'Falling down the rabbit hole': a thematic analysis of young people's views on TikTok algorithms and eating disorder...

TikTok's algorithm is at the centre of its user experience. The platform, which allows users to create and consume short-form content, can enable young people (YP) to feel less alone when experiencing illnesses such as eating disorders (EDs) by encouraging them to build communities around mental health-related content. However, emerging research suggests TikTok's algorithm might exacerbate ED symptoms by leading YP into spirals of ED content. This paper provides a lived experience perspective on what experiencing high volumes of ED content on TikTok's For You Page (FYP) can be like for YP.

We conducted 17 semi-structured interviews in which participants (UK-based, aged 18-25, with experience of disordered eating or an ED) described their experiences of using TikTok. We identified three themes that express how participants interact with ED content on TikTok: (1) View One, See More, (2) Morbid Curiosity, and (3) From Helpful to Unhelpful. Theme 1 describes viewing one unhelpful video and then being exposed to more of this content on the FYP. Theme 2 refers to YPs descriptions of a strong impulse to view ED content when it surfaces on their FYP even if it is felt to be unhelpful. Theme 3 recounts YPs experiences of viewing potentially helpful content (e.g., pro-recovery videos) and then being presented with pro-ED content on the FYP. Through a close linguistic analysis, we examine how participants talk about how they feel when viewing ED content on TikTok.

Participants reported engaging regularly with ED content on TikTok. Their interactions with ED content show that the personalised nature of TikTok's algorithm (which is sensitised to how long a user watches a video) can interact with and exacerbate some ED behaviours and psychologies, leading some YP into what they describe as negative echo-chambers of ED content.

Platforms should assume greater responsibility for their algorithms' roles in intensifying ED symptoms and improve the efficacy of functions that help users control the content they see. A greater awareness of the role of TikTok in exacerbating ED thoughts and behaviours among mental health professionals is also necessary.