Exploring the interplay between social media addiction, mindful eating, intuitive eating, orthorexia nervosa, and mental health in young adults

Hatice Merve Bayram (1) , Hatice Kübra Barcın-Guzeldere (2) , Elif Ede-Cintesun (3) , Zehra Margot Celik (4)
(1) Istanbul Gelisim University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Abeokuta, Cihangir Mah., Şehit Jandarma Komando Er Hakan Öner Sk. No:1 Avcılar, İstanbul , Turkey
(2) Istanbul Medeniyet University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Atalar Mh. Şehit Hakan Kurban Cd. 34862. Kartal, İstanbul. University Southampton, Faculty of Health Sciences, Department of Environmental and Life Science, University of Southampton University Road Southampton SO17 1BJ. UK , Turkey
(3) Istanbul Sabahattin Zaim University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Halkalı Cad. No: 281 Halkalı Küçükçekmece, İstanbul , Turkey
(4) Marmara University, Faculty of Health Sciences, Department of Nutrition and Dietetics, Marmara Üniversitesi Recep Tayyip Erdoğan Başıbüyük Külliyesi Sağlık Bilimleri Fakültesi Başıbüyük Mah. Süreyyapaşa Başıbüyük Yolu Sk. 4 B Maltepe, İstanbul , Turkey

Abstract

Background: Considering the reported negative effects of social media on mental health and the popularity of healthy eating movements on these platforms, a potential relationship between orthorexia nervosa (ON), intuitive eating, mindful eating, and social media addiction warrants investigation.


Aims: This study aimed to explore the complex relationship between social media addiction, mindful eating, intuitive eating, ON, depression, anxiety, and stress in young adults.


Subjects and Methods: A cross-sectional study was conducted on 303 students, in Istanbul, Türkiye, between December 2023 and May 2024. Participants completed an online questionnaire assessing demographic characteristics, Orthorexia Nervosa Questionnaire (ORTO-11), Intuitive Eating Scale – 2nd edition (IES-2), Mindful Eating Questionnaire (MEQ), Depression, Anxiety, Stress Scale-Short Form (DASS-21), and Social Media Addiction Scale (SMAS). Body weight and height information were self-reported. Data were analyzed using SPSS 24.0.


Results: Of the participants, 67.7% were at risk of ON. According to ON classification, IES-2 and SMAS scores of participants with the risk of ON were higher and statistically significantly different compared to the participants with no risk of ON (p < 0.001, and p = 0.047, respectively).  The ORTO-11 showed a positive moderate correlation with IES-2 scores (r = 0.401, p < 0.01), however, it showed a negative weak correlation with MEQ (r = -0.362, p < 0.01). Additionally, there was a negative weak correlation with ORTO-11 and SMAS (r = -0.104, p < 0.05). Logistic regression analysis revealed that all predictors were associated with the risk of ON. These variables predicted 13% of the variance.


Conclusion: The results suggest that modern social media may contribute to orthorexic symptoms, mindful and intuitive eating behaviors, and mental health outcomes. 


Keywords: intuitive eating, mindful eating, orthorexia nervosa, social media addiction.

