Owning smartphone at age 12 may raise child’s disordered-eating risk

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So much is happening in the life of a young adolescent: They’re beginning to assert more independence and autonomy. They’re pivoting away from the influence of their parents, and toward the social cues of their peers. They’re navigating puberty and its subsequent onslaught of new bodily insecurities.

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What happens when a smartphone is added to this already turbulent mix? A new study by researchers at the University of California at San Francisco suggests there may be one specific risk of giving a smartphone to a 12-year-old child: They may be more likely to exhibit disordered eating symptoms two years later.

Their study, published Friday in the journal JAMA Network Open, followed nearly 9,000 adolescents and found that participants who owned a smartphone at age 12 were more likely to report eating disorder symptoms two years later. Nearly 70 percent of adolescents in the study owned a smartphone at age 12 – and by age 14, researchers found that those children had a 67 percent higher risk of binge-eating behaviour and a 50 percent higher risk of inappropriate compensatory behaviours (for instance, using diet pills or laxatives, vomiting or exercising excessively) to prevent weight gain. (The study focused on disordered eating behaviour or symptoms, even if they did not meet the clinical threshold for diagnosis with an eating disorder.)

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Teens who owned a smartphone at age 12 were also found to have about twice the risk of tying their self-worth to their weight, and a 49 percent higher risk of reporting eating disorder symptoms of any kind. (All study participants are part of the national Adolescent Brain Cognitive Development Study, which includes a racially and economically diverse sample of children and is the largest long-term study of brain development and child health in the United States.)

The study does not prove causality, the authors noted, but the findings suggest that families might consider the timing of when to give a child their own smartphone, and that clinicians should note smartphone ownership as a factor when assessing a child’s eating disorder or mental health risks.

The study also found that girls who owned a smartphone at age 12 were nearly three times as likely to report worry about weight gain at age 14.

“Body image concerns don’t always look the same in boys and girls,” said Jason Nagata, lead author and an associate professor of pediatrics at UC at San Francisco. “Girls may be more concerned about gaining weight, while some boys with body image concerns may actually want to gain weight or become more muscular. That may help explain why we saw a difference for worry about weight gain, but not for the other eating disorder symptoms.”

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A growing body of research has shown clear associations between exposure to appearance-related content on social media and the emergence or worsening of disordered eating symptoms, Nagata said. But in this study, rather than homing in on how adolescents use their phones – tracking which apps they’re accessing, or how much time they’re spending on their device – researchers wanted to better understand the risks posed by merely owning a phone by age 12.

“We were really focused on a different question than what has traditionally been asked,” he said. “Rather than focusing on social media specifically, or problematic media use, we just really wanted to know: Does it matter when a young person gets their first smartphone? Because we know that’s a question that a lot of parents are grappling with.”

The researchers focused on early adolescence, Nagata said, because it represents not only a pivotal developmental stage but also “a particularly sensitive period for body image, with puberty changing the body at the same time that kids are especially sensitive to peer feedback,” Nagata said. “And a smartphone then puts a world of appearance-focused content right in a young person’s pocket.”

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While the minimum age for most social media accounts in the U.S. is 13, he said, his prior research has shown that 64 percent of American adolescents are already accessing social media by ages 11 and 12 (and among those underage users, each had an average of more than three separate social media accounts).

To Jessica Scheer, chief executive of the National Eating Disorders Association (NEDA), the study underscored a mounting concern that eating-disorder experts have been closely monitoring for years. Smartphones open up a world of dangerous, algorithmically amplified content surrounding body image, exercise and eating habits, she said – messages that can exacerbate disordered eating behaviour, or make it especially difficult for young people to maintain recovery from eating disorders. Earlier this year, NEDA surveyed individuals with eating disorders, as well as caregivers and clinicians, to better understand how digital exposure is affecting young people in particular – and the responses were sobering, Scheer said.

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“To have so many people raise their hands and say that after being exposed to this content, they were more likely to have eating disorder thoughts and behaviours, and the fact that that could actually jeopardize someone’s recovery commitment, is a real and dangerous thing,” she said.

