The Antisocial Doctors Podcast
Join Dr. Rebecca Berens & Dr. Sonia Singh as they unpack viral health trends with curiosity, nuance, and compassion. No snark, no shame —just thoughtful conversations about what’s true, what’s hype, why we're drawn to it and how to find calm and clarity in the chaos of social media and online health advice.
The Antisocial Doctors Podcast
Episode 6: Is it Helpful to Know #WhatIEatInADay?
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You are listening to the Antisocial Doctors Podcast, hosted by me, Sonia Singh, a board certified internal medicine physician with a Master's in nutrition and a special interest in health anxiety
Rebecca Berens MD:and me, Rebecca Barons, a board certified family medicine physician with a special interest in disordered eating.
Sonia Singh MD:We're also a millennial women anxious moms and curious humans navigating social media. We've seen firsthand how these platforms can be powerful tools for education and connection, but can also make us unwell.
Rebecca Berens MD:This podcast is meant to be the antidote to your doom. Scrolling, a solve for the anxiety, stress, guilt, shame, and confusion that comes from social media's messaging around health. In each episode, we discuss a health related topic, trending on social media with curiosity, nuance evidence, humility, and compassion.
Sonia Singh MD:This is not your average debunking podcast. We wanna explore not just what is trending on social media, but why? Why are so many people drawn to this? What is the nugget of truth here? What are the facts? What can we learn from this as patients and doctors? No shame. No blame, no snark.
Rebecca Berens MD:We're so glad you're here.
Sonia Singh MD:All right. Good afternoon, Rebecca. Good afternoon, Sonya. So we're, if this eventually video, if the videos of this podcast eventually make it to some platform, you may notice that we have switched to being our own homes or offices, rather than being in a studio just'cause. We too are busy moms that have a hard time getting our physical bodies in one place together. It's a
Rebecca Berens MD:challenge.
Sonia Singh MD:Yes. Anyway I'm really excited to cover this week's topic. I know you've been excited to cover it for a while. Oh yeah. So tell us a little bit, we, we couldn't even help ourselves. We started chatting before we even started recording about this, and we're off to the races. But anyway, we're starting at the top. So tell us, what is this week's claim and what was the inspiration for covering this topic?
Rebecca Berens MD:Yeah. So, this week we're gonna be asking is it helpful to know hashtag what I eat in a day. And this is not something that I've ever had a patient directly bring up to me in a visit. In some ways, you know, a lot of the other things we've covered are questions we've directly gotten from patients. Or heard, brought up in some way by patients, like they've seen a claim online and they're asking about it. This one's a little bit more insidious because I don't think anyone directly says oh, I saw this. What I eat in a day video. Is this what I should eat in a day? No one's really asking that, but people are coming in. Saying I know what I should be doing or I'm trying to eat clean, or I'm trying to manage whatever condition with diet and exercise and this is what I'm supposed to do to do that. And the where is that information coming from? I think a lot of times it's coming from content like this. Mm-hmm. Um, so that's what I wanna talk about today. So the claim is a little bit more implicit in these videos. Mm-hmm. It's not so direct as it is with some of our others, but, but I definitely think there is outright claims being made by these, uh, videos just in a more insidious way that's not so obvious.
Sonia Singh MD:Yeah. I think just having a conversation about. What are these videos actually saying to us? Or what are we looking for in them, or what, what does this information mean? I think that question is just really interesting in itself, but I think you're right that, in a lot of ways it's sort of setting the ideal, like it's setting the standard for a lot of people of what they sh. Doing and what they should be aspiring to. And they don't even realize that it's doing that, but that's what it's doing. And so I think we see the manifestations of that when people come in having these expectations for themselves and their, what, you know, what they're eating and putting in their bodies that is modeled off of some of these things. And because like you said, it's so insidious, they may not even be questioning well, is that how I should actually be eating? It's accepted that is. The best way, okay. Well cool. So the claim is a little nebulous in this episode. Why do you think this category of video has become so popular? I mean, 10 years ago, I don't even think I would've had any concept of what this idea was. And now when you say, hashtag what I eat a day, I'm like. Oh yes, I know exactly what those videos are.
Rebecca Berens MD:Yeah. So lemme, I'll just describe an example of what I'm talking about just in case anyone is not sure what I mean. So the, what I eat in a day videos we have all seen them. Essentially it's some person sharing their meals and snacks. Throughout the day, and they're usually eating them or preparing them or doing, interacting with the food in some way. It's not just a picture. And they sometimes are also interacting other aspects of their day, like they're working at their computer while also eating their lunch or they're, doing a workout, and then they're carrying their protein shake out after their workout or they're playing with their kids or baking cookies with their kids or whatever. And they usually are. Saying like what I eat in a day as a person. Managing PCOS naturally or as a postpartum mom trying to lose weight. So there's sort of inherently a claim that this is what I'm doing to manage this health condition or for, to reach this health goal. Mm-hmm. Without directly saying it. Okay. And and so the sort of the, the, what is implied there is if you want to look like me or if you want to, if you have the same goal as I do, this is what you should be doing. And it's also sort of creating this, tie to identity around your food choices that if you are this kind of person Your choices about food define you, if you do this this certain way, you'll be, you'll be able to identify as this kind of person. So there's both health claims and then also sort of like identity claims coming with it. And I think, in terms of virality, we as humans are interested, intrinsically interested in other humans, we are. We are wired to be social and to wanna know what other people are doing. And eating and sharing meals is a hardwired human activity. Like every culture has shared meals as a part of the culture. And because it's, it's just something that is, is part of us as humans. And increasingly, especially nowadays with, through the pandemic and with social media, even before the pandemic there was increasing. Isolation and loneliness and spending less time eating with other people. There was actually a, the World Happiness Report in 2025 that I found that showed, there's clear evidence that Americans in particular are spending more and more time dining alone. In 20 23, 1 in four Americans reported eating all their meals alone the previous day, which was an increase of 53% since 2003. And it has increased in all age groups, but particularly for young people. So not only do we have, just general social isolation, but we also have isolation during this very hardwired human moment of connection of sharing a meal. And is this our way of sort of trying to, are we drawn to this to try to replace that missing connection? I think the other thing is that we have this, Sort of idolization of certain body types or, a certain goal that we wanna reach and we see a person who has what we want and we think, I want that. If I do what they do, I'll get what they have. And so it just sort of, reinforces that sort of inherent belief that we have. Whether or not that's true it reinforces that when we see that kind of content. I also found this very interesting. Term that I had never heard of before that I hope I'm gonna pronounce correctly, it's called Muck Bang. Which is, a Korean word that combines the words for eating and broadcasting. And these are videos specifically that showcase people eating that, includes a lot of the sensory elements, like sounds and things like that. That some people are drawn to based on A SMR, the autonomous sensory meridian response. So people have a positive sensory response from hearing and seeing someone else eating, which is a whole other category of this that it was so interesting to me'cause I'd never heard of it before. But I think is also being integrated into a lot of these videos.'cause a lot of these videos do show people actually. Actively eating, not just mm-hmm. The pictures of the food, which is very different than going to a website that has a recipe picture, right. And shows you a picture of a plate. You're actually seeing someone eating. And whether that's tied to our social connection of the sounds of, of people eating or not. I don't know. But that was just a whole other interesting area of this that actually does have some research on it as well that we'll talk about.
