For Emma Adams-March, what began as a simple ambition to live a “healthier” life quickly spiraled into the darkness of food restriction, isolation and a two-year battle with anorexia nervosa.
After feeling stressed, lonely and insecure starting college at the University of Montana in 2017, Adams-March began eating fewer than 800 calories a day. For the next two years she endured a living nightmare of excessive exercise and an obsessive desire to gain control in her life.
“I thought the grass would be greener on the other side of losing weight,” Adams-March said. “In reality, it was lonelier, emptier and more stressful than ever.”
Although she would eat six times a day and on the surface seemed to be maintaining a “healthy lifestyle,” on the inside she was crumbling to pieces. To keep herself committed, she looked to fitness accounts on social media encouraging her to stay dedicated to her lifestyle and continue to lose weight.
“I constantly looked at old pictures of myself on Instagram for comparison thinking my face used to be thinner, my legs leaner and stomach flatter,” she said. “I gave into the lies that I needed to look a certain way.”
Her body was shutting down. Her hair was thinning and her digestive system was falling apart. In just four months, Adams-March went from 126 pounds to 92.
“I isolated myself from hanging out with friends because I feared I would be offered food that didn’t fit into my calories, would miss a workout or was already too tired from time put in the gym with such little fuel in my body,” Adams-March said.
When she encountered social media posts promoting weight loss, dieting or unhealthy eating behaviors, she questioned her worth and fell deeper into the trap of her illness.
Emma Jepsen, an 18-year-old college freshman at Northeastern University, experienced a similar path to a life of destructive eating and obsessive thoughts.
“I started out with exercising and eating healthier, cutting out processed foods and things that diet culture said were bad for you,” Jepsen said. “It very quickly became obsessive and restrictive and downward spiraled. It was very dark.”
Jepsen cut herself off from most relationships in her life and her disease spread like wildfire, with thoughts about eating, exercising and a desire to look thin encompassing every aspect of her life. She began counting calories, obsessively planning her meals — even waking up extra early to measure ingredients and ensure her caloric intake for the day was exact.
“On a Friday night I wouldn’t want to get pizza with my friends so oftentimes I would meet up with them later after I made my own food,” Jepsen said. “It was a really dark point in my life.”
Both Adams-March and Jepsen acknowledged comparison to other girls’ bodies and eating habits on social media as damaging for their well-being and body image.
“I would see people who posted that every meal they ate was super healthy and I was like, ‘Oh, I want to be like that,’” Jepsen said. “You assume that if you eat the same way you are going to look that way.”
With the combination of a surge in social media use, two years of an isolating global pandemic and the popular new app TikTok, disordered eating and body dissatisfaction are on the rise among young girls.
A beginner’s guide to TikTok and its algorithm
TikTok has infiltrated teenage culture: 63% of kids 12–17 are using the app, according to a survey by Forrester Analytics. The app, launched in 2016 by Chinese company Bytedance, now has more than a billion users worldwide, with 41% of those between ages 16–24.
The video-sharing app allows users to incorporate popular music with dances, challenges and trends, playing into teenagers’ obsessions with going viral and staying relevant among their friends.
TikTok has created an even more accessible way for young girls to be exposed to weight loss content, especially with its unique algorithms that creates a hyper-focus on the interests of the user.
The algorithm creates an individualized, highly curated viewing experience for users. It constantly collects data about each user and what interests them as they scroll. Each person’s “For You” page depends on which videos they linger on, share with friends and like or comment on.
“The algorithm is very sophisticated,” said Jennifer Mills, a professor at York University who studies the link between eating disorders and social media. “If you’re looking at the pro-eating disorder stuff or extreme dieting stuff then that’s a lot of what content you’re getting.
The recommendation system also pays attention to what users search for in the discover tab, such as sounds, trends or topics. The app is built to keep users watching and clicking for as long as possible.
In a 2021 study by The Wall Street Journal, researchers created a dozen bot accounts posing as 13-year-old girls interested in weight loss.
Between October and early December, the app showed the bots “more than 32,000 weight-loss videos, many promoting fasting, offering tips for quickly burning belly fat and pushing weight-loss detox programs and participation in extreme weight-loss competitions.”
Social comparison on TikTok
Social comparison, especially among teenage girls attempting to mold their identities, is intensified by TikTok culture and the personalized algorithm, which has many trends centered on appearances.
“This was happening long before social media,” Mills said. “Social media didn’t cause this phenomenon of social comparison, but it has hijacked our brain’s natural inclination for social comparison and now provides infinite opportunities for us to compare ourselves to other people.”
For many people, seeing content on the app and wishing they looked like a certain body in a video is common. In fact, Mills and other researchers call the tendency “normative discontent.”
“Not everyone who is dissatisfied with their appearance is going to go on to engage in risky or unhealthy behaviors,” she said. “For people who are more vulnerable to disordered eating, they don’t say ‘I wish I looked like that,’ they say ‘I’m going to look like that.’”
It is that vulnerable population of disordered eaters who are in danger of starting or continuing unsafe behaviors. With videos promoting extreme low-calorie diets, quick fixes to burn belly fat, and “healthy” food replacements for sweets, viewers begin to question their worth and eating habits.
