Internet Addiction Symptoms,Disordered Eating,and Body Image Avoidance

Abstract

Internet addiction is an increasing concern among young adults. Self-presentational theory posits that the Internet offers a context in which individuals are able to control their image. Little is known about body image and eating concerns among pathological Internet users. The aim of this study was to explore the association between Internet addiction symptoms, body image esteem, body image avoidance, and disordered eating. A sample of 392 French young adults (68 percent women) completed an online questionnaire assessing time spent online, Internet addiction symptoms, disordered eating, and body image avoidance. Fourteen men (11 percent) and 26 women (9.7 percent) reported Internet addiction. Body image avoidance was associated with Internet addiction symptoms among both genders. Controlling for body–mass index, Internet addiction symptoms, and body image avoidance were both significant predictors of disordered eating among women. These findings support the self-presentational theory of Internet addiction and suggest that body image avoidance is an important factor.

Introduction

Over the last decade, Internet use has grown exponentially, with approximately three-quarters of the population of North America using Internet¹. In France, the increase in Internet use has followed a similar pattern with the greatest time spent online reported by those between the ages of 15 and 25.^2,3 The resulting behavioral changes in the way individuals relate to each other and to society have drawn increasing attention to what is termed Internet addiction. Internet addiction refers to the pathological and excessive use of Internet that can be likened to other clinically defined addictions such as pathological gambling.⁴

Internet addiction has been described within an interpersonal and social framework. Many authors have referred to the facilitating role of the Internet in terms of social interactions, and its appeal for those with difficulties establishing face-to-face relationships.^5,6 The potential for pathological use resides in the anonymity of these exchanges, as the Internet provides a safe place for social interaction.⁷ In particular, it has been proposed that socially anxious individuals are drawn to the Internet, as it affords for increased control over self-presentation, and minimizes the possibility of making a negative or undesired impression on others.⁸ Perceived control and efficacy regarding self-presentation during online communication might enhance social confidence. In line with this theory, Internet addiction has been associated with shyness, loneliness, and social anxiety.^8–10

Moreover, the self-presentational theory would suggest that individuals drawn to the Internet in view of its confidence-enhancing properties would tend to use Internet for social communication purposes as opposed to other types of online activities that have been described as related to Internet addictions such as online gambling or impulsive buying.⁶ This framework would therefore predict that individuals suffering from high levels of body image anxiety and in particular body image avoidance, the wish to avoid situations in which body shape is conspicuous, might be more vulnerable to Internet addiction. Body image avoidance differs from negative or distorted body image, as it captures the behavioral avoidance component of body image concerns as opposed to the evaluative affective component. While affective dimensions of body image are important, it has been generally shown that attitudes are limited predictors of behaviors.¹¹ Directly exploring the behavioral avoidance consequences of negative body image is therefore a useful tool.

In addition, the close relationship between body image concerns, disordered eating on the one hand, restricted social interactions, and social avoidance on the other is well documented.^12,13 The self-presentational framework would therefore also predict that body image avoidance and Internet addiction might be accompanied by disordered eating. In line with this, case reports have described that Internet addiction may be related to negative body image.¹⁴ In addition, Internet addiction has been described as comorbid with Body Dysmorphic Disorder.¹⁵ More recently, overweight preoccupation has been reported to be a significant predictor of problematic Internet use among men,¹⁶ and over half of the women interviewed from a large dating site were found to have misrepresented their weight and looks.¹⁷ Further, Tao and Liu¹⁸ reported high levels of disordered eating among Internet addicts compared to controls, and among 15 patients meeting criteria for Internet addiction, Bernardi and Pallanti¹⁹ reported that one suffered from a comorbid eating disorder. However, to date, little is known about the relationship between Internet use and body image and disordered eating. Explanations for the link between Internet addiction and disordered eating have included its mood regulation function (as an alternative to food)¹⁸; however, it is also possible that Internet addiction increases known risk factors for eating pathology such as negative affect body image dissatisfaction (through sedentariness) and perceived pressure to be thin (through exposure to weight-loss advertisements or online interactions).²⁰

The aim of the present study was therefore twofold: first, to examine the content of Internet Websites viewed by participants with high levels of body image avoidance and disordered eating. We expected participants high on these dimensions to display a preference for social and communication Websites, since the Internet would provide them with an anonymous way of engaging in the social interactions they avoid in real life due to body image concerns. The second aim was to explore the association between Internet addiction, body image avoidance, and disordered eating among a sample of French young adults. We hypothesized that both body image avoidance and Internet addiction symptoms would be significant predictors of disordered eating.

