TikTok Changed How We Talk About Health

Some of the posts are raw. Some are insightful, others wildly elaborate. Some are just plain wrong.

TikTok, which may soon be banned in the United States, has changed American culture in many ways. But its impact on how we talk about health stands out. In tens of millions of videos, users have opened up about their health and how they take care of themselves in big and small ways. They have touted “Oatzempic” for weight loss and extolled the (supposed) benefits of beef tallow face masks. They have shared their abortion stories and brought viewers inside the reality of living with terminal illnesses. And sometimes they have shared health advice so off-base that doctors and therapists stepped in to correct the record.

“Anyone that had a camera and a personality could get their message out,” said Aric Prather, a sleep psychologist at the University of California, San Francisco. More than 10 million videos are tagged #health on the app, and millions more are posted under related hashtags like #selfcare.

TikTok wasn’t the only platform to democratize information online. But there is something special about the way its algorithm brings people together to talk about deeply personal topics, and keeps the conversation going as more and more users join in.

TikTok broadcasts the minutiae of how people try to stay well — the morning lemon water, the evening “sleepy girl mocktails.” No space is too private, no aspect of daily life too banal to become a “ritual” or a “routine.”

This type of content is so popular that it has spawned a sort of personal health arms race. People share increasingly complicated skin care routines, with lip scrubs, red-light masks and pricey serums. (Even teens and preteens with supple, unravaged skin swap “anti-aging” tips.) Users try to optimize their sleep (and their viewers’) by taping their mouths shut at night and boiling lettuce in water to drink before bed. When they wake up, they document their “morning shed” as they strip away layers of sleep accessories and beauty products.

There is an irony to the fixation on better rest. “TikTok in particular is a funny vehicle for it, given that many people spend a lot of time not sleeping and watching it instead,” Dr. Prather said.

… and a window into what doctors thought about it.

The flood of health advice from users with no medical expertise brought doctors to TikTok in droves. Many see themselves as fact-checkers, helping people separate truth from fiction, said Dr. Brooke Jeffy, a practicing dermatologist in Scottsdale, Ariz., who often posts on the platform.

Numerous studies have found TikTok to be a breeding ground for inaccurate health information. Doctors have expressed concerns that such misinformation — particularly on serious diseases like cancer — could have dangerous consequences for people’s health.

A spokesperson for TikTok declined to comment on the Supreme Court decision this week and the platform’s contributions to health conversations in the United States, instead pointing to collaborations with health authorities and mental health resources on its site.

It took self-diagnosis mainstream.

There’s an uncanny sense that the app knows you, serving up content that describes your symptoms — and sometimes even dangling a diagnosis.

Some creators have built large followings by detailing “hidden signs” of conditions like autism, attention deficit hyperactivity disorder and bipolar disorder. Others share quizzes to get people thinking about whether they might have one of these conditions.

Some of these posts, which have led users to diagnose themselves with mental health conditions, oversimplify complicated disorders. Some of them have no basis in fact at all. Some videos have been sponsored by telehealth companies that offered treatments for these conditions.

“Therapyspeak” has also exploded on the platform, with people branding their exes “gaslighters” or talking about “trauma bonding” — using, misusing and popularizing jargon that was once confined to the therapist’s office. These terms have become so pervasive that videos popped up to parody the trend.

It ushered in a new era of diet culture.

Weight loss content was around long before TikTok, and it will persist long after it. But TikTok gave us more palatable terms to reinforce long-running and harmful ideas about body image, said Lizzy Pope, an associate professor of nutrition at the University of Vermont who has studied the messaging around weight on TikTok.

“Diet culture’s always shape-shifting,” Dr. Pope said. For a while, she noted, many posts on TikTok were all about “protein, protein, protein.”

“I think it’s just a guise for losing weight,” she added.

For example, Dr. Pope said: You’re not dieting when you cut out carbs; you’re balancing your hormones, according to TikTok. You’re not “cleansing” to lose weight; you’re caring for your gut health. Julie Balsamo, a creator who posts about gut health in TikToks like the video above, told The New York Times that social media posts sometimes suggest that gut health is all about “restriction.” Her message, she said, is that a healthy gut comes from a diverse diet.

Perhaps nothing turbocharged the TikTok conversation around weight and weight loss more than the rise of Ozempic. The app has become a hub for people to show off their bodies “before” and “after” new weight loss and diabetes drugs. Users record their first injections and document their side effects. Some research suggests that TikTok videos have even driven up interest in the drugs — and, potentially, prescriptions for them.

It got us talking about taboo health topics.

In the early months of the Covid-19 pandemic, the platform became a forum for people to connect over the anxieties of isolation under lockdown, to swap Covid information (and misinformation) and to talk about their health challenges.

“We couldn’t seek out care in the ways that we normally did, and as a result you got these comment sections of everybody trying to figure out everyone else’s problem,” said Dr. Sasha Hamdani, a psychiatrist in Leawood, Kan., who posts about mental health in TikToks like the one above. “And it just became this incredible way for people to destigmatize and for health care providers to reach people truly where they were at.”

At the same time, she said, people seemed to become more willing to talk about mental health, abortion, addiction and other once-taboo topics in confessional-style videos. It inspired Dr. Hamdani to do so herself: She posts frequently about her struggles with A.D.H.D.

Thriving communities have emerged around physical and mental health issues. There’s DiabetesTok, where users take people through supermarket aisles to find foods to help keep blood sugar in check. There’s GriefTok, where posts about loss feel as intimate as diary entries. And there’s SoberTok, where people discuss their struggles with alcoholism and recovery.

Each video is a small but meaningful part of the collective endless scroll.

Credits: @nutritionbyjulie/TikTok; @winnie_thepooj/TikTok; @jelks/TikTok; @megsdeangelis/TikTok; @dermangelo/TikTok; @des.dallagiacomo/TikTok; @trinityywyaa/TikTok; @carringtonxx/TikTok; @thepsychdoctormd/TikTok; @jojoasmr/TikTok; @brookejeffymd/TikTok; @baptisthealthsf/TikTok.