A revised examination of the dual pathway model for bulimic symptoms: The importance of social comparisons made on Facebook and sociotropy.
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Five cross-sectional studies yielded statistically significant associations between social media usage and various clinical eating disorders, including night eating syndrome, binge eating disorder and bulimia nervosa.
“Five cross-sectional studies yielded statistically significant associations between social media usage and various clinical eating disorders. These ranged from night eating syndrome [67], to binge eating disorder [68] and bulimia nervosa [69].”
From The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people (2023) · cites this paper as [69]
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“Bulimic symptoms were assessed at T1 and T2 using the bulimia and food preoccupation subscale from the EATe26 (Garner et al., 1982).”
MethodRisk and maintenance factors for eating pathology: A meta-analytic review.
Stice, E. M. (2002) · Psychological Bulletin · doi:10.1037/0033-2909.128.5.825 · Cited by 2,531 · see citing works
Binge eating as escape from self-awareness
Heatherton, T. F., & Baumeister, R. F. (1991) · Psychological Bulletin · doi:10.1037/0033-2909.110.1.86 · Cited by 2,259 · cited 1× · see citing works
“The second pathway is via negative affect: increased body dissatisfaction leads to negative internal states, and binge-eating/ purging behaviors are thought to be mechanisms that distract attention away from these negative mood states (Heatherton & Baumeister, 1991).”
BackgroundFacebook Use Predicts Declines in Subjective Well-Being in Young Adults
Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D. S., Lin, N., Shablack, H., Jonides, J., & Ybarra, O. (2013) · PLoS ONE · doi:10.1371/journal.pone.0069841 · Cited by 1,596 · cited 1× · see citing works
“Given the apparent popularity of Facebook, as well as the influence of Facebook use on negative mood (Kross et al., 2013; Sagioglou & Greitemeyer, 2014), it is important to examine whether this factor is etiological to BN symptomology by examining it in the context of the DPM. Studies that have…”
BackgroundHolland, G., & Tiggemann, M. (2016) · Body Image · doi:10.1016/j.bodyim.2016.02.008 · Cited by 1,395 · cited 1× · see citing works
“Indeed, extant research has provided initial evidence linking those who make social comparisons to others on Facebook with body dissatisfaction (see Holland & Tiggemann, 2016 for a review).”
BackgroundStice, E. (2001) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.110.1.124 · Cited by 1,251 · cited 1× · see citing works
“…with past research, our findings support the view that body dissatisfaction is a risk factor for symptoms of BN (Stice, 2002) and depression (Salafia & Gondoli, 2011), and that depression was associated with restrained eating, arguably due to the effects of starvation on mood (e.g., Stice, 2001).”
ResultStice, E. M. (2001) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.110.1.124 · Cited by 1,247 · see citing works
Perloff, R. M. (2014) · Sex Roles · doi:10.1007/s11199-014-0384-6 · Cited by 913 · cited 1× · see citing works
“Researchers have argued that exposure to such images on Facebook might lead to body dissatisfaction as individuals likely compare their bodies to the “enhanced” bodies of others (Perloff, 2014; Williams & Ricciardelli, 2014).”
BackgroundNetGirls: The Internet, Facebook, and body image concern in adolescent girls
Tiggemann, M., & Slater, A. (2013) · International Journal of Eating Disorders · doi:10.1002/eat.22141 · Cited by 741 · see citing works
Facebook Photo Activity Associated with Body Image Disturbance in Adolescent Girls
Meier, E. P., & Gray, J. (2014) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2013.0305 · Cited by 585 · cited 1× · see citing works
“It was hypothesized that the process of comparing one's self to others on Facebook might lead females to internalize the sociocultural norm of the thin ideal (Meier & Gray, 2014).”
BackgroundFardouly, J., & Vartanian, L. R. (2015) · Body Image · doi:10.1016/j.bodyim.2014.10.004 · Cited by 522 · cited 2× · see citing works
“Seven questions from Fardouly and Vartanian’s (2015) study were taken to measure participants' tendency to compare their appearance to others on Facebook.”
BackgroundGreenwood, S., Perrin, A., & Duggan, M. (2016) · Cited by 496 · see citing works
Social Comparison 2.0: Examining the Effects of Online Profiles on Social-Networking Sites
Haferkamp, N., & Krämer, N. C. (2011) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2010.0120 · Cited by 457 · cited 1× · see citing works
“…it in the context of the DPM. Studies that have examined how individuals present themselves on Facebook indicate that females often digitally enhance images in accordance with stereotyped representations of the thin ideal (Haferkamp & Kr€amer, 2011; Rodgers, Melioli, Laconi, Bui, & Chabrol, 2013).”
