65© Springer International Publishing AG, part of Springer Nature 2018
D. Šmahel et al., Digital Technology, Eating Behaviors, and Eating Disorders,
https://doi.org/10.1007/978-3-319-93221-7_4
Chapter 4
Technology, Body Image, and Disordered
Eating
4.1  Introduction
In general terms, body image refers to an individual’s self-perception and cognitive
appraisal of his or her own body. Disordered eating refers to a wide spectrum of
eating patterns characterized as being detrimental to health, such as self-induced
vomiting. Both body image and disordered eating have been linked to mass media
exposure. Several studies have shown how mass media technologies such as television
shape body image attitudes, which in turn can influence eating patterns (e.g.,
Levine & Harrison, 2009). However, human technology goes far beyond mass
media technologies. The use of new media technologies, such as the Internet, provides
new opportunities for creating and sharing digital content that may affect
body image attitudes. Moreover, the rapid development of technologies is creating
a disruptive transformation across a broad spectrum of human activities (United
Nations, 2015). For instance, several decades ago it was not possible to use the
human body to communicate with machines, and now that is feasible using brain-­
computer interfaces.
It is important to look beyond media influences on body image and to explore
other ways in which technology can influence body image and disordered eating.
With this idea in mind, the present chapter is split into two major sections. In the
first section, our aim is to provide the reader with key concepts dealing with body
image. We have therefore selected three major theoretical frameworks characterized
by having a long tradition in exploring body image and disordered eating. These
frameworks are cognitive-behavioral, sociocultural, and cognitive neuroscience.
These three frameworks provide key concepts related to body image, necessary to
better comprehend the link between technology, body image, and disordered eating.
In the second section, our goal is to provide a brief overview of studies exploring the
link between body image, disordered eating, and technology. In order to include
diverse technologies in this discussion, we divide this second section into four subsections.
The first two subsections are an overview of studies exploring the link
66
between body image, disordered eating, and traditional mass media technologies
(such as television and magazines) along with the Internet and mobile technologies.
The remaining two subsections explore how emerging and future technologies may
be linked with body image and disordered eating.
4.2  Key Concepts Involved with Body Image
Body image is a complex phenomenon that has been studied by several disciplines,
including behavioral science, cognitive science, philosophy, linguistics, and sociology,
among others. Most of the knowledge and concepts regarding body image have
been discussed and summarized in such substantial works such as Seymour Fisher’s
Development and Structure of the Body Image (2 volumes) (Fisher, 1986), the
Aberdeen Body Group’s compilation The Body: Critical Concepts in Sociology (5
volumes) (Blaikie et al., 2004), or more recently Thomas Cash’s Encyclopedia of
Body Image and Human Appearance (Cash, 2012b).
For this chapter we have identified three major frameworks that, taken together,
can provide us a holistic perspective of body image. Thus, employing cognitive
neuroscience, cognitive-behavioral, and sociocultural perspectives, we expect to
provide the reader with key concepts used in the study of body image. These
concepts will allow the reader to comprehend the relationship between technology,
body image, and disordered eating, which is discussed in the second part of
this chapter.
4.2.1  Cognitive-Behavioral Model
Within the cognitive-behavioral field, the work of Thomas Cash (2012a) on body
image is renowned, because his theory integrates the most widely accepted components
of behavioral sciences: perceptual, cognitive, and affective. According to
Cash’s theory, body image has two main dimensions: perceptual and attitudinal
(Cash, 2012a). In this sense, body image can be defined as the self-perception and
cognitive appraisal of the body (e.g., attitudes, thoughts) and affective responses to
this appraisal (e.g., feelings). The perceptual dimension refers to the degree of accuracy
we have in judging our body’s physical dimensions. The attitudinal dimension,
which is much more complex, implies body image attitudes which are “dispositional
ways of thinking (cognitions), feeling (affect or emotions), and behaving”
(Cash, 2012a, p. 334). Furthermore, in Cash’s theory (2012a) body image attitudes
are subdivided into two conceptually distinct components: body image evaluation
(i.e., evaluative beliefs and extent of satisfaction or dissatisfaction/disparagement
with the body or physical appearance) and body image investment (i.e., cognitive,
behavioral, and emotional importance placed on the body or physical appearance).
