International Journal of Adolescent Medicine and Health, 2026 (Scopus)
Social media (SM) has emerged as an important environmental context associated with children's and adolescents' eating behaviors, body image and psychological well-being, fueled by the proliferation of visual and appearance-focused content. Trends such as "thinspiration"and "fitspiration"have been widely linked to the internalization of unrealistic body ideals and higher levels of body dissatisfaction, particularly among adolescent girls. Concurrently, exposure to digital marketing of high-fat, sugar and salt (HFSS) foods has been associated with less healthy nutritional preferences and dietary norms among youth. This narrative review synthesizes recent evidence (2020-2025) to examine the association between SM exposure and disordered eating in children and adolescents, with a particular focus on underlying psychosocial, neurobiological and environmental mechanisms. Key mechanisms discussed include social comparison processes, appearance-related pressure, dopamine-mediated reward-reinforcement cycles and algorithm-driven amplification of appearance and food-related content. In addition to risk mechanisms, this review highlights protective factors that may mitigate adverse outcomes. Media literacy, supported by parental guidance and psychoeducation, emerges as a promising preventive framework capable of strengthening adolescents' digital resilience and reducing vulnerability to disordered eating behaviors. From a public health perspective, media literacy should be considered not only an individual skill but also a scalable preventive strategy integrated into educational and health promotion initiatives. Overall, SM represents a complex digital ecosystem that poses both risks and opportunities for youth health. Conceptual integration of behavioral, neurobiological and public health evidence underscores the need for multidisciplinary and preventive approaches to promote healthier digital engagement among children and adolescents.