Modeling Bulimia Nervosa in the Digital Age: The Role of Social Media

Globalization has fundamentally reshaped societal dynamics, influencing how individuals interact and perceive themselves and others. One significant consequence is the evolving landscape of eating disorders such as bulimia nervosa (BN), which are increasingly driven not just by internal psychological factors but by broader sociocultural and digital contexts. While mathematical modeling has provided valuable insights, traditional frameworks often fall short in capturing the nuanced roles of social contagion, digital media, and adaptive behavior. This review synthesizes two decades of quantitative modeling efforts, including compartmental, stochastic, and delay-based approaches. We spotlight foundational work that conceptualizes BN as a socially transmissible condition and identify critical gaps, especially regarding the intensifying impact of social media. Drawing on behavioral epidemiology and the adaptive behavior framework by Fenichel et al., we advocate for a new generation of models that incorporate feedback mechanisms, content-driven influence functions, and dynamic network effects. This work outlines a roadmap for developing more realistic, data-informed models that can guide effective public health interventions in the digital era.