Sonia Singh MD:That's so interesting. Again, on the surface, this just seems like such a little silly fad of a, type of viral video. But that, all of that makes a lot of sense. I think a thing that comes into my mind a lot about why I would be drawn to it or why, I don't know, I, I feel like this is my inner thing of why I feel drawn to it, is kind of knowing. Am I normal? Is what I do normal? And what, what you're describing of like people being increasingly isolated and not having meals together, you may not know what your friends eat for lunch'cause you never eat lunch with them. So you are kind of curious about what they're eating and how their lunch looks. I think, there's, the other thing I would say is I think there's just increasing noise and confusion about food generally. There's just. So much information coming at us, like on social media and in the news and everywhere, just about the food and the food supply and what's good and what's bad. And I remember I had a patient just a few weeks ago tell me I just, I don't even know what to eat for breakfast. And I was like, well, what do you like? And she was like, I like yogurt. And I was like, you can eat yogurt. And she was like, well, but there's so many types that I, I, I started eating one and then I heard that that type was maybe bad. And then maybe there was another one that was. I'm like, I just, she was so overwhelmed by the amount of stuff that was coming at her that I think to see a person that you would like to be like, or that you would like to emulate or you think shares your goals, values, whatever, and to see this is exactly what they're eating, feels comforting or reassuring or feels like maybe it breaks through some of the noise and confusion. So, yeah, I think there's so much to why we're, I can understand that, why they're so popular and they're so viral. I think the first time I ever watched one was like I. I really like watching the Architectural Digest Celebrity on tours. And so I had watched the Gwyneth Paltrow one and then immediately afterwards it served me, Gwyneth Paltrow's Vogue, what I eat in a day. And I was like, well, this should be fascinating. I'm sure it was. It was. And then I think it served me like a few more in a row, and I remember one of them I was just like. None of that stuff was food. I listened to the whole thing and it was like a smoothie, a bone broth, a bar, like it was like, anyway, it was very, it was very fascinating. And yeah, after I watched a couple I was like, this is interesting. But maybe for me it was interesting for different reasons. Yeah. Anyway, yes, I see so many reasons why it's viral and a lot of those are a lot deeper than I think, would appear on the surface. So what is there a nugget of truth? Is there some value in, is there some actual value in what I eat in a day? Or like, what is, what is the thing that keeps us coming back?
Rebecca Berens MD:Yeah, so what's the nugget of truth? Presumably at least some of these people. Sharing truly what they actually ate in a day. I'm sure many of them are promoting a certain thing that they may have eaten that day for promotional purposes, but is this what they eat every day? How much of this is true? Is this a typical day for them? Is this something that I ate today because I got paid to promote this product and this post is this something I am. Sharing as aspirational but is not really actually reflecting my regular day to day. We really don't know. Right? But there's probably at least some people who are truly sharing what they actually eat in a day. But does it matter? But that personate in a day, what does that have to do with you? I think for some people they want to. Share their experience. Say they have a chronic illness and they're seeing another person with a chronic illness who struggles with some of the same symptoms they do and they see what they eat in a, maybe that's helpful. Maybe they're like, oh, you know what? I struggle with swallowing this texture of food and this other person has the same condition and they have found a way to overcome that with this. Maybe that's really helpful information that you learned from and you learned, a true truth from that person of how they manage their life. That's helpful to you. But there's also on like the caveat that just because you do the exact same thing as something someone else, even if they have the same medical condition you do, you are a different people, there's a lot that's different about you. You may not have the same outcome. So how relevant is that to you? I've also seen a lot of the content that's trying to be body positive to try to counteract a lot of the diet culture messaging. Coming from, a lot of what I eat in a day video. So I'll see things like what I eat in a day as a fat person who's not trying to lose weight. Mm-hmm. That kind of thing. Which, maybe that's really helpful to normalize to people. Like, you don't have to be following this super restrictive diet, you can just eat normal food that you enjoy for all your meals. And I guess what I found interesting in the context of looking at this is there is actually research on this and how helpful is that? Does that actually counteract. Any of these messages, is it helpful to people to see that content or not? So we'll talk about that, but I think there is a nugget of truth probably somewhere, but how relevant it is to anyone I don't really know.
