Skip to main content
PLOS One logoLink to PLOS One
. 2022 Nov 1;17(11):e0267997. doi: 10.1371/journal.pone.0267997

Weight-normative messaging predominates on TikTok—A qualitative content analysis

Marisa Minadeo 1,#, Lizzy Pope 1,*,#
Editor: Eliana Carraça2
PMCID: PMC9624392  PMID: 36318532

Abstract

Tiktok is a social media platform with many adolescent and young adult users. Food, nutrition, and weight-related posts are popular on TikTok, yet there is little understanding of the content of these posts, and whether nutrition-related content is presented by experts. The objective was to identify key themes in food, nutrition, and weight-related posts on TikTok. 1000 TikTok videos from 10 popular nutrition, food, and weight-related hashtags each with over 1 billion views were downloaded and analyzed using template analysis. The one-hundred most viewed videos were downloaded from each of the ten chosen hashtags. Two coders then coded each video for key themes. Key themes included the glorification of weight loss in many posts, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition information. The majority of posts presented a weight-normative view of health, with less than 3% coded as weight-inclusive. Most posts were created by white, female adolescents and young adults. Nutrition-related content on TikTok is largely weight normative, and may contribute to disordered eating behaviors and body dissatisfaction in the young people that are TikTok’s predominant users. Helping users discern credible nutrition information, and eliminate triggering content from their social media feeds may be strategies to address the weight-normative social media content that is so prevalent.

Introduction

Social media is incredibly popular with young adults [1], and may be an arena where young adults are exposed to content that perpetuates diet culture. Diet culture is a system of beliefs that worships thinness, promotes weight loss as a means of attaining higher status, demonizes certain ways of eating while encouraging others, and oppresses people who do not match up with the prescribed vision of “health,” most frequently women, trans people, larger-bodied people, people of color, and people with disabilities [2]. Several previous studies examined the presence of diet-culture content on social media, finding that content perpetuating the thin ideal and weight normativity is prevalent across various hashtags, #thinspiration, #fitspiration, #cheatmeal, #weightloss, #quarantine15, and social media sites such as Instagram and Twitter [38].

Weight normativity posits that health is only possible at a specific weight, weight and disease are linearly related, and one has a personal responsibility for meeting weight expectations [9]. Because weight is seen as integral to health, the weight-normative approach focuses on weight management and achieving a “normal” weight. The ubiquitous nature of diet culture follows logically from weight normativity as weight management is seen by both as essential to health. In contrast to weight normativity, the weight-inclusive view of health recognizes that bodies come in a variety of shapes and sizes, and believes that people in all body sizes can achieve health if given the opportunity to pursue health behaviors and access to non-stigmatizing health care [9]. Importantly, weight-inclusivity does not define weight control as a health behavior. As weight-inclusive approaches are associated with improved physical and mental health outcomes, weight-inclusive messaging may help foster health promoting behaviors [1014].

The presentation of diet culture, weight normativity, and the thin ideal on social media is problematic, as research indicates that social media usage in adolescents and young adults is associated with disordered eating and negative body image [1517]. Although previous research has examined the food and weight-related content on several social media platforms quite thoroughly, the video-sharing app, TikTok, is a new and popular social media platform commonly used by young adults, and little to no research has examined the content of posts on TikTok. Since the app went worldwide in 2018, it has been downloaded over two billion times globally [18]. The app is like Instagram or Twitter where you can follow and like posts from certain accounts, but it is unique in several ways. The biggest difference with this increasingly popular social media site is that the app consists only of short videos created by its users. The app is very user friendly, providing a wide array of tools for creators to utilize such as filters, special effects and sounds from popular songs, TV shows, their own voice or other popular TikToks. TikTok is also notorious for trends; a certain dance, sound, prompt or hashtag will go viral and other users will then create their own versions. With TikTok, users don’t need to follow certain accounts, or even have their own account, to view posts tailored to them. The default page on the app is its “for you” page, with endless, algorithmically curated videos based on content that a user has interacted with or watched previously. Therefore, the TikTok algorithm literally tailors content “for you.” If someone consistently engages with diet, weight loss, or food content those videos will continue to appear unless the user actively selects a window labeled “not interested”.

The potential exposure to endless weight or food-related content becomes more concerning when considering TikTok’s user demographics. Most TikTok users are in Gen-Z (people born in the mid-1990’s to mid-2010’s). In July 2020, TikTok reported that one-third of its 49 million daily users were at or below the age of 14 [19]. Although TikTok recently created censorship policies on eating disorder content, [20,21] it is possible that the app still contains a substantial amount of content that reinforces the thin ideal, weight normativity, and diet culture, and may have the same negative impacts on eating behavior and body image as previous social media sites [16]. Conversely, if TikTok posts portray more weight-inclusive or body-positive content they could potentially help improve body image and feelings of acceptance [22,23].

Many health professionals may not even know what TikTok is or how to use it, making it impossible for them to counteract any dangerous messaging young adults may be absorbing on the app. The purpose of this study was to identify themes present in popular food, weight, and body-related posts on TikTok. We hypothesized that food, weight, and body-related posts would be very popular on TikTok, the most evident themes would be weight normative, and young people would be the most frequent content creators. Determining the themes around food and weight on TikTok can help health professionals better understand what messages young adults are seeing around food and weight to then counteract the effects of inaccurate or weight-normative content.

Methods

Video collection

Hashtags are used on social media to collect content related to a specific topic. On TikTok, users can add hashtags to the caption of their post with the hash sign (#) prefacing a word or phrase. When users then click or search certain hashtags or topics, they will be brought to a feed of videos with that hashtag. In this study, initially, a list of thirty body-image and eating-related hashtags was collected by searching TikTok for food, nutrition, weight and body image related content, and noting which hashtags were commonly used by creators and had the most views. The thirty hashtags were generated both by brainstorming a possible list of food, weight, and body image-related words based on professional expertise in the nutrition field, as well as using TikTok for multiple weeks noting what hashtags were commonly used on food, nutrition, and weight-related posts (see Table 1).

Table 1. Initial list of food/weight/body hashtags.