“When you see the comments being like, ‘They look so good,’ ‘What did you do?’, ‘Tell me all your secrets,’ and if you look like the person beforehand, they’re basically telling you you’re not good enough, you need to change,” Jepsen said.
For young girls with eating disorders, the body dissatisfaction and negative body image that come from social comparison can quickly turn from thoughts to dangerous behaviors and extreme eating habits.
“The brains of young women in particular are grabbed very easily by those images,” Mills said. “A lot of what young people look at — particularly women — is appearance-focused. They’re seeing people who are showing off their bodies; their bodies are the central focus of the post.”
For girls who are highly interested in weight loss, rigorous exercise or food, the algorithm begins feeding them videos centered on weight loss techniques.
An endless stream of content
The algorithm is a finely tuned machine, its purpose being to find what kind of videos you want and feed you more and more of them.
On the app, users do not get to choose what content they see; the videos are served in an endless flow. Because each user’s “For You” page is a unique myriad of videos, triggering content can easily pop up with no warning.
“A trigger could be anything that’s going to start that eating disorder dialogue in their head that could lead to harmful behaviors,” said Meggie Holden, a registered dietician and founder of Compassionate Nutrition.
Christine Parks, a recent BYU grad who struggled with binge eating disorder for years, expressed how idealized content on social media is harmful for the eating-disordered brain.
“I used social media as a way to fuel my eating disorder,” she said. “I’d look up inspirational accounts of people on weight loss journeys or people straight up in the middle of eating disorders.”
Parks would search on social media for ways to deter hunger and keep up her diet.
“It was just one search away from a bunch of pro-eating disorder content,” she said.
The algorithm also exposes girls to dieting tactics and unhealthy habits that maintain eating disorder behaviors. It gives them new ideas about how to lose weight and keep it off.
“They’re learning things about restricting and ways to manipulate weight from TikTok,” Holden said.
Videos promoting extreme low-calorie diets, quick fixes to burn fat and shed pounds leave girls vulnerable to comparison and quickly engulf them into a competitive arena of weight loss and self-hatred.
“Social media is a breeding ground for insecurities and self-glorification,” Adams-March said. “Having recovered from my journey with anorexia, I see how harmful yet influencing each post about body image, food and exercise are.”
“What I eat in a day” videos where users show everything they ate in a day — sometimes paired with how many calories or other nutritional facts — are a common trend, with more than 10 billion views.
“I absolutely hate with a fiery passion ‘what I eat in a day’ videos,” Holden said. “It is really triggering for someone who has an eating disorder just because they are already comparing what they’re eating with other people so when they see other people eating in a certain way they’re like, ‘Oh maybe I should be eating that,’ or ‘I should eat less than them.’”
“Glow up” videos show extreme transformations of girls’ and women’s bodies — usually before and after drastic weight loss — make being skinny seem desirable and easy. This trend has more than 44 billion views.
“It was hard being on TikTok because a lot of the videos I got were ‘what I eat in a day,’ glow ups and transformations and it was overwhelming me because all of the videos were like that,” Jepsen said. “The videos are very toxic, even if they’re not meant to be, they are very triggering.”
Although the trends have an element of inspiration and curiosity, the videos often do not show the full context of how the person lost the weight, what they were eating or if they completed the weight loss in a healthy way.
Girls are bombarded with posts from people around their age who have no health expertise or knowledge in the field, and many trust what they see as the ideal way to look or behave.
What is TikTok doing?
The app has made measures to censor eating disorder content from users. Common eating disorder hashtags are blocked, and explicit searches for eating disorder content are met with resources for hotlines and help.
On Feb. 8, the company put out a plan to strengthen their policies to “promote safety, security and well-being on TikTok.”
The app shared plans to remove content promoting disordered eating with the help of “eating disorders experts, researchers and physicians.” The app’s announcement, if pursued, would mark important progress to understand and regulate content that is harming people who struggle with disordered eating.
Is there a positive side?
TikTok promotes diet culture and disordered eating among young girls, but is there a positive side to the app?
Although there are trends promoting weight loss, the app also contains content supporting body positivity, intuitive eating and healthy habits.
“If you’re willing to look for it you can find it,” Holden said. “With having all that information out there, it is easier to flood your social media with those more positive resources.”
Social media also creates a platform for girls to express their struggles with eating and be open about their recovery process and healing their relationship with food.
Jepsen created a TikTok account at the beginning of the COVID-19 pandemic and has run her Instagram account @eatzbyemma_ for two years. The account now has more than 10,000 followers. Jepsen uses the account to share about her recovery, love of baking and the importance of balanced eating.
“It helped me join that community of people who knew what I was going through during the recovery process,” Jepsen said. “Everyone knows it’s such a hard battle with recovery but they want you to get through and recover because it’s so amazing to come through on the other side.”
Parks also created an Instagram account to help end the stigma and bring awareness to eating disorders. Her account @ed_stories has more than 2,300 followers and shares people’s stories about body image and disordered eating.
“There are so many people that have a history of this that you would never guess,” Parks said. “It’s been awesome and validating to create that space.”
For anyone struggling with an eating disorder, get help here.