The Impact of Social Media on Dietary Behaviors and Body Image of College Students: A Qualitative Approach ()
1. Introduction
The world’s internet revolution has changed how people communicate, gain knowledge, and share information [1]. This is especially true in young adults; it was reported that 84% of young adults aged 18 to 29 use social media (SM) [1]. The vast majority of young American adults reported using YouTube (81%), Facebook (69%), Instagram (40%), Pinterest (31%), and LinkedIn (28%) [2]. As of 2023, of Facebook users, 76% of women reported using the platform, compared with 59% of men [3]. The daily average time spent on SM was reported to be about 2 hours and a half [4] [5]. Worldwide, adults reported spending time on SM to keep in touch with family/friends, fill their spare time, read the news, find information, and manage their health [4] [6].
The use of SM sites as a resource for health and wellness-related information has continued to increase, and concerns are being raised regarding its influence on adolescents and young adults [5] [7]. Zhang [8] examined the current use of SM in a small sample of 38 college students; they reported using Facebook, Twitter, Tumblr, and Myspace for health and wellness information, including weight loss. It has been suggested that as many as 81% of young adults look for nutrition-related news on SM, and only 32% reported concerns about the accuracy of the information received [5]. SM content can negatively influence health behaviors [7]. Young adults who used SM for weight control or to lose weight were found to have a higher risk of being overweight or obese compared to normal-weight individuals [5]. Research suggests that SM use is correlated with unhealthy eating behaviors and stress. Sampasa-Kanyinga et al. [9] reported that the use of social media websites like Facebook, Twitter, Instagram, and MySpace was associated with unhealthy eating behaviors, including breakfast skipping, consumption of sugar-sweetened beverages, and energy drinks among youth. Qutteina et al. [10] conducted a cross-sectional study with undergraduate female students and found that extensive use of social media, especially Instagram, was positively linked to disordered eating behaviors. Another study indicated that 23% of young adults reported changing their diet based on information gained from social media [11]. More recent research had mixed conclusions regarding the relationship between usage and time spent on social media and body mass index (BMI) [12] [13]. While Al Saud et al. found a significant association between social media addiction and BMI [14]. There is also consistent evidence regarding the influence of social media information on body image and the potential for a negative body image to create eating disorders. Zeeni et al. [7] have suggested that SM affects body image dissatisfaction, eating disorder risks, stress, anxiety, and depression. In a sample of college females, Al Saud et al. found that 50% of participants reported addiction to social media, and nearly 75% reported negative body image [14]. Another study found that social media platforms like Facebook and Instagram allow users to follow celebrities, intensify exposure to these influencers’ messages and images, and result in negative mood and body dissatisfaction [15].
Many of these studies have been cross-sectional surveys and do not examine young adults’ understanding of the information they obtain from SM and how that information influences their behavior. The utilization of self-reported height and weight data and the varied demographics of participants in these studies may warrant further investigation, especially using a qualitative approach.
This research aimed to explore the impact of social media on diet behavior and perception of body image of college students. In particular, the objective of this study is to gain a greater understanding of the particular context and the processes when young adults utilize the information received from SM. Another specific objective of the study was to utilize the most frequently discussed thematic items for developing a survey instrument to be used in the study’s second phase.
2. Methods
2.1. Data Collection
This study took place in 2021. The research protocol (IRB-2021-75) was granted an expedited review and was approved by the University Institutional Review Board (IRB) before data collection. A cross-sectional qualitative study of three focus groups, approximately 60 minutes each, was conducted with 18 college students until data saturation was reached. The sample size was determined considering the recommendations of Krueger and Casey [16] as each focus group consisted of at least six participants. A mass email with a sign-up link was sent to undergraduate students at a public university in the Southern United States. Participants were required to be undergraduate students and at least 18 years of age at the time of recruitment. Participants who met the selection criteria were invited to participate and confirm their availability. An electronic written consent was obtained from each participant by email. The researchers created and followed guiding open-ended questions that included introductory, transition, and key questions (Appendix). The introductory and transition questions were used to encourage all participants to talk. The key and ending questions were more specific and focused to yield the most useful information regarding the impact of social media on diet behavior and body image. Probe questions were asked as needed to elucidate the responses. The focus group questions were developed and then reviewed by the researchers and student assistants to ensure clarity and that they were understood [16]. All focus groups were held and recorded using Zoom, and participants used pseudonyms to maintain confidentiality.
