A new user who opens TikTok for the first time can find himself in a stream of videos about eating disorders within half an hour. RTL Nieuws and De Groene Amsterdammer discovered this by creating new user accounts that automatically scrolled through the app.
All users get to see videos on TikTok that closely match their interests. TikTok knows how to derive those preferences from something very simple: how long you keep watching a video. Liking videos and following accounts is possible, but not necessary. This makes TikTok fundamentally different from a competitor such as Instagram, where users must actively look up and follow other accounts themselves.
Unsolicited eating disorder videos
Those preferences lead to increasingly specific niches. During the research, we discovered three pathways that lead from common interests to eating disorders. Our automatic accounts were instructed to spend a little longer watching videos about diets, sports or fitness. They didn’t specifically look for eating disorders, but were shown those videos anyway. When that happened, they stuck with it just as long as videos that matched their other interests.
We saw that videos about dieting get more and more intense until it’s about extreme weight loss and eventually anorexia. An interest in fitness videos follows a similar pattern. And those who like to watch thin women, such as in K-pop films, get videos of even thinner women.
For example, it concerns these types of videos:
“These kinds of videos can be extremely triggering if you have an eating disorder or are not feeling well,” says Annemarie van Bellegem. As a pediatrician at the Amsterdam UMC, she specializes in eating disorders. “You then constantly compare yourself to the people you see in the films and glorify the most extreme variants.”
Susceptibility to eating disorders
The automatic accounts from the study are not quite the same as real people, who have more diverse interests. But that excessive interest fits with the sensitivity to eating disorder videos that people with a predisposition to eating disorder have, say experts.
“If you are vulnerable and come across these kinds of videos on TikTok, the algorithm can just grab you by the scruff of the neck. It is a danger to young people,” says Eric van Furth. He is professor of eating disorders at Leiden University. “Whether you develop an eating disorder depends on genetic factors and environmental factors. Genes do not change, but the environment can be more or less pathogenic.”
Moderators can do little
TikTok’s algorithm may be able to collect videos about eating disorders and show them to people who hit it, moderators at the company can do little about it. Most of the videos seen by the research accounts do not violate TikTok’s moderation policy, we know from internal company documents.
This concerns, for example, films in which thin people tell what they eat in a day, but with the description that they are recovering. TikTok’s house rules expressly allow such ‘recovery videos’.
Pediatrician Van Bellegem criticizes TikTok’s moderation policy. “Recovery videos can also be triggering. People sometimes tell me that it helps them with their recovery, but when they look back on it later they realize that they weren’t really recovering then. It’s part of a negative stream of thoughts.”
We also see videos of people who have been admitted to a clinic for eating disorders and dance with a probe in their nose. “Quite worrying,” says Professor Van Furth. “The underlying message with such a dancing girl is, ‘I’m not going to eat’. You have no idea how serious it is from the maker, are they just making a funny film or are they really recovering? The combination of a cheerful music with worrying content gives a contradictory message, that is not a good cocktail.”
Difficult to determine intention
Earlier research by RTL News also showed that it is difficult for moderators to determine the intention of a TikTokker. Then we saw that moderators are given less than 15 seconds to rate a video, making it difficult to understand their true intent.
In addition, moderators only see one video, not the uploader’s other videos or the context of the other videos a user sees. While it is precisely the overwhelming amount of eating disorder films that make them so harmful. “One movie isn’t the problem, but when you’re exposed to slim bodies and weird diets for hours on end, it adds up in your head,” says Van Bellegem.
‘Huge trigger end’
Charlotte Simons knows how harmful the TikTok videos can be. For years she had bulimia, from which she managed to recover. But two years ago she had a relapse and, like millions of Dutch people, she now scrolled a lot through TikTok. “I was interested in Pilates and vegetarian food, so I got a lot of videos about that. But gradually I got more and more eating disorder videos. Influencers who talked about what they ate in a day, when it was clearly far too little. It was very triggering for me.”
Having previously recovered from anorexia, Simons recognized how damaging the videos were to her and tried to guard against them. “I blocked the accounts that posted the videos and if I did get one, I quickly swiped through so as not to give the algorithm the signal that I was interested in it. But there was still no way around it.”
In response to the research, State Secretary for Digitization Alexandra van Huffelen says that she will continue to address TikTok about the negative effects of content that can be found on the platform. “So far I have not been reassured that the company complies with all the rules.”
TikTok did not respond to multiple requests for comment.
Want to know more about this research? Read the detailed account here.