Body image hashtag Number of views Eating behavior hashtag Number of views
#weightloss
#plussize
#weightlossjourney
#bodypositivity
#fatloss
#weightlosscheck
#ED
#edrecovery
#skinny
#weightlosstips
#bodyshaming
#bodyimage
#skinnny
#bodyconfident
#haes
9.7B
2.6B
2.1B
2.0B
1.6B
1.3B
641.3M
638.4M
421.6M
365.6M
264.1M
183.2M
146.7M
79.9M
15.3M
#health
#healthy
#whatieatinaday
#diet
#mealprep
#healthyfood
#nutrition
#dieting
#nutritiontips
#calories
#intuitiveeating
#dietculture
#metabolism
#antidiet
#healthymealideas
9.0B
5.0B
3.2B
3.0B
2.1B
1.2B
1.1B
221.7M
185.9M
201.2M
111.2M
60.1M
58.6M
22.5M
9.0M

All thirty hashtags had at least 9 million views per hashtag, and the most popular had 9.7 billion views. From this list of thirty, we eliminated the “health” and “healthy” hashtags because we felt they were too broad for the specific focus of the study, as they could include content on not smoking, wearing sunscreen, getting sleep, or other health behaviors beyond the focus of this study. The top ten most viewed hashtags from the original list were then included in this study except for choosing #nutrition with 1.1 billion views versus #healthyfood with 1.2 billion views, as it seemed important to analyze the content of videos purporting to be about nutrition which could be weight inclusive or perpetuate diet culture (Table 2). Since the posts were collected in September 2020, #nutrition now has more views that #healthyfood.

Table 2. Final selected hashtag list.

Hashtag Views
#weightloss
#whatieatinaday
#diet
#plussize
#weightlossjourney
#mealprep
#bodypositivity
#fatloss
#weightlosscheck
#nutrition
9.7B
3.2B
3.0B
2.6B
2.1B
2.1B
2.0B
1.6B
1.3B
1.1B 

Each of the ten hashtags had more than 1.1 billion views per hashtag and we believed were divided between hashtags that were likely to present weight-normative content (#weightloss, #diet, #weightlossjourney, #fatloss, #weightlosscheck) or potentially contain weight-inclusive or weight-neutral content (#whatieatinaday, #plussize, #mealprep, #bodypositvity, #nutrition). Although the original list of thirty hashtags contained several such as #intuitiveeating and #haes that may have been most likely to contain weight-inclusive content, those hashtags had considerably fewer views, 111.2 million and 15.3 million respectively than any of the top 10 hashtags used in this study which each had at least 1 billion views (see Table 1). These more specific weight-inclusive hashtags were then not selected for analysis because they did not represent a large share of the food/weight/body posts viewed on TikTok, and would not give an accurate idea of what the “average” TikTok viewer would find on their for you page, as the for you page is most likely to display videos with many views. The first 100 videos under each of the ten selected hashtags as well as a screenshot of their first frame and caption were downloaded in September 2020, and the files were each labeled with the hashtag and record number. The videos were publicly available and downloadable, so our collection and analysis complied with necessary terms and conditions. TikToks in each hashtag are displayed from the most views to the least views, so downloading the first 100 videos in each hashtag meant that the most viewed videos in each hashtag were collected. Any TikToks that were not downloadable were not included in the study, as a small percentage of users do not allow their videos to be downloaded. Because all videos were publicly available, the study was approved as exempt by the University of Vermont Committee on Human Research in the Behavioral and Social Sciences, STUDY00001190. As all of the TikTok videos analyzed were publicly available, informed consent was waived by the ethics committee.

Codebook development

After preliminary analysis of a subset of 100 TikToks (10 from each hashtag), a list of codes was developed using a template analysis approach that included codes that we expected to find in the data such as posts that were food related, depicted exercise, reflected someone’s body image, represented weight normativity or weight inclusivity, or discussed weight loss, as well as codes reflecting themes that emerged from the subset of TikToks [24]. Demographic codes for age, gender presentation, race/ethnicity, and body size were also included in the codebook, as was a code noting any professional degrees of the user. After codebook creation, two coders watched and coded ten videos from each of the hashtags. Codes from each coder were compared to ensure consistency of code application. Coders then proceeded to code the remainder of the TikTok videos independently. Once all coding was completed individually, cross comparisons were run in Excel between the two coders’ spreadsheets to identify any differences in coding. Videos with discrepancies were viewed again by two coders together and final codes were agreed upon. In total, four coders worked on the project with two coders coding each video. The study authors trained the two additional coders who were nutrition undergraduate students. When coding discrepancies were noted, the two study authors looked at each video and determined final coding. All codes used in the codebook except for demographic codes can be found in the linked supplementary material file.

Data analysis

Demographics were coded for videos in which the creator was visible in the video. Following the methods used by Lucibello et al., demographic codes were determined based on the perceived age (teenager, young adult, millennial, middle aged adult or elderly person), gender presentation (male, female, trans male, trans female, non-binary) and race/ethnicity (white presenting or non-white presenting) of the person in the video [4]. The body size of the user (average/medium frame, thinner than average frame, and larger than average frame) was also coded for, in line with methods from previous research [4,6]. Users with health professional degrees were coded if they explicitly stated their profession in the video or the comments.

TikTok content was analyzed using thematic analysis with quantification, which allowed us to identify, analyze, and report key themes from the qualitative TikTok data [25]. Code frequencies were tabulated using SPSS Software (IBM Corp., Chicago). The frequency data helped identify how often various codes and resulting themes appeared in each hashtag. The research group reviewed and refined key themes together, and identified TikToks that were emblematic of each key theme. The analytic plan was pre-specified, and the hypotheses were determined before data was collected.

Results and discussion

Young female creators predominate on TikTok

Our results indicate that the majority of TikTok content analyzed was created by young users of high school (11.1% of posts) and college ages (42.4% of posts) versus millennials (28.2%) and those in middle age (3.3%). Age could not be determined in 15.2% of posts. When considering previous literature on the negative influence of social media on young people’s body image and eating behaviors, there is reason to be wary of the impact of the app on its young adult users [2628]. Most videos (64.6%) were created by female presenting users, as opposed to male presenting users (30.6%). Young females who create and engage with weight or food-related content on TikTok are at risk of having internalized body image and disordered eating behaviors from other aspects of their lives [29] making exposure to weight, food, or body-related content particularly troublesome. When observing race and ethnicity, white presenting individuals were most represented (56.1%) followed by non-white presenting individuals (32.6%). Thirty-four percent of TikToks were created by users coded to be of an average/medium frame, versus only 16.6% of posts showing someone with a larger than average frame. Therefore, the most common creators engaging with the nutrition-related hashtags, even those explicitly related to weight loss were actually those who most conformed to the thin ideal. These results are similar to explorations of the fitspiration, cheatmeal, and weightloss hashtags on Instagram where researchers also found a lack of body diversity, with mostly thin, muscular individuals depicted [3,6,7].

