One of the debates about media usage is the potential harmful effect that it has on body image and related eating disturbances because of its representations of the "ideal body". This study focuses on the drive for thinness among the visitors of various health-oriented websites and online platforms because neither has yet been sufficiently studied in this context. Specifically, this study aims to bring more insight to the risk factors which can increase the drive for thinness in the users of these websites. We tested the presumption that web content internalization is a key factor in this process, and we considered the effects of selected individual factors, specifically the perceived online social support and neuroticism. We utilized survey data from 445 Czech women (aged 18-29, M = 23.5, SD = 3.1) who visited nutrition, weight loss, and exercise websites. The results showed a positive indirect link between both perceived online social support and neuroticism to the drive for thinness via web content internalization. The results are discussed with regard to the dual role of online support as both risk and protective factor. Moreover, we consider the practical implications for eating behavior and weight-related problems with regard to prevention and intervention.

Faculty of Social Studies Masaryk University 60200 Brno Czech Republic

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Pritchard M., Cramblitt B. Media Influence on Drive for Thinness and Drive for Muscularity. Sex Roles. 2014;71:208–218. doi: 10.1007/s11199-014-0397-1. DOI

Warren C.S., Gleaves D.H., Cepeda-Benito A., Fernandez M.D.C., Rodriguez-Ruiz S. Ethnicity as a Protective Factor against Internalization of a Thin Ideal and Body Dissatisfaction. Int. J. Eat. Disord. 2005;37:241–249. doi: 10.1002/eat.20102. PubMed DOI

Thompson J.K., Heinberg L.J., Altabe M., Tantleff-Dunn S. Exacting Beauty: Theory, Assessment, and Treatment of Body Image Disturbance. American Psychological Association; Washington, DC, USA: 1999.

Harper K., Sperry S., Thompson J.K. Viewership of Pro-Eating Disorder Websites: Association with Body Image and Eating Disturbances. Int. J. Eat. Disord. 2008;41:92–95. doi: 10.1002/eat.20408. PubMed DOI

Juarez L., Soto E., Pritchard M.E. Drive for Muscularity and Drive for Thinness: The Impact of Pro-Anorexia Websites. Eat. Disord. 2012;20:99–112. doi: 10.1080/10640266.2012.653944. PubMed DOI

Jones M.E., Blodgett Salafia E.H., Hill B.D. The Effect of Parental Warmth on Girls’ Drive for Thinness: Do Both Parents Matter? J. Child Fam. Stud. 2019;28:182–191. doi: 10.1007/s10826-018-1243-9. DOI

De Pasquale C., Pistorio M.L., Tornatore E., De Berardis D., Fornaro M. The Relationship between Drive to Thinness, Conscientiousness and Bulimic Traits during Adolescence: A Comparison between Younger and Older Cases in 608 Healthy Volunteers. Ann. Gen. Psychiatry. 2013;12 doi: 10.1186/1744-859X-12-34. PubMed DOI PMC

Fernandez S., Pritchard M. Relationships between Self-Esteem, Media Influence and Drive for Thinness. Eat. Behav. 2012;13:321–325. doi: 10.1016/j.eatbeh.2012.05.004. PubMed DOI

Tiggemann M. The Role of Media Exposure in Adolescent Girls’ Body Dissatisfaction and Drive for Thinness: Prospective Results. J. Soc. Clin. Psychol. 2006;25:523–541. doi: 10.1521/jscp.2006.25.5.523. DOI

Sands R. Reconceptualization of Body Image and Drive for Thinness. Int. J. Eat. Disord. 2000;28:397–407. doi: 10.1002/1098-108X(200012)28:4<397::AID-EAT7>3.0.CO;2-U. PubMed DOI

Wiederman M.W., Pryor T.L. Body Dissatisfaction, Bulimia, and Depression among Women: The Mediating Role of Drive for Thinness. Int. J. Eat. Disord. 2000;27:90–95. doi: 10.1002/(SICI)1098-108X(200001)27:1<90::AID-EAT10>3.0.CO;2-0. PubMed DOI