Scholars have employed this distinction between body image evaluation and
importance to study their association with disordered eating (e.g.,Tiggemann, 2004).
4  Technology, Body Image, and Disordered Eating
67
Nevertheless, most of the attention has been focused on body image evaluation,
under the general concept of body dissatisfaction (i.e., individuals’ negative cognitive
and affective appraisals of their own body including body features, shape, and
weight). The interest in body dissatisfaction arises because there is evidence suggesting
that body dissatisfaction is a powerful driver and predictor of disordered eating
behaviors (Berge, Loth, Hanson, Croll-Lampert, & Neumark-Sztainer, 2012).
The other major component, body image investment, involves self-schemas
about one’s appearance, which are experience-based cognitive generalizations (e.g.,
assumptions, beliefs) serving to process appearance-relevant information (Cash,
2012a). Thus, appearance schematic persons would place more importance on
appearance for judging self-worth (i.e., self-evaluative salience) and would consider
having or maintaining an attractive appearance to be very important (i.e., motivational
salience), being both the two main dimensions of body image investment
(Cash, 2012a).
However, it is important to note that body image is not static but rather dynamic
and diverse; this is due to several aspects, including individual differences and societal
factors (Mills, Roosen, & Vella-Zarb, 2011). For instance, Cash (2005) suggests
that when an individual encounters negative appearance evaluations (e.g., being
teased), the individual uses coping strategies such as appearance fixing (i.e., correcting
a perceived flaw in physical appearance), body avoidance (i.e., evading perceived
threats to body image), and body acceptance (i.e., positive acceptance of
body image experiences). Thus, the relationship between body image and disordered
eating implies accounting for individual-level factors, such as self-regulating
processes (Timko, Juarascio, Martin, Faherty, & Kalodner, 2014).
The cognitive-behavioral model of body image provides key concepts to explain
the relationship between body image, disordered eating, and technology. Notably,
most of the concepts from the cognitive-behavioral model have been integrated later
by other empirically based models of body image, such as the sociocultural model
(e.g., Cafri, Yamamiya, Brannick, & Thompson, 2005) and objectification theory
(e.g., de Vries, Peter, Nikken, & de Graaf, 2014).
We will focus next on the sociocultural model, which is backed up by a large
body of research explaining the link between technology (mostly media), body
image, and disordered eating (see also Fig. 1.1 in Chap. 1 of this book). However,
readers should be aware that objectification theory and identity-related theories,
such as impression management theory, are also promising theoretical models to
explain such a link (e.g., Melioli, Rodgers, Rodrigues, & Chabrol, 2015).
4.2.2  Sociocultural Model
The sociocultural model integrates most of the concepts previously mentioned (see
also Cash, 2005), but it places major emphasis on explaining how society and culture
influence body image attitudes and disordered eating. Moreover, the sociocultural
model is frequently used as a theoretical framework to explain the link
between body image and eating disorders. The sociocultural model posits that the
4.2 Key Concepts Involved with Body Image
68
key agents of socialization processes (i.e., parents, peers, and media) disseminate
standards of beauty (e.g., an “ideal body”), to which people tend to compare themselves
(a phenomenon called social comparisons), as well as cognitively to buy
into these ideals or standards (a phenomenon called internalization) (Thompson,
Heinberg, Altabe, & Tantleff-Dunn, 1999). The ideal body to which people tend to
compare themselves, as well as internalize, is usually referred to as a thin but toned
body for women (thin ideal) and a lean but toned body for men (muscular ideal)
(Tylka, 2011).