The glorification of weight loss and frequency of a weight-normative perspective

When looking at the data, a striking theme was the prevalence of weight-related content across all ten hashtags. Nearly 44% of all the videos coded in this study had content about weight loss, and 20.4% of all videos explicitly showed a person’s weight transformation in the video. Many of these videos followed the same format and included similar hashtags, filters, and sounds, speaking to the nature of TikTok and the ability for trends to become popular. Even, the whatieatinaday hashtag and mealprep hashtags that we believed at the beginning of the study may be weight-neutral and portray a variety of eating styles and meal preparations were quite weight normative with users showing how they meal prepped for a certain diet, or what they ate in a day to lose weight. In fact, the whatieatinaday hashtag has become so weight normative and triggering that videos using it now carry a trigger warning for eating disorders including a link to the National Eating Disorder Association’s help line because so many people were using the hashtag to show how little they ate in a day [21].

The glorification of weight loss across many videos, and reoccurring suggestion that if you just try hard enough you can lose weight too, undoubtedly elevate the key principles of weight normativity, and may reinforce to viewers the belief that weight is an important indicator of health status and overall self-worth [9,30]. This danger is increased by the substantial number of views that these hashtags are receiving. The weight loss hashtag alone had almost 10 billion views at the time the videos were collected, showing that billions of people are interested enough in losing weight to engage with the hashtag. The number of views the weight-loss focused hashtags received vastly outnumbered the number of views more explicitly weight-inclusive hashtags received (see Table 1). In our study, less than 3% of all videos were coded for weight inclusive messaging or content, suggesting that weight-inclusive messaging is not prevalent across some of the most viewed nutrition, food, and body-related hashtags on TikTok.

Among the videos that depicted weight loss transformation, common themes included exercise routines and diet plans, often with images of routine weigh-ins and clothing “down-sizes.” Twenty-two percent of videos depicted physical activity. Many of the videos depicting physical activity were also coded for weight loss, indicating that physical activity was being portrayed not for its inherent benefits to physical and mental health [31], but as a means to achieve weight loss. In multiple cases, the creator mentioned finally becoming “happy” after losing the weight, and how their journey to “better themselves” was not done yet, exemplifying diet culture’s message that a person’s body size is indicative of their health and moral status.

As discussed earlier, TikTok is unique in that users can choose from a variety of sounds to add to their videos. Several sounds were found to occur frequently as part of the weight loss trends and included language that poses weight loss as paramount. Dialogue, sounding like a pep talk from a coach or a trainer, containing phrases such as “no excuses,” “get up” and “if you want it bad enough, you’ll do it,” implies that deciding not to pursue weight loss or being unable to lose weight is a personal motivation failure. These videos may give viewers the idea that intense weight loss transformations are both attainable and something to strive for–not only for appearance purposes but also for physical and mental well-being as previous research has illustrated the strong influence that media reinforcing the thin ideal has on people’s self image [32,33]. Although some may argue that viewing weight transformation videos is motivating, Jebeile et. al found that adolescents in larger bodies reported that viewing successful weight loss videos felt unmotivating and discouraging when weight loss was portrayed as very easy, as it often is on social media [3].

Perhaps portraying weight loss would be less harmful if long-term weight loss was generally achievable. However, as Tylka et. al (2014) discussed in their literature review of weight normativity and weight inclusivity, weight loss interventions almost always fail; only about 20% of individuals who participate in weight loss interventions maintain the weight loss after one year, and this percentage decreases by the second year [9]. The collection of videos glorifying weight loss on TikTok represent a moment in time, but do not show the longer-term effects of weight loss interventions, such as weight-cycling, or repeated dieting and weight loss attempts over many years [34]. All these outcomes can result in negative impacts to both mental and physical health [3537]. Furthermore, each time someone questing to lose weight is unable to keep the weight off, the perception that they must then be lazy or lacking in willpower is reinforced [38,39].

A large percentage (21%) of total users did portray a positive body image, however very few posted videos lacking weight-normative undertones. Often creators were positive about their body image because they had lost weight, and rarely were depicting body positivity for a body that would not be deemed “acceptable” by diet culture. Similarly, while there were videos that mentioned or showed a person’s weight gain, these videos were the minority of weight-related content and reinforced diet culture beliefs. Weight-gain content tended to be masked with body positive hashtags and mentions of “self-love,” but still suggested that weight gain is inherently negative. Voice-overs and comments in these videos excused their weight gain or reassured themselves that it was okay to have gained weight. For example, a common caption would be something like, “I gained 20 pounds, but I still love myself.” Having to state that you still love yourself when your weight increases suggests exposure to weight bias and fat phobia [40]. Such weight-related stigmas lead to social issues such as devaluation, discrimination and rejection of individuals who are in fat bodies [40].

Food as a means of pursuing wellness

Thirty-eight percent of videos explicitly showed food (cooking, eating, getting take-out etc.), and 11.9% of videos featured active cooking. A major theme that emerged about the food content in the chosen hashtags was that food content seemed to be devoid of pleasure or social/cultural influences, and instead was perceived as a means of pursuing health or wellness. A significant portion (14%) of all videos mentioned a specific diet or dieting. Repeated examples of fad diets from this subset of TikTok videos were high-protein or low-calorie diets, liquid “cleanses,” and intermittent fasting. These tended to be posed as ways to achieve a certain body “goal.” A noticeable number of users also shared videos of themselves making weight loss or detox teas or drinks, to which they attributed their weight loss. Videos like this may be especially deceptive for a viewer because often the diet or recipe is paired with a thin, attractive person, leaving the impression that the drink played a role in attaining the idealized body type. Another theme among food content was instructional videos of users showing how to make “healthy” versions of “junk” foods. Assigning good or bad labels to food brings emotion and morality to eating. These emotions are internalized as we eat, and eating a food deemed “bad” by diet culture’s standards may lead to negative perceptions of self after consumption [41]. Moralizing food can cause hyper-awareness about food choices, and foster beliefs that certain foods should be avoided because they will cause weight gain or poor health. This can lead to development of eating disorders such as Orthorexia Nervosa, an eating disorder defined as the obsession with “correct” eating and a fixation on foods’ role in our physical health [41,42].

