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Blog reviewed by Steve Clarke (MSc, PGDip, FdSc, MBACP (Accred)), Hospital Director at Priory Hospital Roehampton

The rise of digitally-altered photos on social media

The impact of social media on mental health has become painfully clear in recent years. As technology develops and people spend more time online, audiences are more and more exposed to the harmful effects of these platforms. Not only do they promote constant unhealthy comparisons with other people, they blur the lines of reality in a way that makes it impossible to live up to the imaginary world we see online, possibly resulting in poor mental health, body dysmorphia and eating disorders.

The rising popularity of photo-editing features are facilitating the make-believe aspect of social media in worrying new ways. They casually encourage the habit of creating a false visual narrative for ourselves, which isn’t just about giving the impression of an enviable lifestyle anymore – it’s around how we actually look. This is inevitably leading to worry that social media’s associated risks around mental health challenges, not least eating disorders in this case, are greater than ever.

At the tap of a screen, filters on Instagram, Facebook and others, along with dedicated photo-editing apps such as Facetune, allow facial features to be sculpted, blemishes eliminated and body proportions altered. Rather than this manipulation of the truth being a new idea, it is an extension of what social media users have been doing for years; maintaining an illusion of perfection with a carefully-curated online presence.

These increasingly sophisticated filters and editing tools now allow this fantasy to be constructed to worrying new levels. The edited content they can produce, ever further removed from real life, is constantly at the fingertips of social media users who frequently have their phone nearby, threatening the resulting feelings of inferiority at any time of the day or night. These negative beliefs around self-image can eventually lead to deeply damaging behaviours, like body dysmorphia, which is how eating disorders start. Once an eating disorder such as anorexia or bulimia takes control of your life, treatment is usually the best course of action for restoring emotional wellbeing and a healthier relationship with food and your own body.


The impact of edited photos on self-esteem

Of course, presenting a fictional version of ourselves is bound to have serious consequences on self-esteem over time. These retouched images can erode the confidence of both the people creating them and those viewing them. A negative view on body image and body dysmorphia are common results of photo editing. Photo editing allows anyone to pursue specific, idealised and unachievable beauty standards, hiding our real selves from the world and discarding any notion of accepting our flaws and differences.

Seeking acceptance from others online in this manner is highly damaging in various ways; a leading issue it that it ties our self-worth with our physical appearance. Social media brings a huge amount of pressure to conform to what others will deem attractive, which perpetuates negative beliefs around our body. Greater ‘body dissatisfaction’ is linked to increased symptoms of mental health conditions and can result in a higher risk of eating disorders.

A 2019 study showed how the internet is changing our brain function, particularly with the ‘digital manipulation of images to inflate physical attractiveness’. The time spent on social media was shown to correlate with mental health problems, including depression and suicidal feelings, in teenagers, particularly girls. Research has shown that the majority of young people spend more than two hours per day on social media, so it is clear why there is a growing mental health crisis among this age group.


The growing gap between fiction and reality

The above study also discussed how social media’s impact on body image stems from the way it ‘showcases hyper‐successful individuals constantly putting their best foot forward’. In that same vein, the struggle with embracing our real, unfiltered identity is worsened by the fact that influencers are editing their content too. When celebrities make their aspirational existence seem that much more unattainable, the disconnect between reality and fantasy grows even wider. Not only are our friends airbrushing their appearance, supermodels are making their waists look even thinner too. This means that existing role models become even more unrealistic to live up to, as their followers – the people who look up to and constantly compare themselves to them – judge their own bodies based on an artificial reality. The impact on self-worth then becomes even more devastating due to the huge reach of these influencers, with a single edited photo bringing out insecurities in thousands or millions of people.

A 2019 Mental Health Foundation study among teenagers (aged 13-19), showed that one in four girls and one in ten boys had edited their face or body in digital photos, due to poor body image, which could result in severe body dysmorphia later on in life. The study also found that over a third of young adults (aged 18-24) had recently felt shame over their body image, with one in four feeling overwhelmed by their negative feelings about their appearance. The harm caused by the online world doesn’t just affect teenagers. 22% of the adult age group in the study said that they had worried about their body image as a result of the posts they saw on social media, compared with 22% of teens.