Sonia Singh MD:Well, so, okay. So I'm gonna challenge you a little bit because like I can think of one time I remember I. I think it was when I had just had my first son and I I think I was watching YouTube videos of newborn life, like people describing this is my schedule with my newborn.'cause at that time, despite being 35 and a doctor, and I was still like, am I doing it right? When am I supposed to feed myself? When am I supposed to shower? When is the baby supposed to, I just, I needed to see someone doing it. And so I was watching a lot of these Newborn life videos and I, again, I wasn't seeking it out, but I remember being served one that was like. You know what I eat in a day is a mom of a newborn, and this woman was vegan, which I'm not vegan, but I remember watching that video and feeling kind of inspired by it because I was like, okay, this lady has all these other dietary restrictions that I don't even have. And she pulled it together. She had a very simple breakfast and then she went out and went to a bowl place for lunch, and then she ate half the bowl later in the day. And then she had a frozen thing for dinner. It was, I guess part of it was maybe the intent of that particular video was really just it's doable. If you, if you have a kind of a structure and a plan, rather than, she was not trying, the video was not trying to promote any particular health goal, but she was basically saying it's possible to even do this, with a newborn. I mean, I can see the flip side of that, which is like somebody watching that and still feeling like, well, she can do it. How come I can't do it? Or just feeling worse that somebody else was able to do it. But I do remember, I still remember watching that video and thinking okay, this is doable. Like I could do this. This is not as impossible as I'm feeling it is right now. So anyway, I can see how it can go both ways depending on what your internal mindset and feeling is in that moment. But. I feel like I have watched videos that have made me feel, I guess in an aspirational way of this thing is achievable and it, it's not as hard as I'm feeling like it is internally.
Rebecca Berens MD:Yeah, and I think, there is definitely some value in that, and I think what you're describing is this is a replacement for. The village that is gone. Yeah. You know, like we Yes, that's true. You know it pre, maybe in the past you would've observed other people in your circle, your neighborhood, your village, whatever, who have had a newborn and watched how they did it, or. Someone was bringing them lots of meals, and so it was easy for them to eat throughout the day. And now we're so isolated and siloed and we've, we've lost the village. And so you're like, what am I supposed to do? Yes. I've never seen this happen before. Yes. And so, yeah, it's sort of fulfilling a societal need that's been lost. And so yeah, there's definitely potential benefit. In that case. And then I think there's also obviously lots of potential harms and it's, it's very variable person to person how that information is received and processed and used. And then also What's aspirational for one person or inspirational for one person could inspire very disordered patterns in another person. Yeah. Or like you said, it could make you feel guilty that you can't do the same mm-hmm. Thing that they're doing because in your circumstance, even though your circumstances are likely very different,'cause I imagine someone who has the wherewithal to film their entire day when they have a newborn has a lot of help because I cannot even fathom how I would set up a camera. Like, I was just
Sonia Singh MD:like, how is this lady even doing
Rebecca Berens MD:this? You know? That's like a camera crew situation or something. You have like multiple family members setting up cameras for you if you're filming yourself. I mean, if you're not, you were getting a lot more sleep than I was.
Sonia Singh MD:I think you're so right about that. How. It's probably that desire of mine that I was having was born out of not being able to observe other people. My baby was born in 2020. I did not have nearly the same urge to watch YouTube videos with as like a child, but in 2020, I literally was not seeing anyone doing anything. So I certainly was not. Able to witness another new mom and what they were what were they doing all day? I just, I could not wrap my head around what I was supposed to do all day with this baby. Yeah. I think you're a hundred percent right that we turn to these things for that sense of community and support and validation and guidance because. Sometimes we're not getting it anywhere else, so, yeah,
Rebecca Berens MD:and I had my first baby pre pandemic and I remember that maternity leave being alone in my house all day every day. And there weren't quite the same level of content in 2018 as rapidly developed after that. But I was watching a lot of TV shows about people with newborns. I can't remember what it was called. There was one on Netflix that was very irreverent and working mom, but very validating working moms. No, it wasn't, gosh, I can't remember what it was called, but you know, I think we do just need some external. Validation or like visualization of what on earth is happening and we really just don't get that anymore. Yeah. And so yeah, I think there's, this potentially fills that role, but of course we wanna be cautious about is what we're observing actually true and useful and helpful. And I think that's different person to person.
Sonia Singh MD:Yeah. Yeah. Okay. So tell us a little bit more about the facts around what I eat in a day videos. I was surprised to hear that you found facts I didn't, it's amazing that this
Rebecca Berens MD:has been studied. I was fascinated at the existence of any study about what I eat in a day video, but there were many and I was quite shocked. But also. I'm glad because this is the kind of thing that does need to, I mean, this is such a huge part of our lives now. We should be studying the impact of it. So the fact, so nutrition related content on social media is often inaccurate and associated with conflicts of interest. This should come as no surprise to anyone. There was a study that evaluated TikTok content, including what I eat in a day videos. And it was identifying the topics, the types of creators, assessing the accuracy and quality of the content using evidence-based frameworks and in analyzing engagement metrics such as likes, comments, shares. So most common creators, no surprise, health and wellness influencers and fitness creators. There were also, there was a lot of recipes and there was a lot of weight loss specific content. Mm-hmm. So when they evaluated these posts, 82% of the applicable posts lacked transparent ad advertising disclaimers. 77% failed to disclose conflicts of interest. 63% promoted stereotypes. 55% did not provide evidence-based information. 75% lacked balanced and accurate content, and 90% fail to point out the risks and benefits of the Advice presented. So as total 36% of posts were considered completely accurate, 24%, mostly inaccurate, and 18% completely inaccurate. And there was no statistical significance between the level of accuracy and the engagement metrics, so, mm-hmm. Meaning. The inaccurate stuff was still shared and promoted just as much as accurate stuff.