All focus group transcripts were verified against the audio file by the lead researcher to ensure accuracy. A demographic information questionnaire was completed by all participants at the end of each session. Each focus group lasted about one hour, and each participant received a $20 gift card as a token of appreciation for their participation.
2.2. Data Analysis
The focus group transcripts were coded using a thematic codes list including both pre-established codes based on the Grounded Theory by Corbin and Strauss [17] [18] and free (inductive) codes as they arose directly from the transcripts. To ensure reliability and inter-coder agreement, two of the researchers independently transcribed and coded the recordings [19]. The transcripts were coded in 3 phases: open, axial, and selective coding. Atlas.ti 9 Windows (Version 22.0.6.0) was used to analyze the data [20]. Krippendorff’s alpha test was used to estimate the inter-coder reliability [21]. The Krippendorff’s alpha value ranges from −1 to 1, with 1 representing the unanimous agreement between the raters, 0 indicating random guessing, and negative values suggesting systematic disagreement [22]. Two of the researchers coded a random sample of the focus group entries independently. The reliability analysis produced a high value (Krippendorff’s α = 0.99), indicating inter-coder reliability and agreement between the coders.
3. Results
3.1. Demographics of Participants
The demographics of the participants are presented in Table 1. Most participants (n = 12) were female, and six were male. Participants were well-diversified in their educational level and major. Fourteen out of the eighteen participants ranged in age from 18 to 25 years.
Table 1. Demographics of focus group participants.
| Characteristic |
Frequency |
| Age Group |
|
| 18 - 25 years |
14 |
| 26 - 33 years |
3 |
| 34 years and older |
1 |
| Gender |
|
| Female |
12 |
| Male |
6 |
| Ethnicity |
|
| White |
10 |
| Hispanic or Latino |
4 |
| African American |
2 |
| Other |
2 |
| Year in College |
|
| Senior |
8 |
| Junior |
7 |
| Sophomore |
3 |
| Major |
|
| Nursing |
5 |
| Health Sciences |
3 |
| Healthcare Administration |
3 |
| Food Science and Nutrition |
2 |
| Public Health |
2 |
| Finance |
1 |
| Criminal Justice |
1 |
| Environmental Science |
1 |
3.2. Social Media Platforms and Contents
Social media platforms the participants reported utilizing were TikTok, Twitter, Instagram, Facebook, YouTube, Snapchat, Reddit, and Pinterest. For instance, a participant mentioned “I feel like Facebook and Instagram’s probably my number one and then tik tok has been second now and then Facebook third. And its probably, Instagram is probably the most I use and I’d say, gosh I could be on there from anywhere from four to six hours of the day.” Another participant said, “Snapchat and Facebook and occasionally I use all platforms from Reddit to YouTube”.
The participants in this study reported that they use social media platforms to look for fitness information, recipes, diet, and nutritional supplements information. The following are examples of how different participants searched for and used the information:
“I mainly use Instagram and I’ve never searched for diet or health-related content, but if um, there’s one person that pops up on my feed that has um, like recipes or workout advice I may look at their page and then follow them.”
“I use more of mine for fitness so when I say I’m going to use their advice it’s more so for fitness so I have a guide when I’m in the gym.”
“Most of the posts I see are like people at the gym and then like, afterwards they will go have something to eat. And yeah, sometimes it looks really good and obviously they’re trying to eat healthy.”
“I enjoy seeing um things people promote being their like diet things or different supplements because I feel like it gives me like… I can go look that up and learn more about it even though I know it is probably not useful I may learn something useful from it.”
3.3. Identified Themes and Sub-Themes
This study took a Grounded Theory approach in defining the overarching themes and subthemes. Two of the researchers used the three phases as Strauss and Corbin recommended: open coding and axial coding [18]. Open coding was used to identify conceptual and theoretical ideas within the data. Axial coding examines the conceptual and theoretical ideas in the data and works to identify the phenomena in the data: conditions, actions, and consequences.
