The association between orthorexia nervosa and social media use: A systematic review and meta-analysis
5 affiliations
- 1MEDICA Research Investigation, Hadath, Lebanon.
- 2Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon.
- 3Faculty of Medical Sciences, Caucasus International University, Tbilisi, Georgia.
- 4INSPECT-LB (Institut National de Santé Publique Epidémiologie Clinique et Toxicologie-Liban), Beirut, Lebanon.
- 5Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Abstract
Orthorexia nervosa (ON) is a newly described mental disorder characterized by an extreme obsession with the consumption of healthy foods, resulting in anxiety and impaired functionality. This systematic review and meta-analysis aims to synthesize the association between social media use and orthorexic tendencies among adolescents and adults. PubMed, Web of Science, Embase, Scopus, and PsycINFO were searched through January 2026. Original studies assessing the association between social media use and ON were included. Zero-order correlations between social media and orthorexia measures were pooled using Fisher’s z under a random-effects (REML) model; heterogeneity, subgroup and meta-regression, sensitivity and publication-bias analyses were performed; certainty was rated with GRADE. Of 33 included studies, 22 contributed to meta-analysis of the correlation between social media use and ON symptoms, yielding a small positive pooled correlation (r = 0.20, 95% CI 0.15–0.25; I² = 84.3%; very low certainty by GRADE). This association remained stable across leave-one-out, subgroup, and sensitivity analyses (r = 0.18–0.20), and after adjustment for potential publication bias (bias-adjusted r = 0.17). A secondary analysis of two studies with reconstructable 2 × 2 data suggested greater odds of ON among heavier users (OR = 1.57, 95% CI 1.25–1.97). Pooled ON prevalence differed sharply with the diagnostic threshold (39.9% at the ORTO-15 cutoff below 35 versus 65.5% below 40), reflecting extreme heterogeneity (I² > 90%) across studies. Narrative synthesis indicated that the type of content consumed was more consistently associated with ON than platform or duration of use alone Social media use is associated with greater orthorexic tendencies. However, because all included studies were cross-sectional and overall certainty of evidence was very low, causality and directionality cannot be established and reverse causality remains plausible. Longitudinal and experimental research is needed to clarify the direction of this relationship.
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BibTeX
@article{nakhl2026association,
title = {{The association between orthorexia nervosa and social media use: A systematic review and meta-analysis}},
author = {Anna-Marina Nakhl and Muhammad Ahmad Barakat and Jana Kotaich and Elssy Elleik and Ahmad Afyouni and Linda Abou Abbas},
journal = {PLOS Mental Health},
year = {2026},
month = oct,
doi = {10.1371/journal.pmen.0000758},
url = {https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000758},
note = {CC BY},
}
RIS
TY - JOUR
TI - The association between orthorexia nervosa and social media use: A systematic review and meta-analysis
AU - Anna-Marina Nakhl
AU - Muhammad Ahmad Barakat
AU - Jana Kotaich
AU - Elssy Elleik
AU - Ahmad Afyouni
AU - Linda Abou Abbas
PY - 2026
DA - 2026/10/21
JO - PLOS Mental Health
DO - 10.1371/journal.pmen.0000758
UR - https://journals.plos.org/mentalhealth/article?id=10.1371/journal.pmen.0000758
AB - Orthorexia nervosa (ON) is a newly described mental disorder characterized by an extreme obsession with the consumption of healthy foods, resulting in anxiety and impaired functionality. This systematic review and meta-analysis aims to synthesize the association between social media use and orthorexic tendencies among adolescents and adults. PubMed, Web of Science, Embase, Scopus, and PsycINFO were searched through January 2026. Original studies assessing the association between social media use and ON were included. Zero-order correlations between social media and orthorexia measures were pooled using Fisher’s z under a random-effects (REML) model; heterogeneity, subgroup and meta-regression, sensitivity and publication-bias analyses were performed; certainty was rated with GRADE. Of 33 included studies, 22 contributed to meta-analysis of the correlation between social media use and ON symptoms, yielding a small positive pooled correlation (r = 0.20, 95% CI 0.15–0.25; I² = 84.3%; very low certainty by GRADE). This association remained stable across leave-one-out, subgroup, and sensitivity analyses (r = 0.18–0.20), and after adjustment for potential publication bias (bias-adjusted r = 0.17). A secondary analysis of two studies with reconstructable 2 × 2 data suggested greater odds of ON among heavier users (OR = 1.57, 95% CI 1.25–1.97). Pooled ON prevalence differed sharply with the diagnostic threshold (39.9% at the ORTO-15 cutoff below 35 versus 65.5% below 40), reflecting extreme heterogeneity (I² > 90%) across studies. Narrative synthesis indicated that the type of content consumed was more consistently associated with ON than platform or duration of use alone Social media use is associated with greater orthorexic tendencies. However, because all included studies were cross-sectional and overall certainty of evidence was very low, causality and directionality cannot be established and reverse causality remains plausible. Longitudinal and experimental research is needed to clarify the direction of this relationship.
SN - 2837-8156
ER -