Advocacy groups are calling TikTok out for exploiting its audience and exposing them to harmful content, such as pro-eating disorder videos that promote weight loss, thinness, and disordered eating behaviors. Unfortunately, TikTok is just the latest iteration in this disturbing trend. Before social media websites, people launched their own websites that glorified eating disorders. They used these spaces to create a community (labeled “pro-anorexia” or “pro-ana”), sharing stories and “tips” on dangerous eating behaviors.
TikTok reaches a very young audience. Some estimates suggest that one-third of users in the U.S. are 14 or younger; more than half of American adolescents use the platform daily. Given that eating disorders most commonly peak around 15 years of age, encountering and normalizing this harmful content can put adolescents at heightened risk for eating disorders.
Compounding this issue is TikTok’s powerful algorithm. Despite its own ban on content that promotes eating disorders, pro-anorexia hashtags and videos remain accessible – and are actively pushed to vulnerable users.
Valerie Lookingbill and colleagues identified TikTok videos under these hashtags. For pro-eating disorder content, common hashtags were “ed tiktok,” “starving,” and “thinspo” (short for “thinspiration”). Pro-recovery content used hashtags such as “ed recovery,” “ed awareness,” and “pro recovery.” The researchers downloaded 20 videos from each hashtag and studied the content portrayed in the sample of 200 TikTok videos.
After examining common ideas that occurred across the videos, the authors identified 4 major themes. The first theme was “encouraging the development or sustainment of eating disorders.” These videos portrayed eating disorders as a lifestyle choice (instead of an illness). They glorified harsh ideals (extremely thin and underweight bodies) and used harsh language to inspire users to meet these ideals. The second theme was “sharing physical or emotional experiences with eating disorders.” These videos generally challenged the glorification of eating disorders online, describing personal experiences as a way to educate and raise awareness. The third theme was “sharing narratives of recovery,” which focused on celebrating journeys from disordered eating to health. The fourth theme was “social support.” These videos covered stories of receiving support for eating disorders or individuals who are providing social support to others.
[This finding] demonstrates the power of community and connectedness in building resilience against misinformation and harmful behavior.
The authors then analyzed the videos’ visual, auditory, and textual elements and categorized the videos into 3 domains: “pro-eating disorder,” “anti-eating disorder,” and “pro-recovery.” Pro-eating disorder videos centered on a desire for disordered eating behaviors, without mentioning recovery or possibility of harm. Anti-eating disorder videos actively challenged pro-eating disorder perspectives and discussed the harms of the behavior. And pro-recovery videos encouraged or celebrated recovery from past eating disorders. Out of the 200 videos, the team found that most of them (62%) could be categorized as pro-recovery, while 29.5% of videos were pro-eating disorder and the remaining 8.5% were anti-eating disorder.
Pro-recovery videos contained the most accurate information, which is especially promising for adolescents who have already struggled with an eating disorder. Lookingbill and colleagues hypothesize that the pro-recovery content creators engage in results in “community defensive information practices.” By leveraging their own experiences to address gaps in our understanding of eating disorders, these creators increase community awareness of harmful health behaviors. Not only does this create a stronger sense of community for the audience, but it also equips young viewers with a foundation for identifying misinformation.
This finding especially demonstrates TikTok’s potential for sharing accurate and positive stories about eating disorders. It also demonstrates the power of community and connectedness in building resilience against misinformation and harmful behavior. By focusing on stories that improve the well-being of the community, pro-recovery creators provide their audience information that could build a positive association with health.
Health experts can implement similar community-driven initiatives to inspire collective action. Leveraging social media in these campaigns can help combat the spread of misinformation to vulnerable audiences.
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