Facebook’s recently leaked internal documents on the mental health harms of Instagram for young people includes what many hailed as a jarring finding. For 1 in 3 teen girls, being on Instagram exacerbates body image issues. This statistic, uncovered by the Wall Street Journal, doesn’t surprise me. When I was in middle school, I was among the 1 in 3.
Scrolling past dog portraits and sunset shots, I paused my thumb’s autopilot to look closer at a post in my Instagram feed. A fitness account offered a simple piece of advice: To lose weight, you should never eat when you’re not hungry.
At an age when I struggled to accept my changing body, I thought the post offered the solution I desperately wanted. When I wasn’t hungry at mealtimes, I despaired over the pounds I believed would accumulate if I ate. To avoid that feeling, I restricted my portions by more each week and rarely allowed myself to eat if I was hungry between meals. I weighed myself multiple times per day, ignoring my hunger if the number on the scale hadn’t budged. Within a few months, my weight had fallen dangerously low, and my behaviors were concerning enough to result in a diagnosis of anorexia.
Even as I entered recovery, I couldn’t bring myself to tell my friends what was happening. Longing to feel that I wasn’t alone, I instead turned to Instagram. On the same platform that had triggered my eating disorder, I spent hours poring over dozens of accounts, most run by teen girls, sharing recovery experiences and exchanging support. A search for an eating disorder hashtag would yield collages of carefully portioned meals, descriptions of bad days, and photos of emaciated bodies.
I felt connected to the girls behind the accounts in a way I couldn’t be to my friends, my offline support group, or my psychiatrist. But their raw portraits of eating disorders may have hurt my recovery more than they helped. Alone in my bedroom with no in-person connections to turn to, I wasn’t prepared to process the fear and despair I felt when I vicariously relived the experiences of others so similar to my own. But I felt that Instagram provided more support than doctors who hadn’t been through an eating disorder—making me less engaged in my treatment.
Most alarming, the “recovery” posts normalized dangerous thoughts and behaviors. My body no longer seemed so ill when compared with those of girls who had to be hospitalized. When every picture of food I saw on Instagram was accompanied by a description of the emotional turmoil behind it, I couldn’t imagine I would ever eat a meal uninterrupted by the voice of my eating disorder.
My experience isn’t uncommon. As Facebook’s leaked research shows, Instagram increases body image issues for 32 percent of teenage girls who feel bad about their bodies. As many as 40 percent of Instagram users who feel unattractive report that Instagram triggered this feeling. These correlational findings based on self-reported data do fall short of a rigorous study proving cause and effect. But when lives are on the line, it would be irresponsible to react with anything other than extreme concern.
According to internal research from March 2020, “The tendency to share only the best moments, a pressure to look perfect and an addictive product can send teens spiraling toward eating disorders.” I agree that perfectionism can be dangerous in itself—but I found that the resulting communities immersed in unhealthy behaviors and thoughts in pursuit of those impossible ideals were just as harmful.
While these findings are the first to come from Facebook itself, academic researchers have raised alarm bells about the relationship between eating disorders and social media for years. It’s difficult to assess cause and effect, but a study from 2013 suggests that high school girls with Facebook accounts had significantly greater body image concerns than those who weren’t on the platform. In another 2013 study by the same researchers, tweens girls on Facebook were found to be more likely to diet, to internalize the thin ideal, and to have lower body esteem. An additional study from 2017 discovered a strong correlation between time spent on social networking sites and eating disorder symptoms and concerns.
To Instagram’s credit, the platform has taken steps to protect its users from eating disorder–promoting content. Instagram’s community guidelines forbid promoting eating disorders and graphic images of self-harm. Facebook’s more detailed eating disorder policies ban specific triggering content, such as thigh gaps, when shared with eating disorder terms. (As my colleagues at the Stanford Internet Observatory note in their analysis of social media mental health policies, it is not sufficiently clear whether these more detailed guidelines apply to Instagram.)
