The unsettling rise of eating disorders in NZ – is social media to blame?

NZ Herald

2 days ago

Rose's feed became a very dark hole she would crawl into.
'I can't separate myself from what I'm seeing on my phone – it's just too hard. I might start off looking at pictures of dogs but eventually I'd get a model in nice clothes and I'd flick over to my main page and it'd be people doing 'body checks' – and I'd start comparing myself.'
She says it brought on a feeling of terrible pressure, like the air was being sucked out of her lungs, reminding her that she needed to purge or starve herself to be worthy enough.
It got progressively worse.
Rose has veneers to replace the eroded enamel of her teeth caused by vomiting. Photo / Jason Dorday
When Rose's mother died in 2012, it was like the floodgates opening. Her mother had also dealt with anorexia so extreme dieting behaviours were normalised for Rose.
After her mother's death, Rose developed bulimia with bingeing and vomiting tendencies that became a vicious cycle.
When she traces back to the time when her eating disorder began spiralling, it correlated with spending more hours on Instagram.
She was 17 years old and had little adult supervision around her, making her slide into harmful habits even deeper.
'One hundred per cent of my daily thinking just became about food and how to avoid it, or how to get the food and purge it,' Rose said.
'Everything is punishment. It is just the most shameful thing, and you hide it from everyone. You become increasingly insulated and distant from the whole world.'
New Zealand Eating Disorders Clinic director Kellie Lavender says the past decade has revealed a disturbing trend.
'It's a massive increase,' Lavender said.
'Quite frighteningly, for the first time recently, research from Australia highlighted that over 11,000 individuals in the the five to nine-year-old age group presented with an eating disorder.'
Previously, data had not even been captured for this age group due to there being such low levels of presentations for eating disorders.
A University of Otago study found a four-fold increase in eating disorder hospitalisations between 2009 and 2024.
Evidence from 50 studies in 17 countries in a 2023 international report indicated social media usage led to body image concerns, eating disorders and disordered eating.
Lavender says that lack of conclusive research means it is difficult to conclude that social media is the reason behind the rise in eating disorders because the causative factors of the illness are highly-complex.
However, the growth of eating disorders in New Zealand's population marks a troubling reality for young people living in a world dominated by social media.
Social media algorithms fuelling eating disorders
Auckland University research fellow Dr Samantha Marsh, who devotes her spare time to research into social media harm, says algorithms are designed to produce endlessly refreshing, highly personalised content that is based on the model of slot machines at a casino.
'A recent study showed that about 80% of girls say that when they're on those platforms, it's had a negative impact on the way they view themselves and how they look,' Marsh said.
Dr Samantha Marsh says social media companies are making upwards of $11 billion per year through advertising to children alone. Photo / Dean Purcell
Instead of seeing a balance of posts, a person with an eating disorder will inevitably see online content they are obsessing over or even trying to avoid.
'The content isn't about what is of interest to you necessarily, it's what people can't look away from. Outrage, disgust and being scared by something are things we pay attention to,' Marsh said.
The algorithm will pick up on the fact a person with an eating disorder is hovering on, liking or commenting on nutrition-related content and push even more of these posts to their feed, she says.
Starship Children's Hospital child psychiatrist and paediatrician Hiran Thabrew works with severe cases of young people who have spent time in hospital for eating disorders.
Thabrew says the highest risk group for adverse mental health effects from social media is women and younger girls, specifically 13 to 15-year-old girls.
Dr Hiran Thabrew, who works at Starship Children's Hospital, says parents need to keep an eye on what their children are watching on their phones. Photo / RNZ, Cole Eastham-Farrelly
However, the rise of pro-steroid, muscle-building gym content on TikTok and other apps could be driving rates of body dysmorphia in young males due to increased exposure to unrealistic body types.
'For boys, it's not quite the same. It's not so much being thin as having abs and having muscles. Those perceptions of muscularity and certain shapes are becoming more apparent,' Thabrew said.
'It's the sportier boys who are very much into gym culture that are the most vulnerable subgroup.'
Gym influencer and pro-steroid content is on the rise for young males on apps like TikTok. Photo / 123rf
In her assessments with patients at the clinic, Lavender asks them about their social media habits and whether they follow 'thinspiration' or 'fitspiration' influencers.
'The look is validated and glorified, it almost becomes like an achievement, the less calories you have or the thigh gap,' she said.