BackgroundDissonance and healthy weight eating disorder prevention programs: A randomized efficacy trial.
Stice, E. M., Shaw, H. E., Burton, E. M., & Wade, E. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.2.263 · Cited by 390 · see citing works
Sagioglou, C., & Greitemeyer, T. (2014) · Computers in Human Behavior · doi:10.1016/j.chb.2014.03.003 · Cited by 387 · see citing works
Dittmar, H., & Howard, S. (2004) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.23.6.768.54799 · Cited by 355 · cited 1× · see citing works
“It is thought that if an individual makes a comparison to an individual that, relatively speaking, is perceived to be closer to the thin ideal (i.e., an ‘upward comparison’) the resulting discrepancy might generate increased body dissatisfaction (Dittmar & Howard, 2004).”
BackgroundStice, E. M., Nemeroff, C. J., & Shaw, H. E. (1996) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.1996.15.3.340 · Cited by 312 · cited 7× · see citing works
“In conclusion, the present findings provide limited longitudinal support for the original conceptualization of the DPM as proposed by Stice et al. (1996).”
BackgroundMethodResultInfluentialRobins, C. J., Ladd, J. S., Welkowitz, J., Blaney, P. H., Díaz, R. J., & Kutcher, G. S. (1994) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/bf02239408 · Cited by 310 · see citing works
Rodgers, R. F., Chabrol, H., & Paxton, S. J. (2011) · Body Image · doi:10.1016/j.bodyim.2011.04.009 · Cited by 268 · see citing works
Ferguson, C. J., Muñoz, M. E., Garza, A., & Galindo, M. (2013) · Journal of Youth and Adolescence · doi:10.1007/s10964-012-9898-9 · Cited by 261 · see citing works
The effect of deprivation on food cravings and eating behavior in restrained and unrestrained eaters
Polivy, J., Coleman, J., & Herman, C. P. (2005) · International Journal of Eating Disorders · doi:10.1002/eat.20195 · Cited by 257 · see citing works
The Effects of the Media on Body Image: A Meta-Analysis
Holmstrom, A. J. (2004) · Journal of Broadcasting & Electronic Media · doi:10.1207/s15506878jobem4802_3 · Cited by 223 · cited 1× · see citing works
“…support for the links between different types of pressures (e.g., family) on body dissatisfaction and BN symptoms, it should be noted that metaanalyses by Ferguson (2013) and Holmstrom (2004) have found little evidence to support the influence of thin-ideal media effects on these same constructs.”
BackgroundThe Stice model of overeating: Tests in clinical and non-clinical samples
van Strien, T., Engels, R. C. M. E., van Leeuwe, J., & Snoek, H. M. (2005) · Appetite · doi:10.1016/j.appet.2005.08.004 · Cited by 214 · see citing works
Stice, E., Shaw, H. E., & Nemeroff, C. J. (1998) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.1998.17.2.129 · Cited by 213 · see citing works
Ferguson, C. J. (2013) · Psychology of Popular Media Culture · doi:10.1037/a0030766 · Cited by 193 · cited 1× · see citing works
“…support for the links between different types of pressures (e.g., family) on body dissatisfaction and BN symptoms, it should be noted that metaanalyses by Ferguson (2013) and Holmstrom (2004) have found little evidence to support the influence of thin-ideal media effects on these same constructs.”
BackgroundComparative effects of Facebook and conventional media on body image dissatisfaction
Cohen, R., & Blaszczynski, A. P. (2015) · Journal of Eating Disorders · doi:10.1186/s40337-015-0061-3 · Cited by 173 · cited 1× · see citing works
“As the authors of previous studies have speculated (Cohen & Blaszczynski, 2015; Fardouly & Vartanian, 2015), it is possible that individuals might engage in an upward social comparison whilst using Facebook (e.g., by comparing their bodies to the bodies of thin females), resulting in negative…”
Internet Addiction Symptoms, Disordered Eating, and Body Image Avoidance
Rodgers, R. F., Melioli, T., Laconi, S., Bui, É., & Chabrol, H. (2013) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2012.1570 · Cited by 143 · see citing works
Petrie, T. A., Tripp, M. M., & Harvey, P. J. (2002) · Psychology of Women Quarterly · doi:10.1111/1471-6402.00060 · Cited by 141 · see citing works
Psychosocial variables associated with binge eating in obese males and females
Womble, L. G., Williamson, D. A., Martin, C. K., Zucker, N. L., Thaw, J. M., Netemeyer, R., Lovejoy, J. C., & Greenway, F. L. (2001) · International Journal of Eating Disorders · doi:10.1002/eat.1076 · Cited by 137 · see citing works
Personality factors in dysphoria: A psychometric refinement of beck's Sociotropy-Autonomy Scale
Clark, D. A., & Beck, A. T. (1991) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/bf00960448 · Cited by 107 · cited 1× · see citing works
“To this end, research has examined whether the personality trait sociotropy [defined as the need for dependence on and/or approval from others (Clark & Beck, 1991)] is associated with BN symptoms.”
