Bad influence: ‘Pro-eating disorder’ content is putting vulnerable people at risk

When Adrienne Rennie was 15 she turned to orthorexia as a means “to manage childhood trauma”.

Orthorexia, a fixation with ‘clean’ eating, became her way of coping with a childhood marked by emotional neglect.

Raised by an alcohol dependent parent, she saw academic excellence as a one-way ticket to “a brand-new life”. But when she began to struggle with a few subjects, that dream faltered. “I didn’t know how to cope with what I deemed to be absolute catastrophic failure,” she says.

It started innocently – reading a friend’s school essay on ‘pro-eating disorder’ forums. But soon after that exposure, her interest grew into an obsession that trapped her inside the toxic online community that fuelled disordered eating.

Already fit and healthy, she thought: “If I’m not going to do well at anything else, then I can be the best I can be at being healthy and being a clean eater.”

And a “total cycle of disorder” began, she continues. “I developed a real inability to understand what was actually nutritious for me. I would over-exercise; I had a really strict set of rules that I had to follow. I became scared of a lot of foods because I would see them as being unhealthy.”

She adds: “It [the eating disorder] and I became kind of one.

“It caused me to close off quite a lot of relationships. I became really bad tempered, really angry [and] incredibly secretive. And isolated. My anxiety got worse. My whole mood got worse. My self-worth just totally plummeted and I was just absolutely exhausted.”

Her story is one of millions.

Eating disorders are conditions characterised by extreme worry about body shape and weight, and can be expressed in various forms including anorexia, bulimia and binge eating. 

According to the eating disorder charity Beat, there are 1.25 million people suffering from an eating disorder in the UK. Estimates show one person dies from these mental illnesses every 62 minutes, and anorexia nervosa has the highest mortality rate of any psychiatric disorder. 

Organisations are clear that someone cannot become unwell solely by accessing social media content but insist that it can significantly increase the risk of developing an eating disorder.

An internal study by Facebook leaked to the media in 2019 revealed four in 10 Instagram users who felt dissatisfied with their bodies said their thoughts began while using the app, and a study from the US-based Eating Recovery Centre revealed those spending more than three hours daily on social media were twice as likely to develop eating disorders than those with less screen time.

The glorification of extreme thinness is not new. In the mid-20th century ultra-thin models dominated fashion magazines and television ads. But the rise of social media has made this ideal more pervasive and harder to escape. Unlike traditional media, online platforms are always on, and now anyone can manipulate images, creating unrealistic beauty standards that spread instantly and widely.

It [the eating disorder] and I became kind of one

Elizabeth Evans, a professor of behavioural science at Durham University, says: “It was a kind of passive exposure to media when it was books and magazines. There was lots of time when you were just away from those pictures. It wasn’t in your pocket in your phone. It wasn’t notifying you… [Now] you’re putting more of yourself out there, and other people are putting far more of themselves out there and it’s everywhere, it’s 24/7.”

Dr Agnes Louise Johnston, consultant psychiatrist at NHS Grampian, acknowledges more and more people are seeking treatment and citing a negative online experience as a contributing factor. “It starts off with just following two or three fitness influencers” and quickly gets out of control, she says.

“People can’t quite understand why that’s not realistic, it’s not healthy, because they want the lifestyle that they see on the screen and it’s quite difficult to sometimes sense check that if you are a bit isolated.

“We have patients coming in with very restrictive diets which are not necessarily around pre-existing cultural, religious or ethical reasons. But are around a very eating disorder-driven reason and easy access to these kinds of things that go online is certainly a factor. That can be very dangerous because cutting out an entire food group without medical advice can be harmful.”

Algorithmic feeds and viral trends can often reinforce behaviours that normalise disordered eating. Platforms lock vulnerable people in echo chambers of strict dieting ‘tips’ that present restrictive eating as ordinary, making it more difficult for people to realise they are unwell and seek treatment. For Adrienne, like for many other sufferers, social media became a community during a time she felt extremely lonely. ‘Thinspo’ (short for ‘thin inspiration’) influencers became her “mentors”, figures to look up to.

“This is particularly concerning because we know that for some people denial of an issue can already be a part of their eating disorder,” says Alex Jones, national lead for Scotland at Beat.

Eating disorders, especially anorexia, are also characterised by being quite competitive – something platforms intensify by fostering a culture of constant comparison. Users are overexposed to ‘fit’ content that has been co-opted to promote extreme weight loss behaviours, while also being subjected to relentless feedback on their appearance.