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References

Ahmed, Y. A., Ahmad, M. N., Ahmad, N., & Zakaria, N. H. (2019). Social media for knowledge-sharing: A systematic literature review. Telematics and Informatics, 37, 72–112. https://doi.org/10.1016/j.tele.2018.01.015 [Crossref] [Google Scholar] [Publisher]
Anastasiades, E., & Argyrides, M. (2022). Healthy orthorexia vs orthorexia nervosa: Associations with body appreciation, functionality appreciation, intuitive eating and embodiment. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27(8), 3197–3206. https://doi.org/10.1007/s40519-022-01449-9 [Crossref] [Google Scholar] [PubMed] [Publisher]
Arusoğlu, G., Kabakçi, E., Köksal, G., & Merdol, T. K. (2008). Ortoreksiya Nervoza ve Orto-11’in Türkçeye Uyarlama Çalışması. Turk Psikiyatri Dergisi, 19(3). [Google Scholar] [PubMed] [Publisher]
Asil, E., Yılmaz, M., Ayyıldız, F., & Yalçın, T. (2023). The effect of social media use on orthorexia nervosa: A sample from Turkey. Nutricion Hospitalaria, 40(2), 384–390. https://doi.org/10.20960/nh.04217 [Crossref] [Google Scholar] [PubMed] [Publisher]
Awad, E., Salameh, P., Sacre, H., Malaeb, D., Hallit, S., & Obeid, S. (2021). Association between impulsivity and orthorexia nervosa / healthy orthorexia: Any mediating effect of depression, anxiety, and stress? BMC Psychiatry, 21(1), 604. https://doi.org/10.1186/s12888-021-03594-4 [Crossref] [Google Scholar] [PubMed] [Publisher]
Babbott, K. M., Mitchison, D., Basten, C., Thornton, C., Hay, P., Byrne, S., Goldstein, M., Heruc, G., van der Werf, B., Consedine, N. S., & Roberts, M. (2022). Intuitive Eating Scale-2: Psychometric properties and clinical norms among individuals seeking treatment for an eating disorder in private practice. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27(5), 1821–1833. https://doi.org/10.1007/s40519-021-01326-x [Crossref] [Google Scholar] [PubMed] [Publisher]
Bas, M., Karaca, K. E., Saglam, D., Arıtıcı, G., Cengiz, E., Köksal, S., & Buyukkaragoz, A. H. (2017). Turkish version of the Intuitive Eating Scale-2: Validity and reliability among university students. Appetite, 114, 391–397. https://doi.org/10.1016/j.appet.2017.04.017 [Crossref] [Google Scholar] [PubMed] [Publisher]
Brytek-Matera, A., Gramaglia, C., Gambaro, E., Delicato, C., & Zeppegno, P. (2018). The psychopathology of body image in orthorexia nervosa. https://iris.uniupo.it/handle/11579/99814 [Google Scholar] [Publisher]
Christodoulou, E., Markopoulou, V., & Koutelidakis, A. E. (2024). Exploring the Link between Mindful Eating, Instagram Engagement, and Eating Disorders: A Focus on Orthorexia Nervosa. Psychiatry International, 5(1), Article 1. https://doi.org/10.3390/psychiatryint5010003 [Crossref] [Google Scholar] [Publisher]
Çömlekçi, M. F., & Başol, O. (2019). Gençlerin Sosyal Medya Kullanım Amaçları İle Sosyal Medya Bağımlılığı İlişkisinin İncelenmesi. Manisa Celal Bayar Üniversitesi Sosyal Bilimler Dergisi, 17(4), Article 4. https://doi.org/10.18026/cbayarsos.525652 [Crossref] [Google Scholar] [Publisher]
Costandache, G. I., Munteanu, O., Salaru, A., Oroian, B., & Cozmin, M. (2023). An overview of the treatment of eating disorders in adults and adolescents: Pharmacology and psychotherapy. Advances in Psychiatry and Neurology/Postępy Psychiatrii i Neurologii, 32(1), 40–48. https://doi.org/10.5114/ppn.2023.127237 [Crossref] [Google Scholar] [PubMed] [Publisher]
Cunningham, S., Hudson, C. C., & Harkness, K. (2021). Social Media and Depression Symptoms: A Meta-Analysis. Research on Child and Adolescent Psychopathology, 49(2), 241–253. https://doi.org/10.1007/s10802-020-00715-7 [Crossref] [Google Scholar] [PubMed] [Publisher]
Demirer, B., & Yardımcı, H. (2024). Is mindful eating higher in individuals with orthorexia nervosa?: A cross-sectional study. Journal of Public Health, 32(3), 455–460. https://doi.org/10.1007/s10389-023-01829-0 [Crossref] [Google Scholar] [Publisher]
