Anorexia is one of the deadliest mental illnesses.
It is an illness that can have a devastating, lifelong impact – and in many cases it proves fatal.
In recent years there has been a surge in awareness about the damaging influence social media sites can have on people living with eating disorders.
Disturbing content that promotes and encourages dangerous behaviour can be found all over the internet, and certain social media platforms.
Despite a drive to tighten regulations, the posters of this content are quick and adaptable – finding ever-more inventive ways of feeding their insidious messages into the minds of the vulnerable.
Emily Beaumont, 17, knows just how damaging this content can be.
She has spent the majority of her teenage years battling anorexia and self-harm, being repeatedly hospitalised and, at times, fearing for her life.
She is desperate for changes to social media policy to be made and wants to prevent other young people from stumbling across dangerous online content.
‘My eating disorder began when I was around 13 years old,’ Emily tells Metro.co.uk.
‘It started off with just trying to eat healthier and exercising a bit because I felt fat – even though I wasn’t. Then, when I started to weigh myself and saw the number go down, I felt proud of myself and like I was achieving something.
‘My weight carried on going down and I was eating less every day. My parents thought I just wasn’t well until we went to the doctors and I finally confessed that I was doing it on purpose.
‘I was down to my lowest weight at this point, so I was taken to hospital to be re-fed. This was when I was diagnosed with anorexia in 2015.
‘I began to gain weight, but I seesawed between anorexia and self-harm. I had many inpatient admissions for self-harm, tube feeding and numerous attempts on my life. It got to a stage where I had to be on bed-rest to reserve energy because I couldn’t even function.
‘At some points we didn’t know if I was going to make it through the night.
Emily says that her condition was exacerbated by what she was seeing online. She says posts on Instagram caused her anxiety to spike and gave her the tools she needed to become even more ill.
‘Instagram is difficult for people with eating disorders because we can be extremely competitive,’ explains Emily.
‘If someone with anorexia sees, for example, someone else who they perceive to be “more ill” than them, they will do all they can to beat them. It’s terrifying.
‘I have been there and I hated it, but there is nothing you can do because it’s the voice in your head telling you all these negative things and you believe them.
‘Instagram is full of eating disorder accounts and hashtags. For example, if you search healthy eating or something similar, somewhere on the page there will be hashtags of anorexia or other eating disorders.’
Instagram say they work hard to protect users and remove this kind of content as soon as they are told about it.
‘Nothing is more important to us than the safety of the people who use Instagram,’ an Instagram spokesperson explained.
‘We have never allowed content that promotes or encourages eating disorders and will remove it as soon as we are made aware of it – either through in-app reports or the technologies we have to help us detect it.’
But Emily’s experience of witnessing posts like this before they were removed had a really damaging effect.
‘Once you’re on there and see these “perfect” people, you’re caught in the trap and it is incredibly difficult to escape,’ she explains.
‘There are triggers all over the internet and media for people suffering with eating disorders and I find it disgusting. I understand that you can’t get rid of it all, but something needs to be done to regulate it.’
The ways that social media can intensify eating disorder symptoms are various. As well as the sense of competition and practical tips, Emily says she sees a lot of unhealthy images that masquerade as inspiration.
‘I have seen so many posts on Instagram that can be damaging to people with eating disorders’ such as hashtags on “thinspiration”, which predominantly feature malnourished girls.
‘There are many accounts which actively encourage anorexia. This is mind-blowing to me, because anorexia is one of the deadliest mental health conditions.
‘There are also accounts that people use to vent about their conditions. Now, I understand that we all need places to let our feelings out, but Instagram and other social media sites are not the place for that.
‘Especially where people are posting photos of themselves clearly on deaths door and uploading graphic content of self-harm.’
For Emily, these posts were intensely triggering. As a teenager living in 2019, it is almost impossible to live an entirely offline life, but when Emily’s mental health was at its worst, the inescapability of social media was too much.
‘When I was deep in anorexia’s grasp, seeing these photos on Instagram really fuelled the fire,’ she tells us.
‘I was already very ill and seeing these posts not only made me feel worthless and fat, but they also gave me tips on how to lose weight and get away with it.
‘I was following all the hashtags because I was so deeply engrossed in losing weight to be the thinnest, I couldn’t help it.
‘Now when I see these posts, it does still affect me, but not nearly as badly as it did before.
‘They do sometimes make me feel like I want to go back to that, but I’ve learnt to ignore them and distance myself from that content that inevitably comes up.’
So what is the answer? As it’s impossible to predict who will be affected by an eating disorder and at what point in their lives, an all-out avoidance of social media doesn’t seem feasible.
