How TikTok became a hotbed of pro-anorexic videos and severely underweight influencers promoting ‘thinspiration’
DANCING shyly, popular teenager Amy* is just one of the 800million TikTok users who love performing for the camera – but her moves aren’t the first thing you notice.
Painfully skinny, the bones on her bare legs jut out, and on closer inspection it becomes clear she’s in hospital – an inpatient recovering from a serious eating disorder and regularly posting about her experiences.
While her account is based on her recovery, her 50k followers are shown regular images of her gaunt, unwell body and detailed videos about her diet which, while innocently intentioned, are the type of content experts warn can still expose users struggling with their own disorders to "triggering" content which "glamorises" eating disorders.
TikTok's community guidelines prohibit content that seeks to promote or glorify eating disorders, and the company says such videos will be removed.
But Amy's posts are just the tip of the iceberg.
Dig a little deeper, and a sinister underlayer of purposefully cruel videos telling teens to “starve themselves” and restrict their diets are easily accessible, and can even creep up on people’s TikTok feeds randomly.
‘Influencers risk glorifying eating disorders’
Tragically, eating disorders are all too common, with approximately 1.25million people in the UK suffering from one, according to charity Beat, and there has long been an issue with social media users being subjected to potentially harmful and exacerbating content.
It’s a particular problem on TikTok because the ‘For You’ feed shows users a random mix of videos using an algorithm, which means even if you don’t follow any eating disorder content, you may scroll on to it anyway accidentally.
“Forty one per cent of TikTok’s 800million users are between the age of 16 and 24," explains Kerrie Jones, clinical director and founder of eating disorder clinic Orri.
"This is important because it is also the typical age bracket where people are vulnerable to developing eating disorders and the lack of content regulation and the use of algorithms that deliver content automatically means that people are at risk of consuming harmful content without even actively looking for it.
“The rise of our influencer generation means that there’s a risk of romanticising and even glorifying eating disorders with content that focuses on food, eating and exercise habits.
“This type of content can exacerbate someone’s existing eating disorder symptoms – keeping them trapped in the cycle of their illness – or encourage those who are vulnerable to engaging with an unhealthy relationship to food and exercise.”
'I'd prefer to choose what I watch'
Call centre worker India Edmonds, 22, from Brighton, knows exactly how damaging it can be.
She developed an eating disorder when she was 14, and at the height of it was using social media to find ‘thinspiration’ photos, weighed just six stone, was admitted to hospital and almost died.
“For me, the illness hasn’t completely gone and I still get thoughts about my weight and what I eat, but with treatment I can cope with it now and have learned to live with it and it doesn’t control my life anymore," she says.
“Social media can have such a negative impact on people with eating disorders, and with TikTok you don’t need to even look for it - it just comes up on your feed, which could easily be triggering. You can’t control it.
“It’s hard when you constantly see videos of people who seem so perfect - it’s easy to compare yourself to them. Because videos can just pop up on your feed, it can be difficult to ignore."
Due to the competitive nature of eating disorders, seeing other people talking about their experiences is enough to remind India of how she felt at the depths of her problem.
She says: “If I see videos of people with eating disorders I do end up clicking on them and looking at their profile. It makes me think about it a lot more, and it sounds odd but sometimes makes me miss it - for me it was about weight and being ‘small’ and I sometimes compare myself to them without even realising.
“I’d prefer to choose what I watch. A couple of weeks ago a video popped up made by a girl who was an inpatient on a psych ward and she was glamorising it and I didn’t agree with that - she made it look fun which could be so damaging for people watching.
“It reminded me of my own experience, and was upsetting. I come across a lot all the time on social media. Sometimes it feels it’s just to get the likes or views.
“Even for someone who doesn’t have an eating disorder, young teens who are easily influenced - it would easily put the idea into their head and think they could do it too.”
‘Interact with me to starve’
While TikTok has taken action to ban certain hashtags such as ‘anorexia’ and ‘bulimia’, many users keen to view eating disorder content simply use common misspellings of these terms that still return examples of harmful eating disorder videos.
It doesn’t take long to find intentionally sinister content.
One user promises to post: "thinspo, meanspo and fatphobia – interact to starve”, and says: “Skip dinner, wake up thinner.”
One post by a "pro ana" user, liked nearly 1,000 times, recommends a ten day diet plan that varies between eating absolutely nothing to eating a maximum of 200 calories a day.
Another user, who recommends exercising five hours a day, posts a picture of a girl’s midriff, with the caption: “If your ribs aren’t showing you aren’t trying hard enough”.
Fans write in and give their height and weight, and the account writes back to tell them how much weight they need to lose.
‘Five snow peas for lunch, 20 calories’
While this is obviously sinister content, the line between normal and "harmful content" is far from obvious too.
Videos that at first glance seem positive or harmless can also trigger those with an eating disorder, and sometimes even popular influencers play a role in this.
Doctor Aragona Giuseppe, medical advisor at Prescription Doctor, says: “The most damaging [content] is of course is the pro-ana content but also even a person posting their diet plan or their ‘what I eat in a day’ can have hugely damaging effects on a young person, because they start to believe that they should also be limiting their intake of food also.
“The obsession with weight and losing weight has always been apparent, however, it is becoming heightened by TikTok because it appears so normal as well as people being able to access this type of content 24/7.”
