Safe spaces or toxic places? Content moderation and social dynamics of online eating disorder communities

Social media platforms have become critical spaces for discussing mental health concerns, including eating disorders. While these platforms can provide valuable support networks, they may also amplify harmful content that glorifies disordered cognition and self-destructive behaviors. While social media platforms have implemented various content moderation strategies, from stringent to laissez-faire approaches, we lack a comprehensive understanding of how these different moderation practices interact with user engagement in online communities around these sensitive mental health topics. This study addresses this knowledge gap through a comparative analysis of eating disorder discussions across Twitter/X (2.6M tweets), Reddit (178K submissions), and TikTok (14K videos) spanning from 2019-2023. Our findings reveal that while users across all platforms engage similarly in expressing concerns and seeking support, platforms with weaker moderation (like Twitter/X) enable the formation of toxic echo chambers that amplify pro-anorexia rhetoric. These results demonstrate how moderation strategies significantly influence the development and impact of online communities, particularly in contexts involving mental health and self-harm.