Adolescents with eating disorders report exposure to “pro-Ana” materials on TikTok without searching for it – PsyPost

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Social media is a very prevalent mode of communication, especially among young people, but it comes with significant pitfalls. A study published in the Italian Journal of Pediatrics suggests that the use of TikTok can reduce self-esteem and encourage disordered eating.
Eating disorders are very serious mental illnesses that are extremely detrimental to physical and mental health and have high mortality rates. Among the many factors that influence disordered eating are beauty standards and cultural norms. In recent years, as social media has risen and grown exponentially in popularity, beauty standards have been enforced and shared, and communities have formed around promoting eating disordered behaviors on the internet. Of particular concern has been the rise of pro-Ana (pro-Anorexia nervosa) communities, which promote unhealthy eating habits.
One app that has gained popularity with young people in the last few years is TikTok, where a substantial amount of content revolves around being thin. This study seeks to explore how the use of TikTok may influence eating disorders in children and adolescents.
For their study, Jacopo Pruccoli and colleagues utilized 78 patients from an eating disorder center for children and adolescents in Bologna, Italy. The sample was 93.6% female. Participants completed measures on paper between January and February 2021 and answered measures on TikTok usage that Pruccoli and colleagues designed. This included varied questions about the types of content participants were consuming on TikTok, their effects on self-esteem, pro-ED content, time spent on the app, and more.
Results showed that TikTok was the primary social media for this sample of 12 to 16-year-olds, suggesting that it has great influence over today’s youths. Participants’ main searches on the app were for “diet” and “cuisine” content.
A large number (64%) of the participants reported coming across content that encourages eating disorders without actively searching for it, and the majority (59%) of participants expressed lower self-esteem after viewing diet-related videos on TikTok. “This result should encourage the preparation of specific studies further investigating the relationship between [social media] algorithms and the spread of disordered eating behaviors among children and adolescents,” the researchers said.
Despite these very real and significant harms, a portion of participants (32%) identified TikTok as a source of ED recovery support, showing a more positive side of social media use.
This study took steps into understanding the effects of TikTok usage on children and adolescents with eating disorders. Despite this, there are limitations to note. One such limitation is that this sample was predominantly female and comprised of Italian participants from one eating disorder center. This could severely limit generalizability and future research should try to replicate with more diverse samples.
Additionally, due to the lack of research on the topic, the researchers created their own survey to use as their main measure; future research may want to include established measures as well, perhaps of self-esteem or disordered eating behavior, of which there are many.
“Further studies are needed to systematically analyze the relationship between [social media] and the pathogenesis and treatment options for ED,” the researchers concluded.
The study, “The use of TikTok among children and adolescents with Eating Disorders: experience in a third-level public Italian center during the SARS-CoV-2 pandemic“, was authored by Jacopo Pruccoli, Marta De Rosa, Lucia Chiasso, Annalisa Perrone, and Antonia Parmeggiani.

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