Methods

Participants

The study included a convenience sample of 392 participants (68 percent women) who completed an online survey. Participants were recruited from January to May 2010 via a snowballing procedure to reach a wide range of individuals through inviting participants to complete an online survey via email and social networks and to circulate the study information to their own social network. Ages ranged from 19 to 35, with mean age (SD)=25.20 (4.25). We restricted the age range of inclusion to 18–35 years, as young adults have been suggested to be particularly vulnerable to body dissatisfaction and disordered eating.²¹ Participants all provided informed consent, and no financial compensation was offered. The study received approval from the relevant authorities. Online surveys present a number of limitations in terms of data collection; however, it has been suggested that a number of these limitations are common to other means of data collection.²² Further, they are particularly useful for including participants suffering from anxiety-related concerns who may be difficult to reach via more traditional methodologies.

Measures

Internet use

Participants reported average time spent online during the week and at the weekend. A total week average was calculated by summing these values. Based on the classifications of types of Internet addiction,⁶ participants further reported what percentage of their time online was spent on social and communication Websites, information Websites, online game sites, shopping Websites, and cybersex or pornographic Websites.

Internet addiction

The Internet Addiction Test (IAT)^23,24 Internet addiction symptoms. The 20 items are scored on a five-point scale ranging from “Rarely” to “Always.” An example item is, “How often do you find yourself anticipating when you will go online again?” Summed scores of the responses to the 20 items are classed as “average Internet use: 20–49,” “occasional or frequent problems due to Internet: 50–79,” “significant problems: 80–100.” In the present sample, Cronbach's alpha-coefficient was 0.90.

Disordered eating

The 26-item Eating Attitudes Test (EAT-26)^25,26 assessed participants' levels of disordered eating. The items are scored on a 6-point scale ranging from “Never” to “Always.” An example item is, “I avoid eating when I am hungry.” In the present sample, Cronbach's alpha-coefficient was 0.88.

Body image avoidance

The Body Image Avoidance Questionnaire¹³ assessed the behavioral components that accompany body image disturbance such as grooming and weighing behaviors, avoiding social activities, eating restraint, and nonrevealing clothing. The 19 items are scored on a six-point scale ranging from “Never” to “Always.” An example item is, “I wear baggy clothes.” In the present sample, the alpha-coefficient was 0.83.

Body–mass index

The body–mass index (BMI) was calculated using participants' self-reported height and weight.

Data analyses

Descriptive statistics were reported for all variables of interest according to the gender. We conducted correlational analyses to explore the relationship between body image avoidance, disordered eating, and different types of Internet use. Finally, to explore predictors of disordered eating, we entered the variables into a hierarchical regression analysis with the BMI in the first step, and Internet addiction symptoms and body image avoidance in the second step. The significance level was set at α=0.05, and all analyses were conducted using PASW 18.0.

Results

Descriptive statistics

Summary statistics for the study variables are presented in Table 1. Participants were classified according to the IAT categories. Forty (10.2 percent) participants met the criteria for Internet addiction according to the IAT criteria (defined as the “occasional to frequent” or “serious problems” categories), including 14 men and 26 women. The mean (SD) weekly hours spent online by those with and without pathological Internet use were 42.87 (12.13) versus 22.02 (14.25), p<0.001.

Table 1.

Summary Statistics

	Males (n = 139), mean (SD)	Females (n = 292), mean (SD)
Age	26.40 (5.32)	24.62 (3.49)
BMI	23.00 (3.52)	22.08 (3.92)
Time spent online	27.96 (16.03)	21.83 (14.50)
Internet addiction	35.51 (11.83)	32.29 (11.32)
Disordered eating	4.41 (4.54)	9.58 (11.24)
Body image avoidance	17.93 (8.13)	24.68 (12.75)

BMI, body mass index.

Body image, disordered eating, and type of Internet use

Among women, body image avoidance and disordered eating were positively correlated with time spent on social and communication Websites (ρ=0.13, p<0.05 and ρ=0.13, p<0.05 respectively), but not with time spent on any other type of Website. The most frequently cited Websites in this category were Facebook (cited by 172 participants) and MSN (cited by 104). There were no significant relationships among men.

Relationship between Internet use and body image and disordered eating

Among women, time spent online was correlated with disordered eating (r=0.16, p<0.01), but not with body image avoidance (Table 2). Internet addiction scores were correlated with both disordered eating (r=0.33, p<0.001) and body image avoidance (r=0.35, p<0.001). The results from the regression analyses showed that the BMI was not a significant predictor (β=0.02, ns) of disordered eating. However, Internet addiction symptoms (β=0.31, p<0.001) entered in a second step, which were a significant predictor, although body image avoidance (β=0.74, p<0.001) was the only significant predictor when added to the model in step 3. Together, the variables explained 54 percent of the variability in disordered eating (Table 3).

Table 2.

Correlations Between Study Variables Among Males and Females

	BMI	Time spent online	Internet addiction	Body image avoidance	Disordered eating
BMI		−0.20^*	−0.13	0.34^***	0.05
Time spent online	0.05		0.64^***	0.12	0.01
Internet addiction	0.06	0.50^**		0.27^**	0.04
Body image avoidance	0.21^**	0.14	0.35^***		0.29^**
Disordered eating	0.06	0.16^**	0.33^***	0.72^***

Values above the diagonal in the shaded cells correspond to males; those below the diagonal in the clear cells correspond to females.

p < 0.05; ^**p < 0.01; ^***p < 0.001.

