Recent revelations about Meta’s internal research findings have raised new questions about the role of social media in adolescents’ body image and mental health, particularly for girls (Wall Street Journal 2021). High-profile debates have raged about the potential mental health harms of social media (SM), contributing to a recent series of congressional hearings and legislative proposals (Anon 2022). Meanwhile, academics have debated whether time spent on SM contributes to adolescent mental health and wellbeing (Granic et al. 2020; Hamilton et al. 2022; Odgers and Jensen 2020; Orben 2020). In a recent theoretical paper, my colleagues and I highlighted the importance of moving beyond a focus on screen-time, and toward a nuanced perspective on specific SM experiences that may promote vs. hinder positive development (Hamilton et al. 2022). Most recently, we proposed a developmental–sociocultural theoretical framework for how and why specific SM behaviors may increase adolescent girls’ body image concerns (Choukas-Bradley et al. 2022). These perspectives dovetail with sociocultural and developmental perspectives on adolescent SM use, which highlight the need to move beyond one-size-fits-all approaches that center screen-time (Ito et al. 2020).
In this essay, I provide an overview of the state of sociocultural and developmental literature on adolescents’ SM use and body image. First, I discuss key theoretical perspectives regarding developmental and sociocultural influences on adolescents’ body image. Next, I introduce the “perfect storm” framework, a developmental–sociocultural framework for social media’s role in adolescents’ body image and mental health. Subsequently, I provide an overview of the state of the empirical literature on SM use and body image, with sections on social comparisons, the internalization of beauty standards, the “body-positive” movement, appearance-related SM consciousness, selfie behaviors, and individual differences based on identity and social–cognitive factors. Finally, I discuss implications and conclusions.
Adolescent Body Image: Overview and Key Theories
The majority of adolescents experience body image concerns, with rates especially high among girls (Daniels et al. 2020; Neumark-Sztainer et al. 2006). These concerns can include body dissatisfaction and weight/shape concerns (Thompson et al. 1999), body shame (McKinley and Hyde 1996), and self-objectification (Fredrickson and Roberts 1997). A recent nationally representative sample of U.S. youth aged 14-24 found that weight/shape concerns were elevated during the COVID-19 pandemic, with 40% of participants reporting having adopted behaviors aimed at controlling weight and/or shape during the pandemic (Schmid et al. 2022). Importantly, body image concerns have been linked to a broad range of problems that can interfere with adolescents’ wellbeing, including low self-esteem and self-worth, anxiety, disordered eating, depressive symptoms, and academic interference (Biro et al. 2006; Lewis-Smith et al. 2020; Paxton et al. 2006; Stice and Bearman 2001; Vannucci and Ohannessian 2018; Yanover and Thompson 2008). In this section, I discuss key sociocultural and developmental theories of body image.
Sociocultural Theories of Body Image
Since the 1990s, three key sociocultural theories have guided research on how media influences body image. These theories were developed to address mass media (e.g., television, magazines) before the advent of modern SM. First, the tripartite influence model proposed that peers, family, and the media transmit messages about cultural beauty standards, leading to social comparisons and internalization of problematic beauty ideals (Thompson et al. 1999). For example, imagine an adolescent girl who sees advertisements promoting weight-loss products, hears her mother discussing a desire to lose weight, and compares herself to photos of celebrities and popular peers who are thin. This adolescent is likely to internalize the “thin ideal” – the idea that thinness is desirable and important for women to attain. Social comparisons and internalization of unrealistic beauty standards can increase individuals’ perceived discrepancies between their ideal and real bodies, contributing to body dissatisfaction (Thompson et al. 1999). For example, an adolescent who internalizes the “thin ideal,” and who believes their body does not match this ideal, is likely to feel dissatisfied with their body.