Three main themes were identified from the data across all responses: conditions, actions, and consequences. The themes were identified based on the frequency of statements made by the participants. The main themes and sub-themes are summarized in Table 2. Conditions included perceived elements like social media influencers, misinformation, and platforms that participants gave for why and how social media influenced their diet behavior and body image. Actions included elements that shape their action-interaction with the conditions. These included eating behavior, physical activity, and dietary supplement intake. Consequences included anticipated or actual outcomes of action and interaction like body image, ideal weight, and positive and negative social media influence. Views on the influence of social media varied, but most believed social media had a negative influence on dietary behaviors. Figure 1 presents the relationship between the three main themes.
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Figure 1. Relational network of the main and subthemes.
Table 2. Identified themes and sub themes.
| Theme |
Frequency |
| Conditions |
|
| Social media content |
44 |
| Influencers |
42 |
| Social media usage frequency |
25 |
| Social information validation |
24 |
| Social media platforms |
22 |
| Social media misinformation |
19 |
| Actions |
|
| Eating behavior |
46 |
| Dietary supplement intake |
13 |
| Physical activity behavior |
5 |
| Consequences |
|
| Body image |
17 |
| Social Media’s positive influence |
16 |
| Social media’s negative influence |
16 |
| Ideal weight |
8 |
As shown in Table 2, the Conditions theme, participants identified situations in which the action occurs. The Conditions theme was classified into three elements. The elements included social media validation, social media platforms, and social media misinformation. Social media validation participants discussed examining nutrition and diet information they received on SM with individuals who have credentials. An example:
I also follow people that actually are credible like licensed dietitians…. I really enjoy just hearing both their sides and like watching them like okay, seeing what they say about it and then what they say about it and just comparing the two. I normally never listen to influencers because of course I know that it’s unrealistic, but it’s really the following both those pieces.
The third element of the Conditions theme is social media misinformation. The participants discussed the promotion of products by influencers. An example:
I follow people that like I said like influencers that just kinda [kind of] promote things that I don’t think they’re really knowledgeable about because they have no credibility in that area.
In the Actions theme, participants identified the actions they take in response to the conditions. The Actions theme was classified into three elements. The elements include eating behaviors, dietary supplement intake, and physical activity behavior. Eating behaviors participants discussed how social media influencers and content influence their eating behaviors. An example:
There are like certain trends that I see that I kinda [kind of] like will try and like maybe do for a little bit, but like I don’t necessarily alter my entire diet based on one person, like based on one influencer because like, we all are different in our bodies you know, digest and we have different metabolisms, we all-like we all have different bodies.
The following is an example of how participants discussed supplements they learned about on SM.
Participant A: the tik tok trends like the chlorophyll drops people were drinking…. Participant B: It’s so funny you mention that because I was totally hooked into that chlorophyll, so I’m like googling it, I’m researching it, and like honestly when you look at it, it says on there like, if you drink it directly in the liquid form of chlorophyll, that your body can’t break it down to where it can apply it nutritionally and so, there’s like this specific tablet, which I did buy actually, it’s called chlorella, which is a it’s a mixture with something which they add and actually helps you digest it because you can’t just digest it like straight with chlorophyll, like you can’t—it doesn’t—you can, but it doesn’t actually do anything good for you. Unless—you can apply it topically I mean that’s good. So I mean, it’s funny that you mentioned that because I did—I was into that chlorophyll now, just because of the benefits for your skin. It’s supposed to be really good for your skin.
Participants also discussed how SM influenced their physical activity, an example:
I’ve been seeing a lot of beginner-friendly work out videos so they’re geared toward people who haven’t exercised in several years and I found that helpful because it can be really intimidating to start exercising.
In the Consequences theme, four elements were identified. The Consequence theme is a result of the actions or inactions taken. The elements included: body image, SM positive influence, SM negative influence, and ideal weight. An example of how body image was influenced by the SM actions:
It makes you feel like garbage [chuckles]. Honestly, like you see all these girls that are just like smooth everywhere. I mean you don’t even imagine a piece of body hair ever touched them you know? And curves and glow and you’re like wow. You look at yourself in the mirror and you’re like oh my gosh.
