A new study published in PLOS ONE looked at the impact of pro-ana TikTok content on body image dissatisfaction and internalization of societal beauty standards.
“The relationship between body image dissatisfaction, disordered eating behaviours and social media platforms, such as Instagram and Twitter, has been well documented,” study author Madison R. Blackburn told us. “The unique TikTok algorithm is more influential than the choices of individual users in determining the content they see on their ‘For You’ page.”
TikTok users have less control over the content they are exposed to compared to users on other platforms like Instagram, and a user does not need to seek out disordered eating content to be exposed to it. As TikTok users spend most of their time on the personalized ‘For You’ page formulated by algorithm recorded data, much of the content they consume is generated by creators that they do not follow, contrastingly to platforms like Instagram where the homepage newsfeed is curated from electively followed accounts.
“TikTok content is also highly relatable to young audiences because it is generated by young creators, for young users and such creators can circulate dangerous diet-related content without the backlash that a celebrity or well-known influencer would receive for sharing socially irresponsible content,” Blackburn told us. “The ‘For You’ page algorithm and peer-to-peer style interactions warranted specific consideration, separate from other social media platforms. Our study was conducted to examine the influence of pro-anorexia TikTok content on young women’s body image satisfaction and internalization of beauty standards, and to explore daily TikTok use and the development of disordered eating behaviour.”
One theoretical framework for understanding the relationship between social media and body image is the Social Comparison Theory, which suggests that people naturally make upward and downward social comparisons to others in order to evaluate themselves.
« The Transactional Model furthers the Social Comparison Theory by emphasizing the complexity of social media’s influence on body image,” Blackburn told us. “According to this model, individual differences can predispose a person to utilize social media for gratification and proposes that as time spent on social media increases, so does body image dissatisfaction.”
Based on these theoretical frameworks, the research team hypothesized that women in the experimental group exposed to pro-anorexia content would feel significantly worse about their body after viewing these videos compared to women who viewed neutral TikTok content.
“The results showed this to be the case, but surprisingly women exposed to neutral content in the control group also felt worse about their bodies after watching the video compilation,” Blackburn told us. “Sociocultural theories suggest that society perpetuates thinness as the ideal body shape for women which results in an internalization of the assumption that “thin is good”.”
The sociocultural theory emphasizes the significance of social influences such as family, peers, and the media, in the internalization of the thin ideal. The Tripartite Influence model suggests that disordered eating behaviours manifest due to pressure from social agents, specifically media, family, and peers, to conform to socially defined ideals of attractiveness.
“This pressure may lead to engagement in social comparison which the Tripartite Model suggests have been consistently associated with greater internalization of thinness, self-objectification, drive for thinness, and weight dissatisfaction,” Blackburn told us. “In contrast to traditional media where social agents are people of social status like models, celebrities, and influencers, TikTok creators are generally ‘everyday people’ resulting in more horizontal comparisons rather than upward or downward.”
Horizontal comparisons to alike peers may have a particularly profound influence on the degree to which women internalize and align with the thinness ideal. Based on these sociocultural theories, the researchers expected that women in the experimental group would have a greater degree of internalization of the thinness ideal after viewing pro-anorexia content, and these women would have significantly higher degrees of internalization compared to women in the control group.
“I noticed that my own TikTok ‘For You’ Page was filled with content creators glamorizing disordered eating behaviours and obsessing over thinness,” Blackburn told us. “Although the glorification of thinness on social media is not a new concept, what was different about the content I was seeing on TikTok was how explicitly these creators were promoting really harmful disordered eating behaviours. Videos were glamorizing disordered behaviours such as skipping meals, purging, and eating ice to curve hunger in the pursuit of thinness.”
Concerned with what Blackburn was seeing, she wondered if other young women on TikTok were also being exposed to this content, and if so, what impact this was having on their feelings towards their own body and eating behaviours.
The research team recruited 273 female-identifying TikTok users aged 18 to 28 and randomly allocated them into two groups. People with a past or current eating disorder diagnosis were excluded from the study. In the experimental group, participants were shown a 7-8 minute compilation of “pro-anorexia” and “Fitspiration” style content downloaded from TikTok. This content featured young women unhealthily restricting their food intake and giving workout advice and dieting tips, such as describing juice cleanses for weight loss. Participants in the control group watched a 7-8 minute compilation of TikTok videos featuring “neutral” content such as nature, cooking, and animals.
“Using a series of questionnaires, we measured participants’ body image satisfaction and attitudes towards beauty standards both before and after they were shown the TikTok content,” Blackburn told us. “Before the video experiment we asked general questions about daily TikTik use, as well as symptoms of disordered eating and preoccupation with ‘healthy’ eating.”
The study found that participants who used TikTok for more than two hours a day reported more disordered eating behaviours than less frequent users. However, this difference was not statistically significant, explains Blackburn.
“On a questionnaire used to assess eating disorder symptoms, participants who reported high (2-3 hours a day) and extreme (more than 3 hours a day) daily TikTok use averaged scores just below the cut-off for clinically significant eating disorder symptoms,” Blackburn told us. “This suggests that more than two hours of daily TikTok use may be linked to disordered eating in young women, but further research is required to explore this.”
Both groups of women reported a decrease in body image satisfaction from before to after watching the TikTok compilations, however those exposed to the pro-anorexia content experienced the greatest decrease. Women exposed to pro-anorexia content also reported a significant increase in internalization of appearance ideals, whilst conversely, women in the control group reported a decrease in internalization of appearance ideals after watching the neutral content.
“We were surprised that the ‘dosage rate’ of less than 10-minutes of viewing disordered TikTok content elicited a significant effect,” Blackburn told us. “We knew that if we required participants to spend a longer period, say, 20 or 30 minutes, viewing TikTok content as part of the experimental intervention we would likely receive fewer respondents.”
So the researchers set a shorter timeframe, but discussed the possibility that less than ten minutes of exposure may not be enough to elicit a statistically significant effect. As 64% of participants reported seeing disordered eating content on their ‘For You’ page, there was also the possibility that TikTok users in the study would be somewhat desensitized to its effect, but that was not the case.
“Although some preventative measures are in place to prevent access to pro-anorexia content such as blocked searches and resource centre information, most users who are actively seeking out pro-anorexia content can easily circumvent this by being subtle in what they search on the platform to avoid sanction,” Blackburn told us. “While there is merit to these interventions on TikTok, these measures do nothing to address the harm being caused by those who are not seeking out pro-anorexia content but are being exposed to it anyway. Future research should consider whether the current TikTok preventative measures (such as search blocks) are helpful.”
Blackburn believe that It is probably not possible for a social media platform to totally eliminate every risk of psychological harm to users. However, social media companies need to be held to account to place more value on user wellbeing than economic profit.
“Governments need to take a stronger stance on the regulation of platforms and better control the economic benefits of big tech companies when they allow harmful content to circulate,” Blackburn told us.