Second, objectification theory proposed that in a society that sexually objectifies girls and women, girls and women learn to view themselves as if from a third-person perspective—in other words, to engage in self-objectification (Fredrickson and Roberts 1997). Girls who are high in self-objectification, and the closely related construct of objectified body consciousness, are more likely to view their self-worth as being based primarily on how they look, and to prioritize how they look over how they feel – which has been linked body dissatisfaction, body shame, and a range of mental health concerns (Daniels et al. 2020; Fredrickson and Roberts 1997; McKinley and Hyde 1996). Third, uses and gratifications theory emphasizes the agency of individuals in seeking out specific media content (Rubin 1994), such that adolescents’ preexisting tendencies and needs lead them to seek out specific media content. For example, an adolescent with body image interests or concerns may seek out beauty-related content, whereas adolescents who do not spend as much time thinking about their bodies will be less likely to search for body-related content. Since these theories were first published, dozens of empirical studies have supported their key tenets (Daniels et al. 2020; Moradi and Huang 2008). However, these traditional theories did not emphasize the developmental processes that are unique to adolescence.
Developmental Theories of Adolescent Body Image
Several key developmental processes contribute to heightened risk for body image concerns during adolescence. First, pubertal changes lead to dramatic alterations in weight and shape, which bring many adolescents further from sociocultural body ideals. For example, cisgender girls tend to gain weight during puberty, resulting in a greater discrepancy between their real and ideal bodies (Klump 2013; Markey 2010). Additionally, my research team’s qualitative interviews with transgender adolescents shed light on how pubertal development can lead to increased body dissatisfaction, as one’s body develops secondary sex characteristics that are misaligned with one’s gender identity (Romito et al. 2021). In contrast to cisgender girls and transgender youth, cisgender boys may find that the physical changes associated with puberty—particularly increases in muscle mass—may bring them closer to current cultural beauty standards for men; however, boys often experience body dissatisfaction due to other developmental and sociocultural factors discussed below, and may engage in excessive muscle-building behaviors in an effort to conform to the male muscular ideal (Frederick et al. 2022).
Second, during adolescence, youth are acutely attuned to their peers’ behaviors and attitudes, susceptible to peer influences, and concerned about their status among peers (Brechwald and Prinstein 2011; Giletta et al. 2021). Sensitivity to social reward peaks during adolescence, such that positive feedback from peers, or even the mere presence of peers, can activate neural responses associated with reward (Kilford et al. 2016; Sherman et al. 2016). This is in part due to rapid changes in the brain’s socioaffective circuitry during pubertal development, which have been linked to elevated emotional reactivity and social sensitivity (Somerville 2013). Furthermore, adolescents experience a social-cognitive phenomenon known as the imaginary audience, in which they believe they are the unique focus of others’ attention (Elkind 1967). In the context of these biopsychosocial changes, an “appearance culture” develops, in which peers frequently discuss physical attractiveness and ascribe status to those deemed attractive (Jones 2001; Mayeux and Kleiser 2020). The desire to engage in impression management and to present oneself favorably does not end with adolescence (Leary 1996; Schlenker and Pontari 2000), but during the adolescent period, this human drive may intersect with the peer appearance culture and heightened egocentrism to explain adolescents’ uniquely strong focus on physical appearance (Choukas-Bradley et al. 2022).
Some—but not all—of these phenomena are especially relevant for girls. Girls are socialized to prioritize their physical appearance (Daniels et al. 2020). They are bombarded with messages about the importance of being pretty, sexually attractive, and thin. Objectification theory was developed to address shared psychological experiences among women and girls (Fredrickson and Roberts 1997). Overall, research with cisgender adolescents indicates that girls are more likely than boys to report appearance-contingent self-worth (Burwell and Shirk 2009) and girls’ physical attractiveness is especially salient for their social status among peers (Mayeux and Kleiser 2020).