Donini, L. M., Marsili, D., Graziani, M. P., Imbriale, M., & Cannella, C. (2004). Orthorexia nervosa: A preliminary study with a proposal for diagnosis and an attempt to measure the dimension of the phenomenon. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 9(2), 151–157. https://doi.org/10.1007/BF03325060 [Crossref] [Google Scholar] [PubMed] [Publisher]
Elsayed, W. (2021). The negative effects of social media on the social identity of adolescents from the perspective of social work. Heliyon, 7(2). https://doi.org/10.1016/j.heliyon.2021.e06327 [Crossref] [Google Scholar] [PubMed] [Publisher]
Framson, C., Kristal, A. R., Schenk, J. M., Littman, A. J., Zeliadt, S., & Benitez, D. (2009). Development and Validation of the Mindful Eating Questionnaire. Journal of the American Dietetic Association, 109(8), 1439–1444. https://doi.org/10.1016/j.jada.2009.05.006 [Crossref] [Google Scholar] [PubMed] [Publisher]
Galea, S., Buckley, G. J., & Wojtowicz, A. (Eds.) (with Committee on the Impact of Social Media on Adolescent Health, Board on Population Health and Public Health Practice, Health and Medicine Division, & National Academies of Sciences, Engineering, and Medicine). (2024). Social Media and Adolescent Health. National Academies Press. https://doi.org/10.17226/27396 [Crossref] [Publisher]
Gramaglia, C., Gambaro, E., Delicato, C., Marchetti, M., Sarchiapone, M., Ferrante, D., Roncero, M., Perpiñá, C., Brytek-Matera, A., Wojtyna, E., & Zeppegno, P. (2019). Orthorexia nervosa, eating patterns and personality traits: A cross-cultural comparison of Italian, Polish and Spanish university students. BMC Psychiatry, 19(1), 235. https://doi.org/10.1186/s12888-019-2208-2 [Crossref] [Google Scholar] [PubMed] [Publisher]
Hamurcu, T. G. Ö., & Yılmaz, S. (2023). The Correlation between Orthorexia Nervosa and Social Media Use in Nursing Students. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 11(1), Article 1. https://doi.org/10.33715/inonusaglik.1156789 [Crossref] [Google Scholar] [Publisher]
Hobart, J. A., & Smucker, D. R. (2000). The Female Athlete Triad. American Family Physician, 61(11), 3357–3364. https://www.aafp.org/pubs/afp/issues/2000/0601/p3357.html [PubMed] [Publisher]
Horovitz, O., & Argyrides, M. (2023). Orthorexia and Orthorexia Nervosa: A Comprehensive Examination of Prevalence, Risk Factors, Diagnosis, and Treatment. Nutrients, 15(17), Article 17. https://doi.org/10.3390/nu15173851 [Crossref] [Google Scholar] [PubMed] [Publisher]
Kalika, E., Hussain, M., Egan, H., & Mantzios, M. (2023). Exploring the moderating role of mindfulness, mindful eating, and self-compassion on the relationship between eating-disordered quality of life and orthorexia nervosa. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 28(1), 18. https://doi.org/10.1007/s40519-023-01542-7 [Crossref] [Google Scholar] [PubMed] [Publisher]
Kepios. (2024). Global Social Media Statistics. DataReportal – Global Digital Insights. https://datareportal.com/social-media-users
Koçyiğit, E., Uzunlar, E. A., Özer, Ş. D., Zakkour, H. K., & Akbulut, G. (2022). The relationship between intuitive eating, eating disorders, and body image perceptions in young adult women. Mediterranean Journal of Nutrition and Metabolism, 15(3), 407–418. https://doi.org/10.3233/MNM-211583 [Crossref] [Google Scholar] [Publisher]
Köse, G., Tayfur, M., Birincioğlu, İ., & Dönmez, A. (2016). Adaptation study of the mindful eating questiıonnare (MEQ) into Turkish. JCBPR. 2018; 5 (3): 125-125. Journal of Cognitive-Behavioral Psychotherapy and Research, 3(1), 125–134.
Lovibond, S. H. (1995). Manual for the depression anxiety stress scales. Sydney Psychology Foundation.
