TikTok’s wellness trends breed misinformation
Amid an endless stream of memes and lighthearted videos, pseudoscience content is rife on TikTok. From ineffective coronavirus cures to anti-vaccination content, the video sharing app has become fertile ground for all manner of disinformation.
Owned by the Beijing-based tech company ByteDance, the app brings together the most scrollable qualities of social media: unlimited content, served up to users by a tireless algorithm and hundreds of thousands of custom image filters. In just four years, the app’s rise has been meteoric, reaching two billion downloads last October and beating older platforms such as Twitter and Snapchat in terms of total active users.
TikTok’s popularity has highlighted a number of vulnerabilities, including users who share videos that promote unscientific and, in some cases, dangerous medical advice, diets and treatments. In response, it issued an expanded policy on misleading content in early 2020, adding a “misleading information” category to its reporting toolkit for users. In the first half of that year, more than 104 million videos were removed from the app for violations.
Here are five anti-science trends discovered by Coda Story:
Baking soda and Covid-19
What could possibly connect Russian-language TikTok, my grandmother and the late scientist and physician Ivan Neumyvakin? The answer can be found in most kitchen cabinets. Before his death in 2018, Neumyvakin was an evangelist for the medicinal properties of baking soda. He loved the stuff so much he wrote an entire book about it. It recommended the ubiquitous white powder to treat all manner of ailments, from hemorrhoids and urinary tract infections to cardiac arrhythmia. Neumyvakin’s ideas were so well known that his name was the first one my grandmother dropped when I told her I was writing on this subject.
So, what does any of that have to do with TikTok? As I wandered through the platform’s labyrinth of bad science surrounding Covid-19, one video stood out. It shows a man who connects the hose of a Soviet gas mask to the spout of a kettle. He adds baking soda to the water inside, brings it to a boil, puts on the mask and inhales the steam. A caption states that doing so will cure a dry cough — one of the main symptoms of coronavirus. The video attracted more than 200,000 views and 3,000 reactions.
Another clip that does much the same thing has reached 170,000 views. Although these videos do not mention Neumyvakin, this exact procedure can be found on page 31 of his book. One video involving a milk and baking soda cocktail, which opens the third chapter, does give him a shout-out, though.
Baking soda, which is unsurprisingly ineffective against Covid-19, is far from the most bizarre silver bullet being proposed by people during the pandemic. Some have touted chloroform, while others have even promoted camel urine. Its growing visibility as a purported Covid-19 remedy does, however, underline something important.
My grandmother told me that the widespread medicinal use of household staples in the Soviet Union was prompted by a lack of access to quality state health care. By this logic, such myths should have swiftly died out with the fall of communism. Now, though, citizens of former-Soviet nations still have to contend with struggling health systems, a lethal virus is rampaging around the world and platforms like TikTok have a reach far greater than any book. Repackaged in shiny new wrappers, the same old ideas now seem more prevalent than ever.
Intermittent fasting advice
With viral challenges, lip syncing and dance moves to pop songs, TikTok has offered millions of people across the globe a sense of community during the coronavirus lockdowns. Staying at home also prompted a slew of recipes, instructions for sourdough starters, workouts and healthy eating videos. But, on that same menu, the platform has also served up a feast of junk science and nutritional misinformation.
Recently, the respected Twitter account Food Science Babe posted the following message: “There’s SO much false information on TikTok regarding food, I could spend all day every day trying to refute all the videos people tag me in and I wouldn’t even make a small dent. So frustrating if this is where younger generations are getting their info.”
TikTok, which is wildly popular among teenagers and young people, is flooded with videos with hashtags such as #intermittentfasting and #whatIeatinaday.
Intermittent fasting — which involves not eating for a specified amount of time, sometimes up to 24 hours — might prove beneficial to some when recommended by a health professional, but 15-second videos with glittery filters hardly ever go into the details. Meanwhile, the portions in #whatIneedinaday videos are as small as a single tangerine for breakfast.