It’s all too easy for teens to wind up with social media feeds filled with images and messaging that glorify disordered eating, Scheer said – everything from “thinspo” and “fitspo” hashtags, to posts promoting “water fasting” (wherein someone consumes only water for 24 or 48 hours), to “what I eat in a day” reels. Many posts purportedly focused on nutrition and exercise are especially perilous, Scheer said, “because there is a lot of eating-disorder content that is masquerading as wellness content.”

The widespread marketing of increasingly popular weight-loss drugs is also affecting teens, the survey found. “People were talking about GLP-1 ads coming up on their phone – and that was something that was obviously very, very concerning for us,” Scheer said.

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Adolescence is a time when it’s normal for children to seek more autonomy and privacy, Scheer said, but where smartphones are concerned, it’s unsettling to consider what might be happening beyond a parent’s view: “Eating disorders in particular thrive in isolation.”

Rachel Rodgers, an associate professor of applied psychology at Northeastern University whose research focuses on body image and disordered eating, also noted that adolescents in particular are still developing the emotional regulation, digital literacy and cognitive skills that are necessary to make sense of the social media landscape. They might not understand that something they’re looking at is a form of image marketing, Rodgers noted, and they’re also more apt to absorb negative messaging around body image, even if it isn’t directed at them personally.

“Our research has shown that witnessing weight-related and appearance-related interactions between other people can be some of the most potent social learning experiences for younger people,” she said. “These are especially affecting if someone they know receives appearance-based feedback that is clearly negative.” Adolescents internalize this lesson, she said – “that if they don’t look a certain way in the content that they’re creating, they will receive similar feedback.”

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So when should parents allow their kids to have a smartphone? Experts typically avoid a one-size-fits-all answer, emphasizing instead that parents need to consider their individual child and family needs, establish clear guidelines around phone access, and maintain open communication with their children about what they’re seeing on their devices.

“I don’t think that this study necessarily gives an answer for parents in terms of what the ideal age is for your child to have a smartphone, because there are obviously many other considerations, depending on your family’s communication needs – but I do think that it’s a warning sign that getting a first smartphone isn’t just about the device itself, but how it can change a child’s access to the digital world,” Nagata said. “So if and when a parent does get their child their first smartphone, it’s important to think about what kind of guidance and guardrails can come along with that phone, and to have regular conversations and check-ins about it.”

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Nagata notes that the American Academy of Pediatrics recommends that families establish a household media plan and designate screen-free time frames – and particularly where disordered eating is concerned, he added, parents should aim to keep phones away from mealtimes.

It’s also worthwhile for parents to avoid a sense of peer pressure – even among siblings. “What is the right time for one teen to get a phone might not be the right time for another teen, even within the same family,” Rodgers said.

She recommends that parents take advantage of parental controls and remain involved in their teens’ social media use. “Parents who can co-use social media platforms with their teenagers are the ones who are most likely to be able to provide the critical analysis needed, to provide sense and meaning-making, and to be there in the right time and place to have the right conversations around what a teenager might be seeing,” Rodgers said.

Scheer is also a parent of a teen, she said, and she understands how daunting it is to make sure that a child’s smartphone use is actually “safe.” “I thought I put the right parental controls on the phone for my child, and I found out she was able to download TikTok, and that was one thing we had an explicit conversation about,” she said. “These things can slip through parents’ fingers so easily, and that is very concerning to me. And parents are asked to do so much in this day and age.”

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But even in the absence of clear red flags in a child’s behaviour, experts agreed, it’s a mistake to think that any child is immune from the influence of image-focused content on their phone screen. Scheer said she was struck by the study’s mention of the fact that more than one in five children and adolescents exhibit symptoms of disordered eating, even if they don’t meet the threshold for diagnosis. “We already have a high prevalence rate, whether we recognize it or not,” she said. “And we’re just raising the risk profile of those adolescents to develop eating disorders when we’re putting a smartphone in their hand.”

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