A growing body of research in HCI focuses on understanding how social media and other social technologies impact a given user’s mental health, including eating disorders. In this paper, we review the results of an interview study with 10 clinicians spanning various specialties who treat people with eating disorders, in order to understand the clinical contexts of eating disorders and social media use. We found various tensions related to clinician comfort and education into the (mis)use of technologies and balancing the positive and negative aspects of social media use within active disease states as well as in recovery. Understanding these tensions as well as the variation in the current process of diagnosing patients is a critical component in connecting HCI research focused on eating disorders to clinical practice and ultimately assessing how digital self-harm could be addressed clinically in the future.

Eating disorders (EDs) are a worldwide public health concern that impact approximately 10% of the U.S. population. Our previous research characterized these behaviors across online spaces. These characterizations have used clinical terminology, and their lexical variants, to identify ED content online. However, previous HCI research on EDs (including our own) suffers from a lack of gender and cultural diversity. In this paper, we designed a follow-up study of online ED characterizations, extending our previous methodologies to focus specifically on male/masculine-related content. We highlight the similarities and differences found in the terminology utilized and media archetypes associated with the social media content. Finally, we discuss other considerations highlighted through our analysis of the male-related content that is missing from the previous research.

Digital self-harm encompasses a variety of activities, including the use of social media to facilitate or amplify mental illness-related behaviors. To understand the extent of these behaviors and their impacts, we conducted an in-depth case study with three patients who are in recovery from an eating disorder. We collected survey data, conducted interviews reflecting back to their technology use during their active disease state, and reviewed up to 18 months of their social media data leading up to the start of their initial point of recovery. Through the triangulation of this data, we explore the role of social media and social technologies in relation to their eating disorder. By utilizing this methodology, we were able to provide a contextually rich and nuanced lens for exploring the impacts of digital self-harm on this group of patients. We found that patients acknowledged that the eating disordered content on social media had a negative impact on their health, often contributing to a worsening of the physical manifestations of their disorder. Conversely, while they actively consumed this content, our participants did not produce online content related to eating disordered activities or behaviors. Finally, we discuss the patterns within their social media data and how platform designers and operators could use these findings in the future through design considerations for future platform-based interventions.