JMIR Publications

ABSTRACT

Background:

The ubiquitous use of smartphones has given rise to addictive patterns of use, often termed “problematic smartphone use” (PSU), which disproportionately impacts children and young people and is associated with poor mental health. Emerging evidence suggests that patterns of smartphone use (e.g., PSU and high screen time) may also influence eating patterns and contribute to symptoms associated with eating disorders (ED), although the nature of this relationship remains poorly understood.

Objective:

The aim of this systematic review was to examine the association between PSU and ED psychopathology or ED-related outcomes (e.g., body dissatisfaction, emotional eating, food addiction) in clinical and non-clinical populations and explore potential moderators and mediators.

Methods:

This pre-registered systematic review conducted according to PRISMA guidelines searched three databases (PubMed, EMBASE and Web of Science) for studies published after January 2011 reporting data on PSU and ED psychopathology.

Results:

Thirty-six studies met the pre-specified eligibility criteria, with almost all reporting cross-sectional data in non-clinical populations (mean±SD age 17.0±5.5). Most studies were assessed as being of good quality (n = 28; 78%). In these non-clinical samples, the vast majority of studies reported a positive association between PSU and ED psychopathology, which was largely consistent across age groups and countries. Identified mediators of this relationship included greater emotional regulation difficulties, and anxious and depressive symptoms. Positive associations were also found across studies between PSU and several ED-related outcomes including food addiction, body dissatisfaction, uncontrolled eating and emotional overeating. Daily smartphone use was consistently related to higher ED psychopathology.

Conclusions:

PSU and greater daily screen time are associated with higher ED symptoms, body image dissatisfaction, and broader disordered eating behaviours. Due to a paucity of studies in clinical populations, these conclusions are generalisable only to non-clinical populations (i.e., those without a formal diagnosis of an ED). Further longitudinal research in clinical populations is needed to fully contextualise the impact of PSU and screen time on ED risk and severity.