“The Perfect Storm”? A Developmental–Sociocultural Framework for Social Media’s Role in Adolescent Girls’ Body Image and Mental Health
The developmental and sociocultural theories discussed thus far in this section can help explain why body image concerns have long been common among adolescents, and especially girls. How does SM intersect with these factors? This is the core question my colleagues and I addressed in our developmental–sociocultural theoretical framework for the role of SM in adolescent girls’ body image concerns (Choukas-Bradley et al. 2022). We proposed that the features of SM intersect with the broader developmental and sociocultural factors discussed above, to create the “perfect storm” for exacerbating some girls’ body image concerns (see Figure 2.1). We focused specifically on girls, but here we address the state of the literature for adolescents of all genders. Sociocultural and developmental approaches to youth technology engagement encourage moving beyond one-size-fits-all theories and a focus on time spent using SM, and toward studying the specific forms of SM engagement that may exacerbate or protect against mental health risks among different adolescents (Ito et al. 2020). The “perfect storm” framework focuses on specific, subjective SM experiences that are affected by gender and individual differences.
Figure 2.1 The “Perfect Storm” Developmental–Sociocultural Framework of Social Media Use and Body Image Concerns, Adapted from the version first published in Choukas-Bradley et al. (2022) in Clinical Child and Family Psychology Review (Springer).
State of the Literature: A Summary of Empirical Research on Adolescents’ Social Media Use and Body Image
Systematic reviews indicate that heightened exposure to appearance-focused SM sites is associated with greater body dissatisfaction – covering a broad range of methods and both adolescent and adult samples, with predominantly female participants (de Valle et al. 2021; Fioravanti et al. 2022; Holland and Tiggemann 2016; Saiphoo and Vahedi 2019). In this section, I provide an overview of the state of the literature in several research areas related to specific SM experiences: social comparison, the internalization of beauty standards, appearance-related social media consciousness, selfie behaviors, and other individual differences based on identity and social-cognitive factors.
Social Comparisons on Social Media
Social comparison is one of the primary ways through which SM use affects body image (Rodgers 2016). On highly visual SM sites, many adolescents are exposed to curated, edited, and idealized images of peers, celebrities, and a novel SM-specific reference group, influencers—those who gather large followings based on their SM presence (Choukas-Bradley et al. 2022). A recent systematic review of experimental studies found social comparisons related to physical appearance to play an important role in links between SM use and body image, although the majority of these studies focused on adults (Fioravanti et al. 2022). Most research focused on adolescents’ appearance-related social comparisons on SM has relied on cross-sectional, non-experimental studies. Consistent with experimental work with adults (Fioravanti et al. 2022), cross-sectional studies with adolescents have also found social comparison to play an important role in the link between appearance-related SM use and body dissatisfaction across many nations (Chang et al. 2019; Jarman et al. 2021a; Roberts et al. 2022; Rodgers et al. 2020; Ryding and Kuss 2020; Scully et al. 2020; Yang et al. 2020). An important methodological note is that cross-sectional, non-experimental studies cannot determine causality or temporal precedence. For example, these study designs cannot rule out the possibility that adolescents who initially have higher social comparison tendencies are more likely to seek out appearance-related SM content (consistent with uses and gratifications theory; Rubin 1994).
Several aspects of SM may help explain the role of social comparison. First, social comparisons with SM images of friends, peers, influencers, and celebrities can trigger body dissatisfaction because these images are often carefully selected and edited with filters, blemish-correctors, and reshaping/resizing tools, in order to maximize attractiveness (Choukas-Bradley et al. 2022; Chua and Chang 2016; Scully et al. 2020). For example, in an experimental study conducted in the Netherlands, girls exposed to edited, reshaped/resized SM images of young women reported worse body image than those exposed to unedited photos, but only among girls with high social comparison tendencies (Kleemans et al. 2018). Second, adolescents’ SM feeds blend images of peers, celebrities, and influencers, blurring the lines among various sources of social comparison (Johnson et al. 2019). Many influencers are young women who become famous by demonstrating beauty routines or simply by posting attractive photos. The effects of SM influencer imagery exposure on body image have thus far primarily been examined among young adult women, with experimental studies finding higher negative mood and body dissatisfaction among those exposed to this imagery (Lowe-Calverley and Grieve 2021; McComb and Mills 2021). Third, researchers have examined the effects of exposure to SM content that specifically promotes thinness or fitness (i.e., “thinspiration” and “fitspiration” content), which has been linked to body dissatisfaction among young women in lab studies (Robinson et al. 2017; Rounds and Stutts 2020), likely due to upward social comparison processes, as well as internalization of beauty ideals (Rodgers 2016).
