P3A051: Online “body Checking” and Its Effects on Teenage Eating Disorder Culture

Background: “Body checking” (BC) refers to the act of seeking reassurance from others regarding the size, appearance, and look of one’s body and is a symptom of eating disorders (ED). TikTok, a popular video-sharing app with one billion monthly users, has banned use of the hashtag #bodycheck and prompts ways to connect with the National Eating Disorder Association; however, users can easily circumvent this and spread ED-related content. This study assesses the prevalence of BC content to highlight potential impacts on pediatric populations and inform clinicians regarding current ED trends.

Methods: TikTok videos under #bodychck, #bodychec, and #bodychek were collected using an online web scraper. The following data were collected: 1) gender & estimated age (Fig. 1); 2) has/is working towards socially desirable body type (SDBT) (e.g., hourglass, visible abs); 3) posing; 4) seeking comments on body; 5) discusses how BC is harmful; 6) mentions ED & body image issues. Two trained coders reviewed initial data points; a third coder would adjudicate disagreements. Gender and age was either self-reported or ascertained by the coders. Descriptive analysis was conducted in R.

Results: A total of 136 videos (6,231,548 views) were analyzed. Females created 69% (n=94) of videos; males made 29% (n=39); other genders created 2% (n=3) (Fig. 1). 57% (n=77) of creators were young adults, of which 58% (n=45) were explicitly working towards a SDBT. Overall, 68% (n=92) of videos consisted of users working to achieve SDBT. Of the 79% of posing videos (n=108), 88% (n=95) had SDBT and 81% (n=87) were working towards one. An amount of 4% (n=5) explicitly sought comments on their body. 15% (n=20) discussed how BC is harmful; of those, 11 mentioned BC’s influence on ED and 8 related it to body image issues. A total of 13% (n=17) discussed ED and 13% (n=17) discussed body image issues in general.

Conclusion: An alarming amount of young women and men are seeking assurance on their bodies via TikTok. The age breakdown analyzed suggests that girls start exhibiting ED symptoms earlier than boys, but the 29% of male-created BC content was higher than expected. Users have shown that they can easily create new hashtags or trends to participate in BC and other ED-related behaviors, which can be as simple as misspelling keywords. It is likely that there are other hashtags spreading such content that were not analyzed, emphasizing a possible larger problem. It is imperative for pediatricians to discuss ED and the harms of online BC and other ED trends with their patient population. Pediatric medical organizations must stay updated on youth online trends in order to work with social media platform moderators to minimize harmful content.