The #orthorexia community on Instagram

Purpose: This mixed-methods study delved into the relationship between orthorexia nervosa (ON) and Instagram. Methods: Two quantitative data sources were used: content analysis of pictures using #orthorexia (n = 3027), and an online questionnaire investigating the experience of ON and the use of Instagram of people sharing ON-related content on Instagram (n = 185). Following, interviews (n = 9) were conducted with people posting ON-related content on Instagram and self-identifying as having (had) ON. Results: People who share ON-related content on Instagram were found to be primarily young women (questionnaire = 95.2% females, mean age 26.2 years; interviews = 100% females, mean age 28.4 years), who were found to be heavy social media users and favor Instagram over other platforms. Questionnaire respondents agreed in defining ON as an obsession with a diet considered healthy, with bio-psycho-social negative consequences, though those who self-identified as having (had) ON were more likely to point out the negative impairments of ON. Interviewees deemed Instagram partially responsible for the development of ON. Instead, they agreed that Instagram encourages problem realization. Content analysis showed that ON is encoded in pictures of ‘food’, ‘people’, ‘text’ and ‘other.’ Interviewees revealed that they started posting to recover, share information, help others, and they felt inspired to post by other accounts. A sense of belonging to the #orthorexia community emerged, where people share values and ideals, and seek validation from others. Conclusion: Conversations around #orthorexia on Instagram generate supportive communities aiding recovery. Individuals use Instagram for helping others and themselves recovering from ON. Understanding how people help each other, manage their health, cope with symptoms, and undertake recovery can inform the implementation of therapeutic interventions for ON. Level of evidence: Level III, evidence obtained from well-designed cohort or case–control analytic studies.