This trend worries health experts. Many blame a longstanding toxic dieting culture and believe that the internet has only aided its spread. Now, some registered dietitians have taken to social media to promote healthy eating and provide a positive influence.
“While there are obviously tremendous dangers to anyone at any age to restricting calories like this, the teen years are a particularly sensitive time for undernutrition,” said Abbey Sharp, a dietitian who reviews online nutrition misinformation on a dedicated YouTube channel. According to her, nutritional deficiencies experienced at a young age can cause severe growth retardation and hormonal imbalances — and that’s before you get to the psychological effects and the development of long-term eating disorders.
Under its community guidelines, TikTok prohibits “content that promotes eating habits that are likely to cause adverse health outcomes,” but many of these videos appear to do exactly that.
Misinformation about reproductive health
Young people are increasingly turning to TikTok to learn about sex. With 69% of users between the ages of 13 and 24, that is not surprising. Given the rampant nature of misinformation about reproductive health on the platform, it is, however, troubling.
According to Dr. Jennifer Lincoln, an OBGYN in Portland, Oregon, the amount of false claims about reproductive health on the platform speaks to the challenges young people face in accessing accurate information in schools across the U.S.
“Comprehensive sex education that’s medically accurate in the United States is completely the exception, not the rule,” she said.
That means people are finding information elsewhere. This led Lincoln to set up her own TikTok account, in order to provide a relatable evidence-based voice for young people. Now she debunks myths about sexually transmitted infections and periods to her 1.7 million followers.
Birth control is a hot topic. One stubborn trend of misinformation involves the contraceptive pill. Scrolling through #birthcontrol or #birthcontrolproblems turns up hundreds of videos of women claiming, without evidence, that birth control is toxic and causes infertility.
A lot of the information about birth control is sensationalized or presented out of context, explained Lincoln. “What it does is it makes people who are using birth control to not get pregnant feel really uncomfortable, like they’re harming their body.”
TikTok is also full of naturopathy. Often, it’s about selling a product, like “womb detox” — whatever that is — or supplements that claim to help women cleanse after using birth control, which is totally unnecessary.
Other bad science trends are even more worrying. A search for “do it yourself” abortions turns up dozens of videos of young girls holding clothes hangers — a potentially lethal method of back-alley termination. Others falsely claim that ibuprofen or cinnamon can be used to prompt miscarriage.
“I report those a lot,” said Lincoln.
“Keeping our community safe is our top priority,” said a TikTok spokesperson, in response to questions for this story. “Our community guidelines make clear we do not permit misinformation that causes harm to individuals, our community, or the larger public, including medical misinformation. We have reviewed the videos that have been brought to our attention and taken appropriate action, including removal, against content that violates these guidelines.”
TikTok’s Body Dysmorphia problem
A new “challenge” has been sweeping TikTok. Ask your resident Gen-Zer about it, if you have one. It’s called the “Time Warp Scan.”
“It’s, like, this filter where a laser moves down the screen, freezing the video. If you move at the right time, it distorts your body,” my 23-year-old sister told me. You can extend your butt, lengthen your forehead or slim your hips, she explained, like you’re in a hall of mirrors. The top video using the filter has more than 30 million likes.
But viral filters like these have started a bigger conversation, prompting users to ask why TikTok makes them feel ugly. Another filter, called “invert” sparked a trend where users flipped their selfie videos back and forth to show the mirror image of their face. The trick highlights how asymmetrical your face is — and has been upsetting some users.
“Hopped on TikTok to cheer me up and it just made things worse,” said influencer Abby Price, showing herself bursting into tears as she reversed the image of her face.
Counter-campaigns have been cropping up on the app, encouraging people to “turn off beauty mode,” which smooths skin and enhances facial features like an instant facelift.
“Filters don’t help with the negative perception, the unreal way of looking at yourself,” said Sandeep Saib, a mental health activist who campaigns to raise awareness of body dysmorphic disorder (BDD), a mental health condition where individuals are fixated on the perceived flaws of one part or more of their body. “It’s basically fuel to the flame. It’s damaging, and it doesn’t do any justice to someone that’s suffering or trying to recover from BDD. It’s doing exactly what they’re trying to avoid.”