Participants also discussed the positive influence of SM on their actions, an example:
I’m constantly I mean I probably make new recipes from Pinterest or somewhere, even Instagram um, twice a week at least. I mean, I make um, a lot of different smoothies and it’s not like I just do it because like those people do it, I do it because it actually genuinely looks good and it has good ingredients.
There was also discussion of the negative influences of SM on actions, an example:
Like there are different types of like these perfect bodies that we all want to achieve. And I know for me, it’s like, well I want her flat stomach, but I want her legs, and I want her arms and its like—it’s not realistic. Like, we can’t have—like I can’t take a body part from each of these women and be like I want my body to look like that because it’s just not possible unless I am literally like training ten hours a day. So I think for me, I really feel like, I may be hard on myself when I’m like, wait, I want my arms to be bigger, but if I do that I’m gonna be bigger here. So, it’s just like social media does really kind of like put a scale on what I want to look like. Do I want to look like this or would I rather look like this?
The last element was the influence of the actions on ideal weight. An example:
It makes you feel like garbage [chuckles]. Honestly, like you see all these girls that are just like smooth everywhere. I mean you don’t even imagine a piece of body hair ever touched them you know? And curves and glow and you’re like wow. You look at yourself in the mirror and you’re like oh my gosh [chuckles] what’s going on? But I will say. I follow a lot of women that are discouraging because of that because you know they look so perfect.
4. Discussion
The internet has changed how young adults receive health and wellness-related information. The influence of SM has continued to increase, and concerns are being raised regarding its influence on the health behaviors of young adults. This study aimed to understand better the impact of exposure to social media nutrition information on college students’ body image and diet behavior. Three main themes were identified based on the discussions during the focus groups.
Conditions were the participants’ explanations for their actions, the actions were in response to the conditions, and the consequences were the results of the actions.
The Conditions theme represented the participants’ perceived reasons or explanations for their actions. These conditions included the frequency of using social media platforms, the type of social media platform, social media influencers, social media content, misinformation, and validation of social media information. Diet and food-related content on social media may influence people’s diet and physical activity behavior. Boswell and Kober conducted a meta-analysis study [23]. They found that visual cues of foods, e.g., images and videos, are conditioned responses that increase the likelihood of eating and weight gain [23]. A participant in this study indicated that they search for different content on social media, including diet and fitness information. For instance, a participant said, “I had heard about intermittent fasting just randomly, I think, and then I did look it up, like probably on YouTube.” Another participant said, “I usually look at something for like to exercise of the day, or something, you know, if I want to focus today on leg day. I try to get something different, you know, just so I could… work differently around working muscle groups.” The role of influencers was evident in the responses.
A participant mentioned, “There’s one person that pops up on my feed that has um, like recipes or workout advice I may look at their page and then follow them.” Another participant said, “I follow like a nutritionist who is actually like a Ph.D., and you know, it seems like she knows everything that she’s doing, and she provides like a meal guide and everything, which was really helpful, but the problem was the fact that she her food we’re not the kind of foods that I eat and know like the cuisines are very different.” One study found that digital marketing for unhealthy foods by an influencer on blogs increased children’s intake of unhealthy snacks [24]. Because social cues are perceived as ‘popular’ and prized by young adults, influencers may significantly influence the promotion of health and healthy products [25]. Oftentimes influencing individuals to promote and advertise multiple health products in their feeds or videos that they enjoy and recommend is a highly successful marketing model [25] [26]. These conditions in which the young adults find information on SM about nutrition, diet, and physical activity then influence their actions. Previous research supported the role of social cognitive factors in influencing diet behavior and physical activity. For instance, Anderson-Bill, Winett, and Wojcik [27] used an intervention based on the constructs of the Social Cognitive Theory with web-health users. They found that perceived social support and the use of self-regulatory behaviors were significant predictors of physical activity and nutritional behavior of the participants.
