A rise in eating disorders as a result of TikTok content

Word Count: #2021

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Context and Introductory Material

TikTok is a video focused social media app that consists of videos 15 seconds to 3

minutes long. The videos you view on TikTok are served to you in an endless stream known as

the “For You Page”, or the FYP (NYT). TikTok is incredibly popular and has a wide reach

around the world. There are over one billion users worldwide, and 167 million TikTok videos are

watched per minute. 33% of these viewers are minors (Geyser 2022). Qustodio, a digital safety

app used by parents to monitor their children’s online habits, reports that kids in the United

States aged 4 to 15 spend an average of 87 minutes watching TikTok videos (“Qustodio annual

report on children’s digital habits” 2021).

TikTok is also very popular amongst adolescents. According to a peer-reviewed source

published in Developmental Cognitive Neuroscience about adolescents’ likeliness to conform to

parents vs peers, “Learning how to balance being themselves and fitting in with their social

group can be particularly challenging during adolescence, a developmental period during which

the need to establish a unique identity coincides with the desire to find belonging within social

groups” (Do et al 2020). This is especially true in the age of social media. Apps like TikTok

produce a slew of influencers and online celebrities that adolescents attempt to mirror. Thus,

adolescents’ need to establish a unique identity coincides not only with the desire to find

belonging within social groups, but also with people on social media.

An app as popular with adolescents as TikTok is expected to be relatively safe—

especially considering its popularity with children. Nonetheless, critics like the New York Times

(Smith 2021) and the Guardian (Paul 2021) suggest that however popular it is, TikTok may be

putting children in harm's way. Several body checking trends have made their way to TikTok.

According to the National Eating Disorders Association, body checking is when someone takes a

mental note of their body shape, weight, appearance, or size (NEDA 2022). Although most

people do this, for a person with any form of disordered eating, body checking can lead to
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continued limitations on what one eats (Stanborough 2020). The hashtag #bodycheck currently

has 87.5 million views on TikTok (TikTok 2022). Other hashtags like #skinnycheck and #size0

has 1 million and 1.4 million views, respectively. Trends like these are more dangerous than

users realize. Research by the House of Commons Women and Equalities Select Committee in

2020 investigated how much influence images on social media have on how minors aged 6 to 18

feel about their body image. 59% of those surveyed reported that social media images are

extremely influential on their body image. 24% reported that the images are very influential,

12% reported that the images are somewhat or slightly influential, and the remaining 5% labeled

social media images as not influential at all. This means that images on social media have a large

influence on young people, and that is bad news for parents of TikTok users.

Many reputable sources have found a link between the rise of eating disorders and

adolescents using tiktok. The Wall Street Journal, the Guardian, and the Philadelphia Inquirer

have all found that TikTok is home to extreme diet content (Johnson 20201), pro-anorexia

content (Paul 2021), and general pro-eating disorder content (Ao 2021). What’s more, according

to Yale Medicine, eating disorders have been on the rise since 2020’s pandemic year in the

United States (Katella 2021). This raises the question: What can TikTok do about the increase of

eating disorders occurring as a result of their app’s content?

"The role of advertisements on TikTok in the rise of eating disorders"

Advertisements are a contributing factor to the rise of eating disorders occurring on

TikTok. The aforementioned study by the House of Commons revealed that many participants

encounter advertisements that negatively impact their body image when using social media. 76%

of adolescent minors have seen advertisements for weight-loss organizations when using social

media. High numbers of participants have also seen ads for cosmetic surgery, shapewear, and

gyms. While it is not uncommon to see ads of these sorts, Jaywant Singh, a professor of
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marketing at Kingston University, tells Olivia Petter of The Independent that ads like these

trigger something referred to by psychologists as “compensatory consumption”. He defines this

as “a behavior in which individuals try to overcome [a] threatened perception of self by

acquiring the product being advertised to them” (Petter 2017). In other words, consumers buy

certain products because advertisements purposefully trigger an insecurity and then sell a product

that is marketed to cure it. Seeing these types of ads on TikTok can cause adolescents to attempt

to conform to societal pressure to look a certain way. This often manifests in unhealthy eating

habits. Fortunately, there is a solution to this. John Alan Cohan in his piece published by the

Journal of Business Ethics argues that portraying women naturally in ads and showing that

beauty does not have to be an unattainable ideal will combat the current marketing strategy that

plays on insecurities (Cohan 2001). Per the study referenced in the introductory material, there is

greater conformity toward positive over negative influence in early adolescence (Do et al).

Hence, Cohan’s idea that body positive advertisements will have a greater influence on

adolescents is promising. Because adolescents are more likely to respond to positive influences,

ads portraying women naturally could positively influence adolescents on TikTok. A limitation

of this solution is that it's improbable that advertisers will shift their marketing strategy to stop

harming adolescents when that strategy is making them money. Regardless, multiple studies,

including one published in Science Direct, indicate that an increase in body positive ads could

overshadow the negative ones (Rodgers et al 2019). Thus, boosting positive ads on TikTok could

prevent teenage users from adopting unhealthy eating habits as a result of negative ads.

