Women who spend time on TikTok are at a greater risk of disliking their own bodies and feeling worse about their appearance — especially if they’ve been exposed to pro-anorexia content, a study published Wednesday suggests.
Australian researchers surveyed 273 women ages 18 to 28 from July 2021 to October 2021 about their TikTok use. As part of the study, the participants were then shown what was referred to as “pro-anorexia,” also known as “pro-ana,” images.
The study found that the women surveyed had a negative body reaction after as little as 10 minutes viewing content on TikTok.
“Because disordered eating content is so prevalent on TikTok, there was also the possibility that TikTok users in our study would be somewhat inoculated [to] its effect but that certainly was not the case,” Rachel Hogg, senior lecturer in the School of Psychology at Australia’s Charles Sturt University, said in an email to NBC News. Hogg and her colleague Madison Blackburn conducted the study.
The new findings add to previous research about the potential risks of social media when it comes to young women and body image. Common Sense Media, a group that studies how media and technology influences kids and families and the British advocacy nonprofit Center for Countering Digital Hate have highlighted similar concerns about TikTok in recent research.
Meta, the parent company of Instagram, also came under scrutiny in 2021 after an explosive Wall Street Journal report found that the company knew its platforms could be toxic to teen mental health. Some have sued platforms like Meta and TikTok, claiming apps like Instagram have been damaging to children.
“These are illnesses that thrive in silence, right? And so part of, I think, what the digital world has an opportunity to do is to connect people to resources that help them be less alone,” Doreen Marshall, CEO of the National Eating Disorder Association, told NBC News.
In the new study, Blackburn and Hogg point to TikTok’s “For You” page algorithm as the reason the platform differs from others when it comes to showing people dangerous content. TikTok’s algorithm generally curates itself to a user’s interests and shows them content that is similar to what they engage with. If a person likes, comments, saves or shares a video, the algorithm will likely show the user similar content.
“The algorithm on TikTok is much more influential than the choices of individual users in determining the content they see on their For You page,” Hogg said.
According to the study, 64% of the women told the researchers that they had previously been “exposed to disordered eating content” on their “For You” page.
It’s unclear whether content that the researchers labeled as “pro-ana” can cause long-term issues. Rather, they specifically focused on how young women felt immediately after using the platform and seeing “pro-ana” images.
Although the study doesn’t specify what accounts participants were shown or exactly what videos were used, it identified hashtags and genres, including #GymTok and #FoodTok. Videos included women using “gallows humor about their disordered eating behavior, starving themselves, and providing weight loss tips such as eating ice cubes and chewing gum to [sic] curve hunger.” The participants who were shown those videos reported greater displeasure with their appearance.
A user seeking out anti-anorexia content to support their recovery from an eating disorder may be exposed to the exact opposite of what they were looking for — harmful dieting content.
Hogg and Blackburn explained via email that the “pro-ana” content that exists on TikTok runs the gamut from “implicit,” such as body checking or wellness advice from nonprofessionals, to “explicit” content, which includes creators talking about starving themselves.
“One of the saddest realities to me is that the blunt nature of the algorithm is such that searching for body positivity content may result in users being exposed to pro-anorexia content, Hogg said. “A user seeking out anti-anorexia content to support their recovery from an eating disorder may be exposed to the exact opposite of what they were looking for — harmful dieting content.”
A spokesperson for TikTok declined to comment to NBC News on the study’s findings.
In its Community Guidelines, TikTok says it does “not allow showing or promoting disordered eating and dangerous weight loss behaviors, or facilitating the trade or marketing of weight loss or muscle gain products.”
Since 2021, when the study was conducted, TikTok has changed aspects of its algorithm to make sure users don’t repeatedly see a limited type of kind of content, the platform said in a 2023 blogpost. TikTok explained its “system” does this by “looking for repetition among themes like sadness or extreme diets, within a set of videos that are eligible for recommendation.” It then will swap out videos that are too repetitive for content about other topics, it said.
It added that it works with a number of organizations that specialize in its users’ well-being and continues to make tweaks to how and why certain content is or isn’t shown.
The platform does attempt to curb searches for harmful terms and will redirect users in an attempt to get them help. For example, a search for the term “anorexia” causes a message to pop up that says, “You’re not alone,” with an image of a heart hugging a stomach. The user is given options to press a red button that brings them to a resources page or they can press a button to call the National Alliance for Eating Disorders. No content is displayed when the term is searched.
In 2022, in response to a report that suggested TikTok boosts posts about eating disorders, a spokesperson told The Associated Press that the platform does “regularly consult with health experts, remove violations of our policies, and provide access to supportive resources for anyone in need.”
Still, the authors of the study say that users can find ways around TikTok’s censors by using slang and creative terminology like “edtkt0k,” which the platform doesn’t block.
The new findings show a need for more research into how social media affects eating disorders in young women, Marshall said. However, the study doesn’t prove that TikTok causes an increase in disordered eating behavior.
Marshall expressed concerns about the limitations in the study.
“One thing I took away from the study is that the way they were describing, even what people were exposed to — I was having a hard time really understanding what that content actually was,” said Marshall, who was not involved in the study. “So, you know, it just echoes that we really need more studies like this to understand the impact of social media on those that are vulnerable to eating disorders.”
Marshall mentioned that there is very little data on the long term ramifications of eating disorders and their causes because, for example, it is hard to get some to participate in studies for years. She also explained that different types of content affect people differently and it’s hard to know what the researchers of the study considered “pro-ana.”
Eating disorder content is not exclusively a TikTok problem, and content promoting “pro-ana” content has been a decadeslong issue online. Unhealthy beauty standards in the media dates back even further.
But as recently as 2023, teens were reporting seeing “pro-ana” content on their “For You” page. As of last year, eating disorders were at an all-time high, according to experts.
Marshall said that because eating disorders are so complex, and are both mental and physical health disorders, “it’s hard to know what the role of social media is in general.”
“While there’s been some movement, having platforms create some standards around this,” Marshall said. “Eating disorders are pretty complex, so we really need to understand more about the intersection and the influence of social media as part of a person’s environment.”
The National Alliance for Eating Disorders Helpline provides support, resources and information about treatment options at 1-866-662-1235, Monday through Friday. You can also text “ALLIANCE” to 741741 if you are experiencing a crisis to be contacted by a trained volunteer. More information about eating disorders, including other free and low-cost support options, can be found on the National Eating Disorder Association’s website.
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