Adolescent Cohort Links Smartphone Ownership to Eating Disorder Symptoms

A cohort study published in JAMA Network Open found that US adolescents who owned a smartphone at age 12 were more likely to report eating disorder (ED) symptoms at ages 12 and 14 than peers who did not.

According to the authors, associations between the age of smartphone ownership and ED risk had not been examined before, even though adolescents are getting smartphones at increasingly younger ages. The investigators analyzed data from 8957 participants in the Adolescent Brain Cognitive Development (ABCD) Study, a cohort recruited from 21 US sites and followed from 2018 to 2024. Of these participants, 6225 (69.5%) owned a smartphone at age 12, as reported by a parent or caregiver. Adolescents self-reported ED symptoms on the Kiddie Schedule for Affective Disorders and Schizophrenia.

In adjusted cross-sectional analyses, smartphone ownership at age 12 was associated with a higher prevalence of binge-eating symptoms (prevalence ratio [PR], 1.61; P = .003), self-worth tied to weight (PR, 2.21; P = .04), and any ED symptom (PR, 1.36; P = .007). The longitudinal analyses controlled for symptoms at age 12. In those, owning a smartphone at 12 was associated with a higher risk at age 14 of binge-eating symptoms (risk ratio [RR], 1.67; P = .01), compensatory behaviors to prevent weight gain (RR, 1.50; P = .002), self-worth tied to weight (RR, 2.03; P = .002), and any ED symptom (RR, 1.49; P < .001).

Overall, worry about weight gain was not associated with smartphone ownership in adjusted models. In sex-stratified cross-sectional analyses, however, the association was significant among female adolescents but not males. By age 14, 24.2% of smartphone owners reported at least 1 ED symptom. Models were adjusted for sociodemographic factors, pubertal status, depressive and attention-deficit/hyperactivity symptoms, body weight, parental monitoring, and ownership of other devices.

The authors noted that ownership was not randomized and reverse causation cannot be ruled out, so the study cannot establish causality. ED symptoms were self-reported and coded as yes or no, and the researchers had no data on what content adolescents viewed or how they used their phones. Participants excluded for missing data differed from the analytic sample, which may limit generalizability. The authors suggested that clinicians may consider screening for smartphone ownership and social media use when assessing ED and mental health risks. They called for research into the mechanisms behind these associations.

Source: Nagata JM, Wong JH, Talebloo J, et al. Smartphone ownership and eating disorder symptoms in early adolescence. JAMA Netw Open. 2026;9(9):e2637897. doi:10.1001/jamanetworkopen.2026.37897