Both the tendency to engage in social comparisons with the beauty ideal and the
extent of internalization of such an ideal are both linked to our attitudes and perceptions
in regard to our own body (Karazsia, van Dulmen, Wong, & Crowther, 2013;
Myers & Crowther, 2009). As social individuals, we acquire information about ourselves
by comparing with similar others or ideal others on relevant domains, such as
physical appearance. This social comparison process is key to defining our self-­
concept, as well as modifying it through action. Moreover, social comparisons usually
comprises the perception of social norms (i.e., what individuals think is done
by others and what they believe must be done), which are linked to body image
perceptions (e.g., Bair, Steele, & Mills, 2014). Similarly, social norms seem to be
direct predictors of eating intentions and indirect predictors of eating behaviors
(e.g., Hagger, Chan, Protogerou, & Chatzisarantis, 2016). Regarding internalization,
several studies have shown that individuals not only internalize a beauty ideal
but also internalize other appearance-related attitudes, such as weight bias (i.e., prejudicial
and derogative views of overweight bodies) (Vartanian & Porter, 2016).
Both kinds of internalization are strong predictors of body change behaviors including
the development of eating disorders (e.g., Boswell & White, 2015; Homan,
2010; Schvey, Roberto, & White, 2013).
Nevertheless, it should be noted that some individuals are more prone to be influenced
by sociocultural pressures than others. For instance, when an individual lacks
a clearly defined sense of self, he or she may be more likely to seek out and adopt
social norms of the beauty ideal as part of his/her own identity (Dittmar, 2009).
Similarly, dispositional factors of the individual, from the most stable (e.g., personality
traits) to the most transient (e.g., mood), as well as developmental factors (e.g.,
media preferences by age), and sociocultural factors (e.g., perceived group norms)
together shape and are shaped by an individual’s selective media use (Valkenburg,
Peter, & Walther, 2016). In other words, some individuals can be more susceptible
to media effects, as well as more prone to engage with certain media content and
interactions, such as appearance-focused media (Almenara, Machackova, &
Smahel, 2016). Finally, our body image attitudes and perceptions are not static;
rather, they interact with other cognitive processes to elicit action, such as the self-­
regulatory processes involved in body-related behaviors. For instance, some studies
suggest that high levels of body dissatisfaction, coupled with high use of appearance
fixing as a coping strategy, predict the consideration of cosmetic surgery (Callaghan,
Lopez, Wong, Northcross, & Anderson, 2011).
In sum, taking together both the cognitive-behavioral and the sociocultural models,
we can visualize body image as a dynamic spectrum of attitudes and ­perceptions
(Mills et  al., 2011), ranging from mindful body acceptance (Tylka & Wood-
4  Technology, Body Image, and Disordered Eating
69
Barcalow, 2015) to extreme body dissatisfaction (Davis & Scott-Robertson, 2000),
embedded within a given sociocultural context.
4.2.3  Cognitive Neuroscience
Within cognitive neuroscience, there is no universally accepted taxonomy of brain-­
based or consciousness-based body representations, mostly due to the diversity of
definitions (de Vignemont, 2016; Gaudio, Brooks, & Riva, 2014). Nevertheless, the
most widely accepted types of body representations are body schema and body
image, the former involving action and the latter linked to perception (Pitron & de
Vignemont, 2017). Body schema refers to sensorimotor representations of the body
based on a variety of sensory signals (e.g., proprioceptive, kinesthetic, tactile, etc.),
which are collected from past bodily experiences and constantly updated to allow
motor control and action without the necessity of conscious monitoring (Coslett,
2014; Di Vita, Boccia, Palermo, & Guariglia, 2016; Gallagher, 2005, 2017; Longo,
2016; Pitron & de Vignemont, 2017; Reed, 2002). Body image involves a more
visual and semantic representation of the body, which includes perceptions, attitudes,
beliefs, and emotions pertaining to one’s own body and is thus more closely
tied to an individual’s conscious experience (Coslett, 2014; Di Vita et al., 2016;
Gallagher, 2005). Although body schema and body image are usually treated as two
distinct concepts, both systems interact with each other in forming intentional action
(Gallagher, 2005). Thus, it is important to note that body schema and body image
are intertwined (Pitron & de Vignemont, 2017).