Brunet J., Sabiston C.M., Dorsch K.D., McCreary D.R. Exploring a Model Linking Social Physique Anxiety, Drive for Muscularity, Drive for Thinness and Self-Esteem among Adolescent Boys and Girls. Body Image. 2010;7:137–142. doi: 10.1016/j.bodyim.2009.11.004. PubMed DOI

Warren C.S., Holland S., Billings H., Parker A. The Relationships between Fat Talk, Body Dissatisfaction, and Drive for Thinness: Perceived Stress as a Moderator. Body Image. 2012;9:358–364. doi: 10.1016/j.bodyim.2012.03.008. PubMed DOI

Galmiche M., Déchelotte P., Lambert G., Tavolacci M.P. Prevalence of Eating Disorders over the 2000–2018 Period: A Systematic Literature Review. Am. J. Clin. Nutr. 2019;109:1402–1413. doi: 10.1093/ajcn/nqy342. PubMed DOI

Tiggemann M., Miller J. The Internet and Adolescent Girls’ Weight Satisfaction and Drive for Thinness. Sex Roles. 2010;63:79–90. doi: 10.1007/s11199-010-9789-z. DOI

Bissonnette-Maheux V., Provencher V., Lapointe A., Dugrenier M., Dumas A.A., Pluye P., Straus S., Gagnon M.P., Desroches S. Exploring Women’s Beliefs and Perceptions About Healthy Eating Blogs: A Qualitative Study. J. Med. Internet Res. 2015;17:e87. doi: 10.2196/jmir.3504. PubMed DOI PMC

Ransom D.C., La Guardia J.G., Woody E.Z., Boyd J.L. Interpersonal Interactions on Online Forums Addressing Eating Concerns. Int. J. Eat. Disord. 2010;43:161–170. doi: 10.1002/eat.20629. PubMed DOI

Boepple L., Thompson J.K. A Content Analysis of Healthy Living Blogs: Evidence of Content Thematically Consistent with Dysfunctional Eating Attitudes and Behaviors. Int. J. Eat. Disord. 2014;47:362–367. doi: 10.1002/eat.22244. PubMed DOI

Smahel D., Machackova H., Smahelova M., Cevelicek M., Almenara C.A., Holubcikova J. Digital Technology, Eating Behaviors, and Eating Disorders. Springer; Cham, Switzerland: 2018.

Flynn M.A., Stana A. Social Support in a Men’s Online Eating Disorder Forum. Int. J. Mens. Health. 2012;11:150–169. doi: 10.3149/jmh.1102.150. DOI

Hwang K.O., Ottenbacher A.J., Green A.P., Cannon-Diehl M.R., Richardson O., Bernstam E.V., Thomas E.J. Social Support in an Internet Weight Loss Community. Int. J. Med. Inform. 2010;79:5–13. doi: 10.1016/j.ijmedinf.2009.10.003. PubMed DOI PMC

McCormack A. Individuals with Eating Disorders and the Use of Online Support Groups as a Form of Social Support. CIN Comput. Inform. Nurs. 2010;28:12–19. doi: 10.1097/NCN.0b013e3181c04b06. PubMed DOI

Custers K., Van den Bulck J. Viewership of Pro-Anorexia Websites in Seventh, Ninth and Eleventh Graders. Eur. Eat. Disord. Rev. 2009;17:214–219. doi: 10.1002/erv.910. PubMed DOI

Rouleau C.R., Von Ranson K.M. Potential Risks of Pro-Eating Disorder Websites. Clin. Psychol. Rev. 2011;31:525–531. doi: 10.1016/j.cpr.2010.12.005. PubMed DOI

Turja T., Oksanen A., Kaakinen M., Sirola A., Kaltiala-Heino R., Räsänen P. Proeating Disorder Websites and Subjective Well-Being: A Four-Country Study on Young People. Int. J. Eat. Disord. 2017;50:50–57. doi: 10.1002/eat.22589. PubMed DOI