The TikTok algorithm and content moderators and their role in pro-eating disorder

content

TikTok’s algorithm tracks which videos you watch, how long you watch them, and

whether or not you press the “like” button. It will put videos with similar hashtags, premises, or
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content creators on your For You Page. While TikTok has been cracking down on eating disorder

promotion by blocking hashtags and removing pro-eating disorder content, many videos slip

through the cracks. The Guardian recently found at least two dozen. They noticed that many

hashtags used to spread unhealthy eating were intentionally misspelled to avoid being banned by

TikTok’s algorithm. For example, the hashtag “#thinspo” — short for “thinspiration” — was

changed to #thinspao and #thinsprø after the original was banned. And seemingly innocuous

hashtags like #caloriedefecitsnacks and #weightlossprogress are linked to content encouraging

users to restrict and count calories (Paul 2021). The hashtag “What I Eat in a Day” is a trend

where people detail how many calories they’ve eaten, often switching between mirror shots of

their skinny bodies and the foods they are eating. It has over 7 million views (TikTok 2022). The

Guardian's attempts to engage with dieting content through a fake acount on TikTok lead to

“full-blown eating disorder promotion in less than 24 hours”. The hashtag #WhatIEatInADay led

to videos with hashtag #ketodiet and eventually #Iwillbeskinny and #thinspoa. This means that

adolescents looking for fitness content are likely being overwhelmed with content promoting

eating disorders in the span of a day. The effects are dangerous. The CEO of the National Eating

Disorders Association told NBC News that her organization has heard several complaints from

TikTok users that the app is “helping to blur the line between fitness and eating disorders”

(Anscombe 2020). If adolescents who seek out fitness videos are fed low-calorie diets and

high-intensity exercises by the algorithm, these habits will become synonymous with a healthy

fitness regimen in their minds.

Reporting this type of content is ineffective. Tiktok’s community guidelines say that

TikTok bans quote “content depicting, promoting, normalizing, or glorifying activities that could

lead to eating disorders” (TikTok 2022). When you report a TikTok the video is under review

until a content moderator sees the video and determines whether or not the video violates

community guidelines. Once a decision is made, the video will either be left untouched or it will
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be removed. Many users have tried to report videos promoting eating disorders only to be told

they don’t breach TikTok’s guidelines, according to ABC News (Dias et al 2021). This system

leaves each reported video in the hands of content moderators, whose qualifications according to

tiktok are being a college graduate who speaks english, cares about current events, is familiar

with internet regulations, and has good oral and written competence (TikTok 2022). This list of

qualifications comes directly from TikTok’s career page. Nowhere on that list does it mention

that people should show a certain level of expertise on suicide and self harm, eating disorders, or

bullying— each being categories that you can report a video for. In order to get better at

screening videos that violate their community guidelines, TikTok needs to hire more qualified

individuals to be content moderators. Then users can be confident that each report is being

handled with care.

Prevalence of hate comments on TikTok and their effect on body image

It’s no secret that hate comments can get really nasty on the internet. In fact, many news

organizations, like NPR, have decided to get rid of their comment sections altogether. According

to Verywell Mind, “If you struggle with your body image and then read negative comments

online about how you look or how other people look, this may worsen your thoughts.” Negative

thoughts about your body image can lead to disordered eating patterns, which are often the first

steps towards developing an eating disorder. There are plenty of these types of comments on

TikTok. Countless YouTube videos depict TikTok users reacting to the hate comments they’ve

received. Charlie D’Amelio, the most followed content creator on TikTok, was only 15 years old

when she started to open up about the amount of hateful comments she receives about her body.

In April of 2020, D’Amelio tweeted “STOP TALKING ABOUT MY BODY! it's not your place

to tell me if i'm losing weight or gaining weight” (D’amelio 2020). Kouvr Annon, another

popular TikToker, opened up about the body shaming she’s received in her TikTok comment
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section. She shared “it's so hard to be confident in yourself and love yourself when the world

tells you that [you're] 'fat' or 'ugly'” (Annon 2020). She was only 20 at the time. Clearly, age

doesn’t stop online trolls from commenting with harsh words about adolescents’ bodies.

According to the Better Health Channel, a part of the Australian Government's Department of

Health, being teased about appearance in childhood contributes to developing negative body

image (Better Health Channel 2022). Because interactions aren’t face to face on the internet,

people are far more willing to spread hate on the internet than in-person— there are no real

consequences to their actions (Wakefield 2015). Likewise, children and adolescents are more

likely to encounter negative comments about their bodies online rather than from a peer or

family member. Consequently, adolescents who are on the internet are more likely to develop a

negative body image than those who aren’t. Because of this, comment sections should be

removed altogether to avoid causing so much damage. Unfortunately, it is unlikely that TikTok

would take this step. There is no evidence that anyone is campaigning for the removal of the

comment section, so the issue isn’t on TikTok’s radar. Regardless, getting rid of the comment

section and removing the negativity from its source is a good step towards preventing

adolescents from developing negative body image and towards stopping the spread of eating

disorders on TikTok.

Conclusion

Because adolescents are so susceptible to images on social media, it is TikTok’s

responsibility to remedy the damage occurring on their app. In order to halt the rise of eating

disorders in adolescents as a result of advertising, the algorithm, and hate comments, TikTok

must boost body positive ads, hire qualified content moderators, and get rid of the comment

section. A combination of these solutions will help to silence negativity contributing to negative

body image, unhealthy eating habits, and eating disorders.

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