Speaker 3:Yeah. Um,
Rebecca Berens MD:so yeah, this was a really interesting study that, was no surprise to me, certainly, but I think it's important for a person to be aware of when they're consuming. This kind of content.
Sonia Singh MD:I think we touched upon this study in one of our initial episodes on just social media and how it affects our wellness generally. But something that really has struck me in the past few months mostly is you know, there's been all this discussion about Oh, the food pyramid, the food pyramid was so bad for us and it gave us these crazy, ideas about what we should be eating, you know? And actually the food pyramid that everyone always hates on has been changed a long time ago. So that, that, that food pyramid was retired a very long time ago. But anyway, I actually don't think, as a doctor, I think it, like the first thing that strikes me is I'm like, I don't know how many Americans are really guiding their food decisions based on whatever the FDA said was the food pyramid or what the current guidelines say, or the MyPlate recommendations. I actually think today, in today's current day and age, social media is driving what people think is the ideal what they should be eating. They're not consulting the FDA website. They're not coming and asking us most of the time. And so, like you said, I think it's just so important that we are just as we should make sure that the recommendations that come out, at a national level and by big societies and everything are, are studied and well-informed and evidence-based. The reality is most people are getting that guidance from social media. So we better be studying it and alerting people that it, it is or is not accurate or fact checking it in some way. So yeah, I mean I'm just so glad that people are studying it because it should be scrutinized just as much as the, official guidelines we follow.
Rebecca Berens MD:Oh, absolutely. Yeah. And I think, for the average person, like I think it's unrealistic to believe that we could ever control. That the information that is posted being accurate, and I don't think that would be well received. There would be censorship concerns about that. Right. And at some point, like people can share what they do. That's. Yeah, what social media is for. It would be, it would be an overstep to police people sharing their day-to-day lives. But also I think it's just important for, as a consumer of information, having that sort of critical eye. Okay, I saw this. Let me look more into this. Let me learn more about this. What does the evidence say? Because I think we, we do, I think sometimes. Put too much stock in what people we know and trust, say, without considering all of the risks and benefits and the other evidence. And it's important to have trusted source of, of information, but it's also important to know that trust does not equate to evidence. And having, a variety of sources that you're looking at that you can critically examine while you're making a decision.
Sonia Singh MD:I also think just the scope of what you mentioned, like just how many posts there are and then the extremely high percentage of them that are inaccurate in some way or biased or. The risks, I think there's this false sense of oh yeah, this seems true.'cause you're following three different people that are promoting the same product or saying that they did a certain thing and it worked for them. So to a lot of people, I think that feels like, okay, yeah, that's fact checked. It's not one random person is saying it and I'm believing it. Or even going to Google, Google Gemini, AI is pulling from what is on the internet, and so it's pulling from the same massive amount of. Questionable information, and so oftentimes that answer will also just validate what is most prevalent, in a lot of these platforms. So it's hard, it's really hard to go out and fact check, on your own, yeah.
Rebecca Berens MD:Yeah. And it's, it's not reasonable to expect that everyone has the resources to be able to even find those kind of, yeah. Information. But I think it's just important for people to know, okay, what I'm seeing. May or may not be true. Yeah. And maybe take that to a professional who does have the resources to help you, guide you on that by consulting with evidence and, and all of that. So I think it's, it's just a, it is just consumer awareness, yeah. So the next study that I found that I found particularly interesting, so there, there was actually evidence that watching what I eat in a day video, specifically increased body image, preoccupation and urges to engage in eating disorder behaviors, including binge eating, vomiting and induced vomiting, over exercise restriction, all of that. So this was an appetite July, 2025. Does watching short form what I eat in a day. Videos impact eating disorder, cognitions and urges to engage in eating disorder behaviors, an experimental investigation of TikTok. So this was a study of college students. There is 481. 72% were women, 68% were white. So not a totally representative sample necessarily of the general population. But, they were randomly assigned to view lifestyle eating only or non-ED, non-ED related control, which were, hashtag art short form videos from TikTok for six minutes and before and after they rated their weight and shape preoccupation and urges to binge eat, vomit and exercise. And they did, they analyzed this information and revealed significant interactions by time and condition. So type of video and, type of behavior for weight and shape, preoccupation and eating disorder, behavior urges. So the lifestyle video had an increase in weight and shape preoccupation and exercise. The eating only ones had an increase in weight and shape, preoccupation and urges to binge eat. Vomit and exercise and the control condition, which was the art videos, had a decreased urge to binge eat in exercise, but no change in weight, shape, preoccupation or urge to vomit. So, and the effects related to weight and shape preoccupation for lifestyle were stronger for women. So basically what we're seeing is these lifestyle videos, which, include not just eating, but also exercise and other behaviors. And the eating only ones both had an influence on sort of eating disorder behaviors. Whereas the art videos. They said may be protective against eating disorder risk or just may have no yeah, impact in general, but, but I think, yeah, obviously this is just one study and this is a super interesting study that I think would be. Really interesting to continue to look at. There's some ethical concerns, of exposing people to a lot of this event to study it, but I guess people are getting exposed already. But I think it's further research would be really useful to see how strong this is and if there's any sort of predictive value of which kind of person is more likely to experience this. It would just inform, parents who are advocating for their adolescent children, for example, using social media and then also for, people themselves to be aware of what my risk might be if I'm consuming this kind of content.
Sonia Singh MD:Yeah, but this was just at the study population was just college students, like not necessarily people with any history of disordered eating at basic. Correct. So that's really fascinating because to me what that means is for somebody with any history of disordered eating or who already tends towards some of those types of behaviors or thoughts This effect is probably so much more pronounced, so I think just having that awareness. When I think about that, that feels like something pediatricians and and PCPs, should be really alerting anyone to who's in that category because this is a very clear risk factor for, for worsening or perpetuating those behaviors. But yeah, that's a pretty impressive finding.