Ging D., Garvey S. ‘Written in These Scars Are the Stories I Can’t Explain’: A Content Analysis of pro-Ana and Thinspiration Image Sharing on Instagram. New Media Soc. 2018;20:1181–1200. doi: 10.1177/1461444816687288. DOI

Carrotte E.R., Vella A.M., Lim M.S. Predictors of “Liking” Three Types of Health and Fitness-Related Content on Social Media: A Cross-Sectional Study. J. Med. Internet Res. 2015;17:e205. doi: 10.2196/jmir.4803. PubMed DOI PMC

Eurostat Women Aged 16–29 Using the Internet For Seeking Health-Related Information. [(accessed on 28 March 2020)]; Available online: https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=isoc_ci_ac_i&lang=en.

Eurostat Women Aged 16–29 Using the Internet in Last Three Months. [(accessed on 28 March 2020)]; Available online: https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=isoc_ci_ifp_iu&lang=en.

Van Den Berg P., Thompson J.K., Obremski-Brandon K., Coovert M. The Tripartite Influence Model of Body Image and Eating Disturbance A Covariance Structure Modeling Investigation Testing the Mediational Role of Appearance Comparison. J. Psychosom. Res. 2002;53:1007–1020. doi: 10.1016/S0022-3999(02)00499-3. PubMed DOI

Huxley C.J., Halliwell E., Clarke V. An Examination of the Tripartite Influence Model of Body Image: Does Women’s Sexual Identity Make a Difference? Psychol. Women Q. 2015;39:337–348. doi: 10.1177/0361684314554917. DOI

Keery H., van den Berg P., Thompson J.K. An Evaluation of the Tripartite Influence Model of Body Dissatisfaction and Eating Disturbance with Adolescent Girls. Body Image. 2004;1:237–251. doi: 10.1016/j.bodyim.2004.03.001. PubMed DOI

Pokrajac-bulian A. Thin-Ideal Internalization and Comparison Process as Mediators of Social Influence and Psychological Functioning in the Development of Disturbed Eating Habits in Croatian College Females. Psychol. Top. 2008;17:221–245.

Jones D.C., Vigfusdottir T.H., Lee Y. Body Image and the Appearance Culture among Adolescent Girls and Boys: An Examination of Friend Conversations, Peer Criticism, Appearance Magazines, and the Internalization of Appearance Ideals. J. Adolesc. Res. 2004;19:323–339. doi: 10.1177/0743558403258847. DOI

Gilbert S.C., Crump S., Madhere S., Schutz W. Internalization of the Thin Ideal as a Predictor of Body Dissatisfaction and Disordered Eating in African, African-American, and Afro-Caribbean Female College Students. J. Coll. Stud. Psychother. 2009;23:196–211. doi: 10.1080/87568220902794093. DOI

Low K.G., Charanasomboon S., Brown C., Hiltunen G., Long K., Reinhalter K., Jones H. Internalization of the Thin Ideal, Weight and Body Image Concerns. Soc. Behav. Pers. 2003;31:81–90. doi: 10.2224/sbp.2003.31.1.81. DOI

Peebles R., Wilson J.L., Litt I.F., Hardy K.K., Lock J.D., Mann J.R., Borzekowski D.L.G. Disordered Eating in a Digital Age: Eating Behaviors, Health, and Quality of Life in Users of Websites with pro-Eating Disorder Content. J. Med. Internet Res. 2012;14 doi: 10.2196/jmir.2023. PubMed DOI PMC

Reijo S. Dietary Blogs as Sites of Informational and Emotional Support. Inf. Res. 2010;15:2.