Nutrition advice for weight loss provided by non-experts

Of all videos coded under the hashtag “nutrition,” 47% provided some sort of nutrition advice. These videos primarily offered advice about what foods to eat for different purposes, mostly for weight loss, as one quarter of videos also referenced weight loss in addition to providing nutrition advice. An example pattern would be users showing their weight transformation, paired with explaining “what they ate on their journey.” This suggests again that the purpose of food is to manipulate body size rather than for social or cultural fulfillment. Another key finding was the lack of professional representation on TikTok. Given the high percentage of videos that provided nutrition advice to viewers, it is surprising how few came from a health professional. Of all the videos, 1.4% were created by registered dietitians, suggesting very little expert nutrition advice on the app. Users without professional knowledge are sharing nutrition tips that can be inaccurate, and often for the purposes of weight loss. These types of videos likely spread and encourage harmful dieting interventions to a vulnerable audience that may not have strong media literacy skills. Health professionals should recognize that their young adult clients may be gathering nutrition information on TikTok, and that much of it is not evidence-based.

Working to counter inaccurate and weight-normative content on TikTok

As seen in the current study, content displaying diet culture themes is often present on social media, a primary source of information for many young adults. In regard to health behaviors such as eating, exercise, or body image, young people are vulnerable to the influence of social media content, and are not always able to discern which posts offer evidence-based advice and which do not [26,27]. Exemplifying the impact of media on body image, Tiggemann and Miller found that adolescent girls who reported more time spent on social media were also more likely to have high internalization of the thin ideal [28]. This is not surprising when content on social media commonly represents ideas that are rooted in diet culture and weight normativity as seen in the current study. Acknowledging the weight-normative content on social media is important if health practitioners would like to help young people develop healthy relationships with food and their bodies.

The results of this research raise questions about how the dissemination of weight-centric messaging can be countered. Can the influence of TikTok and other social media apps be used to spread more positive and accurate information about food, health and weight? In September 2020, TikTok released a blog post where the company pledged to focus on safeguarding their community from harmful content, and stated their goal to support a body-positive environment for their users [20]. While it is significant that the platform has acknowledged the danger of diet culture content trending on their app, the content used in this study was collected after the initial changes were made, indicating that the problem is still pressing; even with PSA’s and resources, diet culture remains a viral topic. For example, recent trends targeted quarantine bodies, promoting fad diets, exercise routines, and diet supplements advertised to help lose the weight gained during lockdown as we approach a post-pandemic lifestyle [43,44].

Perhaps diet culture can be combatted by the spread of weight-inclusive content, such as Health at Every Size and Intuitive Eating focused content, which work to celebrate the diversity of body sizes, and reject weight as a symbol of health and morality. A wide range of literature has found these weight inclusive models to have many benefits, such as improvement of eating disorder behaviors, as well as associations with improved physical and mental health outcomes [1014,45,46]. Some research has also found that exposure to body positive content on social media improves body image for young women [22,47]. Increasing awareness and presence of these paradigms on social media could help mitigate the negative effects of diet culture messages on young viewers.

The dearth of expert voices on TikTok is difficult to combat, because it is challenging for experts like Registered Dietitians to garner views by mastering the TikTok algorithm, which often demands that one’s content is appealing to adolescents and young adults. Social media success can be cultivated by experts but takes concerted creative effort, time investment, and the right persona. Especially on TikTok, videos go viral in a way that is largely controlled by the proprietary algorithm that places videos on users’ for you pages. Therefore, although certainly it would help if more registered dietitians were able to gain attention on TikTok, it may be more realistic to help adolescents and young adults learn how to discern expert advice from unqualified advice by working on their media evidence analysis skills. Building media literacy for young adults is important, as previous research has found that media literacy may help decrease body dissatisfaction and thin-ideal internalization [48]. It may also behoove practitioners to discuss what type of content young adults are seeing on TikTok and how they could begin to avoid the weight-normative content on the app if they would like to by blocking or unfollowing particular accounts. Helping young adults curate their social media feeds is one way to reduce exposure to diet culture messaging. Future research should focus on how health experts can best engage with youth on platforms like TikTok.

Strengths and limitations

This study is the first to our knowledge to examine nutrition and body-image related content on TikTok. TikTok’s popularity especially among young people makes it an important driver of cultural trends, and therefore it is imperative to understand the content present on the app. The study also included a large sample of highly viewed videos, indicating that the themes identified are representative of the content millions of users are engaging with. Additionally, the study deliberately coded for weight inclusive content in an effort to better understand if weight inclusivity is widely represented on a social media site. Previous work on social media has not specifically examined the presence or absence of weight inclusivity.

It is important to note that all videos were coded based on subjective observations by the four female coders. This means that gathering results such as user demographics (age, race, gender, body size) was not meant to be definitive, but rather to gather a general understanding of the people who are creating this type of content based on the available information that could be observed from the video. While differences in coder opinions were accounted for by having each video coded by two different coders, and then running cross comparisons, there is no way of knowing the exact demographics of each user beyond merely our observations. Additionally, not all TikTok videos were downloadable. A small percentage were skipped over when collecting the 100 videos from each hashtag because of this, and were not included in the study. Some of the videos appeared in more than just one of the selected hashtags, so the total 1000 videos that were coded included several duplicates, possibly reducing variety in the data. However, since the first 100 downloadable videos of each hashtag were chosen, duplicates in this study exist because they were popular enough to appear in the top viewed videos of more than one of hashtags, and so their inclusion in the study still provides valuable insights. The videos also only capture one point in time, and trends across TikTok change frequently. Therefore, it is possible that although the hashtags analyzed remain quite popular on the app, specific trends depicted in the video may have changed over time. Finally, as the study only examined one social media platform, the results cannot be generalized across various other social media outlets.

Conclusions

This analysis found that nearly all the 1,000 TikTok videos collected displayed content that was notably weight normative. Key themes included glorification of weight loss, the positioning of food to achieve health and thinness, and the lack of expert voices providing nutrition and health information. Perhaps the most problematic finding from this study is that young people are most frequently engaging and creating diet culture content. The many trends associated with weight loss omit lifestyle factors that play a role in weight and health, and leave viewers with the message that weight loss and thinness is achievable and desirable to all, potentially leading to unhealthy perceptions and behaviors surrounding food, weight and body image [49]. Knowing what type of weight, food, and nutrition-related content is prevalent on TikTok is important so health professionals can better understand what type of messaging young people are engaged with, and begin to formulate strategies to counter the negative impacts that may arise from frequently viewing weight-normative content.