Johnston says: “If you’re bombarded constantly by perfect bodies online or perfect diet plans... it can be a short step then to feeling compelled to follow those kind of rules, and very often with an eating disorder things start off as an idea and then they become a rule, and once you’ve got a rule that you don’t eat this particular food, then it’s very frightening.”

The issue is particularly bad on X – formerly known as Twitter – where pro-eating disorder content is rampant, with many users openly sharing tips, even referencing disordered behaviours in their usernames.

In researching this article I came across multiple profiles which promoted eating disorder ‘inspo’ (inspiration) that had received thousands of likes and hundreds of retweets. I reported them to X for encouraging self-harm, but the posts remain online.

I also contacted X for comment, but it did not respond by the time of going to print.

They want the lifestyle that they see on the screen and it’s quite difficult to sometimes sense check that if you are a bit isolated

Other platforms have begun rolling out guardrails against this content. On Instagram and TikTok, searches related to eating disorder content are met with a pop-up window that directs users to a national helpline. But the system is far from being foolproof, with dangerous posts easily accessible by slightly changing spellings or using coded language to bypass the search algorithm.

“Nowadays you can see influencers are making money out of it. You can see that they’re well-known, they’ve got a good following, and you can see that they’re getting lots of social approval for some content that’s actually not very helpful at all, including things like ‘day on a plate’. I can watch a day on a plate and be like that’s 800 calories in a day. That shouldn’t be a day on a plate. That should be one of several plates,” Evans says.

However, a Meta – the parent company of Instagram – spokesperson said the firm had “never allowed” content that encourages or glorifies eating disorders and removes such posts when it becomes aware of it. They added that the firm also removes content that makes “miraculous claims about a diet or weight loss product when attempting to buy or sell it”.

TikTok was also contacted for comment, but it did not respond by the time of going to print.

Those going through a transition period, namely adolescents, are particularly vulnerable to harmful content online. A UK Government report revealed two-thirds of under-18s are not satisfied with their appearance and, worryingly, Ofcom research shows children as young as five are going online unsupervised. Social media offers a level of privacy and independence that can make the consumption of eating disorder content harder to detect.

Johnston explains: “As your brain develops you become more able to identify for yourself what right and wrong is, but at a young age you are very dependent on what older people tell you. And when some older person is online telling you this is a good way to live or this is a good thing to do, they would be more likely to follow. There has undoubtedly been a rise in eating disorders among young people.”

This overreliance on social media can also become a significant barrier to recovery. Johnston notes that treatment often operates under the goal of ‘getting back to normal’. But for many, daily life is now inextricably linked with time spent online. On average, UK social media users spend more than 1.5 hours across six platforms each day and research shows that half of UK and US adolescents check their accounts at least once every hour.

In a study of 499 individuals with clinical or subclinical eating disorders, 97 per cent said social media hindered their recovery, with one participant admitting to using it for “motivation to not eat for a bit longer” when they felt hungry.

But what can be done to stop the crisis? Under the Online Safety Act, platforms have a legal duty to remove harmful content, including posts that encourage eating disorders.

While it is clear that platforms like X are significantly underperforming in their obligation to remove such content, the issue remains: how do you differentiate between ‘fitness’ content and those spreading dangerous trends?

Beat Scotland’s Jones describes the online safety laws as a “a good first step” but insists there is “more to be done”, pointing to harsher filters.

“It’s never acceptable to shame people into changing their appearance to fit a certain ideal and it’s incredibly dangerous to do so. Advice on nutrition and fitness should only ever be given out by qualified professionals,” Jones says.

Similarly, while the Scottish Government’s 2021 eating disorder strategy was welcomed, Beat was quick to sound a note of caution, highlighting that “clearer and more ambitious promises” were needed to enable “a transformation of the care offered to people affected by eating disorders in Scotland”.

Things start off as an idea and then they become a rule, and once you’ve got a rule that you don’t eat this particular food, then it’s very frightening

Experts suggest introducing media literacy in schools, while Evans points to the potential of “micro-interventions” – informative pop-ups that would appear on users’ feeds with statistics on the volume of misleading content they may encounter – as a key method for early prevention. “It’s hard to take content down, but if you can balance it out with things that help people be more critical consumers of content you’re in a real sweet spot for reducing future risk where somebody’s already completely on the way to an eating disorder,” she says.

Years on, Adrienne is now a CAMHS (Child and Adolescent Mental Health Service) therapy support worker at NHS Fife. She is no longer afraid of certain foods, has started exercising again, and is able to spot content that may be harmful to her. But she admits that if she was still unwell in the current social media environment, she’d be “struggling and finding it harder to recover”.