BackgroundMedia images and female body dissatisfaction: The moderating effects of the Five-Factor traits
Roberts, A., & Good, E. M. (2010) · Eating Behaviors · doi:10.1016/j.eatbeh.2010.04.002 · Cited by 98 · see citing works
Food cravers: Characteristics of those who binge
Gendall, K. A., Joyce, P. R., Sullivan, P. F., & Bulik, C. M. (1998) · International Journal of Eating Disorders · doi:10.1002/(sici)1098-108x(199805)23:4 · Cited by 96 · see citing works
Evans, E. H., Tovée, M. J., Boothroyd, L. G., & Drewett, R. F. (2012) · Body Image · doi:10.1016/j.bodyim.2012.10.001 · Cited by 91 · cited 2× · see citing works
“In addition to the original Stice et al. (1996) publication, eight further cross-sectional studies (Duemm et al., 2003; Evans, Tov ee, Boothroyd, and Drewett, 2013; Hutchinson, Rapee, & Taylor, 2010; Mason & Lewis, 2015; Ouwens, Van Strien, Van Leeuwe, & Van der Staak, 2009; Ruisoto et al., 2015;…”
BackgroundPapp, I., Urbán, R., Czeglédi, E., Babusa, B., & Túry, F. (2013) · Body Image · doi:10.1016/j.bodyim.2012.12.006 · Cited by 79 · see citing works
Dakanalis, A., Timko, C. A., Carrà, G., Clerici, M., Zanetti, M. A., Riva, G., & Caccialanza, R. (2014) · Appetite · doi:10.1016/j.appet.2014.07.022 · Cited by 71 · cited 4× · see citing works
“Our results are inconsistent with all four past longitudinal studies in this area (Allen et al., 2012; Dakanalis et al., 2014; Salafia& Gondoli, 2011; Stice et al., 1998), however, it should be highlighted that this is only the second longitudinal study to assess the entire DPM, and as such,…”
BackgroundResultInfluentialAllen, K. L., Byrne, S. M., & McLean, N. J. (2012) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-011-0231-z · Cited by 66 · cited 2× · see citing works
“Our results are inconsistent with all four past longitudinal studies in this area (Allen et al., 2012; Dakanalis et al., 2014; Salafia& Gondoli, 2011; Stice et al., 1998), however, it should be highlighted that this is only the second longitudinal study to assess the entire DPM, and as such,…”
BackgroundResultThe dual pathway model of overeating. Replication and extension with actual food consumption
Ouwens, M. A., van Strien, T., van Leeuwe, J. F. J., & van der Staak, C. P. F. (2008) · Appetite · doi:10.1016/j.appet.2008.07.010 · Cited by 63 · see citing works
Salafia, E. H. B., & Gondoli, D. M. (2010) · The Journal of Early Adolescence · doi:10.1177/0272431610366248 · Cited by 50 · see citing works
Depressive personality styles, dysphoria, and social comparisons in everyday life.
Giordano, C., Wood, J. V., & Michela, J. L. (2000) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.79.3.438 · Cited by 48 · see citing works
Hutchinson, D. M., Rapee, R. M., & Taylor, A. (2009) · The Journal of Early Adolescence · doi:10.1177/0272431609340522 · Cited by 45 · see citing works
Depressive personality styles, dysphoria, and social comparisons in everyday life.
Giordano, C., Wood, J. V., & Michela, J. L. (2000) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.79.3.438 · Cited by 44 · see citing works
Mason, T. B., & Lewis, R. J. (2015) · Eating Behaviors · doi:10.1016/j.eatbeh.2015.05.015 · Cited by 40 · cited 3× · see citing works
“Further, while the DPM was originally proposed to be a model that accounts for the development and maintenance of bulimic symptoms, a large number of studies have only assessed binge-eating (e.g., Dakanalis et al., 2014; Mason & Lewis, 2015) or overeating symptoms (e.g., van Strein et al., 2005).”