Neuroscientific studies exploring the link between body image and eating pathologies
have dealt with the perception of bodily processes (e.g., Ma-Kellams, 2014;
Murphy, Brewer, Catmur, & Bird, 2017). These studies have focused on interoception
(sensitivity to internal bodily signals such as hunger or satiety), exteroception
(sensitivity to external body-related signals such as temperature), as well as the
interaction between them (e.g., Zamariola, Cardini, Mian, Serino, & Tsakiris, 2017).
The interest in perceived bodily processes arises because a “disturbance in the way
in which one’s body weight or shape is experienced” is a characteristic feature of
anorexia nervosa (American Psychiatric Association, 2013, p. 338). The available
evidence suggests that the integration of multiple sensory signals pertaining to the
body (e.g., interoception) is impaired in individuals with anorexia nervosa (Gaudio
et al., 2014). Similarly, obese individuals are believed to have a reduced interoceptive
sensitivity, thus displaying difficulties in discriminating between internal signals
of satiety and hunger (Herbert & Pollatos, 2014).
Experimental studies have shown that bodily processes are important for higher
level cognitive functions, such as decision-making or memory (Herbert & Pollatos,
2012; Suitner, Koch, Bachmeier, & Maass, 2012). For instance, research has shown
that body movement qualities (e.g., smooth rhythm) can influence what we recall
and how we feel (Suitner et al., 2012). Thus, it is important to recognize the role of
bodily processes in perception, cognition, and action. However, the study of bodily
processes cannot occur in isolation but rather must be part of a dynamic systems
4.2 Key Concepts Involved with Body Image
70
perspective (e.g., Koch, 2014), which includes the interaction of both interoceptive
and exteroceptive perception or even more precisely an “extended proprioceptive
experience” (e.g., Colpani, 2010). Adopting a complex dynamic systems perspective
eschews the view of the body, mind, and environment as independent forms of
actual existence and therefore breaks such classic dichotomies as body-mind or
body-world (Choudhury & Slaby, 2012; Varela, Thompson, & Rosch, 2016).
Following Slaby and Choudhury (2012), this adoption can be achieved by enriching
our conceptual vocabularies and contributing to more complex and theory-rich
explanations of behavior. In the case of studies on body image, it could imply adopting
concepts such as embodiment, embodied cognition, embodied affectivity, enaction,
and intersubjectivity, which are anchored within a general embodied framework
(Fuchs, 2017; Gallagher, 2005; Varela et  al., 2016; Winkielman, Niedenthal,
Wielgosz, Eelen, & Kavanagh, 2015).
In fact, concepts such as embodiment or enaction form the basis of emerging
paradigms in cognitive sciences, such as the 4EA approach (Choudhury & Slaby,
2012). 4EA conceptualizes the mind as embodied, embedded, enacted, extended,
and affective (Choudhury & Slaby, 2012). Although there is no consensual definition
of embodiment (Chrisley & Ziemke, 2003; Ziemke, 2003, for a review), it refers
here to a view of cognition, not as individualized or independent, but rather tied to
bodily processes and embedded within both the physical and the social environment
(Choudhury & Slaby, 2012). Enaction, on the other hand, “refers to the dynamic
integration of perception, cognition, and knowledge with action” (Choudhury &
Slaby, 2012, p. 11), so that perception and action are intertwined, not differentiated.
To summarize, we have seen three major frameworks (cognitive-behavioral,
sociocultural, and cognitive neuroscience perspectives) providing key concepts for
discussing body image. Although these concepts come from diverse disciplines,
they can be integrated into the general notion that body image is a dynamic phenomenon
that comprises cognitive, affective, and social functions, as well as perception
and sensitivity to internal/external bodily signals, which together provide the basis
of a dynamic embodied experience, or enaction.
4.3  Traditional Media Technologies, Body Image, and Eating
Behavior
Within the field of cognitive-behavioral psychology, and particularly in the study
of eating disorders, sociocultural framework has been the mainstream model
for explaining how traditional media technologies, such as television and magazines,
promote body dissatisfaction (e.g., DeBraganza & Hausenblas, 2010).
