Scrolling to heal or hurt? TikTok’s impact on eating disorders

Background and Objectives Social media, particularly TikTok, plays a pivotal role in shaping perceptions of feeding and eating disorders (FEDs). While it offers recovery-oriented content, it also exposes users to harmful narratives that may normalize disordered eating patterns. Understanding how FED-related content engages users is crucial for informing digital health strategies and content moderation policies. This exploratory study aimed to explore the impact of TikTok short videos on FED-related discourse, analysing how different content types of influence user engagement and whether recovery-focused messages generate higher interaction than weight-loss or pro-anorexia (pro-ana) content. Rather than providing a platform-level estimate, the dataset represents an exploratory snapshot of the Italian TikTok landscape during the collection period. Methods An observational cross-sectional study was conducted, involving three independent researchers who analysed 202 TikTok videos collected via 13 predefined FED-related hashtags. Videos were classified based on thematic content (pro-recovery, pro-ana, anti-pro-ana, or neutral) and emotional appeal, while engagement metrics (views, likes, comments, shares, saves) were statistically analysed. To account for the large variance in video age (mean ≈ 530 days, SD ≈ 343), all engagement metrics were normalized by the number of days each video had been online, resulting in per-day averages (e.g., views/day, likes/day). Undownloadable or muted videos (n=58) were excluded, which may have biased the dataset toward content that passed TikTok’s moderation filters. Results Recovery-focused videos were the most prevalent and received significantly higher engagement than pro-ana videos specifically promoting weight-loss behaviours (p=.003). Emotional expression was positively correlated with increased user interaction (p=.007). Additionally, creators with larger follower bases achieved greater engagement (p < .001). No significant differences were observed in broader comparisons between pro-ana and pro-recovery content, although these analyses were likely underpowered. Conclusion Our results underscore TikTok’s ambivalent role in FED discourse: while it amplifies recovery-oriented narratives, harmful content persists. Strengthening content moderation and digital health strategies is crucial to foster safer online spaces for vulnerable users.