Emily agrees. She thinks there needs to be changes, but that the onus is on social media providers and not the users.
‘I don’t think it would be fair for people with eating disorders and other mental health conditions to be forced to avoid social media completely, because there are so many benefits to social media, from communicating with friends to watching dog videos,’ says Emily.
‘But I don’t think that at the moment there is a “safe” way to use Instagram and other social media platforms for people with eating disorders. The damaging content is – from what I have seen -more or less plastered all over it.
‘Personally, I think that people should be mindful of the dangers and do their best to avoid any possible triggers such as “thin” hashtags and anorexia pages or accounts.
‘If they do find accounts like this, they should report and block them immediately. However, if a person feels unable to do this and is vulnerable, they should stay off social media for a while until they feel ready and well enough to return – like I did.
‘Most importantly, anyone who is struggling should get help to beat this merciless illness.’
How to get help
It is important that someone who is worried about themselves finds professional help and support as soon as possible.
The first port of call when looking for help is the GP, and we provide a leaflet that people can take with them to the appointment to help them get a referral to a specialist service equipped to give them the care they need.
We recommend talking to someone they trust about what they’re experiencing and asking for their support in seeking treatment.
People can also get in touch with Beat support services on 0808 801 0677 or at email@example.com, where we can offer support and guidance about their next steps.
Beat, eating disorders charity
‘It is important for Instagram to act in protecting young and vulnerable people from this content, because it can be deadly. Instagram needs to take more action to remove these posts, as I have reported some of them many times and they haven’t been deleted.
‘I could have lost my life to anorexia and I worry that many other people could be at risk due to social media platforms not regulating their content.’
Of course, social media is one piece of an incredibly complex puzzle when it comes to the causes and triggers of eating disorders. The causes of eating disorders are not truly understood, but experts agree that there is a combination of genetic, biological and cultural factors at play.
Instagram would fall under the ‘cultural’ umbrella – and while it may be unfair and reductive to pin such a complicated illness on social media alone, it’s hard to argue against the need for tougher regulation.
‘Social media is never the sole and direct cause of someone developing an eating disorder,’ explains Tom Quinn, director of external affairs at Beat.
‘However, some content on social media can be very harmful for people suffering from an eating disorder. So-called “pro-ana” and “pro-mia” content helps perpetuate the illnesses for people who are already suffering, and is widespread and easily accessible online.
‘We welcome recent increases in certain social media companies’ security measures to protect users from content that promotes eating disorders.
‘We strongly encourage social media platforms to do more to ensure such content cannot be posted, in the same way as they are now cracking down on images of self-harm.
‘It is important to note that most “pro-ana” and “pro-mia” content is posted by people who are themselves suffering from an eating disorder and is not deliberately malicious. Social media platforms should do more to direct affected users to sources of support.’
For Emily, recovery has not been a linear path. But now, back in full-time education, she is able to think positively about her own future. Something that didn’t seem possible at her lowest points.
‘My last major anorexia turn was last year, when I was refusing to eat or drink anything. I would freak out if I was in the same room as food as I thought I would absorb the calories and gain weight.
‘I passed out at home and I had to be taken to hospital by ambulance to be re-fed again. My blood sugars were dangerously low and we were prepared for the worst.
‘It was at this point when something finally clicked in me that I didn’t want to do this anymore and I began the very long path to recovery.
‘I am well on the road to recovery now. I don’t have much anxiety around food anymore and I have few self-harm relapses. I am in college now after not being in mainstream education since 2015, which is a huge achievement for me.
‘I find doing art extremely therapeutic and has helped me throughout my journey.’
Over the past few months, Instagram has been working with experts to improve its approach to suicide and self-injury content – which includes eating disorders. They maintain that they have never allowed content that promotes or encourages anorexia.
‘We know that many people use Instagram in a positive way to get support or support others, so we allow content that discusses suicide, self-harm or eating disorders for the purpose of recovery,’ explained the Instagram spokesperson.
‘As a result of an ongoing expert review into our approach to all self-injury content, we are making some adjustments to our policy enforcement around eating disorders, including classifying more content as promotion, so more is removed.
‘This is a complex area and it is important that we act responsibly to get it right.’
One thing that everyone seems to agree on is the complexity of this subject matter. There doesn’t appear to be a simple solution that will provide quick and effective protection for vulnerable young people.
It is encouraging that Instagram are taking positive steps to improve how they approach this content – but for teenagers like Emily who are growing up with more online influence than any previous generation, the solutions need to come quicker.