Social Media Use and the Internalization of Beauty Standards
As discussed earlier, traditional theories regarding body image focused on both social comparisons and the internalization of beauty ideals, such as the “thin ideal.” Exposure to thin-ideal SM imagery has been found to predict body dissatisfaction in recent experiments with adolescent girls and young adult women (Fioravanti et al. 2022), but beauty standards have also substantially evolved. Boys and men are now socialized to pursue body ideals that are both lean and muscular, whereas girls and women face beauty ideals that are increasingly complex: toned and fit, with a particular “slim-thick” body shape characterized by large buttocks, breasts, and thighs, with a small waist and flat stomach (Frederick et al. 2022; Gültzow et al. 2020; McComb and Mills 2022; Roberts et al. 2022). Recent experimental research indicates that exposure to “Fitspiration” content and/or general muscular imagery through SM increases body dissatisfaction among young adult men and women (Barron et al. 2021; Rounds and Stutts 2020), while self-report studies have documented that muscular ideal internalization mediates the link between SM use and body dissatisfaction among adolescent and young adult men and women (Fatt et al. 2019; Skowronski et al. 2021). The slim-thick body type is a newer area of research focus. McComb and Mills recently conducted an experiment with female Canadian undergraduates, finding that comparisons with slim-thick SM imagery predicted more weight and appearance dissatisfaction than comparisons with thin-ideal images (McComb and Mills 2022). In my team’s recent (not yet published) qualitative interviews with U.S. Black young women, several participants discussed the cultural appropriation of Black women’s bodies and beauty standards in the mainstreaming of this slim-thick beauty ideal (Ladd et al. 2022).
The “Body-Positive” Movement
Importantly, the “body-positive” movement has received extensive public and research attention in recent years. This movement ostensibly aims to increase body acceptance through representation of a diverse range of bodies and broadened definitions of beauty (Lazuka et al. 2020). Overall, findings are mixed regarding the effects of exposure to body-positive content on SM. Some experimental studies with young women have found exposure to such images and captions to be more positive than exposure to thin-ideal or “fitspiration” posts (Cohen et al. 2019; Davies et al. 2020). On the other hand, theoretical and empirical work suggest that the movement may exacerbate the focus on physical appearance, reassert the dominance of White thin bodies, and increase self-objectification (Choukas-Bradley et al. 2022; Cohen et al. 2020; Vendemia et al. 2021). Importantly, supporting uses and gratifications theory, a large study of Czech adolescent girls and boys suggested that body-positive online content may be associated with positive body image only among those who deliberately seek it out (Kvardova et al. 2022). A recent review of studies of body-positive media concluded that non-appearance focused media may be most promotive of body satisfaction (Rodgers et al. 2021).
Appearance-Related Social Media Consciousness & Selfie Behaviors
Is the “imaginary audience” still imaginary in a world where any moment can be photographed and broadcast to a huge audience? How common is it for adolescents to feel worried about their appearance on SM? Might they think about the SM audience even when they are offline? These are the questions that have driven my work related to appearance-related social media consciousness (ASMC), colloquially known as being “camera-ready” (Choukas-Bradley et al. 2019). My colleagues and I first introduced the construct when publishing results from a preliminary study with U.S. young adult women (Choukas-Bradley et al. 2019), and we subsequently developed and validated the Appearance-Related Social Media Consciousness Scale with samples of adolescents (Choukas-Bradley et al. 2020) and young adults (Maheux et al. 2022b). Examples of ASMC experiences include imagining how photos will look on SM, imagining one’s body on SM even when alone, looking at SM photos again and again, and editing photos to make oneself look better (Choukas-Bradley et al. 2020).
