Bulimia Nervosa in Adolescents: Impact of Childhood and Adolescent Sexual Abuse History and the Mediating Role of Social Media

The aim of this study was to analyze whether exposure to esthetic content aligned with beauty standards on social media mediates the relationship between a history of childhood/adolescent sexual abuse and bulimic symptomatology in adolescents, and whether sex moderates these pathways. Participants were 283 secondary school students (52.6% female) from Chimbote, aged 13 to 17 years (M = 15.2, SD = 1.14). The following instruments were administered: the sexual abuse dimension of the CTQ-FC, the bulimia dimension of the EAT-26, and an ad hoc questionnaire assessing exposure to esthetic content on Facebook, Instagram, and TikTok. The results showed a moderate total effect of childhood/adolescent sexual abuse history on bulimic symptoms (β = .38, p < .001). Exposure to esthetic content on social media predicted higher bulimic symptomatology (Facebook [β = .24, p < .01] and TikTok [β = .17, p < .05]), and childhood/adolescent sexual abuse history significantly predicted greater Instagram use (β = .22, p < .01). However, indirect effects through the platforms did not reach statistical significance in the total sample or in sex-stratified analyses (female-male). It was concluded that, although social media use is associated with bulimia and childhood/adolescent sexual abuse history predicts increased symptoms, esthetic content on social media does not function as a significant mediator in this relationship, nor does sex moderate the pathways of the model. Interpretations are discussed within trauma theory and biopsychosocial frameworks, as well as implications for prevention and clinical intervention.