ANDSee Sankar was just 18 when videos detailing how to lose weight started popping up on her TikTok feed. Out of the blue, she was being informed of the best recipes to drop the pounds and keep them off.
It started off as an innocent download for fun, but TikTok was soon fueling an unhealthy and obsessive relationship with food, which ruined almost two years of her life.
“The TikToks I was seeing were eating disorder recipes, ways to lose weight really fast,” says Eve. “Constantly being fed that content really messed with my head honestly. It was what I would see day in, day out.”
It all started when she began to follow hashtags like ‘mid-size fashion’ and influencers who had a similar body to her. She noticed she would then increasingly get harmful content on her page from her.
Eve can even recall seeing videos where someone would take images of average, healthy-sized people and criticize them for being too big.
TikTok also showed her ‘meanspo’ – mean inspiration – videos. These involve people make critical and insulting statements about those who are not seen as ‘thin enough’ by the community, with the aim of ‘inspiring’ them to restrict what they eat, stop eating completely, or remove food from the body by being sick , otherwise known as ‘purging’.
After losing control of the content she was seeing on her feed, Eve reached for something she could control: her diet. She would check the calories of everything she consumed, even tablets, and weigh out all of her food from her. She also kept a spreadsheet of everything she had eaten.
“I was calorie-counting to the point where it affected my life, because I couldn’t eat a meal without totaling up the number of calories in my head,” says Eve.
“It didn’t even really work, because if you do that and you’re restrictive, you’re just going to end up binge eating later, so it just made me miserable.”
After deleting the app last year, Eve feels a lot happier and more confident in herself. “My life is less restrictive because it doesn’t revolve around food so much,” she says. “It’s okay to go out and eat with my friends and I love doing that. It’s something I really missed, but I didn’t even realize I was missing it because I was too busy meticulously counting calories to no end.”
Her story is a common one shared by many others in the UK. Beat, an eating disorder charity, estimates that around 1.25 million people have an eating disorder in Britain. Men make up around 25 per cent of that figure.
The role played by social media in triggering and sustaining eating – although not yet fully determined by scientists – is slowly but surely starting to crystallise.
A recent study which looked at almost 1,000 adolescents’ social media usage found that almost 52 per cent of girls and 45 per cent of boys had an eating disorder.
The study also found a link between disordered eating behaviors and the number of social media accounts a young adolescent has. If they had multiple different social media applications, it is more likely that they would have a high score for behaviors and thoughts associated with disordered eating.
TikTok has a young audience, with 60 per cent of users aged between 16 and 24 years old. Available in 150 countries and with 1 billion users worldwide, it’s growth over the last few years has meant that the number of users has overtaken Snapchat and Twitter, and is fast catching up with Instagram.
The increasing number of users means more responsibility. TikTok announced earlier this year that they will be changing their algorithm to try to stop users from seeing the same videos repeatedly, especially ones which might be distressing and triggering.
Dr Rachel Evans, a chartered psychologist who specializes in eating disorders, said “almost all” of her clients had been negatively impacted by social media, having contributed to the development of their condition or hindered their recovery.
She has a 15-year-old client who acknowledged that images online are not always real, but still wanted to look exactly like those she saw on her screen.
Treating these types of patients is another issue entirely. The NHS states that anyone who believes they might have an eating disorder should see a GP, who will refer them to a specialist.
However, Beat conducted a survey last year which found that 69 per cent of people with an eating disorder felt that their GP did not understand how to help them.
The consequences of inadequate care and support can be catastrophic. Indeed, NHS data for England shows that from April to October 2021, there were 2,682 hospital admissions for under-17s with eating disorders. This marks a 34 per cent rise for the same period in 2020.
Sarah’s own 16-year-old-daughter, who is being kept anonymous, is one of many teenagers in England to have been hospitalized as a result of an all-consuming eating distorter. She lived on TikTok before her condition deteriorated, but is now receiving treatment at a psychiatric ward after harmful content made its way onto her feed from her. To this day, she remains addicted to the platform.
“It’s making our daughter’s mental health worse,” says Sarah. “She acknowledges that she can’t help herself from looking. She likes one TikTok and the algorithm sends her more. She does n’t want to like or follow people but she gets drawn in, and that her voice inside her head is so strong.
Sarah’s daughter became friends with other people through TikTok, two of whom are now in the same psychiatric ward with her.
Campaigners and experts have called for TikTok to tidy up its act and do more to address this ever-growing mental health crisis. Dr Ysabel Gerrard, a lecturer in digital media and society at the University of Sheffield, believes that algorithms are often wrongly blamed, and that more focus should be placed on the platform itself to remove harmful content.
“Algorithms are only as harmful as you teach them to be,” says Dr Gerrard. “If we are talking about an algorithm which promotes something like an eating disorder, then that content shouldn’t be there in the first place. If you rid platforms of content that breaks the rules, then it shouldn’t be able to recommend content which is harmful to you.”
TikTok said it was working to remove content that “promotes or glorifies eating disorders and other dangerous weight loss behaviours”, adding: “We aim to approach eating disorders content with compassion for those affected and looking for support and community.
“We partner with organizations such as Beat to help us continually improve our policies and strengthen our enforcement.”
Tom Rebair, an award-winning mental health campaigner who was diagnosed with anorexia at 17 and is now in recovery, believes the government should be intervening to help shield people from the harmful side of social media.
The Online Safety Bill, published in draft by ministers this month, laid out new rules requiring social media companies to protect young people from legal but harmful content involving self-harm and eating disorders.
“I think the government needs to catch up technology,” Mr Rebair says. “I think technology is 20 years ahead of the government in terms of laws, what should happen and what should be changed. I think there really needs to be a change in the government system.”
Hope Virgo, an author and mental health campaigner, echoes this sentiment, arguing that “we need proper legislation in place to protect those using social media.”
She adds: “The government and TikTok have a lot to answer for when it comes to eating disorders and the way these are handled on social media.”
George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.