BackgroundMethodSocial Media and Body Image Concerns: Further Considerations and Broader Perspectives
Williams, R. J., & Ricciardelli, L. A. (2014) · Sex Roles · doi:10.1007/s11199-014-0429-x · Cited by 33 · see citing works
Jackson, T., Weiss, K. E., Lunquist, J. J., & Soderlind, A. (2005) · The Journal of Genetic Psychology · doi:10.3200/gntp.166.3.346-360 · Cited by 31 · see citing works
Krause, E. D., Robins, C. J., & Lynch, T. R. (2000) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.2000.tb00215.x · Cited by 28 · see citing works
Tests of an extension of the dual pathway model of bulimic symptoms to the state-based level
Holmes, M., Fuller‐Tyszkiewicz, M., Skouteris, H., & Broadbent, J. (2014) · Eating Behaviors · doi:10.1016/j.eatbeh.2014.03.011 · Cited by 27 · see citing works
The addition of sociotropy to the dual pathway model of bulimia.
Duemm, I., Adams, G. R., & Keating, L. J. (2003) · Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement · doi:10.1037/h0087208 · Cited by 26 · cited 9× · see citing works
“The only study to date to assess the influence of sociotropy on the DPM (Duemm et al., 2003) found that sociotropy was associated with thin ideal internalization and negative-affect suggesting that the variable conferred an indirect effect on bulimic behaviors.”
BackgroundMethodResultInfluentialSociotropy and bulimic symptoms in clinical and nonclinical samples
Hayaki, J., Friedman, M. A., Whisman, M. A., Delinsky, S. S., & Brownell, K. D. (2003) · International Journal of Eating Disorders · doi:10.1002/eat.10172 · Cited by 25 · see citing works
The influence of sex-role stereotypes on prose recall
Halpern, D. F. (1985) · Sex Roles · doi:10.1007/bf00287602 · Cited by 22 · see citing works
Narduzzi, K. J., & Jackson, T. (2002) · The Journal of Genetic Psychology · doi:10.1080/00221320209598691 · Cited by 13 · cited 1× · see citing works
“…due to increased levels of sensitivity to rejection, need for approval, and/or social dependency (Duemm et al., 2003; Hayaki, Friedman, Whisman, Delinsky, & Brownell, 2003; Jackson, Weiss, Lunquist, & Soderlind, 2005; Narduzzi & Jackson, 2002; Oates-Johnson & Clark, 2004; Pedlow & Niemeier, 2013).”
Oates-Johnson, T., & Clark, D. A. (2004) · Cognitive Therapy and Research · doi:10.1007/s10608-004-0662-7 · Cited by 12 · cited 1× · see citing works
“…due to increased levels of sensitivity to rejection, need for approval, and/or social dependency (Duemm et al., 2003; Hayaki, Friedman, Whisman, Delinsky, & Brownell, 2003; Jackson, Weiss, Lunquist, & Soderlind, 2005; Narduzzi & Jackson, 2002; Oates-Johnson & Clark, 2004; Pedlow & Niemeier, 2013).”
Sociotropic cognition and eating disordered attitudes and behavior in young adults
Pedlow, C. T., & Niemeier, H. M. (2012) · Eating Behaviors · doi:10.1016/j.eatbeh.2012.10.001 · Cited by 10 · cited 1× · see citing works
“…due to increased levels of sensitivity to rejection, need for approval, and/or social dependency (Duemm et al., 2003; Hayaki, Friedman, Whisman, Delinsky, & Brownell, 2003; Jackson, Weiss, Lunquist, & Soderlind, 2005; Narduzzi & Jackson, 2002; Oates-Johnson & Clark, 2004; Pedlow & Niemeier, 2013).”
Gender Differences in Risk Factors for Stice’s Bulimia in a Non-Clinical Sample
Ruisoto, P., Cacho, R., López-Goñi, J. J., Deus, J. E. R., Vaca, S., & Mayoral, P. (2015) · The Spanish Journal of Psychology · doi:10.1017/sjp.2015.58 · Cited by 6 · see citing works
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Saiphoo, A. N., & Vahedi, Z. (2019) · Computers in Human Behavior · doi:10.1016/j.chb.2019.07.028 · Cited by 539 · see citing works
Dane, A., & Bhatia, K. (2023) · PLOS Global Public Health · doi:10.1371/journal.pgph.0001091 · Cited by 289 · see citing works
Engeln, R., Loach, R., Imundo, M. N., & Zola, A. R. (2020) · Body Image · doi:10.1016/j.bodyim.2020.04.007 · Cited by 178 · see citing works
Fat Talk and Body Image Disturbance
Mills, J., & Fuller‐Tyszkiewicz, M. (2016) · Psychology of Women Quarterly · doi:10.1177/0361684316675317 · Cited by 104 · see citing works
Vahedi, Z., & Zannella, L. (2021) · Current Psychology · doi:10.1007/s12144-019-0150-6 · Cited by 86 · see citing works
Modica, C. A. (2019) · Body Image · doi:10.1016/j.bodyim.2019.02.002 · Cited by 57 · see citing works
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Ventura, V., Cavaliere, A., & Iannò, B. (2021) · Trends in Food Science & Technology · doi:10.1016/j.tifs.2021.02.018 · Cited by 47 · see citing works
Stangl, F. J., Riedl, R., Kiemeswenger, R., & Montag, C. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1141663 · Cited by 33 · see citing works
“, 2015), perceived social comparison direction on Facebook (Faranda and Roberts, 2019), perceived social comparison on Facebook (Puccio et al., 2016; Chow and Wan, 2017; Flynn et al., 2018; Alfasi, 2019), perceived social comparison when using Facebook passively (Nisar et al.”