Table 3.

Results from Regression Analyses Among Males and Females Predicting Disordered Eating

		Adjusted R ²	Change in R ²	β
Males
Step 1	BMI	0.00		0.00
Step 2	Internet addiction symptoms	0.00	0.00	0.12
Step 3	Body image avoidance	0.07	0.07^*	−0.33^**
Females
Step 1	BMI	0.00		0.02
Step 2	Internet addiction symptoms	0.08	0.08^**	−0.31^**
Step 3	Body image avoidance	0.54	0.46^**	−0.74^**

^*p < 0.05; ^**p < 0.001.

Among men, time spent online correlated with neither body image avoidance nor disordered eating. Internet addiction symptoms were correlated with body image avoidance (r=0.27, p<0.001), but not disordered eating (Table 2). In a hierarchical regression analysis, neither BMI entered in the first step (β=0.007, ns), nor Internet addiction symptoms entered in the second step (β=0.12, ns) were significant predictors of disordered eating; however, body image avoidance entered in the final step was a significant predictor (β=0.33, p<0.001). Together, the variables explained seven percent of the variability in disordered eating (Table 3).

Discussion

The aim of this study was to explore the relationships between Internet use addiction, body image avoidance, and disordered eating. Overall, the results suggest an association between body image avoidance, Internet addiction, and eating disturbance, and that the use of social and communication Websites among women may play a role in this association.

About a-tenth of our sample, regardless of gender, reported Internet addiction. Although comparisons with previous studies are difficult due to the great heterogeneity of sampling methods, the numbers found in our study seem comparable with those described among similar age groups.²⁷ In line with previous findings, time spent online was a significant predictor of Internet addiction spent significantly more time on Internet.²⁸

In line with our expectations, among women, high levels of body avoidance and disordered eating were moderately associated with the proportion of online time devoted to communication Websites only. Although the amount of explained variance is somewhat small, these findings provide some partial support for the self-presentational theory of Internet addiction in that there were moderate associations between body image avoidance and Internet addiction, and suggested that concerns regarding others' evaluation of one's appearance and the desire to control self-presentation might play a role in the development of Internet addiction. Individuals with high levels of body image concerns and disordered eating could be particularly vulnerable to pathological Internet use. This is particularly concerning as other authors have suggested that Internet addiction may in turn lead to increased social isolation.²⁸ This suggests that individuals experiencing high levels of body image concerns and disordered eating may use online communication as a coping mechanism that could get caught up in a vicious circle leading to higher levels of psychopathology.

Our second hypothesis was that Internet addiction symptoms would be associated with body image avoidance. This was found to be the case among both men and women with moderate-to-large-effect sizes. These findings regarding the role of body image avoidance further the understanding of the association between Internet addiction and body image concerns. They suggest that, while levels of negative body image may contribute to Internet addiction,¹⁶ an important factor is the resulting extent to which the individual is motivated to avoid situations in which others are able to appraise his or her body shape and size. Again, this finding provides some support for the self-presentational theory of Internet addiction; however, the correlational nature of the study precludes from drawing conclusions as to causal relationships.

Finally, we expected both body image avoidance and Internet addiction symptoms to contribute to disordered eating. Among women, both Internet addiction symptoms and the role of body image avoidance were significant predictors of disordered eating, although only body image avoidance remained significant in the final model. However, among men, no relationship was found between Internet addiction symptoms and disordered eating, and only body image avoidance was a significant predictor of disordered eating. These results regarding disordered eating and body image avoidance corroborate those of Tao and Liu,¹⁸ who similarly reported that levels of disordered eating differed among female Internet dependents and nondependents, and found no significant relationships for men. The gender differences observed in our findings may be due to a number of factors, including the well-documented gender differences of levels of body image and eating concerns²⁹; however, our findings may also have lacked statistical power somewhat due to the predominantly female sample.

This study is not exempt from a number of limitations. First, the generalizability of the results is somewhat limited by the snowballing recruitment strategy and the predominantly female sample. Furthermore, the gender imbalance in our sample is unusual in that it is predominantly women. Secondly, the proportion of individuals reporting pathological Internet use in our sample is small, which may limit our findings. In addition, the cross-sectional nature of our study meant that results are merely correlational. Finally, although our theoretical framework predicted that individuals experience body image concerns, and disordered eating might be drawn to the Internet, the present study failed to examine the temporal relationships between these variables.

Despite these limitations, our study suggests that body image avoidance and Internet addiction symptoms may play a role in disordered eating, particularly among women, and that clinicians might consider targeting body image avoidance when treating Internet addiction. Further research is necessary to confirm these results and to clarify the temporal relationships between these concerns.

Footnotes

Author Disclosure Statement

No competing financial interests exist.

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