The relationship between body image perceptions and disordered eating behaviors among school Adolescents in Addis Ababa

Abstract

Background Eating disorders (EDs) are serious mental health conditions that often emerge during adolescence and are influenced by psychological, sociocultural, and environmental factors. In Ethiopia, limited qualitative evidence exists on how adolescents experience body image and disordered eating, particularly in relation to local cultural norms and social media exposure. Objectives This study aimed to explore how social media, peers, family, and cultural influences contribute to the development of negative body image and disordered eating behaviours among Ethiopian adolescents. Methods An exploratory qualitative design was used, employing eight focus group discussions (FGDs) and five in-depth interviews (IDIs) with adolescents aged 14–19 years from two public and two private secondary schools in Addis Ababa. Participants were purposively selected based on social media exposure and willingness to discuss body image experiences. Data were collected using semi-structured interview guides, transcribed, translated, coded using OpenCode software, and analyzed thematically within the framework of Social Learning Theory. Results Social media emerged as a major driver of negative body image, promoting unattainable beauty standards and fostering harmful self-comparisons. Algorithm-driven exposure to beauty content, and peer influence further exacerbated body dissatisfaction and unhealthy eating behaviors. Traditional Ethiopian values, strong family ties, and religious faith served as partial protective factors. Girls faced more intense scrutiny and appearance-related pressure compared to boys. Conclusion Negative body image among Ethiopian adolescents is shaped by both traditional and modern influences, including social media, peers and culture. These factors contribute to disordered eating attitudes and behaviors. Current screening tools may not fully capture culturally specific expressions of eating distress. Keywords Adolescents, Body Image, Disordered Eating, Social media, Ethiopia, Peer Influence, Cultural Values, Social Learning Theory