Our research indicates that individual differences in ASMC have relevance to both body image and mental health: higher levels of ASMC have been linked with adolescents’ and young adults’ body image concerns and mental health symptoms in several samples, with new research underway (Choukas-Bradley et al. 2020; Maheux et al. 2022b). One key takeaway point is that girls report higher average ASMC scores than boys. A second key finding is that higher ASMC is associated with higher depressive symptoms among both girls and boys, both concurrently and longitudinally. Third, we have thus far found that ASMC precedes heightened depressive symptoms, rather than developing in response to depressive symptoms (Maheux et al. 2022a). We have recently collected ASMC data among transgender and nonbinary youth (not yet published); understanding how SM affects body image among gender minority adolescents is an important area for future research.
Beyond our lab’s work on ASMC, many other studies have documented connections between appearance-related SM use and preoccupation with one’s appearance. For instance, Zimmer-Gembeck and colleagues developed the Social Media Appearance Preoccupation Scale (SMAPS), consisting of items reflecting online self-presentation, appearance-related activity online, and appearance comparison, and found scores to be associated with a range of indicators of emotional adjustment, appearance concerns, and interpersonal behaviors among Australian adolescent boys and girls (Zimmer-Gembeck et al. 2021). Consistent with our work on ASMC, mean SMAPS scores were higher among girls (Zimmer-Gembeck et al. 2021). Similarly, and consistent with uses and gratifications theory (Rubin 1994), researchers recently examined motivations to engage in SM use, and found that appearance feedback motivations were associated with lower body satisfaction among Australian girls and boys (Jarman et al. 2021b).
Selfie Behaviors
Other research suggests that simply taking or editing selfies may increase an objectified view of the self. For example, a lab-based study with U.S. undergraduate men and women found the simple act of taking a selfie to increase state self-objectification (Salomon and Brown 2020). Additionally, studies have linked adolescents’ SM use with traditional measures of self-objectification (Skowronski et al. 2020; Vandenbosch and Eggermont 2016), and a study of adolescent girls in China found higher selfie-posting to be linked to higher levels of self-objectification (Zheng et al. 2019). Several studies have found selfie editing behaviors to be especially predictive of body image concerns (Tiggemann et al. 2020; Wick and Keel 2020).
Importantly, the visual nature of SM may intersect with its quantifiable peer feedback metrics to exacerbate the focus on selfies. For example, research in Australia and the U.S. indicates that greater investment in SM photos and their feedback is associated with adolescents’ body esteem and disordered eating (Lonergan et al. 2020; Nesi, Choukas-Bradley, et al. 2021). In perhaps the most extreme example of how appearance-related SM use can contribute to an objectified self-concept, qualitative studies from the U.S., Singapore, and Germany highlight a complex set of strategies adolescent girls use to manage their SM presence or “brand” – including “meticulous backstage planning” (Chua & Chang 2016, p. 193) and a “production process” (Zillich & Riesmeyer 2021, p. 7) in which they scrutinize beauty norms, engage in posing and selfie-taking rituals, and extensively edit photos before posting at high-traffic times and requesting peer feedback (Chua and Chang 2016; Yau and Reich 2019; Zillich and Riesmeyer 2021).
