TikTok perpetuates toxic diet culture in teens! 

Social media usage perpetuates disordered eating and negative body image among teens and young adults. 

A recent qualitative TikTok study by researchers, M. Minadeo and L. Pope from the University of Vermont, published in PLOS One (Weight-normative messaging predominates on TikTok—A qualitative content analysis) showed an alarming trend which, because I’m a TikTokdoc who is constantly on the clock app, is not surprising to me.  The study showed that TikTok perpetuates toxic diet culture in teens and young adults. As a TikTokdoc who has shown up every day for the last two years on the app, I would say diet culture is the culture of TikTok. The algorithm highly supports toxic diet culture. 

The researchers looked at the top viewed food, nutrition and weight-related posts on TikTok and whether the information was presented by experts. They looked at the most popular hashtags to see what teens and young adults search for.  Results from this innovative study showed these key themes:  “glorification of weight loss; positioning of food to achieve health and thinness; and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Also, most posts were created by white, female adolescents and young adults.”

In other words, the expert voice is left out. 

Health is left out. 

Teens and young adults don’t listen much to expert physicians (TikTokdocs) like me when it comes to addressing their health issues and achieving a healthy weight and they don’t listen to expert R.D. ‘s when it comes to nutrition. They just scroll on! 

Anyone who is a pediatrician or parent knows the power of peer influence. For me, this study highlights the power of peer influence on social media, specifically in the areas of food, nutrition and weight. 

Teens and young adults want thin privilege, the social capital of thinness and everything that brands like the Kardashians perpetuate. They want out of their social pain and want out now. Teens and young adults are not looking for what’s healthy. They are looking for what will get them the quickest results possible. They are looking to follow TikTok influencers who will fast track them to thinness. 

It’s harmful and is physically unattainable even for the Kardashians who photoshop and nip and tuck their bodies and their images to a point that’s unrecognizable. But they are doubling down on it. The Kardashians are never going to care about your teen’s health. It’s 100% marketing and it’s working well for them. 

Why is it important to know this? Because teens are inundated with social media inputs constantly telling them they are not arising to toxic diet, wellness and fitness industries’ socially constructed standards. One of the teens I coach told me, “I feel like social media and reality TV and even my parents’ beliefs make me feel like the food choices I make aren’t healthy enough.” “Like all bread is bad and even the ‘healthy’ choices I make are never enough.” Thoughts create feelings. Feelings drive actions. That’s a dangerous belief to attach to because she tends to double down on food restriction and self-judging and shaming. 

I committed to show up and learn and respond and create value when I got started on TikTok two years ago as I was launching IME Community, a life and weight coaching platform for teens.

Now, I’m the doctor on TikTok who is known for disrupting fatphobia in medicine by calling out medical gaslighting due to weight stigma and bias, standing up to toxic cyberbullies who target body and fat positive creators, talks about insulin resistance and how to cancel diet culture.  I recently had a viral post on Almond Moms, another toxic trend that I was noticing in parents, that was picked up by Newsweek, NBC News, Today.com and Parents.com. 

I also share my own weight loss journey on TikTok. TikTok has been a think tank for me as a physician creating a digital community to address child health issues. 

I’m getting traction on the app with teens and parents because I keep showing up with intention. I’m a disruptor, an upstander, and show up to coach on my TikTok Lives where my followers share their metabolic health wins inspired by me getting them to think of obesity as hormonal and not simply caloric. I offer a lot of value, connection, compassion, and stay the course accessibility. When I see a common trend, I make a video or duet a video of another creator to address the problem. Just calling out the problem is the first step. 

TikTok allows accessibility to experts, which is something patients don’t get in healthcare systems. TikTok allows for the sharing of a collective experience. I’ve learned more about the real issues patients face on TikTok than I ever did in all my years as a pediatric hospitalist, in private practice, while addressing the childhood obesity epidemic as the founder of a public health community non-profit, in a multi-disciplinary pediatric weight management program working with a Children’s Hospital, and in a population health systems-based setting. All of that work, although I’m exceedingly proud of its impact, combined has not been as helpful to me in learning about the real patient experience as TikTok. 

That doesn’t mean it’s not hard. 

Right now, I’m blocking gym bros left and right who are trolling my recent post where I said, “Just a warning Calorie Deficit is the new BMI and they’re doubling down. They’re doubling down.” I created that video as I’m  noticing a trend that physicians are prescribing calorie deficit to patients and not addressing their insulin resistance and are ignoring their history of disordered eating. I learned about this trend on guess what? TikTok!

Teens notoriously don’t listen to their parents either.

So, how can we as parents fight against powerful social media forces?

First thing is to let go of the word “fight”.

Parents are like me and other expert content creators showing up on TikTok.

We get trolled and canceled by our teens on the daily.

Parents can get traction over time by deciding to show up every day. Listen and learn. Challenge status quo diet culture beliefs. Depersonalize. 

Parents can be mindful of their own inputs and show up with intention on social media apps like TikTok. I’m constantly sending my kids, the youngest is 16, TikTok videos, usually funny ones and sometimes videos from experts. Share a few and let them come to their own conclusions. 

Help your teen create boundaries around social media use and the messaging they see. Help your teen if they get into a TikTok trance at certain times of the day disrupt the pattern not by shaming them for always being on screens (so hard, I know). Instead offer an action step like helping with something around the house or going on a walk. Of course, if the trance and mindless scrolling is affecting their sleep or has negative consequences like not doing homework, you can set some boundaries around use. 

Parents can be more curious, can be more accessible, respond rather than react and show up with intention. Make sure you follow Dr. Karla @imecommunity on TikTok! 

Always work with your teen’s pediatrician if you are concerned that they are showing signs of disordered eating or body image dissatisfaction. 

Here’s a link to the study: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267997

Back to blocking the cyber trolls!

Dr. Karla