Malaeb, D., Salameh, P., Barbar, S., Awad, E., Haddad, C., Hallit, R., Sacre, H., Akel, M., Obeid, S., & Hallit, S. (2021). Problematic social media use and mental health (depression, anxiety, and insomnia) among Lebanese adults: Any mediating effect of stress? Perspectives in Psychiatric Care, 57(2), 539–549. https://doi.org/10.1111/ppc.12576 [Crossref] [Google Scholar] [PubMed] [Publisher]
Miley, M., Egan, H., Wallis, D., & Mantzios, M. (2022). Orthorexia nervosa, mindful eating, and perfectionism: An exploratory investigation. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27(7), 2869–2878. https://doi.org/10.1007/s40519-022-01440-4 [Crossref] [Google Scholar] [PubMed] [Publisher]
Missbach, B., Hinterbuchinger, B., Dreiseitl, V., Zellhofer, S., Kurz, C., & König, J. (2015). When Eating Right, Is Measured Wrong! A Validation and Critical Examination of the ORTO-15 Questionnaire in German. PLOS ONE, 10(8), e0135772. https://doi.org/10.1371/journal.pone.0135772 [Crossref] [Google Scholar] [PubMed] [Publisher]
Mitrofanova, E., Pummell, E., Martinelli, L., & Petróczi, A. (2021). Does ORTO-15 produce valid data for ‘Orthorexia Nervosa’? A mixed-method examination of participants’ interpretations of the fifteen test items. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(3), 897–909. https://doi.org/10.1007/s40519-020-00919-2 [Crossref] [Google Scholar] [PubMed] [Publisher]
Monroe, J. T. (2015). Mindful Eating: Principles and Practice. American Journal of Lifestyle Medicine, 9(3), 217–220. https://doi.org/10.1177/1559827615569682 [Crossref] [Google Scholar] [Publisher]
Nguyen, T. H., Lin, K.-H., Rahman, F. F., Ou, J.-P., & Wong, W.-K. (2020). Study of Depression, Anxiety, and Social Media Addiction Among Undergraduate Students. Journal of Management Information and Decision Sciences, 23(4), 257–276. [Google Scholar] [Publisher]
Niedzielski, A., & Kaźmierczak-Wojtaś, N. (2021). Prevalence of Orthorexia Nervosa and Its Diagnostic Tools—A Literature Review. International Journal of Environmental Research and Public Health, 18(10), Article 10. https://doi.org/10.3390/ijerph18105488 [Crossref] [Google Scholar] [PubMed] [Publisher]
Oberle, C. D., De Nadai, A. S., & Madrid, A. L. (2021). Orthorexia Nervosa Inventory (ONI): Development and validation of a new measure of orthorexic symptomatology. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(2), 609–622. https://doi.org/10.1007/s40519-020-00896-6 [Crossref] [Google Scholar] [PubMed] [Publisher]
Parra-Fernández, M.-L., Rodríguez-Cano, T., Onieva-Zafra, M.-D., Perez-Haro, M. J., Casero-Alonso, V., Fernández-Martinez, E., & Notario-Pacheco, B. (2018). Prevalence of orthorexia nervosa in university students and its relationship with psychopathological aspects of eating behaviour disorders. BMC Psychiatry, 18(1), 364. https://doi.org/10.1186/s12888-018-1943-0 [Crossref] [Google Scholar] [PubMed] [Publisher]
Pökön, M., Başpınar, M. M., & Basat, O. (2021). Prevalence of Orthorexia Nervosa Tendency in Non-obese Population: A Cross-sectional Study. The Anatolian Journal of Family Medicine, 4(3), 252–256. https://doi.org/10.5505/anatoljfm.2021.24085 [Crossref] [Google Scholar] [Publisher]
Primack, B. A., Shensa, A., Sidani, J. E., Escobar-Viera, C. G., & Fine, M. J. (2021). Temporal Associations Between Social Media Use and Depression. American Journal of Preventive Medicine, 60(2), 179–188. https://doi.org/10.1016/j.amepre.2020.09.014 [Crossref] [Google Scholar] [PubMed] [Publisher]
Purba, A. K., Thomson, R. M., Henery, P. M., Pearce, A., Henderson, M., & Katikireddi, S. V. (2023). Social media use and health risk behaviours in young people: Systematic review and meta-analysis. BMJ, 383, e073552. https://doi.org/10.1136/bmj-2022-073552 [Crossref] [Google Scholar] [PubMed] [Publisher]
Rodgers, R. F., White, M., & Berry, R. (2021). Orthorexia nervosa, intuitive eating, and eating competence in female and male college students. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 26(8), 2625–2632. https://doi.org/10.1007/s40519-020-01054-8 [Crossref] [Google Scholar] [PubMed] [Publisher]
