Research has found that high social media use is associated with a greater tendency to compare oneself with others, which in turn may heighten body image concerns and problematic eating behaviours. The aim of this systematic review and meta-analysis was to examine the mean association between online social comparison and body image concerns, eating disorder behaviours and positive body image. Eligible articles published between 2008 and 2024 were searched for in scientific databases. A random-effects meta-analysis was conducted to investigate the direct correlation between social comparison and body image and eating disorder outcomes. Results from 83 studies with 55,440 participants indicated that the weighted average correlation between higher online social comparison and greater body image concerns was significant (r = .454; 95 % CI = 0.409-0.498), as was the correlation between higher social comparison and eating disorder symptoms (r = 0.36; 95 % CI: 0.28-0.43). The mean association between higher social comparison and lower positive body image was also significant (r = -0.242; 95 % CI: -0.329 to -0.155). Meta-regression analysis revealed that the quality of studies, type of social media, country, type of social comparison, percentage of female participants moderated the associations. Findings revealed a moderate size association between higher online social comparison tendencies and worse body image and eating disorder symptoms outcomes, highlighting the need to develop interventions and policies to minimize appearance comparisons on social media.

The eating disorder clinical and scientific community advocates for the use of a shared approach to healthcare that actively involves patients and carers. A systematic review of the literature on guided self-help or self-help in anorexia nervosa (targeting either the individual affected by the illness or their carers) and meta-analyses of studies using randomised controlled designs for the evaluation of the outcomes: (1) drop-out from end-of-treatment assessment, (2) body mass index (BMI), (3) anxiety, (4) depression and (5) quality of life, were undertaken. Guided self-help was directed to patients in 15 studies and to carers in seven studies. The interventions were based on a variety of theoretical models, used different formats (books and digital materials), and were delivered by individuals with a range of experiences and expertise (e.g. individuals with lived experience of the illness, graduate students, or clinically trained professionals). Guided self-help was associated with significantly lower drop-out from the completion of end-of-treatment assessments compared to a control condition. There was an improvement in carers’ wellbeing from skill-sharing interventions. Guided self-help may facilitate patients' treatment engagement and also improve carers' wellbeing.