Rebecca Berens MD:Yeah. And I think, as you said, like it's concerning. Yeah. And I think less so now, but certainly in the past there was this assumption that Content is neutral. You're consuming content, but you're in control of it. You, you are not, you can choose whether or not to be influenced by it, or to change your behaviors based on content you saw. Right. But I think what this also tells me is that it might not be as much in your control as you think it is. Mm-hmm. And I think, I've, I've definitely heard parents of adolescents. I can't even imagine the struggle that they're under. And we will rapidly be in this position of Kids with exposure to smartphones on social media. Even if you do not give them a phone and you do not allow them to see social media, they're going to be exposed to it through peers. Yeah. And I think there's increasing recognition from parents that it's a problem, but I think there's still a lot of parents that maybe are not. As aware of how significant some of these problems could be and how quickly it could have, I mean, this was six minutes.
Sonia Singh MD:It, it really is impressive. The intervention and like what they found. But I think the other big difference, which you pointed to was like. It feels like you're not choosing it. If you're just on social media, not looking for it, it comes up so it's so different than, in the nineties when you and I might have gone somewhere and bought a Cosmo magazine, like you could just be innocently looking at sewing videos and then you, you get served something tangentially related and then suddenly you're in. And so, I think, like you said, there's this illusion that we have control or that it's fine. I'm not interested, I'm not gonna be looking at that stuff, you know? And especially with a kid, the algorithms have this amazing ability to figure out what you're terrified of and what you're anxious about, or insecure and bringing it up, you know? So, yeah, I think that's, it's terrifying.
Rebecca Berens MD:So the next study I wanna talk about was about muck bang, which again, this was a new term for me and I really hope I'm not mispronouncing that. But this was a qualitative content analysis of YouTube comments and Reddit posts of people who have viewed muck bang videos. So the, and again, muck bang is the, videos of like people eating. Often large amounts of food and often like messy food. That makes a lot of sound'cause it's designed for a lot of sensory stimulation. And again, this is just a qualitative analysis of comments. So this is in no way like a. Controlled study. Yeah. But it's still interesting to see what are the responses to this sort of content. And it indicated that viewers of Muck bang videos reported restrictive eating, loss of control around eating and guilt around eating. And I thought this was super interesting because this was not assessed in this study, but for me it could go either way. Is that as a result of the content or are you choosing that content because you already have these feelings and this is one of the ways that you're working that out? Yeah, because certainly we know, like patients with anorexia, for example, one of the symptoms they will experience with star ation is an increased preoccupation around food. So a lot of people will take up cooking or baking and making food for other people, but then not. Eating any of it.'cause they wanna be around food, they're just not taking it in. Mm-hmm. And so this is sort of a way of acting out that symptom in the privacy of your own home. Mm-hmm. But then from, from the flip side, it could also be triggering some of those feelings. You know, this was, that was really not assessed with this study, but certainly some of the other studies indicated that, watching a lot of food related content maybe had an effect on eating behavior. So it's possible it could go both ways. Mm-hmm. But I think that's something that. Could definitely be studied in more detail and would be interesting to see what the outcomes are, if it's, if this is a cause effect or both kind of situation. Right, right.
Sonia Singh MD:Yeah. So in that case, you'd have to do something like the first study where you just get a more general population and expose them to it and see what happens. Yeah. Yeah. Interesting. For sure.
Rebecca Berens MD:And then the last thing I wanted to touch on here is, which I think is important, especially as it comes to parents who are working on addressing their kids' use of social media, is the type of content had more impact than the duration of social media usage. Mm-hmm. So this was a study from eating eating behaviors in 2023. The impact of social media use on body image and disordered eating behaviors. Content matters more than duration of exposure because I think the way that I hear a lot of people talking about handling. Social media with their kids is limiting screen time. They're like, oh yeah, they use it, but they only can use it for 30 minutes. Or, or they only have it while we're awake and at bedtime it comes into my room, but. It doesn't maybe matter the amount of time they spend on it, it matters more what the content is. So this survey was two demographically diverse undergraduate student cohorts in 2015 and 2022 to compare patterns in social media use, body image and disordered eating behaviors between samples. So this was also pre and during pandemic. Which is also an interesting, combination of factors to assess.'cause that was maybe not planned on in 2015. But, but participants in 2022 reported grad greater body image disturbances, more frequent vomiting and laxative use, more time spent on a greater number of social media accounts and with significantly greater use of image-based platforms. So Snapchat, TikTok, and YouTube. So of course, in 2015, Instagram was out, but it was still pretty. Limited, I think it was not as widely used as now. And now of course we have TikTok and we have a lot more image-based things being used. Mm-hmm. But exposure to weight loss content specifically was associated with lower body image appreciation, greater fears of negative appearance, valuation, and more frequent binge eating. And this was not actually reduced by exposure to bo body positivity or body neutrality content. So even having that. More neutral or positive content did not have any protective effect. So I thought that was really interesting and I think there's this perception that if we produce more body positive or neutral content, we can drown out some of the effects of the more negative content. Mm-hmm. And that may not be the case, and maybe we just need to not be doing any of it. But of course that diet related content's gonna be there. So it's, it's a hard, it's a hard balance.
Sonia Singh MD:So I guess I still come back to though like a chicken or the egg thing, because in this, since this is just observation, right? So they're not controlling the content that these people are seeing. They're seeing whatever is getting served to them, right? So if you already have. Your own issues with your body image and concerns about food and around food, then you're going to be consuming more of that content and more likely to have those behaviors. So this one is not quite as shocking and scary to me as the first one. Obviously still shocking and scary, but a little bit less so because again, it's just social media is so good at identifying those things inside of you, even if you are not acting upon them. But maybe this is suggesting that it may make you more likely to act upon them if you're consuming a lot of that content.
