Laura Thornton is senior vice president, democracy, at the German Marshall Fund of the United States.
The night nurse at the hospital’s eating disorder unit is a quintessential mama bear — tough, but with a sparkle in her eye — and the starving girls follow her around like cubs. As she let me out through security one night in early August, she was ranting about social media companies — “the monster,” she called them.
I spent many nights in that hospital because my 13-year-old daughter was disappearing before my eyes. My cheerful, funny, energetic girl had returned from a summer away a ghost of her previous self — sallow skin, sunken eyes, skin and bones under bulky clothes, her mind in a fog.
It was no easy feat to get her into residential care. As I was informed by the specialists in my area, there has been an “explosion” of girls (and some boys) starving themselves, making spaces precious. Why? I’ve asked literally every professional I’ve met — nurses, nutritionists, therapists. The answer: extreme diet culture fueled by social media.
Of course, eating disorders predate the internet, and our culture is saturated by body shaming and unhelpful images. But as one specialist explained to me, because of social media, the degree and depth of warped information that increasingly young children are consuming these days are unparalleled.
The irony is that, for years now, my work has focused on the harms of bad information infiltrating our body politic. When I lived in Eastern Europe, I tracked the impact of Kremlin information operations geared at turning Georgians away from democracy and the West. In my current work, here in the United States, I have examined the proliferation of dis- and misinformation about covid-19 and analyzed how Twitter (now X), Facebook and other platforms have fueled social division, conspiracy theories and distrust in democracy.
Distracted by the harms of the online world in all these ways, I missed the threat inside my home. But as I plunged into my family’s new life of anorexia, I was instantly struck by the parallels between my work and the personal crisis we were experiencing.
The Center for Countering Digital Hate conducted research showing that when its accounts on TikTok paused briefly over and “liked” content about mental health or body image, within 2.6 minutes, they were fed content about suicide, and within 8 minutes, they were fed content about eating disorders. The Tech Transparency Project’s “Thinstagram” research found that Instagram’s algorithm amplifies and recommends images of dangerously thin women and accounts of “thinfluencers” and anorexia “coaches.”
Thus, we see social media overflowing with clips of girls showing off their ribs and challenges to see if their knees are wider than their thighs. My daughter — who understands how these images fueled her disorder and who consented to my writing about her — has described the “meal plan” contests online, with girls bragging about how little they eat.
Worse, the platforms are aware of and profiting from this, as the whistleblower Frances Haugen, formerly of Facebook, helped expose. The platform’s own analysis shows it harms children.
Those of us working on malign information operations are intimately familiar with the ways these platforms operate: Bad, angry information is promoted over the good. Engagement is prioritized over authoritative, constructive content. On YouTube, even when there are multiple complaints and warnings, false content often remains in active circulation.
Hostile actors undermining our democracy and society effectively tap into fear and build community, and can be cultlike in their ability to brainwash. The same is true of the online cult of eating disorders, in which “starvation chat groups” gather fellow travelers, and eating disorder gurus tap into their followers’ fears — planting the idea that you will be hideous and an outcast if you are not thin. The word my daughter uses most about food: “scary.”
I am not absolving myself of responsibility for my daughter’s condition. I know that many children are on social media and not anorexic (thank goodness), and other concerns are at play with my child. I haven’t slept in a long time. I will never know if my daughter would have been fine without social media. Perhaps not. But my daughter has ideas that can have no other source.
There have been ample stories like mine, articles written, research conducted and congressional hearings held. So why are we still here?
If the business incentives of platforms are at odds with our well-being, we cannot expect them to self-regulate. Yet efforts at regulation have faced political inertia or opposition, and the influence of money in our body politic. (Take, for instance, Senate Bill 680 in California, which would have held social media companies responsible for promoting harmful content about eating disorders, self-harm and drug use — and which failed after aggressive lobbying by the tech industry.)
In tackling threats to democracy, our Nordic friends have embraced the “whole of society” approach, involving all sectors — legislatures, the judiciary, private enterprise, civil society. The same must happen in the United States.
Congress could create an independent regulator to provide audits and oversight, and force changes to platform architecture — safety by design. It could pass the Kids Online Safety Act, which would require platforms to automatically enable the strongest safety settings, allow minors to mute algorithmic recommendations and give parents more oversight. It could also hold platforms accountable for harm, as the European Union has done.
The courts can also weigh in — and they will have a chance thanks to a class-action lawsuit filed in September 2022 that alleges that the design of social media platforms has endangered the health of children.
The private sector has a role to play, too. Companies can either call out social media and advocate to protect children, as seen in a heart-wrenching Dove ad about toxic beauty content. Or they can collaborate with platforms such as Instagram in ways that send harmful messaging to girls, as the Brandy Melville clothing line has done with modeling contests and small-size-only expectations.
Those who want to protect children can also go on offense and build preemptive campaigns — as people in my profession have done, trying to get ahead of disinformation. Working in the former Soviet Union, I was frustrated by how funny, emotive and heartfelt the Kremlin’s information operations were, while the United States pathetically countered them with dry 10-point fact sheets. Similarly, videos, chats and images that encourage eating disorders are much more engaging to a 13-year-old than medical research on body dysmorphia.
Civic groups, educators and health institutes can attempt to correct this by flooding the zone with entertaining, body-affirming clickbait that builds girls up rather than rips them down (as the Butterfly Foundation has done in Australia with its “body kind” campaigns). Imagine: retraining the algorithm to favor the good.
As for us, my daughter’s phone is in a dumpster. She might get one (without social media) someday to talk to friends. And I wish the tech giants and politicians fighting against reforms would spend one afternoon where my daughter is. Look at these children suffering, listen to them and the professionals saving their lives, and walk away vowing, “Not one more.”
If you or someone you know needs help, contact the National Eating Disorders Association screening tool, toll-free National Eating Disorders Helpline and 24/7 Crisis Support via text (send NEDA to 741-741).