The body image battle is real in 2026, but the bodies may not be

Experts in mental health and eating disorders are calling for the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) to formally recognize the impact of social media algorithms on the development and progression of eating disorders. As the field prepares for updates to the DSM, expected in 2030, clinicians and researchers argue that the evolving digital landscape must be acknowledged as a critical environmental factor influencing these conditions. The upcoming revision comes amid growing concerns over the role of platforms such as Instagram, TikTok, and YouTube in shaping perceptions of body image, food, and exercise. Social media algorithms, designed to maximize user engagement, often prioritize content that reinforces extreme beauty standards, promotes restrictive diets, or glorifies excessive physical activity. These patterns of exposure, experts say, increasingly mirror the kind of peer pressure once observed in traditional social settings but now operate invisibly within digital spaces. Jessica Scheer, CEO of the National Eating Disorders Association (NEDA), and Riley Nickols, a sports psychologist and clinical adviser for NEDA, highlighted the urgency of incorporating algorithmic influence into clinical evaluations during a recent analysis published in STAT News. They pointed out that while the DSM currently includes environmental factors such as family dynamics, trauma, and cultural influences, it lacks explicit guidance on assessing digital environments. This omission leaves a gap in how clinicians understand and treat eating disorders in today's hyperconnected world. According to the pair, the DSM's focus on observable symptoms and diagnostic criteria means it typically avoids delving into the root causes of disorders. Instead, it provides contextual descriptions that consider external influences. In the case of eating disorders, this includes discussions of environmental, genetic, and psychological risk factors. However, the rapid evolution of technology and its integration into daily life suggest that algorithmic exposure should be treated similarly to other known environmental triggers. A survey conducted earlier this year by NEDA found that 82% of respondents, including individuals with eating disorders, clinicians, and caregivers, believed social media had triggered disordered thinking or behavior. Many participants noted that content related to weight loss, dieting, and fitness was frequently brought up by patients undergoing treatment. Some described specific advertisements or videos as direct catalysts for relapse, underscoring the tangible link between digital exposure and real-world consequences. Despite these findings, the relationship between social media and eating disorders remains complex. While some users experience negative outcomes, others find support, community, and resources online. The challenge lies in identifying which aspects of algorithmic design contribute to harm and ensuring that clinicians are equipped to evaluate these risks effectively. Clinicians argue that recognizing digital reinforcement as a contributing factor does not necessitate changes to existing diagnostic criteria. Rather, it involves updating the DSM to reflect the realities of contemporary clinical practice. By acknowledging the role of algorithms in shaping behavior, the manual could better guide healthcare professionals in understanding the broader context of their patients' experiences. The call for inclusion stems from the observation that for many young people, algorithm-driven feeds exert a psychological influence comparable to in-person peer groups. Yet, these digital interactions often go unexplored during clinical interviews due to a lack of standardized assessment tools. Integrating questions about digital habits and algorithmic exposure into routine evaluations could help identify early warning signs and inform more targeted interventions. As the DSM moves toward its next iteration, the debate over whether to include algorithmic influence reflects broader conversations about the intersection of technology and mental health. Advocates stress that the goal is not to assign blame to platforms but to equip clinicians with the knowledge they need to address the full spectrum of environmental factors affecting their patients' well-being. With the digital landscape continuing to evolve rapidly, the decision on how to incorporate these elements into diagnostic frameworks will likely shape the trajectory of eating disorder treatment for years to come.