Healthy or Harmful? A Look at How Social Media Amplifies Toxic Health Advice

By Bella Edmondson

When her nieces watch cartoons, Jessica Setnick, a Dallas-based registered dietitian and nutrition educator and speaker, feels the urge to butt in. “You know that monster truck can’t fly, right?” she wants to tell them. Setnick spends a lot of time thinking about media messages, and so pointing out things such as that Dora is, in fact, not an explorer often come to mind. But she also leverages these critical-thinking skills for those beyond the pre-school set when she wants to highlight the dangers of believing the information we receive on social media. Sitting in metal-wire chairs around a table barely big enough to accommodate my laptop in her backyard garden in Dallas, filled with out-of-place objects and a central tree providing us shade, she moved beyond her nieces and cartoons, discussing how social platforms perpetuate the world of make-believe, morphing our adult world into something a lot scarier than believing monsters live under the bed.

“It’s like this very self-defeating kind of thing where you’re already feeling bad about yourself, and then TikTok is like I can make you feel better or promises to,” says Setnick. Social media takes the form of a digital, money-making, algorithmic trap we willingly download and worship. As we swipe, like, and follow, we ingest thousands of videos of workouts, diet advice, and “quick fixes” that all promise unequivocally unrealistic results.

But unlike cartoon-watching days or nights where we shivered in bed and wondered about the boogeyman in our closet, no adult will step into our room and point out that the TikTok about losing 10 pounds in one week is a lie. Instead, it’s just you, your screen, and the next thing your “fyp” promises will “change your life.”

Health trends saturate social platforms — from the keto diet, 75 Hard Challange, chlorophyll water diet, baby food diet, lemon in your coffee diet, military diet, calorie counting, Tiffany Magee diet, to eating like Kyle Jenner for a day diet, — making destinations such as TikTok “culture centers” for discovering the next must-try trend, defining the ideal body, and finding the next cure for weight loss, sleep deprivation, and fitness. The hashtag “fitness,” for example, boasts more than 111 billion views. The top health influencer counts nearly 75 million followers. And a filter exists that shows what you would look like 20 pounds skinnier.

Video by Bella Edmondson

But influencers play the most damaging role in spreading misinformation, says Harriet Brown, a journalism professor at Syracuse University, award-winning health and science writer, and author of Brave Girl Eating: A Family’s Struggle with Anorexia. “You don’t need a medical degree to go on TikTok,” she says. “You don’t need any qualifications at all.” The platform allows those with little or no credentials or credibility to advise people to “try this,” “eat this,” to “look like this,” all “in the name of health,” Brown says. She sees influencers’ role as shifting away from leveraging authority and expertise to advertising fueled by personality and pervasiveness. She experienced this firsthand during her daughter’s journey battling anorexia. “It makes you realize how pervasive the messages are when you are suddenly going up against them,” she says. She describes a moment with her daughter at the grocery store looking for the highest calorie ice cream, reading the packaging; meanwhile, everyone else was reading, looking and finding messaging with the lowest.

Brown believes we should look at influencers the same way we look at any other type of advertisement — with skepticism. But influencer marketing differentiates itself by being relatable. When influencers promote a product or service, they don’t just deliver a sales pitch; they integrate it into their own lives, showcasing it to you to the point you believe you can be them one day. Kristin Williams, a registered dietician in Dallas, also encourages viewers to look beyond the face on the screen and reminds us that influencers also exist as people who can be influenced. As media consumers, she encourages us to remember that we likely don’t see what happens behind the scenes we see on our phones, and that everyone we compare ourselves to compares themselves to someone else. “We don’t want to praise disordered eating,” Williams says, explaining how that disordered eating comes in many forms. To illustrate, she told the story of a client who was paid to post her weight loss journey. “This isn’t O.K.,” Willaims says. “It’s frustrating. People mean well, but if they aren’t eating-disorders informed, they don’t know they are triggering.”

Being mindful of inaccurate social content may empower you to limit the influencers you follow and inform who you choose to follow, but you can’t unfollow an algorithm. Five years ago, the term algorithm sounded like the kind of word only the Mark Zuckerbergs of the world used. Now, it exists as a key part of our common vocabulary — at least, it should be. Ellen Taylor, a Dallas-based licensed counselor, has witnessed an increase in clients struggling with eating disorders, body image, and disordered eating over the years and believes algorithms play a role. “I have clients come in every day and tell me that ‘I was doing great and felt a lot better about x,y, z until I got on TikTok, and one thing turned into my whole for you page,” she says. A single search leads to an endless cycle of curated content highlighting messages that say, “you need to be” and “you should be.” In 30 seconds or less, a stranger advises you about your health, and yet they lack your medical records and history. Amanda Simon, founder and life coach of OneL1fe Health and Wellness, based in Colorado, recognizes that TikTok algorithms exist as the complete opposite of how a person should approach health. She embraces the concept of bio-individuality — the idea that no one-size-fits-all approach to health and nutrition exists — and encourages her clients to understand that we are all unique, and we should consider that when we go on platforms and compare ourselves to others. She also advocates for “small habit changes over time.”

Most social media content fails to tout the “small changes over time” message. And that reality poses a particular threat to college students. According to Experian, a data analytics company, 98% of college students use social media. They also enter a “perfect storm” for eating disorders. Alivia Waters, a student at Southern Methodist University, agrees, saying that the media consumed shapes people’s confidence or lack thereof. Waters deleted the TikTok app nine months ago and compares existing without social media as similar to seeing the world after removing rose-colored glasses. “People are blatantly inauthentic,” she says, sharing that many of her friends express to her that they feel pressure to photoshop images of themselves to appear perfect. Registered dietician Kristin Williams calls this an identity crisis. Young people leave home for the first time and try to discover who they are. But the discovery is happening at people’s fingertips. Take away influencers and the algorithm, and the enemy of comparison still exists. Whether it is clothing hauls, “what I eat in a day,” or a quick fix for weight loss, we see someone doing something and think we should be doing it too.

Making new friends, rushing a sorority, adapting to the college classroom while being away from home all encompass the challenges of coming to college. Something not mentioned — the invisible monster that silently dictates how you should dress, how to be skinnier, and how to look prettier. The decisions of a college girl arguably are shaped by what is on the other side of her phone screen, often starting with the words “How to”. Think about it. What to buy, order, eat, drink, do, look like, become — all these answers are readily available and easily attainable with one search on TikTok. A one-stop shop for anything young women could ever need. But why are people left feeling defeated or unsuccessful? Often feeling worse about themselves than before, they went looking for an answer. The rose color glasses are on, and people have gotten used to being comfortable on social media while uncomfortable in their bodies. Since making the personal decision to delete TikTok, Waters has seen the app’s impact on people from a new perspective. “They recognize how much of an impact it has on their mental health and bodily health, but it is so hard to escape because we are so surrounded by it,” says Waters. The problem is not in acknowledging that TikTok perpetuates unrealistic standards but in our unwillingness to do anything about them.

Cover Image Artwork by Bella Edmondson

Bella Edmondson

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