Tong S.T., Heinemann-LaFave D., Jeon J., Kolodziej-Smith R., Warshay N. The Use of Pro-Ana Blogs for Online Social Support. Eat. Disord. 2013;21:408–422. doi: 10.1080/10640266.2013.827538. PubMed DOI

Marcus S.R. Thinspiration vs. Thicksperation: Comparing pro-Anorexic and Fat Acceptance Image Posts on a Photo-Sharing Site. Cyberpsychology. 2016;10 doi: 10.5817/CP2016-2-5. DOI

Kendal S., Kirk S., Elvey R., Catchpole R., Pryjmachuk S. How a Moderated Online Discussion Forum Facilitates Support for Young People with Eating Disorders. Health Expect. 2017;20:98–111. doi: 10.1111/hex.12439. PubMed DOI PMC

Chiu C.M., Huang H.Y., Cheng H.L., Sun P.C. Understanding Online Community Citizenship Behaviors through Social Support and Social Identity. Int. J. Inf. Manag. 2015;35:504–519. doi: 10.1016/j.ijinfomgt.2015.04.009. DOI

Tajfel H., Turner J.C. The Social Psychology of Intergroup Relation. Brooks-Cole; Monrerey, CA, USA: 1979. An integrative theory of intergroup conflict.

Tajfel H. Social Identity and Intergroup Relations. Cambridge University Press; Cambridge, MA, USA: 2010.

Deaux K. Reconstructing Social Identity. Soc. Personal. Soc. Psychol. 1993;19:4–12. doi: 10.1177/0146167293191001. DOI

Haslam S.A., O’Brien A., Jetten J., Vormedal K., Penna S. Taking the strain: Social identity, social support, and the experience of stress. Br. J. Soc. Psychol. 2005;44:355–370. doi: 10.1348/014466605X37468. PubMed DOI

Stets J.E., Burke P.J. Identity Theory and Social Identity Theory. Soc. Psychol. Q. 2000;63:224–237. doi: 10.2307/2695870. DOI

Gual P., Pérez-Gaspar M., Martinez-Gonzalez M.A., Lahortiga F., de Irala-Estévez J., Cervera-Enguix S. Self-Esteem, Personality, and Eating Disorders: Baseline Assessment of a Prospective Population-Based Cohort. Int. J. Eat. Disord. 2002;31:261–273. doi: 10.1002/eat.10040. PubMed DOI

Martin S.J., Racine S.E. Personality Traits and Appearance-Ideal Internalization: Differential Associations with Body Dissatisfaction and Compulsive Exercise. Eat. Behav. 2017;27:39–44. doi: 10.1016/j.eatbeh.2017.11.001. PubMed DOI

Roberts A., Good E. Media Images and Female Body Dissatisfaction: The Moderating Effects of the Five-Factor Traits. Eat. Behav. 2010;11:211–216. doi: 10.1016/j.eatbeh.2010.04.002. PubMed DOI

Rozgonjuk D., Ryan T., Kuljus J.K., Täht K., Scott G.G. Social Comparison Orientation Mediates the Relationship between Neuroticism and Passive Facebook Use. Cyberpsychology. 2019;13 doi: 10.5817/CP2019-1-2. DOI

Fischer L.K., Schreyer C.C., Coughlin J.W., Redgrave G.W., Guarda A.S. Neuroticism and Clinical Course of Weight Restoration in a Meal-Based, Rapid-Weight Gain, Inpatient-Partial Hospitalization Program for Eating Disorders. Eat. Disord. 2017;25:52–64. doi: 10.1080/10640266.2016.1241056. PubMed DOI

Kjelsås E., Augestad L.B. Gender, Eating Behavior, and Personality Characteristics in Physically Active Students. Scand. J. Med. Sci. Sports. 2004;14:258–268. doi: 10.1111/j.1600-0838.2003.00343.x. PubMed DOI

Ellickson-Larew S., Naragon-Gainey K., Watson D. Pathological Eating Behaviors, BMI, and Facet-Level Traits: The Roles of Conscientiousness, Neuroticism, and Impulsivity. Eat. Behav. 2013;14:428–431. doi: 10.1016/j.eatbeh.2013.06.015. PubMed DOI

