104. Investigating the Promotion of Dieting-Related Products on TikTok: A Pilot Study

Social media can play an influential role in promoting harmful weight-related behaviors among adolescents. Recently, much attention has been drawn to TikTok, a video-based platform that has been criticized for promoting pro-eating disorder (ED) videos to young users. Harmful dieting-related products (e.g., weight-loss, muscle-building, cleanse and detox supplements) are commonly touted on the platform and have been prospectively linked with ED in adolescents and may contain toxic ingredients due to minimal regulation. However, few studies have been conducted that explore the public health impacts of misinformation spread through TikTok, and even fewer studies have explored the promotion of ED content on the platform. The overall aim of this pilot study is to explore dieting-related product videos on TikTok, including the promotion of weight-loss, muscle-building, and cleanse/detox supplements. We conducted a cross-sectional observational pilot study to analyze the top 40 most viewed videos as of June 2022 across the three most popular dieting product-related hashtags (#dietpills, #detox, #preworkout) through the TikTok website interface (N=120 videos). Three research assistants and the lead investigator watched videos independently and a codebook was developed. The codebook captured details about the featured people and influencers (e.g., assumed age, credentials, disclosure of sponsorship), product claims and details (e.g., the use of scientific evidence to support claims, where to purchase the product), and other video elements (e.g., tone of the video). Two research assistants conducted a pilot coding of 10 videos per hashtag, and discrepancies were discussed and resolved. Descriptive statistics were conducted to analyze trends within and across each product hashtag. A total of 33 videos under #dietpills, 35 videos under #detox, and 36 videos under #preworkout met the study criteria (i.e., did not use the hashtag to promote irrelevant content). Nearly one-tenth of videos featured children and teens, while one-third included young adults (approximately 18-24 years old). The majority of video subjects did not disclose their credentials (82.7%) and most video creators did not identify whether the promotion of the product was sponsored by the retailer or manufacturer (90.4%). The most common claims across the hashtags were that the product would help viewers lose weight (24%), cleanse or detox their organs (20.2%), and/or exercise more effectively (16.4%); the vast majority of videos (96.2%) did not provide any scientific evidence to support these claims. Videos used a mix of media elements, including popular music songs (33.7%), trending sounds (16.4%), and voiceovers (68.3%). The most popular videos promoting weight-loss, muscle-building, and cleanse and detox products on TikTok heavily feature young people and make unsubstantiated health claims. Adolescent medicine practitioners and researchers should be aware of the social media content that youth are exposed to, assess youth’s knowledge of these products, and consider the implications of TikTok on youth’s use of harmful dieting-related products that may increase their risk of developing ED and consuming unregulated products with potentially toxic ingredients.