Is diet culture fueling a new wave of eating disorders?

by Alice Berry, University of Virginia

edited by Gaby Clark, reviewed by Andrew Zinin

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If you spend much time on the internet, it may seem everyone is rapidly growing thinner. Discourse on celebrities' bodies can feed dayslong news cycles.

Until her Instagram account was restricted a year ago, an influencer charged $20 a pop for access to a community in which users encouraged each other to eat as little as possible.

The pop singer Lorde described being "at war with my body" and trying to "starve myself thinner" on a remix of Charli XCX's song "Girl, so confusing" in 2024.

Pop culture is leading many to speculate that eating disorders are on the rise.

The apparent rise in disorders may be attributed in part to more screen time and a loss of control during the COVID-19 pandemic, a UVA expert says.

"What we know is that there was a documented surge during the pandemic," said Sara Groff Stephens, the director of UVA Health's Eating Disorder Interdisciplinary Team. "We're still meeting people who developed eating disorders during that time, or who started struggling more then. But I do anticipate with GLP-1s, with the shrinking of celebrities, we'll continue to see high rates."

Side effects of eating disorders can include permanent damage to a person's gastrointestinal system, cardiovascular damage and fertility loss. Anorexia is the deadliest mental illness in the United States.

Changes to diagnostic criteria can explain part of the rise, as can improved diagnostic tools. The American Psychiatric Association also added new diagnoses to the Diagnostic and Statistical Manual of Mental Disorders in the 2010s, including conditions like avoidant/restrictive food intake disorder.

Providers often wouldn't diagnose someone with an eating disorder if they were at a higher weight, even if they experienced the same psychological and physical symptoms, like hair loss or loss of menstruation in women. So the APA added "atypical anorexia."

"Historically, the idea that we had that eating disorders only affect thin, white, affluent people was just wrong," Stephens said.

People of color are more likely to engage in disordered eating behavior like skipping a meal than their white counterparts, and more than 6 million American men will experience an eating disorder in their lives, according to the National Eating Disorders Association. Changes that help underdiagnosed groups access treatment are a good thing, Stephens said, though rising rates of eating disorders may result.

Despite increased awareness, what Stephens described as "diet culture" persists.

"Diet culture promotes thinness and dieting, rather than health and well-being," she said. "Continuing diet culture and fatphobia still stigmatize people in larger bodies, rather than accepting health at every size. GLP-1s, combined with our current media environment, are contributing to a renewed cultural emphasis on thinness that feels reminiscent of the '90s and early 2000s culture."

GLP-1s, which can produce substantial weight loss and suppress appetite, may be particularly concerning for people with body image concerns or a history of eating disorders, and Stephens has seen instances of GLP-1 misuse in her clinical practice.

"I've had some patients tell me, 'I told my provider I have this history, and I don't think I need to lose more weight,' and the provider prescribes them anyway," Stephens said. "Sometimes providers are uneducated on eating disorders and just focus on the weight loss piece. We also know that people can get these medications from all kinds of websites currently being advertised."

Few restrictions on social media platforms also contribute to the problem. Diet and weight loss messaging predates the internet, with commercial dieting and weight-focused advice appearing in mass media as early as the late 19th century.

In the 1990s and early 2000s, as the internet expanded, individuals with eating disorders began creating websites, bulletin boards and online communities that explicitly promoted eating disorder behaviors. Back then, individuals had to seek out this content, but now somebody who may be looking for information on how to get started at the gym might be served videos promoting dangerously low-calorie diets or other risky behaviors that could normalize disordered eating.

"The next thing you know, you're seeing blatant eating disorder content, which factors into this social contagion component," Stephens said.

It can seem potentially dangerous to bring these issues up. People may worry that drawing attention to someone's unhealthily thin physique may cause more harm than good.

"We can't protect people from diet culture, but we can have open conversations and ask each other about what we're seeing and how we feel about it," Stephens said. "When you see a very emaciated body, there's concern and worry, and I think it's good to talk about that in a very loving way. And I want people to know that recovery is possible, and recovery is both achievable and wonderful."

Key medical concepts

Eating DisordersGlucagon-Like Peptide-1 Receptor AgonistsAnorexia Nervosa

Clinical categories

PsychiatryPsychology & Mental healthWeight management Provided by University of Virginia Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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