In 2012, Instagram disabled searching for hashtags used for content that promotes eating disorders, such as #ProAnorexia and #ProBulimia. Earlier this year, the platform announced a renewed commitment to fighting eating disorders. Under these updates, when I search for eating disorder terms that have not been banned, I’m now prompted to message a friend, contact a helpline, read advice on building body confidence, or visit a website with information on eating disorders. Despite this progress, nine years after Instagram banned the #ProAnorexia hashtag, I can still get results when I search for #ProAnaTips (“ana” is frequently used to refer to anorexia) and see posts of dangerously thin bodies announcing, “keep calm and the hunger will pass.” The eating disorder resources Instagram displays may redirect the small portion of individuals who are willing to seek help. But it is difficult to stumble across a hashtag like #ProAnaTips, and I doubt that those who actively seek out advice on developing anorexia will be swayed by generic guidance encouraging them to “know that your body is good enough” and “nourish your body with a variety of foods.” Even with resources being offered, I would argue that under no circumstances should an eating disorder how-to guide be accessible within a few keystrokes on a device in nearly every teenager’s pocket.
These changes are only the bare minimum. Instagram has avoided taking responsibility for the more subtle, but sometimes just as dangerous, content that flourishes on its platform. Notably, under Instagram’s updated policies, I still would have been able to see the weight loss advice that spurred my eating disorder, without even any disclaimer. It didn’t explicitly mention eating disorders, so from Instagram’s perspective, it’s not their problem.
That could have been avoided with Instagram’s recommendation algorithm. Because of my research for this article, my Instagram search history is now filled with terms that anyone who has had or knows someone with an eating disorder would immediately identify as extremely concerning. Despite this, I can still freely search for weight loss tips and before and after photos that are just as triggering as explicitly pro-anorexia content. Low-calorie recipes and “What I Eat in a Day” videos linger in my Explore page, ironically juxtaposed with eating disorder awareness posts.
If Instagram can determine which animal photos I’ll find the cutest or memes I’ll laugh at, I’m certain it can employ the same machine learning techniques to flag me as at-risk for an eating disorder. Instagram could then reduce the visibility of weight-loss content, or balance it with body positivity and anti-diet posts. Whether it does so is a matter not of technological complexity but of accepting responsibility and choosing to prioritize user safety.
A trickier matter is recovery accounts. Instagram’s long-standing policy allows discussions about eating disorders that raise awareness or provide support, as long as eating disorders aren’t encouraged. While most of the posts I encountered are acceptable under this policy, my experience shows that the distinction between supporting recovery and encouraging eating disorders is far more complicated than the policy suggests. In their comments on mental health policies, Stanford Internet Observatory researchers noted that recovery posts can help some people feel part of a community while simultaneously triggering dangerous behaviors in others.
If Instagram believes this issue is beyond the capacities of a photo-sharing app, they would be correct. But that doesn’t mean they’re off the hook. In this case, taking responsibility looks like acknowledging that for a topic as complex as mental health, professional input is needed.
Instagram should leverage its partnership with the National Eating Disorders Association to provide users who are about to post content containing eating disorder terms with NEDA’s guide to sharing eating disorder stories responsibly. Based on the guide’s point that an irresponsibly told story can cause serious harm, the implementation of Instagram’s policy should conservatively assume that a borderline post is more likely to harm than help. Finally, given the high prevalence of eating disorders among teenagers, 3 out of 4 of whom are on Instagram, Instagram should consider developing an eating disorder resource center directly incorporated into the feeds of users in the highest-risk age groups. Modeled off of the Voting Information Center, this information hub would encourage young people to learn about eating disorders from trusted experts in settings grounded in the offline world before they encounter the issue on social media.
A few weeks into college, I found myself perched on a bean bag in a circle of a dozen of my new peers who had also signed up for a discussion about body image. One by one, we shared our experiences of our eating disorders and laughed at the irony of serving cupcakes for an event on this topic.
When it was my turn, I was surprised that I was so overcome with emotion I could barely speak. On the surface, the stories my peers had told were no different from those I had followed on social media. These interactions felt infinitely more meaningful because I knew each of the people in the room first as friends I greeted in the dining halls and as study mates for classes. Their eating disorders were a secondary component to their identities, and one that I had no idea existed until that evening. I was overwhelmed by our shared grief over years of our day-to-day lives silently disrupted by the disorders. That feeling was immediately followed by relief: Finally, I wasn’t alone.
A photo or caption can convey a snapshot of what having an eating disorder is like. But to truly be part of a community, I needed a physical space to express and feel. As the recovery posts fade from my Instagram feed, I am full of gratitude for the offline conversations I can have with the support that surrounds me—phones nowhere in sight.
Future Tense is a partnership of Slate, New America, and Arizona State University that examines emerging technologies, public policy, and society.