Cited by 46Eating Disorders and BehaviorsImpact of Technology on AdolescentsBody Image and Dysmorphia Studies

The use of TikTok among children and adolescents with Eating Disorders: experience in a third-level public Italian center during the SARS-CoV-2 pandemic

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Pruccoli, Jacopo, De Rosa, Marta, Chiasso, Lucia, Perrone, Annalisa, Parmeggiani, Antonia·2022·Italian Journal of Pediatrics

Abstract

Background: Recent research has documented the potential associations existing between the use of social media (SM) and the occurrence/development and treatment of Eating Disorders (ED). However, the literature directly addressing the use of SM TikTok among children and adolescents with ED is still scarce. Methods: In January–February 2021, during the second Italian national lockdown due to the SARS-CoV-2 pandemic, an anonymous paper survey was conducted in an Italian third-level center for ED in childhood and adolescence. Demographics, frequency of use of TikTok, frequently viewed topics and hashtags, experienced body-shaming, as well as the use of TikTok (active search, use of proposed contents) and perceived influences of this SM on eating attitudes and self-esteem were assessed. Groups of patients with different perceived SM-induced effects were compared to determine the frequency of their interaction with 3 specific contents (diet, Pro-Anorexia Nervosa (pro-Ana) and pro-ED recovery). Results: Seventy-eight patients (93.6% females, mean age 14.5 ± 2.1 years) were enrolled in the study. For 62.8%, TikTok represented the main SM, used for 1.4 ± 1.0 h/day, with diet (21.8%) as the most frequently used topic category. Pro-Ana and pro-ED recovery contents (“#foryou” and “#edrecovery” as the most frequent, respectively) were both actively searched by patients and proposed by the SM in a significant number of cases. For 59.0%, using TikTok reduced self-esteem, while 26.9% reported TikTok-related significant changes in their daily lives, and 3.8% reported experiences of body-shaming. Patients describing a negative effect of TikTok on their self-esteem more frequently searched and browsed “diet” (p = 0.007) and pro-ED recovery (p = 0.007) contents. Positive qualitative feedback on the SM was also reported. Conclusions: This study documents the use of the SM TikTok among children and adolescents with ED. Individuals with a perceived negative effect of this SM on their self-esteem may show greater interaction with specific content. Further studies are needed to investigate the psychopathological factors influencing the relationship between ED and the use of SM.

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  • Many accounts describing users with conditions such as eating disorders, Tourette's Syndrome, Dissociative Identity Disorder, ADHD, and borderline personality disorder received millions of views on TikTok.

    “Notably, many accounts describing the journeys of users with conditions such as eating disorders (ED), Tourette’s Syndrome, Dissociative Identity Disorder, Attention Deficit-Hyperactivity Disorder (ADHD), and borderline personality disorder received millions of views [40–43].”

    From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [42]

    The Introduction (page unavailable) describes TikTok users sharing eating-disorder recovery experiences and personal stories. It does not report that these accounts received millions of views or address accounts about the other listed conditions. (LLM, conf=0.86)

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  • Ten studies differentiated the population between active and passive users, while only one conducted a content analysis of posts, hashtags, or videos.

    “Given that, ten studies differentiated the population between active and passive users [42, 67, 70, 72, 74–79], while only one conducted a content analysis of the posts, hashtags, or videos [78].”

    From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [42]

    The Methods (Measures; page unavailable) describe a patient survey with open-ended questions about hashtags participants searched, and the Results (Hashtags and users’ comments; page unavailable) categorize and count those reported hashtags. This supports analysis of hashtag information, but not the claim that the study conducted a content analysis of TikTok posts or videos; the hashtags came from patient reports rather than a direct analysis of platform content. (LLM, conf=0.82)

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  • Most of the review's studies reported negative effects of food-, diet- or weight-related contents on body image, increasing in users the perceived importance of their physical appearance to others.

    “most of the review’s studies reported negative effects of food-, diet- or weight-related contents on body image [42, 71], increasing in users the perceived importance of their physical appearance to others [80].”

    From Scrolling through adolescence: a systematic review of the impact of TikTok on adolescent mental health (2025) · cites this paper as [42]

    In Results > Hashtags and users’ comments (page unavailable), patients described videos about physical appearance as prompting comparisons and influencing beauty standards. The paper does not report that TikTok increased users’ perception that their appearance matters to others; its findings concern self-reported experiences among young patients with eating disorders. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Pruccoli et al. reported that for 62.8% of the analyzed sample TikTok represented the preferred social media platform and was used for a mean of 1.4 ± 1.0 h/day.

    “Specifically, Pruccoli et al. reported that for 62.8% of the analyzed sample TikTok represented the preferred SM platform and was used for a mean of 1.4 ± 1.0 h/day [42].”
  • Among included studies, only four reported data about total daily screen time, and four detailed the amount of time spent on TikTok.

    “Among the included studies, only four reported data about total daily screen time [67–70], and four detailed the amount the time spent on TikTok [42, 67, 71, 72].”

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Research works printed but not linked: 1

  1. [26]Ahlse J, Nilsson F, Sandström N. (2020) It’s time to TikTok: Exploring Generation Z’s motivations to participate in #Challenges, Jönköping University [Internet] [Dissertation]. Available from: http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-48708

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Authors
Pruccoli, J., De Rosa, M., Chiasso, L., Perrone, A., & Parmeggiani, A.
Affiliations
Istituto delle Scienze Neurologiche di Bologna (IT)
Corresponding author
Parmeggiani, Antonia
Venue
Italian Journal of Pediatrics
Published
2022-07-30
Volume
48
Issue
1
Pages
138-138
ISSN
  • 1720-8424 (ISSN-L)
  • 1824-7288
OpenAlex
W4288748912
Cited by
46
References
33
Citations by year
2026: 8 · 2025: 10 · 2024: 18 · 2023: 9 · 2022: 1
FWCI
8.66
Type
journal article
Language
en
Open access
Locations
  • The Italian Journal of Pediatrics/Italian journal of pediatrics (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
Keywords
TikTok, social media use, eating disorders, children and adolescents, body shaming, self-esteem, eating attitudes, COVID-19 pandemic, lockdown
MeSH terms
COVID-19, SARS-CoV-2, Adolescent, Feeding and Eating Disorders, Child, Communicable Disease Control, Female, Humans, Male, Pandemics, Social Media

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