Rebecca Berens MD:Yeah, absolutely. And I think that the thing for me was that it's not so time dependent, right? Mm-hmm. That also, the body positive or neutral content doesn't protect you. Like even though it's there. Yeah. And we would, you know, I think a lot of us sort of intuitively think oh, if we just drown it out with more positive content, it will counteract some of this. But it doesn't, at least in this study, it didn't appear to
Speaker 3:have that effect.
Rebecca Berens MD:Yeah. And maybe that's something that could be studied in more detail and, and more specifically targeted maybe people who are already struggling with this thing, these sorts of things, for example, could be. Proactively only shown that content and the other stuff removed. In some way. And would that maybe be beneficial? We don't know. But I think it's just interesting information to, to have in the back of our mind. And like, and like you said, I think it's just more of a discussion point, particularly with parents about adolescents who are struggling with these conversations with their kids about social media use and phones and all of that. This is a thing that could maybe be, discussed as a family and brought up and more directly head on. Yeah. In the forefront of everyone's mind. We're not in control of it, of all of it, but we can be in control of at least some of it and have some open conversations about it to maybe keep the effects as limited as possible.
Sonia Singh MD:Yeah, no, I, I hear your point about the time, and I think that's, I think you're right that a lot of people think okay, well they're, they're just on it so little, they just have so little time on it and, I'm observing them and everything. I have had the experience myself of trying to pull back from Facebook and Instagram for the last few months and I. I'll tell you, sometimes I'll log in'cause I'll get a notification and I'll just do one minute only. But the very top of the feed is always something really juicy. It's something really compelling to me. And the things that I don't want to see that I see all the time are bad things happening to children or, missed diagnoses or like those are my fears. Inevitably the top post on the feed is always one of those two things.'cause it knows what will draw me in, yeah. And so I can imagine if you're a 13-year-old and your mom's okay, you get 10 minutes to look at this, you know, the image can be done like very quickly. You know, that could
Rebecca Berens MD:be a heavy 10
Sonia Singh MD:minutes doesn't take long. Yeah. Yeah. So, yeah, that's a, that's an important point. Okay. I guess one last thing. That I wanted to challenge you on or ask you about your opinion on is now reading this and knowing that even the body positivity content does not seem to mitigate some of these effects. I guess as a some part-time content creator myself, I do wonder sometimes, is there any way to share. What you are eating. Maybe not saying what I eat in a day, but sharing food related information or even what I eat in a day, in a way that does not perpetuate a lot of these, more negative behaviors and, like adverse effects on people's wellbeing.
Rebecca Berens MD:Yeah. We kind of started talking about this right before we started recording this and I think. We don't know really. I mean, Mike, after doing all this, I'm like, maybe not, but I think like, you know, I think like you said it's so person dependent how an individual is going to receive information and how that might impact them individually. But what I will say is the content that my husband receives around food on his feeds is very different than the content that I receive around food on my feeds. And I find the content that he receives generally. Less problematic, at least in my view, compared to what I receive. And damage could potentially still be done in a person who's particularly predisposed, but I would say more of his content is very cooking focused.
Speaker 3:Mm-hmm. So,
Rebecca Berens MD:He'll get a lot of videos'cause he's interested in cooking, so this is why he gets served up this stuff. He gets a lot of videos specifically showing, demonstrating the steps of preparing a meal. Yeah. Right. So it's like this is how you make this and there's not very much discussion of the health of that meal, the nutrient content. Some of the meals are very balanced, some of them are less so, but it's more so this is a delicious meal that you can make in five or 10 minutes and then it shows you all the steps of doing it. And I have to think that. There's less risk for harm in that sort of situation compared to a woman who's skinny in athleisure and gracefully doing yoga in the background while she talks you through all the meals she made that day. It just seems like it has to be different. And this, the latter is all that I ever see or I did when I, when I was using. I've actually, I've, like you said, I've also stopped using a lot of these platforms, but I think, the type of content is very different in the way that it's targeted, and I do think there's a way to do it, but I think it matters how you're talking about it and the sort of imagery that you're using. Mm-hmm. And now obviously we talked about muck bang a little bit, Some of his maybe err more towards the side of muck bang, which may have some of its own effects that need further study. But again, there, there's less eating and there's more cooking. There's maybe a couple of frames at the end where they show, like taking a bite of something, but it's not the bulk of the video, it's the bulk of the video is the actual preparation steps. So it seems more educational to me of this is a way to develop your interest in cooking and learn a new skill than it is about the food.
Sonia Singh MD:Mm-hmm. Yeah, and maybe there's also a difference in individual, it sounds like the goal of a lot of those posts is a particular recipe or a particular meal, or how to do a certain thing, whereas when you do this how I eat in a day thing, there's all these underlying assumptions of This is how I eat every day. This is how, it kind of removes this idea of well, yeah, you might this eat this on one day, but tomorrow could be totally different. And you and I both know this as clinicians who take, you know, dietary intakes and do food diaries and things like that. It's like oftentimes you'll ask a patient, well, tell me about what you eat in a typical day. And it's so hard. That's such a hard question to answer because there's so much variability for the vast majority of people like. As part of my, you know, I did a Master's in Nutrition and for several weeks we had to keep our own food diaries as part of the program. And I was amazed at, just how variable things were for me from day to day thinking, even though I think oh, I don't, it doesn't vary that much, but I think it's, it's so hard to really pin down. What eating in real life is actually like. And just in the same way, you wouldn't record a house tour. If your house is a to, you're gonna, you're gonna straighten the pillow and stuff if you're recording. So if you're recording what I eat in the day, you're not gonna be like, and then I ate this leftover bag of pirate's booty that I found in my backseat. And then I, grabbed a pastry in the office, break room. It's very unlikely that it's really going to be. Reflective of reality, when it's that amount of time as opposed to I made this recipe, you know? Yeah.