In a first-of-its-kind research study in February 2025, University of Sydney senior lecturer and dietitian Dr Rajshri Roy examined 250 different posts regarding nutrition trends on TikTok.
The study found that TikTok's policies failed to prevent misleading nutrition content from going viral, allowing harmful posts to gain traction before being fact-checked or removed.
Sensationalised or controversial nutrition claims often attracted more attention, particularly on platforms that were driven by virality, like TikTok.
Of the 250 posts, 90% failed to point out the risks and benefits of the advice presented.
Weight-loss content was the most prevalent topic, making up 34% of posts.
Health and wellness influencers produced 32% of the posts, whereas just 5% were from dietitians and 3% from health professionals.
Roy said adolescent girls were particularly at risk.
'In terms of what exactly is causing this, there still needs to be further research but social comparison, internalisation of appearance ideals and self-objectification seem to be the mechanisms connecting social media use to eating disorder risk,' she said.
From Lavender's perspective, the amount of time a person was spending on social media was crucial, as higher phone use could lead to increased feelings of pressure to uphold or achieve a certain body standard.
'It feels like we're swimming upstream in terms of trying to change people's attitudes to what beauty is,' she said.
'That seduction of the beauty ideal is so powerful. That you're going to be happier, that you're going to have more friends and more romantic options.'
A study analysing 250 TikTok posts found weight-loss content was the most prevalent topic. Photo / Maridav
Often, the content being delivered to people was highly aesthetic and hidden beneath the veil of a 'wellness lifestyle' that was innocently sharing healthy eating tips or fitness advice.
However, much of the messaging focused obsessively on extreme fitness goals, weight loss or obtaining muscle mass in unhealthy ways for males and, overall, equated body goals with personal success.
Marsh said social media companies were making upwards of $11 billion per year through advertising to children alone.
'In order to make their product safer, they're going to have to take away all the things that hold attention – and that's their business model,' she said.
'I kind of see it a little bit like tobacco companies, where it would be like getting them to take out the nicotine from their products – it's never going to happen.'
Thabrew agrees, adding that social media companies were probably 'quite agnostic' about what was on their sites, which made it difficult when it came to reforming the harm caused by platforms.
'It's really hard, isn't it, when it comes to those companies because they're there to make money and they make it off of their algorithms and how much people interact with things.'
Among experts, there's a general consensus that a link exists between social media use and New Zealand's increase in eating disorders, but in terms of how to address the harmful content, there's no clear answer.
For some specialists, it's important that the pressure gets placed on tech companies to reform their algorithms, but others believe individuals need to monitor their own content and young people should be educated on the potential harms.
Genevieve Mora says the eating disorder sector is 'incredibly under-resourced'.
Voices of Hope co-founder Genevieve Mora, who spent most of her teenage years fighting anorexia, says social media can also be a source of hope for people.
'Social media isn't inherently good or bad and there isn't a single cause of eating disorders, but for many young people, it can add another layer of complexity," Mora said.
'Content like 'What I Eat in A Day' videos and body checking aren't helpful and can be really triggering, especially for someone already struggling.
'But I've also seen the flipside of social media where people find stories like their own and, through that, realise they're not alone, and are encouraged to reach out for help.'
Thabrew said there were positive aspects of social media such as increased health literacy and a sense of connection or community for isolated individuals.
'I think parents have a big role in terms of making social media available to kids in an age-appropriate manner and also keeping an eye on what their kids are using and watching,' he said.
Roy said placing the burden on young people or parents to moderate their social media exposure was 'unrealistic and inequitable', because of the scale and speed of algorithm-driven content.
'I personally think tech companies must increase transparency and take accountability for how their algorithms amplify inaccurate, harmful content, especially when engagement is prioritised over credibility,' she said.
'I also believe that governments have a role to play in regulating digital environments, ensuring platforms implement stronger safeguards around health information and partner with experts to elevate evidence-based content.'
Research in this area was limited as algorithmic models on these platforms were notoriously hard to access, because the companies weren't transparent with them, she said.
More support needed for eating disorders
An international trend of increasing demand for eating disorder services was being experienced in New Zealand as well, according to Health New Zealand Te Whatu Ora mental health and addictions service enhancement national director Phil Grady.
'Eating disorders vary in intensity, severity and duration and most individuals with an eating disorder can be treated on an outpatient basis,' Grady said.
'When a person is referred to a specialist service, they are triaged, with people who have the highest need prioritised and seen urgently.'
