This study describes the development and application of an audit tool for identifying and describing Instagram fitspiration accounts that do not portray potentially harmful or unhealthy content. The tool was easy to use and had excellent inter-rater reliability. 59% of the fitspiration Instagrammers failed to meet our threshold for credibility and were omitted after the first stage of screening. Of the fitspiration Instagrammers deemed credible based on the screening tool, the majority were female, from the US, and Caucasian. Just over half of them had a health-related qualification, typically at a diploma level. We note that all account exclusions occurred at stage 1 screening. It may therefore be appropriate to conduct this rapid screening stage without the stage 2 screening in some instances, though future research should confirm this finding.
Of concern, nearly two-thirds of the popular accounts were deemed to be not credible. Many of these contained hyper-sexualisation or promotion of unhealthy or unrealistic body shapes. Previous content analyses have also revealed high levels of sexualization and objectification of body parts such as the abdomen and buttocks in fitspiration images [6, 23] with images of women more likely to contain sexualization and objectification than images of men [23, 24]. Research suggests that, while the proportion of fitness-focused images posted by female fitness influencers has increased between 2019 and 2021, levels of sexualization and objectification have remained the same [24]. Given the links between exposure to this type of imagery and mood and body image concern [7,8,9,10,11,12], the proportion of accounts containing such imagery is alarming. Individual Instagram users may benefit from education to understand the potential negative effects of following non-credible fitspiration accounts and could use the audit tool, which is freely available with this paper, to identify potentially harmful imagery and inform their decision of whether to follow an account. Future research should examine how viewing credible fitspiration content influences body dissatisfaction and mood.
Conversely, results suggested that many popular Instagram fitspiration accounts do offer credible content, such as example workouts, without including content likely to result in body dissatisfaction or other negative psychological effects. Following these accounts could conceivably increase motivation and exercise education, leading to improvements in heath. While research found that exercise exertion was not greater immediately after viewing fitspiration content [8, 9], exposure to screened credible content, as well as exposure over a longer period, might show different effects. Initial pilot work suggests a 12-week home-based Instagram-delivered exercise program can improve in physical activity in young women [18]. Future experimental research is now needed to examine the effects of exposure to different types of fitspiration content on exercise intention, behaviour, and wellbeing. If positive effects of credible fitspiration content are found, individuals interested in improving their physical activity could use the current audit tool to aid their selection of credible accounts to follow.
The research findings and audit tool may also be useful for public health initiatives. Social media platforms including Instagram impact social and economic outcomes [25]. Within the commercial marketing arena, social media influencer marketing is recognized as a legitimate avenue for driving brand-recognition and sales, representing a $10 billion industry in 2020 [26, 27]. In contrast, public health promoters have been slower to harness this modality, though examples of governments working with Instagram influencers are emerging, for example, to encourage social distancing strategies and vaccine uptake during the COVID pandemic [28, 29]. Future work examining opportunities for physical activity promotion on Instagram appear warranted. This might include identifying credible accounts to partner with, developing new credible accounts using the audit tool as an initial framework, or providing training for social media influencers to ensure their accounts are credible. Research is needed to determine whether exposure to such social media content can translate into measurable health behaviour change.
Fitspiration account holders that were deemed credible after screening were typically young Caucasian females from the United States. These attributes do not contribute to account credibility and are likely to reflect the platform user-base (e.g., a previous content analysis found women appeared in social media fitspiration images more frequently than men [6]), or a potential bias in the webpages used to identify fitspiration accounts. However, a lack of representation of diverse populations should be considered if Instagram fitspiration accounts are to be used for public health promotion. In addition, research suggests that greater diversity in body shape and size is needed to promote positive body image on social media [e.g., 30]. As such, researchers could usefully audit social media account holders across different popular hashtags (e.g., #bodypositive).
Strengths and limitations
A key strength of the current study was its novelty. This is the first published study to attempt to develop an evidence-based audit tool for Instagram fitspiration accounts. The tool has excellent inter-rater reliability and face validity, and is provided in full in this paper’s appendices, making it freely available for use or adaptation (e.g., where it could be applied to other forms of content such as body positivity, body functionality, or to fitspiration material on other platforms such as #FitTok on TikTok). Applying the audit tool to 100 popular fitspiration accounts at the time of the audit provides an overview of the quality and content of these accounts. It may serve as a baseline to which future quality and content audits may be compared.
Limitations must also be acknowledged. Being a new tool in a new field, there are limited avenues for validating the tool, beyond face validity. Furthermore, by design, Instagrammers are continually creating new content. Like any audit tool, this tool is applied in a limited timeframe, and it is possible that accounts deemed “credible” when audited, may not be at a different time (and vice versa). Finally, the content analysis was completed using data available within Instagram; it is possible that some of the account holders had qualifications or commercial programs which were not obvious from their Instagram profiles.
Given the popularity of Instagram, and the high number of people using Instagram to seek health and fitness content, there appears to be considerable opportunities for health promoters to harness this for population health benefit. The audit tool presented in this study helps identify credible vs. non-credible Instagram accounts. Future research is warranted to understand whether exposure to this screened fitness content can positively impact physical activity behavior and health without causing negative psychological effects. To date, most health and fitness related research regarding Instagram has been observational or qualitative in nature, and experimental research designs would help advance this field of research. In addition, the current audit focused on fitness, but observed that many popular fitspiration accounts identified also provide dietary advice. Future research examining the content of diet advice on social media, and potential opportunities for health promotion, would be beneficial.