‘It spreads like a disease’: how pro-eating-disorder videos reach teens on TikTok

·7 min read
<span>Photograph: Robin Utrecht/Rex/Shutterstock</span>
Photograph: Robin Utrecht/Rex/Shutterstock

Instagram has attracted a firestorm after whistleblower Frances Haugen revealed internal research showing the platform downplayed proof of its toxic effects – including the rise of eating disorders – on children.

Related: ‘She opens the app and gets bombarded’: parents on Instagram, teens and eating disorders

But such issues are not limited to the Facebook-owned social media company. The Guardian has found a variety of harmful pro-anorexia hashtags remain searchable on the popular video-sharing app TikTok, where corresponding videos have billions of views combined.

TikTok officially does not allow content promoting or glorifying eating disorders, and enforces such a ban through human and AI moderation. The platform in 2020 imposed additional restrictions on weight-loss ads after facing criticism for promoting dangerous diets, and in March launched a program to connect users who search hashtags related to eating disorders with a helpline.

But at least two dozen problematic hashtags have managed to slip through the cracks, the Guardian found.

  • Fourteen of those hashtags were part of a set of 22 identified by the advocacy group SumOfUs in September as promoting eating disorders on Instagram. More than a month later, they were still active on TikTok.

  • An additional 11 hashtags relating to disordered eating content that were not on Instagram were also operational on the platform, including #skinnycheck with 1m views, #size0 with 1.4m views, and #thighgapworkout with 2.6m views.

  • In addition, many users appeared to intentionally misspell popular hashtags promoting unhealthy eating after they are banned to get around the new regulations. For example, after the platform banned the hashtag thinspo – short for “thinspiration” – users began using #thinspao and #thinsrpø.

  • TikTok’s own search feature suggested some of the popular hashtags used to get around its censorship, prompting the user to search “thinspao” if they simply type “thin” into the search bar.

  • Other seemingly innocuous hashtags such as #caloriedefecitsnacks and #weightlossprogress are rife with problematic content encouraging users to restrict and count calories. The simple hashtag #skinny has 1.7bn views and leads to a number of weight loss videos.

“TikTok as a platform is flying under the radar right now,” said Bridget Todd, a spokesperson for UltraViolet, a women’s advocacy group.

“Everybody knows that Facebook and Instagram have a huge potential for harm when it comes to younger audiences, but we are not talking enough about the dangers of these newer platforms,” she added.

‘More dangerous than Instagram’

Todd said that TikTok, compared with Instagram, may actually be “more dangerous” because of the demographics of its users. The video app surpassed 1 billion active monthly users in September, 60% of whom are between the ages of 16 and 24.

TikTok-specific features have prompted a number of concerns unique to the platform, research from UltraViolet found. TikTok’s “For You” page, a feed of videos from accounts users may not even follow that is recommended by an algorithm based on viewing history, makes it possible for problematic content to start “trending” with little friction. One experiment by the Lowy Institute found, for example, that TikTok’s politically neutral feed turned conservative and far-right in just a day of looping, liking and sharing certain content.

Efforts by the Guardian to engage with diet content led to full-blown eating disorder promotion in less than 24 hours. The popular hashtag #WhatIEatInADay, for example, soon led to #ketodiet videos – then more restrictive diets and eventually overtly unhealthy hashtags such as #Iwillbeskinny and #thinspoa.

Todd said TikTok’s use of augmented reality camera filters can also contribute to negative body image, especially for young girls. While both Snapchat and Instagram have said they won’t allow filters that promote or mimic plastic surgery, TikTok has dozens of beauty filters that let young girls change their skin, face shape, body shape and more.

“This contributes to creating an impossible standard of beauty,” she said.

‘No room for half measures’

UltraViolet has launched a petition that has garnered more than 2,000 signatures calling on TikTok to disable such filters on the accounts of teens. The organization has also called on TikTok to remove all advertisement of weight loss and diet supplement products, and asked it to prevent loopholes for disordered eating hashtags and provide resources from accredited medical and nutrition boards on potentially inflammatory content.

“When you’re dealing with a really young and impressionable user base, there is not room for half measures,” Todd said. “We need to make sure this is meaningfully dealt with, and that means not allowing any of this content on the platform.”

A spokeswoman for TikTok said the platform works to balance censorship of problematic content with efforts to encourage content that is related to prevention of eating disorders, avoiding removal of some eating disorder hashtags that may be used for educational purposes.

TikTok works with the National Eating Disorders Association to provide educational resources for users and restrict ads for fasting apps and weight loss supplements, she added. “We care deeply about the wellbeing of our community and strive to foster a community where everyone feels not only included, but celebrated,” she said.

Jonna Nielsen, a 17-year-old who lives in Pennsylvania, said she began struggling with an eating disorder she feels was worsened by social media at age 15.

Her symptoms began to intensify when she viewed a variety of diet and exercise content on Instagram. The algorithm then led her to more posts about restricting food, intermittent fasting and, ultimately, explicitly pro-anorexia content such as guides on how to hide an eating disorder from parents.

After spending several months in a recovery center, Nielsen said her disease was in remission. But when she returned to her “normal life”, she downloaded TikTok to connect with friends and was quickly plunged back into the middle of similar content.

“Everyone was sharing about how skinny they were, about how they weren’t eating, and I started to feel left out,” she said. “I wanted to stay recovered, but I started to get in this mindset that I wasn’t good enough if I didn’t look like that.”

Nielsen mentioned one of TikTok’s most popular trends, #WhatIEatInADay. The hashtag has thousands of videos with a combined 8.9bn views, including one popular video from Kylie Jenner with 14.7m likes.

“People use #WhatIEatInADay to brag about their diet, and it is often not even enough food for a toddler,” said Nielsen. “It is ruining the idea of what it means to be healthy for people my age.”

Nielsen said she felt her eating disorder was triggered not only by the explicitly pro-eating disorder hashtags, but also by the unrealistic standards of beauty pushed by the app. TikTok’s algorithm and moderators have been shown in the past to favor the content of thin, white users.

‘It’s ruining people’s lives’

TikTok is, paradoxically, also home to a variety of eating disorder recovery communities. TikTok said it promotes positive content with in-app highlights of hashtags such as #bodypositivity, which has 15.3bn views, and #bodyacceptance, which has 214m views.

One creator on the platform went viral in 2020 for her “eat with me” series encouraging users recovering from eating disorders to unite on the app to make healthy eating choices. Hashtags such as #edrecovery are also popular with users documenting their struggles with eating disorders.

However, health experts say such content could also have downsides. One National Institute of Health study published in January found that while pro-anorexia videos have a clear negative impact on users, “anti pro-anorexia” videos aimed at raising awareness of the consequences of anorexia may also provoke disordered eating.

“Our case shows how even these safer videos paradoxically lead the users to emulate these ‘guilty’ behaviors,” the study said.

Nielsen said she sees many users purportedly sharing recovery from eating disorders while – intentionally or not – promoting some of the behaviors they claim to discourage.

“It is almost just as bad when you see these recovery accounts which are really just seeking attention by talking about how little they weigh, or how bad their eating disorders are – that is not actually helping people in recovery,” she said.

Nielsen said she ultimately has deleted TikTok, Instagram and all other social media because she feels it is impossible to use them in a healthy way.

“It spreads like a disease,” she said of eating disorders. “One person talks about it, then another person gets the idea to do the same thing. These platforms need to crack down on it because it is ruining people’s lives.”

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