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Horowitz, Raechel (2022) How do Instagram’s clean-eating hashtags influence Orthorexia Nervosa and the sense of self in self-identified Orthorexia Nervosa tendencies: a mixed methods study. Doctoral thesis, London Metropolitan University.
Background/aims:
Orthorexia Nervosa (ON) involves an obsessional preoccupation with food perceived as healthy (Moroze et al., 2015). Several studies have found those with ON behaviours are particularly active on Instagram. At the time of writing, no research has addressed how those who self-identify as having ON engage with or are engaged by Instagram’s clean-eating hashtags, nor how individuals who self-identify as having ON experience their sense of self whilst using Instagram.
Design/method:
A frequency scale, designed to capture engagement with clean-eating hashtags on Instagram, the ORTO-15, and a demographic questionnaire were completed by 104 females who self-identify as having ON and use Instagram. A Spearman correlation was calculated to examine the relationship between ON symptoms and engagement with clean-eating hashtags. Eight participants who scored in the top 40% of the measures were interviewed using a semi-structured process. Verbatim accounts were analysed using thematic analysis.
Findings:
A statistically significant relationship between individuals who are engaged with clean-eating hashtags and higher levels of ON symptoms was found. Through thematic analysis, four themes were generated: ‘Regulating Self-Worth Symbolically’ (which refers to how the participants regulate their sense of self-worth through Instagram), ‘Finding Meaning & Purpose’ (which discusses how the participant's self-worth and self-esteem are fulfilled through ON behaviours), ‘Repeating Negative Cycles’ (which describes how the participants’ sense of Self is negatively impacted through cycles they find themselves in), ‘Negotiation of a Different Relationship with Lifestyle’ (which refers to the participants’ relationship with changing their ON behaviours).
Conclusions:
The quantitative aspect of this study concluded there is a positive relationship between individuals who are engaged with clean-eating hashtags on Instagram and higher levels of ON tendencies. The qualitative findings highlight that individuals with ON symptoms find their sense of self is negatively impacted by Instagram and engage in behaviours on and off the platform to improve their low self-esteem, self-worth, and protect their ego. It, therefore, provides an improved understanding of the development and maintenance of ON. Clinically, the study provides evidence that clinicians can utilise an integrative approach with CBT-E and object-relations theory.
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