BackgroundChia, J. L. P., Fuller-Tyszkiewicz, M., Buck, K., Chamari, K., Richardson, B., & Krug, I. (2018) · Appetite · doi:10.1016/j.appet.2018.04.017 · Cited by 27 · see citing works
“…risk factor in the development and maintenance of DE behaviors and associated cognitions (Allen, Byrne, & McLean, 2012; Johnson & Wardle, 2005; Puccio et al., 2016; Salafia & Gondoli, 2010; Stice, Davis, Miller, & Marti, 2008; Woods et al., 2010), which if left untreated, may develop into…”
BackgroundNegative urgency and the dual pathway model of bulimic symptoms: A longitudinal analysis
Puccio, F., Fuller‐Tyszkiewicz, M., Buck, K., & Krug, I. (2018) · European Eating Disorders Review · doi:10.1002/erv.2647 · Cited by 10 · see citing works
Self-citationTürk, F., Bozdogan, A., Hughes, R., Longhurst, P., Chilvers, M., & Fitzsimmons‐Craft, E. E. (2026) · International Journal of Eating Disorders · doi:10.1002/eat.70058 · Cited by 24 · see citing works
Nawaz, H., Rabia, M., Javed, H., Yousaf, M., Mahmood, S., & Riaz, M. A. (2023) · PLoS ONE · doi:10.1371/journal.pone.0293798 · Cited by 8 · see citing works
Intrasexual Competition and Unhealthy Weight Control Behaviors among Late Adolescent Females
Boyer, N. A., Forthun, L. F., & Johns, T. L. (2021) · Adolescents · doi:10.3390/adolescents1040033 · Cited by 2 · see citing works
“At the same time, being evaluated unfavorably has emotional implications, as the anxiety associated with this preoccupation can lead to greater dissatisfaction with one’s body [37,38].”
BackgroundDisordered Eating and Risky Sexual Behaviors in College Women
Terrell, K. R., Satanton, B. R., & Hamadi, H. Y. (2022) · Journal of Counseling Sexology and Sexual Wellness · doi:10.34296/04011060 · Cited by 1 · see citing works
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A Narrative Review on the Dual Pathway Model of Bulimic Pathology
Krug, I., Puccio, F., Potingale, J., & Dang, A. B. (2023) · Springer eBooks · doi:10.1007/978-3-031-16691-4_48 · Cited by 1 · see citing works
Self-citationA Narrative Review on the Dual Pathway Model of Bulimic Pathology
Krug, I., Puccio, F., Potingale, J., & Dang, A. B. (2022) · Springer eBooks · doi:10.1007/978-3-030-67929-3_48-1
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“Furthermore, other researchers have reported no support for the restriction pathway (Puccio et al. 2016; Strien et al. 2005) or only partial support, particularly among adolescent girls (Morrissey et al. 2020).”
Social comparisons on social media and mental health: A systematic review and meta-analysisPreprint
Hoppen, T. H., Höfer, L., Schlechter, P., Holling, H., Mutz, J., & Nexhmedin Morina, B. (2026) · medRxiv · doi:10.64898/2026.09.15.26363124
- Authors
- Puccio, F., Kalathas, F., Fuller-Tyszkiewicz, M., & Krug, I.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Puccio, Francis
- Venue
- Computers in Human Behavior
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 65
- Pages
- 142-150
- ISSN
- 0747-5632 (ISSN-L)
- OpenAlex
- W2511480926
- Cited by
- 20
- References
- 58
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 4 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 2 · 2016: 1
- FWCI
- 2.68
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Computers in Human Behavior (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- bulimia nervosa, dual-pathway model, social comparison, Facebook, sociotropy, body dissatisfaction, thin-ideal internalization, depressive symptoms, dietary restraint, adolescent girls
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