MacNeill L.P., Best L.A., Davis L.L. The Role of Personality in Body Image Dissatisfaction and Disordered Eating: Discrepancies between Men and Women. J. Eat. Disord. 2017;5:44. doi: 10.1186/s40337-017-0177-8. PubMed DOI PMC

Scoffier-Mériaux S., Falzon C., Lewton-Brain P., Filaire E., d’arripe-Longueville F. Big Five Personality Traits and Eating Attitudes in Intensively Training Dancers: The Mediating Role of Internalized Thinness Norms. J. Sports Sci. Med. 2015;14:627–633. PubMed PMC

Cervera S., Lahortiga F., Martinez-Gonzalez M.A., Gual P., de Irala-Estevez J., Alonso Y. Neuroticism and Low Self-Esteem as Risk Factors for Incident Eating Disorders in a Prospective Cohort Study. Int. J. Eat. Disord. 2003;33:271–280. doi: 10.1002/eat.10147. PubMed DOI

Izydorczyk B. Neuroticism and Compulsive Overeating (A Comparative Analysis of the Level of Neuroticism and Anxiety in a Group of Females Suffering from Psychogenic Binge Eating, and in Individuals Exhibiting No Mental or Eating Disorders) Arch. Psychiatry Psychother. 2012;14:5–13.

Koren R., Munn-Chernoff M.A., Duncan A.E., Bucholz K.K., Madden P.A.F., Heath A.C., Agrawal A. Is the Relationship between Binge Eating Episodes and Personality Attributable to Genetic Factors? Twin Res. Hum. Genet. 2014;17:65–71. doi: 10.1017/thg.2013.92. PubMed DOI PMC

Henderson Z.B., Fox J.R.E., Trayner P., Wittkowski A. Emotional Development in Eating Disorders: A Qualitative Metasynthesis. Clin. Psychol. Psychother. 2019;26:440–457. doi: 10.1002/cpp.2365. PubMed DOI PMC

Heinberg L.J., Coughlin J.W., Pinto A.M., Haug N., Brode C., Guarda A.S. Validation and Predictive Utility of the Sociocultural Attitudes toward Appearance Questionnaire for Eating Disorders (SATAQ-ED): Internalization of Sociocultural Ideals Predicts Weight Gain. Body Image. 2008;5:279–290. doi: 10.1016/j.bodyim.2008.02.001. PubMed DOI

Chaudhari B., Tewari A., Vanka J., Kumar S., Saldanha D. The Relationship of Eating Disorders Risk with Body Mass Index, Body Image and Self-Esteem among Medical Students. Ann. Med Health Sci. Res. 2017;7:144–149.

Dada G., Feixas G., Compañ V., Montesano A. Self-Construction, Cognitive Conflicts, and Disordered Eating Attitudes in Young Women. J. Constr. Psychol. 2012;25:70–89. doi: 10.1080/10720537.2012.629117. DOI

Rojo-Moreno L., Rubio T., Plumed J., Barberá M., Serrano M., Gimeno N., Conesa L., Ruiz E., Rojo-Bofill L., Beato L., et al. Teasing and Disordered Eating Behaviors in Spanish Adolescents. Eat. Disord. 2013;21:53–69. doi: 10.1080/10640266.2013.741988. PubMed DOI

Graham A.L., Papandonatos G.D., Kang H., Moreno J.L., Abrams D.B. Development and validation of the online social support for smokers scale. J. Med Internet Res. 2011;13:e69. doi: 10.2196/jmir.1801. PubMed DOI PMC

Lang F.R., John D., Lüdtke O., Schupp J., Wagner G.G. Short assessment of the Big Five: Robust across survey methods except telephone interviewing. Behav. Res. Methods. 2011;43:548–567. doi: 10.3758/s13428-011-0066-z. PubMed DOI PMC

Cusumano D.L., Thompson J.K. Media influence and body image in 8–11-year-old boys and girls: A preliminary report on the multidimensional media influence scale. Int. J. Eat. Disord. 2001;29:37–44. doi: 10.1002/1098-108X(200101)29:1<37::AID-EAT6>3.0.CO;2-G. PubMed DOI

Garner D.M. Eating Disorder Inventory-3. Professional Manual. Psychological Assessment Resources; Lutz, FL, USA: 2004.

