Co-Written by Dr Swati Sapna & Upasna Gaba

The concept of watching television has transitioned significantly since the last decade. Traditional television scheduling made viewers stick to the timings of television programming, subjected them to commercials, and made them wait for their favourite shows or films for days or weeks (1). In this digital era, the methods and speed of watching television series have undergone significant changes. On-demand television and online streaming services (e.g., Netflix, Amazon, Disney, Fox, Hulu, when only limited to legal downloading platforms) have gained immense success in recent years by eliminating the restrictions of time and place (2).

Binge-watching (defined as watching between two and six episodes of a TV show in one sitting) has quickly become a common practice among the audience population in this context, most of whom report this as their preferred means of consuming TV entertainment. More precisely, this is an option to spend an evening or a weekend glued to the television, indulged in the consumption of several episodes or even in a single sitting of a whole season of TV shows. Between 2011 and 2015, the prevalence of binge-watching grew to gradually become a standard form of consuming TV series among the general public (3). As of the third quarter of 2020, Netflix had 190 million paying subscribers worldwide. This number grew exponentially, from 5 million in 2012 to more than 190 million in 2020 (4).

People with binge-watching habits sometimes watch several episodes in one go. Also, when an online streaming service simultaneously released all episodes of a season, it prompted widespread “marathon-viewing” sessions among the 18-34 age group who initially binge-watched and then took to social media to share their (apparently positive reviews of such shows. Given this reality, the Tele-industry spends on web series that force people to binge-watch and sometimes all episodes of a particular web series season are released simultaneously to encourage this activity (5).

Impact of binge-watching on Mental health

Binge-watching has undeniably become the norm and engaging way for the contemporary audience to consume media content, such as television shows. This phenomenon has been observed since 2013, but research is still sparse on its psychological conditions, such as personality characteristics and motivational and emotional mechanisms. The likelihood of developing signs of behavioural addiction is the main risk behind repetitive binge-watching behaviour. Recent literature points out that excessive forms of binge-watching could be equivalent to behavioural addictions such as video games/internet addiction or problematic use of social media. This highly immersive behaviour offers instant pleasure and can therefore contribute to the loss of self-control and spending far more time watching television shows than the individual intended initially (3).

Research also shows the association between sedentary behaviour of this sort and neglect of work or social relationships, lack of sleep, procrastination at bedtime, overweight as well as an increase in unhealthy consumption of food (3).The correlation of binge-watching with mood disturbances, sleep disturbances, fatigue, and self-regulation deficiency is confirmed by existing evidence (5). As a sedentary pattern of behaviour, binge-watching is also linked to unhealthy food intake and decreased physical activity, especially among young people.

Other hazardous health consequences due to binge-watching impacting physical health

Instead of going out and becoming physically active, more and more people choose to stay indoors and watch television. Reduced sleep quality, daytime fatigue and insomnia are correlated with binge-watching frequency, with cognitive pre-sleep arousal mediating these relationships, whereas a balanced diet is negatively associated with overall binge-watching (6). Also, research has shown that watching a lot of television raises the risk of obesity by 23% (7). Another reason for the increased risk of weight gain is that watching series for a long time is often linked to the consumption of unhealthy food, implying that people are more likely to consume food that is high in fat and carbohydrates (8). The increased risk of type 2 diabetes, fatal or non-fatal cardiovascular disease and all-cause mortality has also been shown to be consistently related to a longer span of TV viewing time (9). As binge-watching rates increased, questions about physical inactivity resulting in health risks is emerging at an exponential rate.

Binge-watching during the era of COVID-19

People all around the globe, of all age groups, are experiencing anxiety and mental breakdown during the COVID-19 lockdown phase. Such a situation provides a perfect scenario for engaging in online games and watching television as people experience days of loneliness at home. In-home environments, as leisure outlets, are restricted, and internet/TV is easily accessible, readily available, and of course, affordable; it can lead to binge-watching. There seems to be an uptick in binge-watching in the new COVID-19 pandemic situation with a global lockdown state, as individuals have nothing to do (5). During this pandemic, as the sources of entertainment and social interaction has reduced, people all around the globe began to concentrate on the readily accessible modes of entertainment in their home settings. The psychological motivation found for binge-watching is to pass the time and avoid boredom, reduce stress, and overcome loneliness.

An online survey conducted in the general population of four Southeast Asian countries (Bangladesh, India, Indonesia & Nepal) indicates that during the lockdown period, there is a substantial increase in binge-watching with an increase in an average time of 3-5 hours and 5+ hours of binge-watching. This study also revealed that often binge-watching causes significant sleep disturbance, disrupt work completion, and causes conflicts with others.

Therefore, it can be concluded that following back-to-back episodes of a particular show may stimulate the brain, and consequently, interferes with one`s ability to sleep. Other adverse effects on health include depression and anxiety, spinal issues, lack of oxygen, lack of physical activity, and a bigger waistline (10). These effects are the leading risk factors for heart disease and stroke. Limiting binge activity may be beneficial for individuals, as per current evidence, and may also prevent the development of lifestyle-related disorders.

References

  1. Umesh S, Bose S. Binge-Watching: A Matter of Concern? Indian J Psychol Med. 2019;41(2):182–4.
  2. Flayelle M, Maurage P, Karila L, Vögele C, Billieux J. Overcoming the unitary exploration of binge-watching: A cluster analytical approach. J Behav Addict. 2019 Sep 1;8(3):586–602.
  3. Starosta JA, Izydorczyk B. Understanding the Phenomenon of Binge-Watching—A Systematic Review. Int J Environ Res Public Health [Internet]. 2020 Jun [cited 2020 Nov 17];17(12). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344932/
  4. Netflix: number of subscribers worldwide 2020 [Internet]. Statista. [cited 2020 Nov 17]. Available from: https://www.statista.com/statistics/250934/quarterly-number-of-netflix-streaming-subscribers-worldwide/
  5. Dixit A, Marthoenis M, Arafat SMY, Sharma P, Kar SK. Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey. Psychiatry Res. 2020 Jul;289:113089.
  6. Flayelle M, Maurage P, Di Lorenzo KR, Vögele C, Gainsbury SM, Billieux J. Binge-Watching: What Do we Know So Far? A First Systematic Review of the Evidence. Curr Addict Rep. 2020 Mar 1;7(1):44–60.
  7. Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA. 2003 Apr 9;289(14):1785–91.
  8. (13) (PDF) Overcoming the unitary exploration of binge-watching: A cluster analytical approach [Internet]. [cited 2020 Nov 17]. Available from: https://www.researchgate.net/publication/335589973_Overcoming_the_unitary_exploration_of_binge-watching_A_cluster_analytical_approach
  9. Grøntved A, Hu FB. Television Viewing and Risk of Type 2 Diabetes, Cardiovascular Disease, and All-Cause Mortality A Meta-analysis. JAMA. 2011 Jun 15;305(23):2448–55.
  10. Binge Watching | Northwestern Medicine [Internet]. [cited 2020 Nov 17]. Available from: https://www.nm.org/healthbeat/healthy-tips/emotional-health/binge-watching

 Dr Swati Sapna is a dental surgeon and currently a postgraduate student pursuing Masters of Public Health (Epidemiology) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.

Upasna Gaba is a pharmacist and currently a postgraduate student pursuing Masters of Public Health (Health Policy) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.


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