‘Worrying lack of moderation’: how eating disorder posts proliferate on X | Eating disorders

Debbie was scrolling through X in April when some unwelcome posts appeared on her feed. One showed a photo of someone who was visibly underweight asking whether they were thin enough. In another, a user wanted to compare how few calories they were eating each day.

Debbie, who did not want to give her last name, is 37 years old and was first diagnosed with bulimia when she was 16. She did not ­follow either of the accounts behind the posts, which belonged to a group with more than 150,000 members on the social media site.

Out of curiosity, Debbie clicked on the group. “As you scroll down, it’s all pro-eating-disorder messages,” she said. “People asking for opinions on their bodies, people asking for advice on fasting.” A pinned post from an admin encouraged members to “remember why we are starving”.

The Observer has uncovered seven further groups, with a combined total of almost 200,000 members, openly sharing content that promotes ­eating disorders. All of the groups were ­created after Twitter was bought by the billionaire Elon Musk in 2022 and rebranded as X.

Eating-disorder campaigners said the scale of harmful content ­demonstrates serious failings in moderation by X. Wera Hobhouse MP, chair of the all-party parliamentary group on eating disorders, said: “These findings are most concerning … X should be held accountable for allowing this harmful content to be promoted on its platform, which puts many lives at risk.”

The internet has long been a breeding ground for content that promotes eating disorders – sometimes called “pro-ana” – from ­message boards to early social media sites including Tumblr and Pinterest. Both sites banned posts promoting eating disorders and self-harm in 2012 after an outcry over their proliferation.

Debbie said she remembers the pro-ana internet message boards, “but you’d have to search to find them”, she said.

This kind of content is now more accessible than ever and, critics of social media companies argue, is pushed to users by algorithms, which serve people more – and sometimes increasingly extreme – posts.

Social media companies have come under increasing pressure in recent years to improve safeguarding after deaths linked to harmful content.

The coroner in the inquest of 14-year-old Molly Russell, who took her own life in 2017 after viewing suicide and self-harm content, ruled that online ­content contributed to her death.

Two years later, in 2019, Instagram, which is owned by Meta, said it would no longer allow any content depicting graphic self-harm. The Online Safety Act, which was passed into law last year, will require tech companies to protect children from harmful content, including promotion of eating disorders, or face steep fines.

Baroness Parminter, who sits on the all-party group, said that while the Online Safety Act was a “reasonable start”, it fails to protect adults. “The duties on social media providers are only for content that children might see … And of course eating disorders don’t stop when you’re 18,” she said.

Under its user policies, X prohibits content that encourages or promotes self-harm, which explicitly includes eating disorders. Users can report violations of X’s policies and posts, and also use a filter on their timeline to report that they are “not interested” in the content being served to them.

But concerns about a lack of moderation have grown since Musk took over the site. Just weeks later, in November 2022, he fired thousands of staff, including moderators.

The cuts significantly reduced the number of employees working to improve moderation, according to figures supplied by X to Australia’s online safety commissioner.

Musk has also brought in changes to X that have resulted in users ­seeing more content from accounts they do not follow. The platform introduced the “For You” feed, making it the default timeline.

In a blogpost last year, the company said about 50% of the content that appears on this feed comes from accounts that users do not yet follow.

In 2021, Twitter launched “communities” as its answer to Facebook groups. Since Musk took over, they have become more prominent. In May, X announced: “Recommendations for communities you may enjoy are now available on your timeline.”

In January, X’s competitor, Meta, which owns Facebook and Instagram, said it would still allow people to share content documenting their struggles with eating disorders but it would no longer recommend it and would make it harder to find. While Meta has begun directing users to safety resources when they search for eating-disorder groups, X allows users to seek such communities without displaying any warnings.

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Debbie said she found X’s tools for filtering and reporting harmful content ineffective. She shared screenshots of posts from the group with the Observer that continued to appear on her feed even after she reported it and flagged it as not relevant.

Hannah Whitfield, a mental health activist, deleted all her social media accounts in 2020 to help her with her recovery from an eating disorder. She has since returned to some sites, including X, and said “thinspiration” posts glorifying unhealthy weight loss have appeared on her For You feed. “What I found with [eating-disorder content] on X was that it was much more extreme and more radicalised. It definitely felt a lot less moderated and a lot easier to find really graphic stuff.”

Eating disorder charities emphasise that social media is not the cause of eating disorders and that users posting pro-ana content are often unwell and not doing so maliciously. But social media can lead those already struggling with disordered eating down a dark path.

Researchers believe that users might be drawn to pro-eating-disorder communities online through a process akin to radicalisation. One study, published last year by computer scientists and psychologists at the University of Southern California, found that “content related to eating disorders can be easily reached via tweets about ‘diet’,’weightloss’ and ‘fasting’”.

The authors, who analysed 2m eating-disorder posts on X, said the platform offered “a sense of belonging” to those with the illness but that unmoderated communities can become “toxic echo chambers that normalise extreme behaviours”.

Paige Rivers was first diagnosed with anorexia when she was 10 years old. Now 23 and training to be a nurse, she has seen eating-disorder content on her X feed.

Rivers said she found X settings that allow users to block certain hashtags or phrases are easily circumvented.

“People started using hashtags that were slightly different, like anorexia altered with numbers and letters, and it would slip through,” she said.

Tom Quinn, director of external affairs at eating-disorder charity Beat, said: “The fact that these so-called ‘pro-ana’ groups are allowed to proliferate shows an extremely worrying lack of moderation on platforms like X.”

For those in recovery such as Debbie, social media held the promise of support.

But the constant exposure to triggering content, which Debbie feels powerless to limit, has had the opposite effect. “It puts me off using social media, which is really sad because I struggle to find people in a similar situation, or people that can offer advice for what I’m going through,” she said.

X did not respond to a request for comment.