The Actions theme represents the actions participants took in response to the SM condition. These actions included eating behaviors, physical activity, and supplement intake changes. Jackson, et al. found that 23% of university students reported changing their diet due to information received from SM [11]. This included following fad diets, including the “military diet” and “paleo.” [11]. A participant in this study indicated that SM influences their dietary intake, “social media does influence kind of what I eat… Maybe some junk food or something, and it’s like, oh, it’s kind of tempting to try it out.” A different participant indicated that their dietary intake is positively and negatively influenced, “I would also say the daily, uh, influence. Just because sometimes there are healthier options that I see, and I’m like, ‘Oh, that really looks good.’ But also, on the other hand, like there could be this brand-new ice cream flavor that sounds super good and someone like post it and you’re like, ‘Wow, that sounds really good. I’m gonna go have that tomorrow night,’ or something like that. So it’s not just healthy.” Another participant stated, “I can see how that kind of helps influence like my own diet routine because you know I want to look that way or I want to perform better athletically in the same way that they do so, their diet and how they present it, you know, has an influence on mine as well.” Other research by Charry and Tessitore found that the perceived social value of healthy food on SM influenced healthy eating behaviors [28]. Participants in this study indicated that their eating behaviors were impacted by exposure to healthy foods on SM. For example, a participant stated, “I definitely think that it does influence a lot of people to change like I don’t eat out like fast food as much anymore.” Another participant reported frequently using SM to find recipes and discussed how he learned on SM to modify a spaghetti recipe with zucchini noodles instead of pasta. A participant stated, “when I think of like social media and what I think of what I see, I definitely think of healthy eating. That’s like the first thing that comes to my mind.” In this study, the participants also report SM positively influencing physical activity behaviors. A participant discussed how a particular influencer’s workout routine influences her, “I like watching her videos because I find motivation from it, because it kind of inspires me to. You know, do more, when I am in the gym.” This response is consistent with Fitspiration research, suggesting the majority of young adults find this type of content inspiring. Another participant in this study supported that theory, “a lot of pictures of you know their fitness and their diet routine, and so I can see how that kind of helps influence like my own diet routine because you know I want to look that way or I want to perform better athletically in the same way that they do so, their diet and how they present it, you know, has an influence on mine as well.” Participants also discussed how they started taking supplements based on what they saw on SM such as diet pills, and chlorophyll drops. The participants made several points about how they knew these supplements would not produce the expected results however, they tried them anyway. For example, “I kind of have like I know its nutritional but it’s like low key embarrassing but it’s this stuff that I had seen a girl and Ted talk and then my mom had seen it on Facebook… and it pretty much like helps you like digest your food a lot easier and that was one I used and all the like. All the comments on the website were like oh my gosh this stuff works so well it’s like you know I feel so much better. And like I started taking them in like I did not feel like any different feel the hype all these people were saying online, I also feel like sometimes it’s the placebo effect like if you think that pill is going to help you, with your diet appetite.”
However, when discussing the chlorophyll drops, one participant described the use and benefits based on her research and mentioned “so I’m like googling it I’m researching.” Other participants discussed initiating a pre-workout supplement or a protein shake because it was recommended by an influencer. One example, “the person that I just named she um sponsors a protein powder that she uses and I bought it as well and um it you know works really well.” Overall eating behaviors, physical activity and supplement intake were influenced by the content of SM. However, the participants in this study described ways they assessed the information before applying it. They also were able to select from the content portions which they would like to apply to their lives and did not necessarily adopt the entire behavior from the SM influencer.
A participant described it well, “I think that critical thinking is a very important part and playing it plays a really important part into how I decipher, you know, what I want to like. I think that, I believe a lot of the stuff that I see, but I also don’t implement it into my life and I kind of just like scroll past it sometimes, and I think critical thinking.”
