Eating Disorders and Social Media Use among College Students in Japan and China: A Cross-sectional Survey

Abstract Background In recent years, new forms of media called social networking service (SNS), such as Facebook and Sina Weibo, have spread rapidly. The higher the frequency of SNS use in combination with body dissatisfaction, the higher the risk of developing eating disorders (EDs). This study investigated the relationships between ED tendencies, SNS use intensity, and body esteem among Japanese and Chinese college students. Methods A total of 564 Japanese and Chinese college students aged 18–22 years old were surveyed on their age, height, and body weight, including items from the Japanese and Chinese versions of the Eating Attitude Test (EAT-26), SNS Intensity Scale, Body Esteem Scale for Adolescents and Adults (BESAA), Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7 (GAD-7) scale. Results The percentage of all students with a score of ≥ 20 on the EAT-26 was 15.8% (Japanese, 14.7%; Chinese, 17.0%). In the Japanese students, the EAT-26 scores were unrelated to the SNS Intensity Scale but had a weak negative correlation with the BESAA. In the Chinese students, the EAT-26 scores were unrelated to the number of friends on SNSs, and time spent on SNSs, but had a weak correlation with the SNS Intensity Scale and the BESAA. The PHQ-9, GAD-7 and EAT-26 scores were significantly correlated among the respondents. There were differences between sex and the different countries. Chinese women had significantly higher scores on the EAT-26, SNS Intensity Scale, BES-appearance, and GAD-7 than other groups. Chinese men had significantly higher scores on the BESAA, BES-attribution,and BES-weight than other groups. Conclusions The main findings showed that (a) ED tendencies are positively related to SNS use intensity only in China; (b) ED tendencies are negatively related to body esteem in Japan and China; and (c) SNS use intensity is positively related to body esteem in China, but not significantly correlated in Japan; (d) Chinese women show a higher risk of EDs than other groups. The results indicated that the relationships among ED tendencies, the frequency of SNS use, and body dissatisfaction, differ between Japan and China.