Interventions That Use Highly Visual Social Media Platforms to Tackle Unhealthy Body Image in Adolescents and Young Adults: Systematic Review of Randomized Controlled Trials and Quasi-Experimental Studies

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Abstract
Background: Highly visual social media (HVSM) platforms such as Facebook (Meta Platforms, Inc), Instagram (Meta Platforms, Inc), TikTok (ByteDance Ltd), and Snapchat (Snap Inc) have become central to the digital lives of adolescents and young adults. While these platforms have been linked to body dissatisfaction, they are also increasingly used as vehicles for health promotion. However, the evidence on interventions delivered through HVSM to address body image issues remains fragmented. Objective: This review aimed to synthesize available evidence on interventions using HVSM platforms to reduce negative body image in adolescents and young adults. Methods: We conducted a systematic search across 5 electronic databases (Scopus, MEDLINE, APA Psynet, Embase, and Web of Science) for studies published between January 2012 and October 2025. Eligible studies included experimental or quasi-experimental designs evaluating the effect of an HVSM-based intervention on body image outcomes in individuals aged 13 to 35 years. Risk of bias was assessed using the Risk of Bias Tool 2.0 (Cochrane) and was conducted independently by 2 researchers. Results: Eight studies met the inclusion criteria with 4975 participants (2612 in intervention groups and 2363 in control groups). Most studies were conducted in high-income countries and had predominantly female participants. The interventions varied widely in format, duration, and theoretical basis. Microinterventions, brief interactive strategies such as gamified chatbots or short videos, were the most common and had moderate effects. Stimulus-based interventions using content with a positive body image or that did not focus on appearance were also identified, achieving moderate effects (ηp²<.07), as well as combined approaches that integrated digital and face-to-face components to reduce negative body image (P<.001). The use and functionality of interventions using social media platforms were also compared by gender. Conclusions: Body image management platforms offer an emerging avenue for implementing body image interventions in adolescents and young adults. While current evidence suggests modest benefits, the high heterogeneity among presentation formats and the variability in duration make comparisons between these studies difficult. This review synthesizes social media–delivered interventions for body image disturbance, going beyond broader digital approaches centered on websites or apps. It identifies cross-platform, putative mechanisms of action and common intervention formats, highlighting the potential of brief interventions for scalable reach and user empowerment via content curation. These findings define targets for optimization and underscore the need for platform safeguards and supportive policy and regulatory frameworks to enable safe real-world implementation, particularly for adolescents.

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