By Anna | Clay Counseling, PLLC
Content note: This post discusses disordered eating, compulsive exercise, and body image distress in general terms. It does not include numbers, weights, or specific behaviors. If reading this feels hard right now, it's okay to pause or come back to it. Support information is at the end.
Maybe you've been here: Scrolling yet another feed when you come across an influencer page where someone celebrates pounds lost or muscle gained over a period of time. You see the change, the celebration. That's nice, you think, even inspirational. Maybe you'd like this for yourself, you'd like to be healthier, look fitter and feel better about yourself overall. You click the follow button.
We are still learning how this kind of content impacts our behaviors and thoughts toward our own bodies. One thing is certain, a curated social media page isn't always realistic and doesn't accurately represent the beautifully diverse, real life bodies we come across in day to day living. This is exactly why this content can often end up causing harm in the name of promoting health.
How health became a moral project
In 1980, sociologist Robert Crawford gave a name to something he saw taking hold in American life: healthism, a preoccupation with personal health as the main route to well-being [7]. In this view, health is something you control, something you earn, and something that describes who you are morally. Later writers describe how this framing treats health as an individual responsibility and even a moral good, and how it fits neatly with consumer culture, because it points to private, purchasable solutions and away from shared, structural ones [7, 8, 9].
This shift matters. Once health becomes a measure of character, "unhealthy" stops being simply a description and starts becomes a judgment on ones character. This happens often on a subconscious level. Food also isn't neutral anymore and instead, becomes "good" or "bad." Exercise can become something you owe. And instead of your home, your body becomes a project. For anyone already vulnerable to perfectionism, anxiety, or a need for control, that's fertile ground.
What social media adds
Social media didn't invent diet culture, but it delivers it constantly, personally, and in a form that invites comparison.
A systematic review of 20 studies found that using social networking sites is associated with body image concerns and disordered eating. Activities like viewing and posting photos stand out, and appearance-based comparison helps explain this link [1]. Later meta-analytic work found a small but statistically significant association between social media use and disordered eating behaviors [2].
It's important to note that most of this research is correlational, so it shows a relationship, not that social media causes eating disorders. But as in other areas, we can see how social media can intensify risk.
Reviews have linked frequent social media use to body dissatisfaction and are beginning to examine its connection to body dysmorphic disorder, in which people become consumed by perceived flaws in their appearance [6]. A systematic review also found that frequent social media use is associated with symptoms of orthorexia and muscle dysmorphia [4]. Appearance comparison appears to be a key pathway: when what you see online becomes the standard, almost no real body measures up.
"Clean" eating and the rules that follow
Orthorexia, an obsessive focus on eating only foods considered healthy or pure, isn't a formal diagnosis in the DSM-5, but research on it is growing. A recent review found that social media tends to intensify orthorexic tendencies through exposure to idealized eating patterns, while also noting that online spaces can offer peer support in recovery [3]. More and more pages are beginning to identify it as an issue and actively providing support.
When exercise stops being enjoyable
"Fitspiration" content was meant to motivate healthy habits. A narrative review found it often carries distressing themes and has been linked to compulsive exercise, body dissatisfaction, appearance-related anxiety, and an excessive need to control eating [5]. In plan language, it can often be an eating disorder or body dysmorphia dressed up nice as to be socially acceptable.
How do I know if my exercise is unhealthy? In short, exercise that has become compulsive tends to feel less like a choice and more like an obligation, with distress when it can't happen.
The part about who profits
It's worth saying plainly: an industry has grown up around telling people their bodies and habits need fixing. Scholars like Carl Cederström and André Spicer argue that wellness culture turns health into an obligation and a market [8]. I'd describe this as a well-argued critique and not a finding, but it's one that many can recognize right away. When a message makes you feel anxious about your body and then offers a product, a plan, or a rule to relieve the anxiety, it's worth asking, who benefits?
Social media is only part of the problem
I feel the need to emphasize this. The same platforms that spread diet rules also help people find community, recovery support, and accurate information [3]. The question is less "social media: yes or no?" and more "what am I seeing, and what is it doing to me?" With all my clients it's a conversation about being intentional about who you follow and what media you're consuming. Not passively but actively.
When "healthy" may have crossed a line
Only you and the people who care about you can really know. But some questions are worth asking yourself or a support person:
Do food or exercise rules feel rigid, with real distress when you can't follow them?
Has your food or exercise routine begun to push out friends, spontaneity, rest, or things you used to enjoy?
Are you continuing to exercise despite pain, illness, or exhaustion because skipping feels unacceptable?
Does your sense of worth rise and fall with how "well" you followed your rules?
Do you feel anxious, guilty, or ashamed after eating or resting?
Has someone who loves you expressed concern, and do you find yourself defending the routine?
A yes to any of these doesn't mean you have an eating disorder, and I won't diagnose anyone in a blog post. But it can be a sign that talking to someone is worthwhile.
A different relationship with health
In my work, recovery is not about perfection, and neither is a healthy relationship with food and movement. A few things I come back to:
Flexibility over rules. Healthy habits can bend around real life, such as travel, celebrations, illness, and busy weeks. If breaking a rule feels like a catastrophe, the rule may be running you.
Enjoyment and connection. Food and movement can be sources of pleasure and togetherness, not just inputs and outputs.
Repair over perfection. Slips and hard days aren't failure. What matters is coming back to yourself with compassion, much as in good-enough parenting, where repair matters more than getting everything right. Remember, the body is your first home.
A curated feed. Unfollow accounts that leave you feeling worse about your body. Notice who is selling what, and whether the person has real training.
Trust your body's cues. Hunger, fullness, tiredness, and the desire to move are information, and wellness culture often teaches us to override them. Try listening intently and honor what you hear.
You don't have to figure this out alone
At Clay Counseling in Cary, NC, I support people with eating disorders and difficult relationships with food, exercise, and body image, in person and online across North Carolina. If any of this sounds familiar, I'd be glad to talk.
If you'd like support or help finding care right away, the National Alliance for Eating Disorders helpline is staffed by licensed therapists who specialize in eating disorders and offers free referrals: (866) 662-1235, Monday to Friday. If you're in crisis or having thoughts of harming yourself, call or text 988 or go to your nearest emergency room.
Sources
Holland, G., & Tiggemann, M. (2016). A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image, 17, 100-110. doi:10.1016/j.bodyim.2016.02.008
Zhang, J., et al. (2021). The relationship between SNS usage and disordered eating behaviors: A meta-analysis. Frontiers in Psychology. doi:10.3389/fpsyg.2021.641919
Orthorexia nervosa and social media: A literature review. European Psychiatry (2025). doi:10.1192/j.eurpsy.2025.1397 (Add authors from the original page.)
Idealized body images and fitness lifestyles on social media: A systematic review exploring the link between social media use and symptoms of orthorexia nervosa and muscle dysmorphia. (Add authors and journal from the original page; available via PMC12694696.)
Cataldo, I., De Luca, I., Giorgetti, V., Cicconcelli, D., Bersani, F. S., Imperatori, C., & Abdi, S. (2021). Fitspiration on social media: Body-image and other psychopathological risks among young adults. A narrative review. Emerging Trends in Drugs, Addictions, and Health.
The use of social networking sites, body image dissatisfaction and body dysmorphic disorder: A systematic review of psychological research. (Add authors and journal from the original page.)
Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10(3), 365-388.
Cederström, C., & Spicer, A. (2015). The Wellness Syndrome. Polity Press.
Resisting moralisation in health promotion. Ethical Theory and Moral Practice (2018). doi:10.1007/s10677-018-9941-3 (Add authors from the original page.)