Mora said the eating disorder sector was 'incredibly under-resourced', both in funding and in specialist support.
'We see too many individuals struggling alone because they either don't meet outdated criteria for care or the services simply don't have capacity to support them,' she said.
'There are so many passionate, dedicated people working in this space doing everything they can, but the reality is there just isn't enough access for the number of people who need help.'
In Budget 2022, the Government allocated $3.95 million over four years to increase staffing for clinical roles in specialist eating disorder services.
This was the last significant investment the Government has made into eating disorder services.
Grady said 'recruitment was ongoing' and had always been planned to be staged over four years.
To date, 6.2 fulltime-equivalent (FTE) roles had been recruited of 8.5 additional FTE roles budgeted for the 2024/25 financial year.
In a briefing report to the Minister of Health from the Ministry of Health and Health NZ in March 2024, data showed many services responding to eating disorders were 'under significant demand pressure'.
'The regional specialist model offers high-quality support but requires some people to travel away from family and other support to receive treatment and at times struggles to meet demand in a timely manner,' the report said.
'Medical re-feeding services provided in general hospitals are often not well equipped to manage the demand and complexities related to people who experience an eating disorder.'
Mora said early intervention for eating disorders was key and the services needed to reflect that.
There was also concerning evidence of inequity in treatment for Māori with eating disorders.
A report published by the Journal of Eating Disorders last year said that Māori experienced eating disorders at higher rates than non-Māori, however Ministry of Health data showed Māori accessed treatment at disproportionately low rates.
'Eating disorders seem to be under-identified among Māori, in part due to stereotypes about who is impacted by eating disorders,' it said in the report.
An Auckland University study highlighted a 50% increase in hospital admissions for eating disorders during the Covid lockdowns, also disproportionally affecting Māori.
Grady said Health NZ had invested significantly in easy-to-access primary mental health services such as early intervention access and choice services, including integrated services accessed through GPs and Māori, Pacific and youth services.
Mental Health Minister Matt Doocey is currently working on a refresh of New Zealand's eating disorders strategy, which has not been updated for 16 years.
The strategy document – Future Directions for Eating Disorders Services – is due to be published in September.
Grady said it would help to identify opportunities for service improvement and highlight areas for future investment.
'I caused so much damage to my body'
At 31, Rose is now dealing with the aftermath of 15 years of an eating disorder consuming her life.
Rose's eating disorder has affected her health long-term. Photo / Jason Dorday
In the grips of her illness, she began pushing people away who would ask too many questions, leaving her extremely isolated in adulthood.
'With an eating disorder, you're not really living with your values, you might say you're an honest person but you're lying all the time and hiding it from people,' Rose said.
Recovery has now become essential to her and she feels as if part of that process requires her to relearn how to be an adult. Time she once spent unwittingly devoted to her illness is now empty and she is trying to fill it with new hobbies and lasting friendships.
However, the damage caused by her illness is not just emotional – it has had a lasting impact on her body.
She has been fitted with veneers to replace the eroded enamel of her teeth caused by vomiting.
Prolonged periods of malnutrition have led to her developing osteopenia – a condition where bone density is lower than normal, and she is dealing with ongoing gastrointestinal issues due to the harm to her digestive system.
Fertility is a big question mark for Rose and she is unsure whether she will be able to easily have children in the future.
'I caused so much damage to my body,' she said.
Lavender said eating disorders like anorexia were critical illnesses that caused severe and potentially chronic outcomes for individuals.
They were 'incredibly dangerous', she said.
Rose made the decision to deactivate her Instagram and TikTok accounts to protect herself from harmful, triggering content and since doing this, she says she has been 'much happier'.
She has found she is naturally comparing herself less to others.
Of course she wants to be on these apps – most of her friends are on them – but her newfound ignorance of what is trending has been worth it.
Despite the fact she struggles to think positively about the look of her body, she keeps reminding herself its healthy functioning will enable her to be physically capable and to live well.
She is eager to take up horse riding and find exercise that will bring her joy.
It's not an easy road ahead and she is attending regular sessions with an eating disorder specialist in the hopes of making a full recovery.
For now, her thoughts are a little quieter.
Rose's name was changed for this story to protect her anonymity.
Eva de Jong is a New Zealand Herald reporter covering general news for the daily newspaper, Weekend Herald and Herald on Sunday. She was previously a multimedia journalist for the Whanganui Chronicle, covering health stories and general news.
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