Although individuals’ body preferences are diverse across space and time
(Karazsia, Murnen, & Tylka, 2017), sociocultural studies suggest that there are
certain societal mechanisms able to modify body image attitudes, ideals, and
­preferences. One of these mechanisms is Westernization, which occurs due to globalization
and the expansion of modernization (i.e., socioeconomic and cultural
4  Technology, Body Image, and Disordered Eating
71
transition of a society due to higher levels of industrialization and urbanization). In
this regard, Westernization refers to the dissemination of Western values, such as
the standards of beauty that interact with local beauty ideals (Anderson-Fye, 2018;
Calogero, Boroughs, & Thompson, 2007; Levine & Smolak, 2010; Swami, 2015).
For instance, studies have shown how Western standards of beauty, such as the thin
ideal or the muscular ideal, are globally spread by traditional media through magazines
(Yan & Bissell, 2014) and television (Becker, 2004; Becker, Burwell, Gilman,
Herzog, & Hamburg, 2002; Boothroyd et al., 2016; Pritchard & Cramblitt, 2014).
Furthermore, studies have shown that many individuals report their preference for
these beauty ideals in Western and Westernized countries (e.g, Swami et al., 2010).
Studies exploring the content of popular magazines and television shows have
found that such media display ways of behaving that can promote behaviors aimed
at changing body image and eating patterns. Content analyses of popular women’s
and men’s magazines have found that body shaping and weight management are
major topics therein (Ethan, Basch, Hillyer, Berdnik, & Huynh, 2016; Ricciardelli,
Clow, & White, 2010; Willis & Knobloch-Westerwick, 2014). Similarly, content
analyses of popular television shows have found that weight-stigmatizing incidents
are common, spreading obesity stigmatization (known colloquially as “fat shaming”)
and weight bias internalization (Eisenberg, Carlson-McGuire, Gollust, &
Neumark-Sztainer, 2015; Fouts & Burggraf, 2000; Fouts & Vaughan, 2002).
In sum, there is considerable evidence suggesting that the exposure to traditional
media influences body image attitudes, particularly by promoting body
dissatisfaction.
However, susceptibility to media effects is highly mediated/moderated by individual
differences (Valkenburg et al., 2016). Individual factors accounting for the
diversity seen in media effects include, but are not limited to, self-esteem (e.g.,
Mischner, van Schie, & Engels, 2013), body image investment (Boersma & Jarry,
2013), personality traits (Roberts & Good, 2010), and cognitive schemas (López-­
Guimerà, Levine, Sánchez-Carracedo, & Fauquet, 2010).
4.4  New Media Technologies, Body Image, and Eating
Behavior
Compared to traditional media, new media technologies (e.g., Internet-based digital
platforms and applications such as Facebook) are ubiquitous. They also provide
new opportunities for content creation, co-creation, and sharing. Many digital platforms
and applications allow and encourage (or even focus on) posting and sharing
photos and images by individual users. Similar to traditional media, this content can
promote beauty standards, although now such content can be easily shared,
endorsed, and commented on by users themselves (e.g., via social network sites,
such as Instagram). Consequently, the use of these new media can have the same
negative effects on body image as traditional media, such as promoting body dissatisfaction
(Cohen & Blaszczynski, 2015). In this regard, most studies have focused
4.4 New Media Technologies, Body Image, and Eating Behavior
72
on examining how the exposure to content and interactions (engagement) on the
Internet can influence body image and thus eating behavior. Therefore, we will
focus next on studies exploring body-related content and interactions on the Internet,
as well as individual-level factors accounting for the relationship between Internet
use, body image, and disordered eating.
Several studies have shown how body ideals are portrayed and disseminated
through the Internet (e.g., Slater, Tiggemann, Hawkins, & Werchon, 2012). For
instance, a content analysis of popular street fashion blogs on the Internet found that
most images of women (72%) portrayed a body weight below the average, reinforcing
the thin ideal (Kraus & Martins, 2017). Nevertheless, it should be noted that,
compared with consumers of traditional media, Internet users have the chance to
create their own online content and spread it through the Internet, driving online
audience and engagement around it (Almenara et al., 2016).
