TikTok and Eating Disorders: A Narrative Review

TikTok has rapidly become one of the world's most influential social media platforms, distinguished by its algorithmically personalized video feed. Its design prioritizes continuous, engagement-optimized content delivery, raising questions about how such environments may shape eating disorder risk, symptom maintenance, and recovery. This narrative review synthesizes emerging research on TikTok and eating disorders.

We conducted a narrative review of studies identified through targeted database searches and reference screening. Findings were organized into four domains: (1) eating disorder-relevant content on TikTok, (2) algorithmic systems structuring content distribution, (3) psychological and behavioral outcomes associated with content exposure, engagement, and creation, and (4) implications for clinical risk, recovery, and intervention.

Eating disorder-relevant content on TikTok ranges from explicit pro-eating disorder and pro-recovery material to more socially normative dieting, fitness, and appearance-focused content. Algorithm-focused studies indicate that recommendation systems can disproportionately deliver such material to vulnerable users and may be more responsive to passive engagement signals (e.g., watch time) than to explicit actions (e.g., "liking"). Across study designs, greater exposure to and engagement with eating disorder-related content appears to be associated with eating disorder symptoms and related phenomena. Personalized feeds may function as treatment barriers that warrant assessment in clinical settings, and psychoeducation about how recommendation systems operate may help clients recognize and disrupt harmful exposure cycles.

TikTok's algorithmically structured environment may interact with vulnerability to reinforce maladaptive comparison and behavioral cycles. Further longitudinal and clinically focused research is needed to clarify causal pathways and inform evidence-based guidance for clinicians.