Another 2019 study showed how social media has encouraged a rise in the desire for cosmetic surgery among women aged 18-29. This means that its impact is becoming clearer than ever, causing people to alter their appearance not only online, but in real life too. A 2016 study also showed the impact on body image of even older women in middle age and beyond, due to the over-representation and glorification of youth in the media. When it comes to social media and photo-editing apps in particular, however, it does seem logical that the effects on self-esteem are worst among younger age groups, who are the biggest users of these platforms.

The increased risk of eating disorders today

It was already the case in 2019 that 82% of people were using the internet every day, with 91% of 16-24 year olds spending their time online mainly using social media. So given that the 2020 coronavirus pandemic has seen much of the population spending more time at home, the statistics around technology and internet usage will be higher than ever. Social platforms can, to some extent, be used for emotional support by allowing connection with others, particularly during a time of increased isolation from social distancing. However, negative online influences only worsen as we live more of our lives online.

A critical issue with our increasing use of technology is that the increased exposure to online images can result in a higher risk of body dysmorphic behaviours. Many of us are suddenly much more aware of how we present ourselves to others day-to-day, as we see ourselves reflected back on our screens during video calls. At the same time, increased time on social media means seeing more of others online than ever before, becoming more used to what they look like through technology than in reality. If many of those people are also editing their digital appearance, the risks of unrealistic comparisons are clearly now higher than in previous years, when we didn’t spend so much spare time online.

Those who already have eating disorders can be highly vulnerable to the pitfalls of social media, with their body image and self-esteem particularly low. People who suffer from conditions such as Body Dysmorphic disorder (BDD) already have a distorted perception of their weight and appearance, so are even more susceptible to the potential damage of people misrepresenting what they look like online. Those with BDD will become fixated on their perceived imperfections, and can experience obsessive and controlling thoughts which may result in harmful behaviours such as restricting food intake, binging, purging, over-exercising and isolating themselves from friends and family.

A Patient's Real-Life Account of Online Images

One of our clients at Arthur House has spoken about how she had struggled with body image for a long time before seeking treatment, with the photos she saw online being particularly triggering for her.

"Before coming into treatment, I struggled with my body image from a very young age. I would avoid anything which would show any part of me, like mirrors and pictures. Over many years, I only uploaded about three photos with me in to one of my social media accounts, because I always found something to criticise and feel overly self-conscious about. I also found myself comparing a huge amount to people I followed on social media.

Any picture that showed a person in, I would compare every part of their body to mine and inevitably, I would always think they were better looking than I was and I would feel that that was the reason they were so much happier than I felt. 

In order for me to be happy, go out and have fun, I thought (and sometimes still think) that I need to be as thin as (if not thinner than) the people I saw on social media.

Being at Arthur House has helped me realise how much of social media is fake and portrayed to be “perfect” when actually, pretty much everything is edited, photoshopped and glazed over with a filter to make everyone look more ‘idealistic’, but this standard is completely unrealistic.

Being here also helped me to escape this trap of getting caught up in hundreds of triggering photos, by helping me to unfollow the people that had a negative impact on my mental health/self-esteem and find positive, sustainable accounts that promote natural bodies and appearances.

Thanks to Arthur House, I am now able to tell myself and believe (most of the time) that the photos I see on social media, magazines etc. of others’ bodies, are fake and that my standards were/are very unrealistic. Currently, I am following multiple body positive accounts and only one account which has photos I find challenging, but because I think it is important not to completely hide away from triggering images online.

As well as changing my focus to my qualities, I have also learnt to be able to have gratitude for parts of my body (including areas that I dislike) based on what they provide me with, my legs for example, because they allow me to walk and have independence. I have found, thanks to the advice and encouragement of the staff here, that wearing clothes I would usually avoid due to high levels of discomfort has helped me to build some confidence around my body. The environment at Arthur House has been especially good for this type of exposure as I know that I have full support and no judgement from others.

I would really recommend others to try and change their focus of themselves to things such as their personality, qualities and things they can be grateful about, in regards to their body. I can imagine that, like myself, others might feel disheartened at times and want to give up, but it is important to remember that those are the times when it is most important to push through and keep going with the work they have been doing."

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