For instance, it is very common to see Internet users posting “thinspirational”
content (e.g., images of emaciated young women with an eating disorder) or “fitspirational”
content (e.g., an inspirational image of a fitness model lifting weights) on
online social networks such as Instagram (e.g., Carrotte, Prichard, & Lim, 2017;
Ghaznavi & Taylor, 2015; Santarossa, Coyne, Lisinski, & Woodruff, 2016). Since
the Internet is so dynamic, this “inspirational content” can gain a substantial audience
and engagement in a matter of minutes and potentially can go “viral” through
diverse online threads in other social networks and platforms such as Reddit,
Facebook, YouTube, WhatsApp, and even the news. This inspirational content
includes a myriad of body shaping and weight management messages written by
Internet users. For example, some Internet users encourage others to lose weight or
increase muscularity by providing tips and tricks, as well as sharing their support
(Murray et al., 2016; Santarossa et al., 2016).
Studies with young adults and adults have found that some Internet users tend to
engage more than others in social and physical appearance comparisons on the
Internet (Lewallen & Behm-Morawitz, 2016). For instance, individuals with a higher
tendency for social comparisons are more likely to engage in “fat talk” (i.e., talking
negatively about one’s body shape and size) and photo editing, as revealed by studies
of online social network users (Arroyo & Brunner, 2016; Fox & Vendemia,
2016). This higher frequency of online social comparisons can be due to the fact that
users can easily find online similar others including their peers, with whom they
compare more often (Holland & Tiggemann, 2016). Previous studies have shown
that social comparisons and “fat talk” are both linked with body dissatisfaction,
particularly among women (Fardouly & Vartanian, 2016; Sharpe, Naumann,
Treasure, & Schmidt, 2013). Similarly, body dissatisfaction and online appearance
comparisons and online fat talk have all been linked with disordered eating in young
women (Walker et al., 2015). Therefore, it is not uncommon to find individuals with
eating disorders interacting with other users in online communities by sharing their
experiences and support (e.g., Ransom, La Guardia, Woody, & Boyd, 2010)—for
more details see also Chap. 7. In fact, some of these communities are called “proana,”
“pro-mia,” or “ana-mia” because they are seen as promoters of body dissatis-
4  Technology, Body Image, and Disordered Eating
73
faction and eating disorders (Rodgers, Lowy, Halperin, & Franko, 2016). However,
online communities of marginalized individuals can also provide support through
active community engagement and communication among members (Smith,Wickes,
& Underwood, 2015). Similarly, online activism has been used as a resistant response
of Internet users to the negative media portrayal of women’s bodies (Lupton, 2017),
as exemplified by the millions of Instagram posts with the hashtag “body positive”
or “body positivity.”1
This form of activism and advocacy is seen as a powerful way
to generate social change and social justice by disseminating the general idea of
body diversity and thus helping to prevent body image and eating-related issues
(Ferrari, 2012).
Women tend to experience stronger negative emotions than men when comparing
their bodies with others perceived as higher status or desirable, in other words, when
they engage in online upward body social comparisons (Fox & Vendemia, 2016).
Moreover, women are also likely to engage in negative body talk and particularly
“fat talk,” to the extent that it seems to be the norm among young women, both
online and offline (Barwick, Bazzini, Martz, Rocheleau, & Curtin, 2012; Walker
et al., 2015). In contrast, males are more likely to be engaged with online content and
interactions involving ways to increase weight and muscularity (Murray et al., 2016;
Pila, Mond, Griffiths, Mitchison, & Murray, 2017). Finally, although the gender gap
is not clear, some studies suggest that young and adult women are most likely to seek
out weight-loss, nutrition, and fitness content and interactions on the Internet
(Boepple & Thompson, 2016; Santarossa et al., 2016; Simpson & Mazzeo, 2017).