The ‘what I eat in a day’ hashtag has been viewed over 3.3billion times, with users posting everything they’ve eaten over a 24-hour period, with diet versions often focusing on calorie counts.
One user posting under the what I eat in a day hashtag states they have been eating “300-600 calories max” and in one day states lunch was five snow peas, 20cal, and a slice of toast with cheese, 177cal and for dinner – six chicken nuggets, 306cal and four french fries, 32cal”.
There is also an eating disorder version of the hashtag, 'what I eat in a day in recovery', which has been viewed 280,000 times.
Care worker Sarah* works at a psychiatric hospital on an eating disorder ward which supports young girls between the ages of 12 and 18, and has seen how damaging these videos can be first-hand.
It’s such a competitive illness
Sarah, care worker
She says: “One 15-year-old patient who was admitted recently said she found TikTok especially triggering during lockdown, especially the ‘what I eat in a day’ videos which show people’s weight loss food diaries.
"It’s such a competitive illness – if she saw someone’s diet was less than what she ate, she felt like she needed to do the same, or less.
"It’s extremely damaging.”
‘Just stop - you’re sending a really bad message’
This is where the content influencers post plays a pivotal role.
One user with just under 50,000 followers describes themselves as into “fashion, fitness and lifestyle”, and posted a "ten weight loss tips" video recommending drinking lots of water before meals because “you’ll be less hungry”, and also recommends drinking lots of caffeine and intermittent fasting.
The video was posted using a series of contradictory, common hashtags including "healthy living", "lose weight fast" and "fasting for weight loss".
“Thank you so much!!! I’ve been waiting for this video for months now and it was SO HELPFUL!” one user commented, while others were quick to condemn the advice, saying: “Just stop, you’re sending a really bad message to young girls.”
There’s also a new influx in ‘positive eating disorder influencer’ accounts – users who document their recovery with the aim to help others, but also still inadvertently post content that could trigger other users.
One such account with 15,000 followers shows a girl acting out a scene from when she was in an eating disorder ward, and hiding her breakfast up her sleeve to trick the nurses into thinking she’d eaten.
The video was liked over 220,000 times, with one viewer commenting: “Do you know how many young impressionable girls are on this app seeing this?!”
Writer Eve Simmons, 29, had an eating disorder in her early twenties, and was admitted to hospital aged 23.
Speaking about triggering videos on social media, she says: “They’re abhorrent and incredibly damaging, not only to people who have had eating disorders but also people who’re vulnerable to developing them, which could be anyone really.
“I didn’t look at content like that because for me it wasn’t about the way I looked - it was trying to maintain control over my life, which happened via food.
“All of the stuff out there, online or on TV - everything can be a trigger when you’re in that head space, even the smallest things can be a trigger. So imagine what it’s like when you have actual people in eating disorder units with their emaciated bodies posting pictures of their food.
“The thing that also really gets me is influencers who perhaps have ‘recovered’ from their eating disorder and are body positive but are still extremely thin and are still reiterating the very destructive messages but are more disguised because they don’t look so gaunt and unwell now.”
"We know that there are positive recovery communities out there which some of our beneficiaries have found helpful – it can be very encouraging to hear stories from people who were previously unwell and are now thriving," says Beat's director of external affairs, Tom Quinn.
“We would encourage those making positive videos to avoid mentioning specific weights or BMI, or showing photos of themselves when unwell, as although these are well-intended they can be triggering for people currently ill.”
Signs and symptoms of anorexia
- if you're under 18, your weight and height being lower than expected for your age
- if you're an adult, having an unusually low body mass index
- missing meals, eating very little or avoiding eating any foods you see as fattening
- believing you are fat when you are a healthy weight or underweight
- taking medication to reduce your hunger (appetite suppressants)
- your periods stopping (in women who have not reached menopause) or not starting (in younger women and girls)
- physical problems, such as feeling dizzy, dry skin and hair loss
'A complex issue'
A TikTok spokesperson told The Sun Online that the platform "was built to provide a positive place for creativity, and we prioritise the safety and wellbeing of our users".
"Content that supports or encourages eating disorders is strictly against our community guidelines and will be removed," the spokesperson added.
"However for some users, TikTok provides a forum to share their experience of living with or recovering from an eating disorder and expression of this nature is permitted.
"This is a complex and multi-faceted issue and we work each day to ensure that we are growing our policies and practices to keep our community safe."
‘These apps are essentially brainwashing tools’
So, what more do experts think should be done?
"We recognise there have been steps taken to limit the spread of so-called 'pro-ana' or 'pro-mia' content, such as blocking certain hashtags," says Beat's Tom Quinn.
“However, from the amount of triggering videos still live it's also clear that people have been getting around this.
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“We believe there are further measures that still need to be introduced, such as getting real people to filter out harmful content."
The charity also advises users to take breaks from social media, an idea backed by other experts, with Dr Giuseppe adding: “These types of apps are essentially brainwashing tools and the more time people spend watching this type of harmful content the more likely they are to believe that this is normal and of course it will likely trigger eating and body disorders as well as fuel obsession with the way people look.”
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*Names have been changed.
If you're affected or need advice, please visit Beat's website, or call their helpline number 0808 801 0677.