Little T.D., Cunningham W.A., Shahar G., Widaman K.F. To Parcel or Not to Parcel: Exploring the Question, Weighing the Merits. Struct. Equ. Model. 2002;9:151–173. doi: 10.1207/S15328007SEM0902_1. DOI

Menzel J.E., Sperry S.L., Small B., Thompson J.K., Sarwer D.B., Cash T.F. Internalization of Appearance Ideals and Cosmetic Surgery Attitudes: A Test of the Tripartite Influence Model of Body Image. Sex Roles. 2011;65:469–477. doi: 10.1007/s11199-011-9983-7. DOI

McKinley C.J. Investigating the influence of threat appraisals and social support on healthy eating behavior and drive for thinness. Health Commun. 2009;24:735–745. doi: 10.1080/10410230903264303. PubMed DOI

Haas S.M., Irr M.E., Jennings N.A., Wagner L.M. Communicating Thin: A Grounded Model of Online Negative Enabling Support Groups in the pro-Anorexia Movement. New Media Soc. 2011;13:40–57. doi: 10.1177/1461444810363910. DOI

Sowles S.J., McLeary M., Optican A., Cahn E., Krauss M.J., Fitzsimmons-Craft E.E., Wilfley D.E., Cavazos-Rehg P.A. A Content Analysis of an Online Pro-Eating Disorder Community on Reddit. Body Image. 2018;24:137–144. doi: 10.1016/j.bodyim.2018.01.001. PubMed DOI PMC

Espeleta H.C., Beasley L., Bohora S., Ridings L.E., Silovsky J.F. Depression in Latina mothers: Examining the roles of acculturation, enculturation, social support, and family resources. Cult. Divers. Ethn. Minority Psychol. 2019;25:527–538. doi: 10.1037/cdp0000259. PubMed DOI

Grieve R., Indian M., Witteveen K., Anne Tolan G., Marrington J. Face-to-face or Facebook: Can social connectedness be derived online? Comput. Hum. Behav. 2013;29:604–609. doi: 10.1016/j.chb.2012.11.017. DOI

Ibrahim N., Che Din N., Ahmad M., Amit N., Ghazali S.E., Wahab S., Abdul Kadir N., Halim F.W., Halim M.R.T.A. The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia. BMC Public Health. 2019;19:553. doi: 10.1186/s12889-019-6861-7. PubMed DOI PMC

Fitzsimmons E.E., Bardone-Cone A.M. Coping and social support as potential moderators of the relation between anxiety and eating disorder symptomatology. Eat. Behav. 2011;12:21–28. doi: 10.1016/j.eatbeh.2010.09.002. PubMed DOI PMC

Wonderlich-Tierney A.L., Vander Wal J.S. The effects of social support and coping on the relationship between social anxiety and eating disorders. Eat. Behav. 2010;11:85–91. doi: 10.1016/j.eatbeh.2009.10.002. PubMed DOI

Keski-Rahkonen A., Bulik C.M., Neale B.M., Rose R.J., Rissanen A., Kaprio J. Body Dissatisfaction and Drive for Thinness in Young Adult Twins. Int. J. Eat. Disord. 2005;37:188–199. doi: 10.1002/eat.20138. PubMed DOI

Šmahelová M., Čevelíček M., Nehybková E., Šmahel D., Čermák I. Is It Important to Talk about Technologies with Eating Disorder Clients? The Health-Care Professional Perspective. Health Commun. 2019;34:31–38. doi: 10.1080/10410236.2017.1384354. PubMed DOI