There’s another way TikTok users say the app is affecting their perception of themselves: by showing them a seemingly endless succession of perfect bodies. In March, the app faced criticism after leaked documents showed how it suppressed content posted by users it deemed ugly or disabled. At the time, a TikTok spokesperson said that the document’s instructions were no longer being followed.
Carlita, 17, from Ontario, Canada, who asked to be identified only by his first name, joined TikTok in August. “I came into the app because I wanted funny videos and not, like, body dysmorphia,” he said. During the first few days, he felt that the recommendation algorithm was trying to figure out his sexual preferences and tastes. After that, it “basically only showed me these perfect guys. That constant barrage of perfect bodies started to influence my perception of myself.”
TikTok spokesperson Sarah Mosavi said the company is committed to displaying diversity. “Being true to yourself is celebrated and encouraged on TikTok. Our community of creators is vibrant and diverse, and we want each and every one of our community members to feel comfortable and confident expressing themselves exactly as they are,” she said.
But Carlita said TikTok has led him to constantly compare himself with other users. “Eventually it became overwhelming,” he said. He deleted the app a few days ago.
HPV Vaccine Skepticism and Pseudoscience on TikTok
It takes about 15 seconds for Dr. Todd Wolynn to give a brief overview of the human papillomavirus, a sexually transmitted infection that can cause cervical cancer. He’s wearing a light pink shirt, skinny black jeans and dancing in a dad-at-a-Bar-Mitzvah sort of way to the Black Eyed Peas. If this sounds more informal than you might expect a physician to be, consider the venue for his lesson of the day: TikTok.
Wolynn is one of several doctors and nurses taking to the video-sharing app to educate teens about HPV and the HPV vaccine. Although the shot has been proven in studies to prevent cervical cancer, skepticism and misinformation about it still abound on social media.
Content casting doubt about the vaccine attracts a large audience on TikTok. One clip, with 11,000 views, advises viewers against taking Covid-19 and HPV shots. Another, with 2,000, states that the HPV vaccine “ruins lives” and that “unvaxxed kids are far healthier than vaccinated kids.” Others say that it causes death and paralysis. There is no scientific evidence that the HPV vaccine leads to paralysis, while the U.S. Centers for Disease Control and Prevention determined that it is “very safe,” and has not found any “causal links” between it and reported post-vaccination deaths.
Staci L Tanouye, a board-certified gynecologist based in Florida who posts informational videos about sexual health on TikTok and other social media platforms, told me that the HPV vaccine is “kind of the OG of misinformation for young people in particular.”
“It’s basically anecdotal stories of people claiming to be vaccine injured in some way,” she explained, adding that she also sees a lot of “vague accusations” about the shot killing people.
TikTok isn’t the only social media outlet where HPV vaccine skeptics thrive. A recent study, published in the journal Vaccine, analyzing HPV-related content on Facebook found that posts expressing negative attitudes about immunization were prevalent and likely to generate high levels of engagement. Meanwhile, an October 2020 study in the American Journal of Public Health found that, despite the platform’s policy to moderate vaccine-related content, posts about the HPV shot on Pinterest were typically dominated by skeptics and received similarly high levels of attention.
Tanouye, Wolynn and other doctors are posting snappy and whimsical videos about HPV vaccination and prevention on TikTok. Some have even found their way to the hashtag #hpvvaccineharms, disrupting what may otherwise be a rabbit hole of antivax content with credible medical information. The posters include @pacenurses2020, an account made up of nursing students at the U.S.-based Pace University, dedicated to spreading HPV vaccine awareness.
Tanouye explained that their presence is necessary — and that there is an appetite among younger users for solid scientific information. “The more we get on there to combat some of this, the more we’re empowering them to watch something that they might have believed before, but now they’re questioning it, or tagging all of the doctors to point it out,” she said. “So it really is making a difference.”
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