Sariçam, H. (2018). The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive Behavioral Psychotherapies and Research, 7(1), 19. https://doi.org/10.5455/JCBPR.274847 [Crossref] [Google Scholar] [Publisher]
Scarff, J. R. (2017). Orthorexia Nervosa: An Obsession With Healthy Eating. Federal Practitioner, 34(6), 36–39. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370446/ [Google Scholar] [PubMed] [Publisher]
Şentürk, E., Geniş, B., & Coşar, B. (2021). Social Media Addiction in Young Adult Patients with Anxiety Disorders and Depression. Alpha Psychiatry, 22(5), 257–262. https://doi.org/10.5152/alphapsychiatry.2021.21242 [Crossref] [Google Scholar] [PubMed] [Publisher]
Sipahi, S., & Demirel, B. (2021). Sosyal Medyadaki Beslenme ile İlgili Paylaşımların Yetişkin Bireylerin Yeme Tutum ve Davranışlarına Etkisi. Beslenme ve Diyet Dergisi, 49(1), 57–66. https://doi.org/10.33076/2021.BDD.1389 [Crossref] [Google Scholar] [Publisher]
Strahler, J., Hermann, A., Walter, B., & Stark, R. (2018). Orthorexia nervosa: A behavioral complex or a psychological condition? https://doi.org/10.1556/2006.7.2018.129 [Crossref] [Google Scholar] [PubMed] [Publisher]
Tarsitano, M., Pujia, R., Ferro, Y., Mocini, E., Proni, G., Lenzi, F., Pujia, A., & Giannetta, E. (2022). Symptoms of Orthorexia Nervosa are associated with time spent on social media: A web-based survey in an Italian population sample. European Review for Medical & Pharmacological Sciences, 26(24). https://doi.org/10.26355/eurrev_202212_30683 [Crossref] [Google Scholar] [PubMed] [Publisher]
Thorne, J., Hussain, M., & Mantzios, M. (2022). Exploring the relationship between orthorexia nervosa, mindful eating and guilt and shame. Health Psychology Report, 11(1), 38–47. https://doi.org/10.5114/hpr/152733 [Crossref] [Google Scholar] [PubMed] [Publisher]
Tutgun-Ünal, A., & Deniz, L. (2015). Development of the social media addiction scale. AJIT-e: Academic Journal of Information Technology, 6(21), 51–70. https://doi.org/10.5824/1309-1581.2015.4.004.x [Crossref] [Google Scholar] [Publisher]
Tylka, T. L., & Kroon Van Diest, A. M. (2013). The Intuitive Eating Scale–2: Item refinement and psychometric evaluation with college women and men. Journal of Counseling Psychology, 60(1), 137–153. https://doi.org/10.1037/a0030893 [Crossref] [Google Scholar] [PubMed] [Publisher]
Warren, J. M., Smith, N., & Ashwell, M. (2017). A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: Effectiveness and associated potential mechanisms. Nutrition Research Reviews, 30(2), 272–283. https://doi.org/10.1017/S0954422417000154 [Crossref] [PubMed] [Publisher]
Yurtdaş-Depboylu, G., Kaner, G., & Özçakal, S. (2022). The association between social media addiction and orthorexia nervosa, eating attitudes, and body image among adolescents. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 27(8), 3725–3735. https://doi.org/10.1007/s40519-022-01521-4 [Crossref] [Google Scholar] [PubMed] [Publisher]
Zubair, U., Khan, M. K., & Albashari, M. (2023). Link between excessive social media use and psychiatric disorders. Annals of Medicine and Surgery, 85(4), 875. https://doi.org/10.1097/MS9.0000000000000112 [Crossref] [Google Scholar] [PubMed] [Publisher]

Authors

Hatice Merve Bayram
hmbayram@gelisim.edu.tr (Primary Contact)
Hatice Kübra Barcın-Guzeldere
Elif Ede-Cintesun
Zehra Margot Celik
Bayram, H. M. ., Barcın-Guzeldere, H. K., Ede-Cintesun, E., & Celik, Z. M. (2024). Exploring the interplay between social media addiction, mindful eating, intuitive eating, orthorexia nervosa, and mental health in young adults. The North African Journal of Food and Nutrition Research, 8(18), 70–79. https://doi.org/10.51745/najfnr.8.18.70-79

Article Details

Received 2024-07-09
Accepted 2024-09-21
Published 2024-09-23