Supporting information

S1 Table. Codebook definitions and examples.

(DOCX)

Acknowledgments

The authors would like to thank Ellie Blom and Kira Mincar for their help with data analysis, both Ellie and Kira have given permission to be acknowledged.

Data Availability

Links to videos and screenshots from each hashtag used in the study can be found below. The data is shared by hashtag so it is organized logically. #bodypositivity: https://doi.org/10.6084/m9.figshare.21082015.v1 #diet: https://doi.org/10.6084/m9.figshare.21081952.v1 #fatloss: https://doi.org/10.6084/m9.figshare.21081757.v1 #mealprep: https://doi.org/10.6084/m9.figshare.21081673.v1 #plussize: https://doi.org/10.6084/m9.figshare.21070903.v1 #weightloss: https://doi.org/10.6084/m9.figshare.21070846.v1 #weightlosscheck: https://doi.org/10.6084/m9.figshare.21070783.v1 #whatieatinaday: https://doi.org/10.6084/m9.figshare.21067525.v1 #weightlossjourney: https://doi.org/10.6084/m9.figshare.21067510.v1 #nutrition: https://doi.org/10.6084/m9.figshare.21067504.v1.

Funding Statement

The authors received no specific funding for this work.

References

  • 1.Villanti AC, Johnson AL, Ilakkuvan V, Jacobs MA, Graham AL, Rath JM. Social media use and access to digital technology in US young adults in 2016. Journal of medical Internet research. 2017;19(6): e196. doi: 10.2196/jmir.7303 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Harrison C. What is Diet Culture. 2018. Aug 10 [cited 2022 Sept 26]. In: Christy Harrison Blog; [Internet]. New York. [about 2 screens]. Available from: https://christyharrison.com/blog/what-is-diet-culture. [Google Scholar]
  • 3.Jebeile H, Partridge SR, Gow ML, Baur LA, Lister NB. Adolescent Exposure to Weight Loss Imagery on Instagram: A Content Analysis of “Top” Images. Childhood Obesity. 2021;17(4): 241–248. doi: 10.1089/chi.2020.0351 [DOI] [PubMed] [Google Scholar]
  • 4.Lucibello KM, Vani MF, Koulanova A, deJonge ML, Ashdown-Franks G, Sabiston CM. # quarantine15: A content analysis of Instagram posts during COVID-19. Body Image. 2021;38:148–56. doi: 10.1016/j.bodyim.2021.04.002 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Alberga AS, Withnell SJ, von Ranson KM. Fitspiration and thinspiration: a comparison across three social networking sites. Journal of Eating Disorders. 2018;6(1): 39. doi: 10.1186/s40337-018-0227-x [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Tiggemann M, Zaccardo M. ‘Strong is the new skinny’: A content analysis of# fitspiration images on Instagram. Journal of health psychology. 2018;23(8):1003–11. doi: 10.1177/1359105316639436 [DOI] [PubMed] [Google Scholar]
  • 7.Pila E, Mond JM, Griffiths S, Mitchison D, Murray SB. A thematic content analysis of# cheatmeal images on social media: Characterizing an emerging dietary trend. International Journal of Eating Disorders. 2017;50(6): 698–706. doi: 10.1002/eat.22671 [DOI] [PubMed] [Google Scholar]
  • 8.Lydecker JA, Cotter EW, Palmberg AA, Simpson C, Kwitowski M, White K, et al. Does this Tweet make me look fat? A content analysis of weight stigma on Twitter. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2016;21(2): 229–35. doi: 10.1007/s40519-016-0272-x [DOI] [PubMed] [Google Scholar]
  • 9.Tylka TL, Annunziato RA, Burgard D, Daníelsdóttir S, Shuman E, Davis C, et al. The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of obesity. 2014; 2014. doi: 10.1155/2014/983495 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Bégin C, Carbonneau E, Gagnon-Girouard M-P, Mongeau L, Paquette M-C, Turcotte M, et al. Eating-related and psychological outcomes of health at every size intervention in health and social services centers across the Province of Quebec. American Journal of Health Promotion. 2019;33(2): 248–58. [DOI] [PubMed] [Google Scholar]
  • 11.Bruce LJ, Ricciardelli LA. A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite. 2016;96: 454–72. doi: 10.1016/j.appet.2015.10.012 [DOI] [PubMed] [Google Scholar]
  • 12.Hawks S, Madanat H, Hawks J, Harris A. The relationship between intuitive eating and health indicators among college women. Journal of Health Education. 2005;36(6): 331–6. [Google Scholar]
  • 13.Mensinger JL, Calogero RM, Stranges S, Tylka TL. A weight-neutral versus weight-loss approach for health promotion in women with high BMI: A randomized-controlled trial. Appetite. 2016;105: 364–74. doi: 10.1016/j.appet.2016.06.006 [DOI] [PubMed] [Google Scholar]
  • 14.Van Dyke N, Drinkwater EJ. Review article relationships between intuitive eating and health indicators: literature review. Public health nutrition. 2014;17(8): 1757–66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Wilksch SM, O’Shea A, Ho P, Byrne S, Wade TD. The relationship between social media use and disordered eating in young adolescents. International Journal of Eating Disorders. 2020;53(1): 96–106. doi: 10.1002/eat.23198 [DOI] [PubMed] [Google Scholar]
  • 16.Fardouly J, Vartanian LR. Social media and body image concerns: Current research and future directions. Current opinion in psychology. 2016;9: 1–5. [Google Scholar]
  • 17.Holland G, Tiggemann M. A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body image. 2016;17: 100–10. doi: 10.1016/j.bodyim.2016.02.008 [DOI] [PubMed] [Google Scholar]
  • 18.Sherman A. TikTok reveals detailed user numbers for the first time. CNBC. 2020. Aug 24 [Cited 2022 Sept 26]. Available from: https://www.cnbc.com/2020/08/24/tiktok-reveals-us-global-user-growth-numbers-for-first-time.html. [Google Scholar]
  • 19.Zhong R, Frenkel S. A Third of TikTok’s U.S. Users May Be 14 or Under, Raising Safety Questions. New York Times. 2020 Aug 14 [Cited Sept 26]. Available from: https://www.nytimes.com/2020/08/14/technology/tiktok-underage-users-ftc.html.
  • 20.Wadhwa T. Coming together to support body positivity on TikTok. 2020 Sept 23 [cited 2022 Sept 26]. In TikTok Newsroom [Internet]. United States: TikTok. [about 2 screens]. Available from: https://newsroom.tiktok.com/en-us/coming-together-to-support-body-positivity-on-tiktok.
  • 21.Wadhwa T. Supporting #NEDAwareness and body inclusivity on TikTok. 2021 Feb 22 [cited 2022 Sept 26]. In TikTok Newsroom [Internet]. United States: TikTok. [about 3 screens]. Available from: https://newsroom.tiktok.com/en-us/supporting-nedawareness-and-body-inclusivity-on-tiktok.
