Content warning: This piece includes descriptions of eating disorders and self-harm that may be triggering to some readers. The National Alliance for Eating Disorders Helpline provides support, resources and information about treatment options at 1-866-662-1235. You can also text “ALLIANCE” to 741741 to be contacted by a trained volunteer.
Communities that promote eating disorders have been thriving on X, with some users saying the platform has recommended content to them that glorifies or encourages starving, self-harm and being underweight.
Over the last two years, over 173,000 users joined one such X community, a recent feature that allows people to join groups based around a shared interest, making it one of the largest on the platform. More than 70,000 of them had joined since June. Thousands of posts were made in the group daily, including encouragement and instructions for disordered eating.
Many of the users identified as teen girls and young women, some as young as 13.
Users refer to the groups as part of “edtwt”(eating disorder Twitter), referring to X’s previous name. The posts are a glimpse into a thriving social media subculture that has migrated across platforms for over a decade, well before Elon Musk’s takeover of Twitter, and has an even longer history across social media platforms, from Tumblr and Pinterest in the 2010s to Instagram and TikTok today. X, which experienced major upheaval after Musk became CEO of the company, is the latest platform to struggle with moderation of the subculture.
In September, X suspended the largest group for violating rules against promoting self-harming behaviors after NBC News requested comment. Tens of thousands of members then migrated to similar X communities. X suspended two of those communities after NBC News reached out again.
“X prohibits content that promotes or encourages self-harming behaviors and has zero tolerance for child sexual exploitation,” a spokesperson for X said in a statement. “We review Community content when our automated detection or user reporting suggests a potential violation may exist. In this case, after a thorough review, we have suspended the Community for violating our Rules.”
NBC News subsequently identified seven more X communities with 2,000 to 78,000 members featuring content promoting eating disorders and self-harm.
Experts say social media alone isn’t to blame for why eating disorders among teens are at an all-time high, but that the online content can introduce, facilitate and worsen disordered eating. However, moderation efforts have been largely unsuccessful in stopping the subculture from migrating to new platforms.
“For someone who is at risk of an eating disorder, maybe engaging in low-level behaviors, this kind of content really validates that ‘Hey, there are other people doing this,’” said Gemma Sharp, a clinical psychologist and the head of body image and eating disorders research at Monash University in Melbourne, Australia.
“Eating disorders are very competitive disorders. That’s why you see people quoting numbers a lot, goal weights a lot, they want to be the sickest in the community,” Sharp said. “It is a very toxic environment.”
Under Musk’s leadership, X expanded its Communities feature and introduced the algorithm-driven “For You” page as the default tab. This page recommends content based on users’ previous interactions, potentially exposing them to pro-eating disorder accounts and communities.
Three users provided NBC News with screenshots of two dozen posts showing eating disorder content on their “For You” pages in 2024 despite not knowingly engaging with such content previously.
The posts glorified eating disorders and extreme thinness. One post featured an image of a thin torso, rib outlines visible with text saying “I will be skinny.” Another featured a meme in the style of Charli XCX’s “Brat,” with text reading, “I have an eating disorder except I’m not skinny enough yet so I don’t.” Another contained an image of thin legs with the words “About to eat? Stop. Now count down from your weight.”
Some of the pro-eating disorder posts on the “For You” page were recommended alongside eating disorder communities, including one that X suspended. The communities include significantly more extreme material than what landed on the “For You” page from the groups, becoming a rabbit hole for users to fall down.
Before the community was suspended, its creator spoke to NBC News in a phone interview.
“I’ve tried implementing rules and everything, but when something is that big you can’t really moderate it,” said Camille, who spoke on the condition that her last name be withheld for her privacy. She is 20 and said she has had an eating disorder since she was in the seventh grade.
Despite the prevalence of rule-breaking content that got posted in her community, Camille said it was never intended to become a pro-eating disorder space. It was actually supposed to be a safe space, she said, one that escaped her control in part thanks to an algorithm that recommended it so far outside her bubble.
Unlike strictly moderated eating disorder recovery groups, these online communities include content that promotes starving and purging and demonizes bodies and people who aren’t thin or pursuing thinness. These subsections are sometimes referred to as “pro-anorexia” or simply “proana” groups.
A recent study found that a majority of female TikTok users had encountered disordered eating content on their “For You” page, often including pro-anorexia messaging.
In February 2021, in partnership with the National Eating Disorders Association, Instagram and TikTok started directing users to help resources when searching for terms associated with eating disorders. X currently does not.
Camille’s community had more members than any of the communities listed on the Communities tab dedicated to influencers, celebrities, sports teams or cryptocurrency. It had more members than two out of the three official X communities hosted by the platform itself. Out of all the X communities viewed by NBC News on the Communities tab, only nine had more members than Camille’s “edtwt” community before it was suspended.
The growth of this highly visible community on X had stoked alarm and previous calls for intervention. In early September, The Guardian reported that campaigners in the U.K. had called for X to moderate the largest eating disorder community and at least seven others. X did not respond to The Guardian’s request for comment.
Posts in these communities directly encouraged and facilitated disordered eating through group chats and extreme diet challenges. The challenges encouraged eating very little for weeks and months at a time, including days of eating nothing at all.
Other posts advertised group chats where the entire group would be subjected to a single calorie limit. If one of the members exceeded their daily calorie limit, the other members would be told to “eat less” to compensate. The post viewed by NBC News said the group chats would be divided into people over the age of 17 and those under 17.
In a sample of the posts made in the largest eating disorder community during a single one-hour period, there were at least five from accounts that identified themselves as children between ages 13 and 17 that asked for advice on how to maintain disordered eating habits, sought negative feedback on their bodies and even discussed being sexually preyed on by adults online. NBC News also viewed two posts in the X community that were photos depicting graphic images of freshly self-inflicted cuts.
“We know that eating disorders are starting to skew younger,” Dr. Doreen Marshall, the CEO of the National Eating Disorders Association, told NBC News. “Eating disorders have the second-highest mortality rate of any mental health-related disorder, second only to opioid misuse.”
Marshall said eating disorders, which are caused by a number of psychological, biological and environmental factors related to each individual, can be exacerbated by social media content even more than other kinds of mental health disorders.
“I think the challenge with social media now, and particularly for young people, is that we have these images with us all the time,” Marshall said, speaking about content that promotes extremely thin body ideals. “Not only is someone seeing the images, but they’re seeing the images being further glamorized and popularized by the comments.”
Both Marshall and Sharp identified a handful of ways to address and further understand the harms of pro-eating disorder content and communities on social media, including platform transparency and collaboration with experts to provide insight into how algorithms recommend harmful content and how to introduce content that encourages recovery. According to Sharp, pro-recovery content may be one of the best ways to provide help to people struggling with eating disorders.
Both experts warned that removing the communities entirely won’t solve the problems that built them in the first place or prevent their re-creation.
“I know some people have said they need to get off social media entirely in order to recover,” Sharp said. “Some people have said they’ve just changed their behaviors, they’ve avoided certain content, although that’s rather hard to do as we’re finding out with X sending people content they haven’t asked for.”
The National Alliance for Eating Disorders Helpline provides support, resources and information about treatment options at 1-866-662-1235, Monday through Friday. You can also text “ALLIANCE” to 741741 if you are experiencing a crisis to be contacted by a trained volunteer. More information about eating disorders, including other free and low-cost support options, can be found on the National Eating Disorder Association’s website.