The Consequences theme represents the result of the actions or inactions taken in response to the content exposed to on SM. The Consequences included body image, ideal weight, SM positive influence, and SM negative influence. Zeeni et al. found body image dissatisfaction was positively correlated to social media use across genders in a college age sample [7]. A participant described how she feels SM impacts body image and ideal weight, “So I think that it does distort body image and diet in a negative way, and the younger population is probably the most vulnerable to it.” Another participant stated, “a lot of people always want to compare, and I think, compare themselves to others, and social media is an easy way to do that from looking at other people’s bodies and how it compares to theirs.” This is consistent with previous research suggesting frequent exposure to SM correlates with negative body image [10] [14] [15] [29], the ideal weight SM projects were discussed while discussing body image. A participant described ideal weight as, “social media projects a very um kind of like specific societal standard of what a weight should be for, you know, women or in for men on the occasion too um, but I also think that social media is currently in the midst of taking a change and taking like a kind of a turn to where people are promoting that just because you don’t fit the societal standard weight of what people think that you should be, I think that social media is definitely taking a turn to and being more accepting even if you aren’t as specifics like societal weight standard.” Another participant added to this comment, “I honestly got rid of my Instagram for a little bit right before everybody started like showing themselves, like the imperfect side of them just because I was feeling like I was comparing myself way too much to these girls I’m like their skin is so beautiful their bodies so beautiful they’re never bloated half of the time I’m bloated, and I was just it was kind of bringing me down… instead of trying to motivate me to like actually work out or anything.” Participants also discussed how SM content positively and negatively influenced them. One Participant said, “I would say that a lot of it can be positive. It can be people giving you advice, tips, helping you, uh, showing themselves so you get motivation. But then there could also be a lot of negative… just like, here’s what my body looks like, uh, everyone’s body should looks like mine.” The consensus from participants of this study seemed to agree on the content you choose to see impacts whether SM will have a positive influence or a negative influence. One participant described this, “what’s really good about a lot of the social platforms is you can choose what you want to and what you don’t want to see. So, for me, um, if I see like lots of negativity or a post that’s like degrading to either race, party types, food, whatever the case may be, I typically unfollow them.”
The results of this study are consistent with research completed in other countries and with younger populations [29] [30]. First, this study was completed with undergraduate college students in the US. The structured interview focus groups were utilized to elicit information on how young adults perceive and utilize the information received on SM. Specifically to better understand the impact of exposure to social media nutrition information on college students’ body weight and diet behavior. The focus groups provided rich detail full of emotions and differing opinions. However, this research is not without limitations. This study does imply the sensitive topics of eating behaviors and body weight therefore, participants might not have wanted to share all search information during the focus groups. However, participants were encouraged to share thoughts after the focus group if they wanted. No one reached out after. Although the sample was a small group of undergraduate students, the focus groups reached thematic saturation, as no new concepts emerged from the data. These students are very comfortable with all forms of SM discussed. A larger sample size in future quantitative research may provide more variety in experiences and opinions.
5. Conclusion
The results from this study helped explain how young adults receive social media information and then choose to utilize it to modify their dietary behaviors. Young adults are accessing content provided on social media platforms provided by social media influencers. This content has the potential to influence actions like eating behaviors and physical activity. The results from this study provide examples of how young adults receive social media information and then choose to utilize it to modify their behaviors. They also discussed their opinions on the influence it has on their actions. The views on the influence of social media varied, but most believed social media had a negative influence on dietary behaviors and a positive influence on physical activity. There was also a consensus regarding the current negative influence of SM on body image or ideal weight. However, the participants felt this was changing as more influencers were posting “real” photos of themselves. Overall, this study provides additional understanding of the influence of SM and its content on the behaviors of college students. The results help identify how social media platforms can be effectively used to influence healthy weight. This can be accomplished through inclusion in regulations and policies developed to limit exposure to unhealthy food marketing and nutritional misinformation. In addition, improving digital literacy of college students through using popular SM platforms to promote credible diet and healthy weight information may encourage the user to validate the trustworthiness of the information [31]. Dietitians and health educators are recommended to develop a stronger social media presence that promotes evidence-based weight management and nutrition strategies to thwart misinformation on social media platforms.
Funding
This work was supported by two grants from the FAST Award Program by the Center for Enhancing Undergraduate Research Experiences and Creative Activities and the College of Health Science Internal grant at Sam Houston State University.