  • 22.Cohen R, Fardouly J, Newton-John T, Slater A. # BoPo on Instagram: An experimental investigation of the effects of viewing body positive content on young women’s mood and body image. New Media & Society. 2019;21(7): 1546–64. [Google Scholar]
  • 23.Webb JB, Vinoski ER, Bonar AS, Davies AE, Etzel L. Fat is fashionable and fit: A comparative content analysis of Fatspiration and Health at Every Size® Instagram images. Body image. 2017;22: 53–64. doi: 10.1016/j.bodyim.2017.05.003 [DOI] [PubMed] [Google Scholar]
  • 24.Brooks J, McCluskey S, Turley E, King N. The utility of template analysis in qualitative psychology research. Qualitative research in psychology. 2015;12(2): 202–22. doi: 10.1080/14780887.2014.955224 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. International journal of qualitative methods. 2017;16(1). [Google Scholar]
  • 26.Goodyear VA, Armour KM. Young people’s perspectives on and experiences of health-related social media, apps, and wearable health devices. Social Sciences. 2018;7(8): 137. [Google Scholar]
  • 27.Holmberg C, Berg C, Dahlgren J, Lissner L, Chaplin JE. Health literacy in a complex digital media landscape: pediatric obesity patients’ experiences with online weight, food, and health information. Health informatics journal. 2019;25(4): 1343–57. doi: 10.1177/1460458218759699 [DOI] [PubMed] [Google Scholar]
  • 28.Tiggemann M, Miller J. The Internet and adolescent girls’ weight satisfaction and drive for thinness. Sex roles. 2010;63(1–2): 79–90. [Google Scholar]
  • 29.Pearl RL, Puhl RM. The distinct effects of internalizing weight bias: An experimental study. Body Image. 2016;17: 38–42. doi: 10.1016/j.bodyim.2016.02.002 [DOI] [PubMed] [Google Scholar]
  • 30.Clabaugh A, Karpinski A, Griffin K. Body weight contingency of self-worth. Self and Identity. 2008;7(4): 337–59. [Google Scholar]
  • 31.Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Current Opinion in Cardiology. 2017;32(5): 541–56. doi: 10.1097/HCO.0000000000000437 [DOI] [PubMed] [Google Scholar]
  • 32.Dittmar H. How do “body perfect” ideals in the media have a negative impact on body image and behaviors? Factors and processes related to self and identity. Journal of Social and Clinical Psychology. 2009;28(1): 1–8. [Google Scholar]
  • 33.Hesse-Biber SN. The cult of thinness: Oxford University Press; 2007. [Google Scholar]
  • 34.Bacon L, Aphramor L. Weight science: evaluating the evidence for a paradigm shift. Nutrition journal. 2011;10(1): 1–13. doi: 10.1186/1475-2891-10-9 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 35.Lissner L, Odell PM, D’Agostino RB, Stokes J III, Kreger BE, Belanger AJ, et al. Variability of body weight and health outcomes in the Framingham population. New England Journal of Medicine. 1991;324(26): 1839–44. doi: 10.1056/NEJM199106273242602 [DOI] [PubMed] [Google Scholar]
  • 36.Rzehak P, Meisinger C, Woelke G, Brasche S, Strube G, Heinrich J. Weight change, weight cycling and mortality in the ERFORT Male Cohort Study. European journal of epidemiology. 2007;22(10): 665–73. doi: 10.1007/s10654-007-9167-5 [DOI] [PubMed] [Google Scholar]
  • 37.Gaesser GA, Angadi SS. Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. Iscience. 2021: 102995. doi: 10.1016/j.isci.2021.102995 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Puhl RM, Moss‐Racusin CA, Schwartz MB. Internalization of weight bias: implications for binge eating and emotional well‐being. Obesity. 2007;15(1): 19–23. doi: 10.1038/oby.2007.521 [DOI] [PubMed] [Google Scholar]
  • 39.Wang SS, Brownell KD, Wadden TA. The influence of the stigma of obesity on overweight individuals. International journal of obesity. 2004;28(10): 1333–7. doi: 10.1038/sj.ijo.0802730 [DOI] [PubMed] [Google Scholar]
  • 40.Kahan S, Puhl RM. The damaging effects of weight bias internalization. Obesity. 2017;25(2): 280. doi: 10.1002/oby.21772 [DOI] [PubMed] [Google Scholar]
  • 41.Harrison C. Anti-diet: Reclaim your time, money, well-being, and happiness through intuitive eating: New York: Hachette; 2019. [Google Scholar]
  • 42.Koven NS, Abry AW. The clinical basis of orthorexia nervosa: emerging perspectives. Neuropsychiatric disease and treatment. 2015;11:385. doi: 10.2147/NDT.S61665 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Weiner J. The Weight-Loss Industry is Coming for Our Post-Lockdown Bodies. New York Times. 2021 May 5 [Cited 2022 Sept 26]. Available from: https://www.nytimes.com/2021/05/05/opinion/culture/dieting-covid-weight-loss.html.
  • 44.Sole-Smith V. Post-Pandemic Wardrobe Anxiety Has Nothing to Do with Your Body. InStyle. 2021. May 12 [Cited 2022 Sept 26]. Available from: https://www.instyle.com/lifestyle/wardrobe-anxiety-post-pandemic. [Google Scholar]
  • 45.Camilleri GM, Méjean C, Bellisle F, Andreeva VA, Kesse‐Guyot E, Hercberg S, et al. Intuitive eating is inversely associated with body weight status in the general population‐based NutriNet‐Santé study. Obesity. 2016;24(5): 1154–61. doi: 10.1002/oby.21440 [DOI] [PubMed] [Google Scholar]
  • 46.Denny KN, Loth K, Eisenberg ME, Neumark-Sztainer D. Intuitive eating in young adults. Who is doing it, and how is it related to disordered eating behaviors? Appetite. 2013;60: 13–9. doi: 10.1016/j.appet.2012.09.029 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Rodgers RF, Paxton SJ, Wertheim EH. #Take idealized bodies out of the picture: A scoping review of social media content aiming to protect and promote positive body image. Body Image. 2021;38: 10–36. doi: 10.1016/j.bodyim.2021.03.009 [DOI] [PubMed] [Google Scholar]
  • 48.Rodgers RF, McLean SA, Paxton SJ. When seeing is not believing: An examination of the mechanisms accounting for the protective effect of media literacy on body image. Sex Roles. 2019;81(1): 87–96. [Google Scholar]
  • 49.Fardouly J, Pinkus RT, Vartanian LR. The impact of appearance comparisons made through social media, traditional media, and in person in women’s everyday lives. Body Image. 2017;20: 31–9. doi: 10.1016/j.bodyim.2016.11.002 [DOI] [PubMed] [Google Scholar]