Some studies suggest that body image attitudes and perceptions can work as a
mediator variable in the relationship between Internet use and body dissatisfaction
or disordered eating. A mediator is a variable that transmits an effect in a causal
sequence between an independent variable (e.g., Internet exposure) and an outcome
(e.g., body dissatisfaction) (MacKinnon, Fairchild, & Fritz, 2007). For instance, it
was recently found that individuals’ own beliefs about their appearance (i.e., appearance
self-schemas) and the extent of the discrepancy between their perceived physical
appearance and the ideal were both mediators of the link between Instagram
usage and body image satisfaction in young adults (Ahadzadeh, Pahlevan Sharif, &
Ong, 2017). Similarly, a study with young women found that body shame (i.e.,
negative feelings after comparing with the ideal body) and body image avoidance
both mediated the effect of Internet use on bulimic symptoms (Melioli et al., 2015).
In sum, the exposure to appearance-focused online content and interactions can
promote body dissatisfaction and disordered eating, whereas individual-level factors
such as gender can account as mediators/moderators of this effect (Holland &
Tiggemann, 2016; Perloff, 2014; Prieler & Choi, 2014; Rodgers et al., 2016; see
also Chap. 7 in this book).
1
 As of the date of writing this chapter, there were over four million posts in Instagram with the
hashtag #bodypositive. See: https://www.instagram.com/explore/tags/bodypositive/
4.4 New Media Technologies, Body Image, and Eating Behavior
74
4.5  Immersive Digital Technologies, Body Image, and Eating
Behavior
Though most of the attention related to body image and eating disorders is focused
on the negative effects of media exposure, we should not ignore the potential benefits
provided by modern technologies. At present, there is some evidence suggesting that
bodily processes and experiences can be positively modified through immersive digital
technologies such as virtual reality (Riva, Baños, Botella, Mantovani, & Gaggioli,
2016). Virtual reality refers to interactive computer simulations and interactions
through the senses (e.g., visual, auditory) that give participants the feeling of being
immersed in the simulation (Rubio-Tamayo, Gertrudix Barrio, & García García,
2017). The earliest accounts of using virtual reality to positively modify body image
were aimed at reducing body dissatisfaction by increasing bodily awareness
(e.g., Riva, 1998). Most recent developments try to stimulate bodily processes in a
more integrative way, with the aim of improve body experiences and thus to impact
on overall health and well-being (e.g., Riva, Serino, Di Lernia, Pavone, & Dakanalis,
2017). For instance, a study using a virtual reality environment to reproduce a highly
realistic skinny body belly found that young women participants exposed to it
reported decreased discrepancy between estimated and actual size of most body parts
assessed (Serino et al., 2015). Similarly, a recent experimental study used an immersive
virtual reality environment to successfully reduce overestimation of body parts
among patients with anorexia nervosa (Keizer, van Elburg, Helms, & Dijkerman,
2016). Although these results seem promising, there is still the challenge integrating
theory, empirical evidence, and appropriate experimental procedures that take into
account design factors and user experience for human-computer interaction (Iscen,
Gromala, & Mobini, 2014; Rubio-Tamayo et al., 2017).
4.6  Future Technologies, Body Image, and Eating Behavior
In recent years, humankind has been going through a fourth industrial revolution
(Schwab, 2016). Based on the work of the World Economic Forum and Forum’s
Global Agenda Councils, Schwab (2016) has organized the main technological
drivers behind this revolution into three clusters: digital, physical, and biological.
Among the major digital drivers, we have the Internet of Things (IoT), blockchain
technologies, big data, cloud computing, artificial intelligence, machine learning,
and on-demand technology. The major physical drivers include autonomous vehicles,
3D printing, advanced robotics, and new materials. Finally, among the major
biological drivers can be found genetic engineering and neurotechnology (Li, Hou,
& Wu, 2017; Schwab, 2016).
Some of these emerging technologies are likely to influence body image as well
as the ways that body image is related to eating behavior and disordered eating.