Rebecca Berens MD:And what is it the Hawthorne effect of, the effect, like when you're taking that food dire example Yeah. For, for, your master's in nutrition. Does it affect what you do because you know, you have to write it down. I think that's, I think it's only human right? You know, so, I think even just the fact that I think I've, I've even seen some people talking about using this as accountability. I'm trying to follow a certain plan and so I'm gonna post this every day for accountability because I know I will do it a certain way if I have to share it with people. Mm-hmm. There is just, even the act of documenting something changes our action
Speaker 3:behavior.
Rebecca Berens MD:Yeah. So it's sort of a two-way street, but I think it's really, it's, it's just a, a very interesting topic and conversation in general, and I think. For me, researching this episode, I, I just was like, there's so much more to think about this with this than I act, than I thought there was. And it's now something that I very intentionally will bring up if I have a concern about someone, what kind of content are you seeing on social media about this? Particularly if I know someone has started to follow like a really. Rigid diet, and kind of talking about that influence and I think people really appreciate having the space to explore that and realizing the effect it might be having.
Sonia Singh MD:Yeah. I'm so glad we're having this conversation and I hope this conversation is shared widely among, providers who are hearing those things from people. And then also just the general, I. I feel like I just from this conversation am going to be more aware of when I'm being, served that content and how it's making me feel. And I don't think I had given it that much thought before. So, thank you. Well, so what do you think we can take from this kind of, as doctors and humans, what are some of the take home messages from this conversation?
Rebecca Berens MD:Yeah. So I think the big take homes one like this, content has risks. There are actual risks. It is not a harmless, neutral intervention. Yeah. And we should think of it that way. We should think of it as an intervention. Two, we need to have that intentional check-in, like we're talking about the ref, the reflection of how our content might be affecting us. If there's an anxiety that we're struggling with, like you said, you have those things that are fears for you. Checking in with yourself, is this content that I'm experiencing contributing to this? And how can I maybe, change the way that I'm consuming content or whether I'm consuming this content at all to to help myself feel better. And recognizing that you're not as in as much control as you think you are. The algorithm is controlling a lot more than you are, and as much as we don't wanna believe that trying to take whatever steps you can control to, to limit your exposure to things that are not helpful to you. Yeah. Because if we understand those risks and we understand the lack of control we have in some capacities, we can better make better decisions about our social media usage, the content we're consuming and how to protect ourselves.
Sonia Singh MD:I just had an idea. I wonder if because the current way you might try to reduce this exposure to this content and stay on social media would be when you see something pop up and you're like, not interested in this, not interested in this. And I tried to do that for a long time where I would just be like, Ooh. Scary story about a man who, had abdominal pain and died the next day. I don't wanna see this, but. It's just so prolific and so good at it. It will just keep coming up with variations that you have not said that you don't wanna see yet, so I almost wonder if at some point, based on the research that, clearly is accumulating, there will be some ability to set guardrails for yourself. What if you could tell Facebook, look, I have a history of disordered eating. I don't wanna see content of these types, and what if it could filter them for you? No incentive for them to do that. But just from a public health perspective, I just feel like that kind of, those types of guardrails are going to be necessary for people to continue safely using these platforms. Because I really think currently with the current situation, your only choice is to leave it, which we have both kind of clo come close to that conclusion? I think independently.
Rebecca Berens MD:Yeah. I think there are some filters that can be put on. I actually, I was thinking, oh, maybe I should look and then I'm like, I don't have it to look. Yeah, we
Sonia Singh MD:deleted it from our phone. Yeah, I've deleted it and
Rebecca Berens MD:I, I have my brick on so I can't redownload it. So, I think, I think what I've heard from some people that they have found effective is actively searching for things you do wanna see. Because the more you engage with the things you do wanna see, the more of that it will show you. Mm. And the less of those other things. And I think the other thing is, and this requires a bit more, brain power and strength maybe, is when something like that does pop up to just close the app.'Cause it doesn't, like when you close the app, it wants you to stay on the app, right? Yes. So spend a lot of time looking at the content that you do wanna see, and if you see something you don't want, just close the app. I think that gives maybe the algorithm some more negative feedback, but I have definitely heard from people who have said, I've very consciously have, Been searching for the things I wanna see. And it's, it's gradually shifting now in that way. The other thing is, in that one study there was that sort of potential protective effect of hashtag art. And I think that's maybe. Things that are, inspiring to us in ways that have nothing to do with food or body or lifestyle. Yeah. Like art, like music, all of those other humanities. Mm-hmm. I think they're called humanities for a reason. Right? Like they're what makes us human. It could, maybe activate our brain in a different way that might give us a different response. And so I think that's one thing that people could consider doing if they want to remain on social media and wanna try to change their algorithm.
Sonia Singh MD:Oh my gosh. It's like parenting, you know? You're like use constant reinforcement, not negative reinforcement. It doesn't like it when you close the app. It's like we're trying to train like this little gremlin on our shoulder. You know? Essentially at some point you're just like, but why? Why do I have the gremlin? Well, and I
Rebecca Berens MD:gave
Sonia Singh MD:up and I put a brick on,
Rebecca Berens MD:so
Sonia Singh MD:that was me. Yeah, but that's, I've never thought about that. But that makes a lot of sense, is just and I, it's funny because like sometimes I'll think oh, I wanna learn more about this particular thing. And then I, I have done the thing where I consciously, I'm like, oh, I'm gonna like this post'cause then it's gonna show me a few posts about this. And I haven't really thought of that consciously, but that is certainly an effective way to start shifting the algorithm to show you certain things. But yeah, it's just so hard to resist the human urge to not. It's not even, you don't have to click anything. Just your eyeballs have to look at a post for more than a few seconds. Sometimes I'll be very quickly trying to scan an ad'cause I'm like, oh, I don't want this ad again. But I
Rebecca Berens MD:kind of wanna see what it's like a train wreck. You can't look away, you know? I guess it's as, and I'm like, oh my gosh, what? And I was like, we can look at it. Don't look at it scroll, but you can't help yourself. You're just like, what are they saying now?