Decision Letter 0

Eliana Carraça

15 Aug 2022

PONE-D-22-11377Weight-Normative Messaging Predominates on TikTok – A Qualitative Content AnalysisPLOS ONE

Dear Dr. Pope,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

ACADEMIC EDITOR: This is a very relevant topic nowadays, addressed in a well-written paper. Still, there are some concerns with regard to the contribution of the paper to the scientific literature, rigor and depth of analysis, and extrapolation of authors' interpretations of their results. Although our decision is minor revisions, some of these concerns are considered major issues. Thus, these aspects should be well addressed by the authors. Pay close attention to the reviewer's comments. As finding reviewers for this paper was very difficult at this moment, I have also reviewed the paper. Find attached the paper with my comments/suggestions.

Please submit your revised manuscript by Sep 19 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Eliana Carraça

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. In your Methods section, please include additional information about your dataset and ensure that you have included a statement specifying whether the collection and analysis method complied with the terms and conditions for the source of the data.

3. You indicated that ethical approval was not necessary for your study. We understand that the framework for ethical oversight requirements for studies of this type may differ depending on the setting and we would appreciate some further clarification regarding your research. Could you please provide further details on why your study is exempt from the need for approval and confirmation from your institutional review board or research ethics committee (e.g., in the form of a letter or email correspondence) that ethics review was not necessary for this study? Please include a copy of the correspondence as an "Other" file.

4. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability.

"Upon re-submitting your revised manuscript, please upload your study’s minimal underlying data set as either Supporting Information files or to a stable, public repository and include the relevant URLs, DOIs, or accession numbers within your revised cover letter. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. Any potentially identifying patient information must be fully anonymized.

Important: If there are ethical or legal restrictions to sharing your data publicly, please explain these restrictions in detail. Please see our guidelines for more information on what we consider unacceptable restrictions to publicly sharing data: http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. Note that it is not acceptable for the authors to be the sole named individuals responsible for ensuring data access.

We will update your Data Availability statement to reflect the information you provide in your cover letter.

5. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

This is a very relevant topic nowadays, addressed in a well-written paper. Still, there are some concerns with regard to the contribution of the paper to the scientific literature, rigor and depth of analysis, and extrapolation of authors' interpretations of their results. Although our decision is minor revisions, some of these concerns are considered major issues. Thus, these aspects should be well addressed by the authors. Pay close attention to the reviewer's comments.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

********** 

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

********** 

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

********** 

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

********** 

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This is an interesting study presented well however there are some concerns with regard to the contribution to scientific literature and rigor of methods.

1. The analysis done is a content analysis with quantification - please clarify this in the methods

2. There are some findings presented in the discussion such as - line 27 on page 5 An example pattern would be users showing their weight transformation, paired with explaining “what they ate on their journey.” and line 245 on page 13 Dialogue, sounding like a pep talk from a coach or a trainer, containing phrases such

as “no excuses,” “get up” and “if you want it bad enough, you’ll do it,” implies that not trying to

lose weight makes you lazy, and inferior to those who are pursuing weight loss. These findings have not been presented in the results..the analysis could include a thematic analysis -all transcripts (text) could be coded and then themes identified.

3. Much of the discussion reads meaning into the text of the videos this is not scientifically appropriate nor robust as a method

4. Limitation - please mention that this reflects only one social media platform and the study would have been richer if other platforms such as Instagram would have been included

5.Please specify clearly what time period the data was collected- some places 'fall' is mentioned and another place September...this analysis is very sensitive to time and what was trending then may not be trending now..please mention in limitations

6. The discussion currently presents new data with interpretation..please consider deepening the analysis on what the study tells us, who it would benefit what kinds of action can be recommended ..how this study contributes or relates to other scientific literature.

********** 

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachment

Submitted filename: PONE-D-22-11377_editor revision.pdf

PLoS One. 2022 Nov 1;17(11):e0267997. doi: 10.1371/journal.pone.0267997.r002

Author response to Decision Letter 0


12 Sep 2022

Reviewer #1: This is an interesting study presented well however there are some concerns with regard to the contribution to scientific literature and rigor of methods.

1. The analysis done is a content analysis with quantification - please clarify this in the methods

We have clarified that the analysis was a thematic analysis with quantification.

2. There are some findings presented in the discussion such as - line 27 on page 5 An example pattern would be users showing their weight transformation, paired with explaining “what they ate on their journey.” and line 245 on page 13 Dialogue, sounding like a pep talk from a coach or a trainer, containing phrases such as “no excuses,” “get up” and “if you want it bad enough, you’ll do it,” implies that not trying to lose weight makes you lazy, and inferior to those who are pursuing weight loss. These findings have not been presented in the results..the analysis could include a thematic analysis -all transcripts (text) could be coded and then themes identified.

We did conduct a thematic analysis, where we coded all videos including their dialogue, sounds, and actions to identify predominate themes. We have restructured our paper with a combined results/discussion divided by theme to more clearly delineate the themes we identified in the data.