At present, thanks to technologies such as nanotechnology, it is possible to carry
with us very small electronic devices connected to the Internet (i.e., smart devices
4  Technology, Body Image, and Disordered Eating
75
with ­software, sensors, etc.). In a similar fashion, future technologies will allow us
to incorporate those devices into our bodies, carrying with us not only hardware
and software but also a huge amount of data that will be integrated with our bodily
functions as part of interconnected systems, such as distributed ledgers (e.g., a
blockchain from the public health system). In turn, thanks to deep learning (a computational
technique for modeling information automatically) and artificial intelligence
(computational tasks that would require intelligence if done by humans), these
interconnected systems will be constantly monitored, improved, and tweaked toward
a constant perfection (i.e., updated). Moreover, genetic engineering and biohacking
(e.g., tweaking your own DNA) could hypothetically allow humans in the future to
override actual bodily limits, such as those regarding body schema and particularly
multisensory integration, other than prolonging their lifespan and the visible consequences
of aging in the body literally transforming a human body into a cyborg.
Moreover, new technologies will allow us in the future to create a better and more
realistic virtual version of ourselves (i.e., hyperrealistic avatar; Park, 2018), and this
could have an important effect on the way we perceive our bodies. In sum, it could
be hypothesized that emerging and future technologies will be disruptive in terms of
body schema, body image, and embodiment (i.e., bodily processes as a precondition
for cognition). In this sense, we agree with scholars in the field of human-computer
interaction who have called to apply embodied cognition to the study of body image
(Iscen et al., 2014).
Regarding the link between body image and eating behavior, this hypothetical
cognitive disruption on how we perceive and experience body image could bring
new body ideals, as well as new eating patterns, and new eating disorders. Thus, we
propose hypothetical future scenarios that could emerge regarding body perception,
body parts, and bodily functions.
First, digital realities could hypothetically reduce the importance we place on the
physical body, directing the attention toward our digital identities. As seen in the
futuristic short film “Uncanned Valley” by Federico Heller,2
some individuals could
spend most of their time immersed in a virtual reality. Therefore, individuals with
high levels of body image investment and high engagement with the digital world
can direct their attention toward their digital body and appearance, rather than their
physical body. Moreover, due to their isolation, these individuals could be less
exposed to the social norms pertaining to physical appearance in the physical world,
and thus less likely to adopt and internalize beauty ideals from the physical world.
The immediate potential effect of this kind of isolation from the physical world
could be related to difficulties in obtaining appropriate nutrition (i.e., malnutrition).
However, future technologies may be able to automate nutrient delivery, optimizing
the bioavailability of nutrients and making eating behavior merely accessory.
Second, the whole body, as well as body parts, will in the future have improved
functionalities—due, for example, to nanotechnological engineering at neural levels
(Dalton-Brown, 2015). As we said above, future technology could improve the
delivery and bioavailability of nutrients (e.g., proteins). Thus, optimal nutrition
2
 https://vimeo.com/147365861 Archived in: http://web.archive.org/web/*/https://vimeo.com/
147365861
4.6 Future Technologies, Body Image, and Eating Behavior
76
could be tied to bioengineering to help boost fitness capacity and making increased
muscularity attainable to many more people than today. Moreover, other improvements
in body functionalities related to the senses (e.g., improved vision, taste, hearing)
could advance in the same way as muscularity, bringing the perception that a
“superbody” is attainable. Therefore, it could be possible that in the future some
individuals will engage in behaviors aimed to attain this superbody with improved
functionalities and increased muscularity.
In sum, although mere fantasy for us today, these hypothetical scenarios could
suggest how new technologies might someday change our body schema, body
image, and embodiment.
4.7  Conclusions
Body image is a complex phenomenon that has captivated the attention of several
disciplines. Studies presented in this review have shown how body image is linked
to eating behavior, particularly disordered eating. Moreover, we have shown how
traditional media, such as television and magazines, along with new media technologies
such as the Internet, can promote body image dissatisfaction and disordered
eating behaviors. However, it is important to remember that such effects do
not impact everyone; rather, they are mediated and moderated by individual characteristics.
Further, a positive effect of the technologies has also been documented. For
instance, fully immersive digital technologies, such as virtual reality, can be used to
positively modify bodily processes, such as interoceptive awareness. Moreover,
future technologies can bring into scene disruptive changes in cognition and embodiment
and thus alter contemporary ideas about body image and eating behaviors.
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4  Technology, Body Image, and Disordered Eating