Sonia Singh MD:Yeah. I mean, I think we're only just scratching the surface of how powerful these things are. Right now we still have this illusion that we have some sense of control over them, and I just think it's gonna become clearer and clearer that we do not. Yeah. Okay, cool. I think we covered everything. Oh, last, the last question is how might you talk about this with your patients? I think you kind of already, mentioned this, but go ahead and gimme your last 2 cents.
Rebecca Berens MD:Yeah. So, I think the big thing was asking the question, not just about time, but also type of content spent. Mm-hmm. And, and the question that I started asking is, are you concerned about your use of social media? Mm-hmm. Because this is a whole motivational interviewing skill, right? If someone's not concerned about it, that's probably not somewhere you're going to be able to make a lot of headway. But most people I find are concerned. And just the question are you concerned about it? I think opens it up in a way that's not judgmental and is not a way of you're, why are you watching that stuff on social media? It's so trashy. You know? It coming at it with judgment is never effective, but coming at it, are you concerned about it? And if they're not, let it be. Focus on other things, but a lot of people are concerned and wanting to talk about this. And so I think it, it really opens up a lot of avenues to have those conversations. And then I think, like I said, for kids in particular talking to parents about. Not just the screen time, it's the content. Keeping them off of smartphones and social media as long as possible. And if they are gonna be viewing content, making sure that it's kids safe and ideally you are present there with them so that if something comes up that's inappropriate, you can intervene. Before it's. Escalated. And or you can even just have a conversation with them about it after the fact of like, Hey, what did you think about, this thing that you saw? Because having that conversation will be really impactful for them. I do think just in general, for kids, adolescents, adults, anyone really at this point, having that screening for eating disorders and disordered eating behavior, anyone who comes in with a concern about their weight their diet, their exercise, like they've likely looked at this content Yeah. Before they got to your office, if they're coming in with a concern about it. This is not the first day they thought about it. Their algorithms probably been serving them up stuff for a while, so it's not enough to just talk about the concern. It's also important to screen. Have you been restricting your intake? Have you been cutting out any food groups? Have you been exercising to the point of injury? Or even when you're ill, have you been making yourself throw up after a meal because you feel too full? Have you been using laxatives? Really just ask the direct questions because it's often not something that people volunteer. There's a lot of stigma around it. People feel ashamed but you can't help them if you haven't asked the question to know that it's going on.
Sonia Singh MD:I like what you said about asking them if they're concerned because a lot of people actually are and may not think of that as a medical concern to even bring up, their social media usage. But actually I would say if I hadn't had this conversation with you, I can imagine a patient. Just not even thinking that it is something to be concerned about, but maybe just providing them with the education that a lot of the content around nutrition on social media may seem educational or inspiring or, helpful, but there's actually evidence that it can harm you and it can worsen, some of these behaviors and so. Even if they at that time may not be concerned about it, just sharing that information with them and allowing them to take some time to reflect on, wait, how, how does it make me feel? Because I don't think a lot of us, I think we just, we're doing it all the time, so there's not a lot of that checking in happening unless you're prompted to.
Rebecca Berens MD:So, yeah, for sure. And definitely if they're. Starting to bring up oh, I'm following this diet, or I started doing this protocol. That's a really easy time to be like, yeah, you know, there's a lot of information about this on the internet, or you may have seen some posts on social media doing this diet or this whatever. And, this is the concern that I have about it. Unfortunately, there's a lot of paid promotion and, bias posting and things, and so you can kind of bring it up. I think just from a screening perspective the concern, for me at least, has, has caught quite a few people who have concerns that, again, people don't think that as a medical problem. I really didn't think of it as a medical problem until pretty recently, but now I'm like, this is a big medical problem. It's a big one of the bigger ones that we have right now. It's really influencing people's health and it's not something we can ignore and I think important for, any physicians listening to be thinking about that as like a general screening for people.
Sonia Singh MD:Totally agree. Well, thank you so much. This was a really fun episode and we will be, back next. A new topic for you. Yeah. Thanks so much. Okay. Bye bye. Hey, guys. Last but not least, we have a very important disclaimer. This podcast is intended for educational and entertainment purposes only. The content shared on this podcast, including but not limited to, opinions, research discussions, case examples, and commentary, is not medical advice and should not be considered a such. For professional medical evaluation, diagnosis, or treatment. Listening to this podcast does not establish a physician patient relationship between you and the hosts. We are doctors, but not your doctors. Any medical topics discussed are presented for general informational purposes and may not apply to your individual circumstances. Always seek the advice of your own qualified healthcare professional regarding any questions you have about your health. Medical conditions or treatment options, never disregard or delay medical advice because of something you've heard on this podcast. While the hosts are licensed physicians, the views and opinions expressed are our own and do not represent those of our employers, institutions, organizations, or professional societies with which we are affiliated. Although we do our best to stay up to date, please note that this podcast includes discussion of emerging research, evolving medical concepts, and differing professional opinions. Medicine is not static and information may change over time. We, the hosts make no guarantees about the accuracy completely, or applicability of this content, and we disclaim any liability for actions taken or not taken based on the information provided in this podcast. By listening to the Antisocial Doctors Podcast, you have agreed to these terms. Thanks again for joining us.