Other Individual Differences Based on Identity and Social-Cognitive Factors
The differential susceptibility to media effects model addressed media effects broadly, proposing that individual users differ in their susceptibility to media effects (Valkenburg and Peter 2013). The research reviewed in the prior sections highlights several social-cognitive tendencies on which individual adolescents differ – social comparison, internalization of beauty norms, and appearance-related SM consciousness – all of which reflect dispositional factors in social context, and which are developmentally salient during adolescence. Higher individual levels of each of these factors have been linked to increased body image concerns in the context of SM use. Other intrapersonal factors have also been documented as moderators of associations between appearance-focused SM use and body image concerns: investment in appearance, imaginary audience ideation, and appearance perfectionism have all been found to strengthen these associations (Etherson et al. 2022; Lonergan et al. 2020; McComb and Mills 2022; Nesi, Choukas-Bradley, et al. 2021; Zheng et al. 2019).
We have discussed gender throughout this paper as an important identity characteristic that affects SM experiences and body image outcomes. But what about the intersection of race and gender? A critically important area for future research concerns a more thorough and nuanced exploration of the role of race in SM effects on body image. The body image literature has vastly overrepresented White women and Eurocentric beauty standards, and the majority of studies discussed in this paper relied on primarily White female samples from the Global North. As I discuss in the recent “perfect storm” theoretical paper, little is known about how SM may affect the transmission and internalization of beauty standards among girls of color. Consistent with uses and gratifications theory (Rubin 1994) and the co-construction model of adolescents’ online behavior (Subrahmanyam and Šmahel 2011), girls of color may curate their feeds to center images of Black women and girls, leading to exposure to more culturally relevant imagery than is featured in mass media contexts. In our research team’s recent qualitative interview work (unpublished data), Black young women described both positive and negative implications of using appearance-related SM, including the increased representation of Black women, paired with cultural appropriation of Black women’s body features and beauty standards (Ladd et al. 2022).
Future Directions and Implications
Body image has traditionally been viewed as a niche area of psychological science, yet body image is central to adolescent wellbeing, and poor body image is associated with a broad range of mental health struggles. I offer the following recommendations for researchers, clinicians, and policymakers:
Capitalizing on recent public attention toward the role of SM in adolescent girls’ body image concerns, now is the time for policymakers to focus on pushing for regulation of SM content algorithms, and for tech companies’ transparency regarding tech design practices and research findings (Anon 2022; Holdheim 2022; U.S. Surgeon General 2021).
Greater investment is needed to support both basic science research, and prevention programming, related to SM influences on body image concerns. More research is especially needed that focuses on how sociodemographic identities affect specific uses of SM, as well as the implications for wellbeing—with special attention to race, ethnicity, gender identity, sexual orientation, socioeconomic status, and their intersections.
Given the current state of the literature, I recommend that clinicians assess for how adolescents spend time on SM—not their overall screen-time. Recommending abstention from SM use is not only unrealistic, but it would likely be developmentally maladaptive for many adolescents as well. Many SM experiences promote positive expression and meaningful connections (Hamilton et al. 2022). Thoughtful discussions about how to increase values-aligned SM use, rather than encouraging overall reductions in use, may be more palatable to adolescents and more likely to contribute to behavior change.
Given recent evidence of the promise of single-session interventions for body image concerns (Schleider et al.,2023; Smith et al. 2023), investment in the development and dissemination of scalable, evidence-based interventions is important and likely to be fruitful. Moreover, evidence for the efficacy of brief classroom-based interventions further points to the benefits of scalable programs for SM use and body image (Bell et al. 2022; Gordon et al. 2021; Kurz et al. 2022).
Conclusions
This developmental-sociocultural perspective on SM and body image focused on specific, subjective experiences that differ across adolescents, moving beyond a one-size-fits-all approach (Ito et al. 2020). I provided an overview of the theoretical and empirical state of the literature on SM use and adolescent body image. Social media apps and trends tend to develop more quickly than research can keep apace, but the perfect storm framework provides a nuanced, humanistic blueprint for future inquiry into how SM affects body image.
Acknowledgements
I thank Savannah R. Roberts, Anne J. Maheux, Brianna A. Ladd, and Jacqueline Nesi, with whom I collaborated on prior book chapters and papers that helped shape my thinking for the current piece.
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