
Sidani et al.

Eating Concerns
Variable Total Sample (n =1,765) P valueb
Lowa (n = 540) Mediuma (n = 637) Higha (n = 588)

Column %c Column %c

Social Media Use

Volume (time per day, minutes) <0.001

Q1 (0-30) 29.8 37.6 28.3 21.3

Q2 (31-60) 20.8 20.7 23.8 16.9

Q3 (61-120) 23.9 20.9 23.2 28.7

Q4 (121 and above) 25.6 20.8 24.6 33.1

Frequency (visits per week)d <0.001

Q1 (less than 9) 28.1 36.9 25.7 19.8

Q2 (9-30) 25.2 24.7 28.5 21.5

Q3 (31-57) 23.9 21.8 22.6 28.3

Q4 (58 and above) 22.8 16.6 23.2 30.4

Sociodemographic

Age, y 0.67

19-23 33.6 36.1 34.1 29.9

24-26 24.7 24.5 23.7 26.5

27-32 41.6 39.5 42.3 43.6

J Acad Nutr Diet. Author manuscript; available in PMC 2017 September 01.
Gender <0.001

Female 49.7 42.5 48.7 60.3

Male 50.3 57.5 51.3 39.7

Race/Ethnicity 0.03

White, non-Hispanic 57.2 58.5 59.0 53.2

Black, non-Hispanic 13.1 16.3 12.7 9.1

Hispanic 20.8 19.9 19.0 24.3

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Eating Concerns
Variable Total Sample (n =1,765) P valueb
Lowa (n = 540) Mediuma (n = 637) Higha (n = 588)

Column %c Column %c
Sidani et al.

Othere 9.0 5.3 9.2 13.4

Relationship Status 0.99

Singlef 44.6 44.9 44.5 44.5

In a committed relationshipg 55.4 55.5 55.5 55.4

Living Situation 0.85

Parent/Guardian 34.0 34.7 34.4 32.4

Significant other 35.7 34.2 34.7 38.9

Otherh 30.4 31.1 30.9 28.6

Household Income 0.004

Low (under $30,000) 23.0 15.7 25.3 29.4

Medium ($30,000-$74,999) 38.6 43.5 38.3 38.6

High ($75,000 and above) 38.5 40.9 36.4 38.0

Education Level 0.17

High school or less 36.2 34.3 39.7 34.0

Some college 38.3 42.2 32.6 40.5

Bachelor’s degree or higher 25.6 23.5 27.7 25.6

a
Eating concerns represents a summary score for the following items: Losing control over how much I eat concerns me; Food dominates my life; Someone (such as a health professional, a family member,
or friend) has expressed concerns about my eating patterns; My weight negatively affects the way I feel about myself; and I am satisfied with my eating patterns. Low corresponds to scores of 0-3; medium
corresponds to 4-9; high corresponds to 10-20.

J Acad Nutr Diet. Author manuscript; available in PMC 2017 September 01.
b
P value derived using Chi-square analyses comparing proportion of users in each category.
c
Values may not total 100 due to rounding. Column percentages are based on survey weighted data, therefore may not be congruent with the cell frequency proportion of total n.
d
Includes Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit.
e
Includes Multiracial.
f
Includes widowed, divorced, and separated.
g
Includes engaged, married, and in a domestic partnership.
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 Defined as not living with a parent/guardian or significant other.
Sidani et al. Page 13
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h
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Table 2

Bivariable associations between sociodemographic covariates and social media volume among a nationally representative sample of young adults

Volume (time per day, minutes)a

Sidani et al.

Covariate Q1 (0-30) n = 507 Q2 (31-60) n = 365 Q3 (61-120) n = 423 Q4 (121+) n = 454 P valueb

Column %c
Age, y <0.001
19-23 26.7 27.3 36.4 43.5

24-26 27.4 20.0 26.4 23.4

27-32 45.9 52.7 37.2 33.1

Gender

Female 42.4 43.2 52.8 60.7 <0.001

Male 57.6 56.8 47.2 39.3

Race/Ethnicity

White, non-Hispanic 63.2 63.4 54.6 48.0 0.12

Black, non-Hispanic 10.6 10.5 15.2 16.7

Hispanic 16.7 17.5 23.6 25.6

Otherd 9.4 8.7 6.6 9.7

Relationship Status 0.07

Singlee 41.6 37.6 46.8 50.8

Committed relationshipf 58.4 62.4 53.2 49.2

Living Situation 0.15

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Parent/Guardian 31.4 29.2 37.3 37.9

Significant other 40.8 40.9 31.6 29.3

Otherg 27.9 29.9 31.1 32.9

Household Income 0.17

Under $30,000 18.4 20.9 24.6 28.2

$30,000-$74,999 41.3 36.6 42.0 34.4

$75,000 and above 40.4 42.5 33.4 37.4

Education Level .004

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Volume (time per day, minutes)a

Covariate Q1 (0-30) n = 507 Q2 (31-60) n = 365 Q3 (61-120) n = 423 Q4 (121+) n = 454 P valueb

Column %c
Sidani et al.

High school or less 31.9 26.5 38.9 44.8

Some college 37.4 42.1 38.3 37.2

B.A. or higher 30.7 31.4 22.8 18.1

a
Including personal not work-related use. Total sample size does not equal 1,765 due to individuals with incomplete data on this variable (n =16).
b
P value derived using Chi-square analyses comparing proportion of users in each category.
c
Values may not total 100 due to rounding.
d
Includes Multiracial.
e
Includes widowed, divorced, and separated.
f
Includes engaged, married, and in a domestic partnership.
g
Defined as not living with a parent/guardian or significant other.

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Table 3

Bivariable and multivariable associations between social media use and eating concerns among a nationally
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representative sample of young adults

Eating Concernsa
Social Media Use
OR (95% CI)b P valuec AORd (95% CI)b P valuec
Volume (time per day, minutes) <0.001 <0.001

Q1 (0-30) 1 [Reference] 1 [Reference]

Q2 (31-60) 1.35 (0.95-1.93) 1.46 (1.02-2.09)

Q3 (61-120) 1.91 (1.31-2.77) 2.00 (1.37-2.93)

Q4 (121+) 2.14 (1.49-3.07) 2.18 (1.50-3.17)

Frequency (visits per week)e <0.001 <0.001

Q1 (less than 9) 1 [Reference] 1 [Reference]

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Q2 (9-30) 1.49 (1.05-2.12) 1.51 (1.05-2.16)

Q3 (31-57) 1.94 (1.32-2.85) 1.97 (1.34-2.90)

Q4 (58 and above) 2.49 (1.70-3.65) 2.55 (1.72-3.78)

Abbreviations: OR, odds ratio; CI, confidence interval; AOR, adjusted odds ratio.
a
Eating concerns represents a summary score for the following items: Losing control over how much I eat concerns me; Food dominates my life;
Someone (such as a health professional, a family member, or friend) has expressed concerns about my eating patterns; My weight negatively affects
the way I feel about myself; and I am satisfied with my eating patterns. Eating concerns is divided into low, medium, and high tertiles.
b
OR = odds ratio; CI = confidence interval; AOR = adjusted odds ratio.
c
P value derived using test for overall linear trend of ordered categorical independent variables.
d
Adjusted for age, gender, race, relationship status, living situation, household income, and education level.
e
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Includes Facebook, Twitter, Google+, YouTube, LinkedIn, Instagram, Pinterest, Tumblr, Vine, Snapchat, and Reddit.
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J Acad Nutr Diet. Author manuscript; available in PMC 2017 September 01.