3. Much of the discussion reads meaning into the text of the videos this is not scientifically appropriate nor robust as a method

We respectfully disagree that the discussion reads meaning into the text of the videos. The discussion section identifies themes that emerged from the videos and then uses examples from the videos to illustrate those themes. The discussion also explains why these themes may be helpful or hurtful to a viewer. The authors are not implying that a particular creator meant to for example, glorify weight loss, but any video that spoke positively of weight loss was coded into this theme, and then previous research has indicated how the glorification of weight loss may be harmful. In the discussion we hoped to help readers realize why the themes we identified were important, we meant to provide meaning to our themes, not to interpret particular videos beyond categorizing them into our themes. We have made sure to tone down any causative language that may have been in the discussion which hopefully will help with this concern. If you can provide specific examples of where you feel we have over-reached in our discussion, we are happy to revise.

4. Limitation - please mention that this reflects only one social media platform and the study would have been richer if other platforms such as Instagram would have been included

We have added this as a limitation.

5.Please specify clearly what time period the data was collected- some places 'fall' is mentioned and another place September...this analysis is very sensitive to time and what was trending then may not be trending now..please mention in limitations

The posts were collected in September 2020, we have specified this throughout the manuscript. We have added a limitation about how trends continue to change on TikTok, although the hashtags we analyzed have substantially more views today than they did when we analyzed them, indicating that they continue to be popular on TikTok.

6. The discussion currently presents new data with interpretation..please consider deepening the analysis on what the study tells us, who it would benefit what kinds of action can be recommended ..how this study contributes or relates to other scientific literature.

We have restructured the paper to have a combined results/discussion section presented by theme. We feel that this structure better presents our quantitative and qualitative data. In the discussion section we have also added several tie ins to previous literature on social media. We have recommended that adults help young adults curate their social media feeds and improve their evidence analysis skills. We also think it’s important for experts to begin to engage on social media platforms to highlight weight-inclusive content. We have highlighted these suggestions in our discussion. As this paper didn’t study possible solutions to the weight-normative inaccurate content on TikTok, we can only offer suggestions for future research.

Editor’s Comments

We believe we have addressed all of the editor’s comments. Thank you.

Attachment

Submitted filename: Reviewer Response_8_15_22.docx

Decision Letter 1

Eliana Carraça

26 Sep 2022

PONE-D-22-11377R1Weight-Normative Messaging Predominates on TikTok – A Qualitative Content AnalysisPLOS ONE

Dear Dr. Pope,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

ACADEMIC EDITOR:The authors have replied satisfactorily to all reviewer's queries. There are still some minor issues to address. Please make those amendments and resubmit and improved version of the paper. Please check the attached file.

==============================

Please submit your revised manuscript by October 10, 2022. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Eliana Carraça

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments: -

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Attachment

Submitted filename: PONE-D-22-11377_R1_AcEdit.pdf

PLoS One. 2022 Nov 1;17(11):e0267997. doi: 10.1371/journal.pone.0267997.r004

Author response to Decision Letter 1


26 Sep 2022

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

We have checked all references and do not believe any articles have been retracted. We also updated the reference formats for several of the references to make sure they had correct links included. We are happy to update additional references if anything has been missed. Thank you!

Attachment

Submitted filename: PLOS ONE Response To Reviewers 9_26_22.docx

Decision Letter 2

Eliana Carraça

4 Oct 2022

PONE-D-22-11377R2Weight-Normative Messaging Predominates on TikTok – A Qualitative Content AnalysisPLOS ONE

Dear Dr. Pope,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Nov 17 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Eliana Carraça

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Dear Dr. Pope,

Please, resubmit your paper addressing all the editor's comments. Thank you.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2022 Nov 1;17(11):e0267997. doi: 10.1371/journal.pone.0267997.r006

Author response to Decision Letter 2


4 Oct 2022

PLOS ONE Response To Reviewers 9/26/22

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

We have checked all references and do not believe any articles have been retracted. We also updated the reference formats for several of the references to make sure they had correct links included. We are happy to update additional references if anything has been missed. Thank you!

Editor’s Comments

Lines 243-246. Not sure you can make this interpretation. I believe you could say that those sentences imply that one might be lazy or lack strong will to move or do something, bu I cannot see how it can directly imply inferiority and social comparison. Please adjust sentence. Also, find some references that support this interpretation of yours.

We agree that perhaps the dialogue does not imply social comparison directly. We have revised and removed the social comparison language, replacing it with an interpretation that the dialogue implies that not being able to lose weight is a personal failing of motivation. We hope this edit addresses the editor’s concern.

Adjust sentence. There are two "reported". Sentence is confuse.

Thank you, the sentence has been revised.

Attachment

Submitted filename: PLOS ONE Response To Reviewers 9_26_22.docx

Decision Letter 3

Eliana Carraça

20 Oct 2022

Weight-Normative Messaging Predominates on TikTok – A Qualitative Content Analysis

PONE-D-22-11377R3

Dear Dr. Pope,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Eliana Carraça

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Acceptance letter

Eliana Carraça

24 Oct 2022

PONE-D-22-11377R3

Weight-normative messaging predominates on TikTok – a qualitative content analysis

Dear Dr. Pope:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at plosone@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Eliana Carraça

Academic Editor

PLOS ONE

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    S1 Table. Codebook definitions and examples.

    (DOCX)

    Attachment

    Submitted filename: PONE-D-22-11377_editor revision.pdf

    Attachment

    Submitted filename: Reviewer Response_8_15_22.docx

    Attachment

    Submitted filename: PONE-D-22-11377_R1_AcEdit.pdf

    Attachment

    Submitted filename: PLOS ONE Response To Reviewers 9_26_22.docx

    Attachment

    Submitted filename: PLOS ONE Response To Reviewers 9_26_22.docx

    Data Availability Statement

    Links to videos and screenshots from each hashtag used in the study can be found below. The data is shared by hashtag so it is organized logically. #bodypositivity: https://doi.org/10.6084/m9.figshare.21082015.v1 #diet: https://doi.org/10.6084/m9.figshare.21081952.v1 #fatloss: https://doi.org/10.6084/m9.figshare.21081757.v1 #mealprep: https://doi.org/10.6084/m9.figshare.21081673.v1 #plussize: https://doi.org/10.6084/m9.figshare.21070903.v1 #weightloss: https://doi.org/10.6084/m9.figshare.21070846.v1 #weightlosscheck: https://doi.org/10.6084/m9.figshare.21070783.v1 #whatieatinaday: https://doi.org/10.6084/m9.figshare.21067525.v1 #weightlossjourney: https://doi.org/10.6084/m9.figshare.21067510.v1 #nutrition: https://doi.org/10.6084/m9.figshare.21067504.v1.


    Articles from PLOS ONE are provided here courtesy of PLOS

    RESOURCES