Hundreds of extreme weight loss and cosmetic surgery videos were easily found with a simple search on TikTok and available to a user under the age of 18, in violation of the platform’s own policies, CBS News has found.  

CBS News created a TikTok account for a hypothetical 15-year-old female user in the United States and found that, at the very least, hundreds of extreme weight loss and cosmetic surgery videos were searchable and watchable on the platform using the account.

Once the CBS News account interacted with a handful of these videos, similar content was then recommended to the account on TikTok’s “For You” feed. 

Searchable videos ranged from content with captions such as, “nothing feels better than an empty stomach,” to “what I eat in a day” videos promoting restrictive, 500-calorie-per-day diets. Guidelines published by the U.S. National Institutes of Health suggest that girls between the ages of 14 and 18 ingest between 1,800 and 2,400 calories per day.

Many of the videos promoted thin body types as aspirational targets and included the hashtag “harsh motivation” to push extreme weight loss advice.

Some of those videos included messages or slogans such as “skinny is a status symbol” and “every time you say no to food, you say yes to skinny.” 

TikTok’s community guidelines say the platform only allows users over the age of 18 to see content promoting restrictive, low-calorie diets, including videos promoting medications for weight loss or idealizing certain body types. The Chinese-owned platform also says it bans users under the age of 18 from viewing videos that promote cosmetic surgery without warning of the risks, such as before-and-after images, videos of surgical procedures, and messages discussing elective cosmetic surgery.

But CBS News found a range of videos by entering basic search terms on the platform, such as “skinny,” “thin,” and “low cal,” that promoted thin bodies as ideal, while also pushing harmful weight management behaviors. One such video showed an image of a scale with a weight of 39.9 kg (88 pounds) alongside a caption saying “weight loss” and the hashtag “ed,” which is a common abbreviation for “eating disorder.”

Another graphic video with the caption “ana gives you wings” showed a series of models with protruding collar bones and spines. The term “ana” is an abbreviation for the eating disorder anorexia. 

Responding to CBS News’ research, a TikTok spokesperson said Thursday that it was “based on a very limited sample size and does not reflect the experience of the vast majority of our community.”

“TikTok does not allow content that promotes disordered eating or extreme weight loss behaviours, and we work with health experts to provide in-app support resources where needed,” the spokesperson said. 

The spokesperson pointed to a study published in May by the University of Southern California, which found that a majority of the eating disorder content on TikTok is discussion among users about recovery from such conditions.  

The same study noted, however, the platform’s “dual role in both challenging harmful cultural norms and potentially perpetuating them,” regarding body image perceptions and eating disorders. 

“We know that this isn’t a one-off error on TikTok’s part and that children are coming across this content on a scale,” said Gareth Hill, a spokesperson for the Molly Russell foundation, a charity in the United Kingdom that works to prevent young people from committing self-harm. 

“The question for TikTok is, if this is not representative, then why has this account [created by CBS News], which is a child’s account, been shown this content in the first place, and then why is it continuing to get recommended to it?” 

CBS News also found a wide variety of videos available to the under-18 user promoting the weight loss drug Ozempic and various forms of cosmetic surgery. That included videos that showed up on the recommended “For You” feed, which promotes cosmetic surgeries such as rhinoplasty, breast augmentation, and liposuction. 

In one case, a user talking about their waist reduction surgery included a voiceover saying: “I would rather die hot than live ugly.”

A TikTok spokesperson declined to comment specifically on CBS News’ findings regarding cosmetic surgeries being promoted to underage users. 

TikTok says it has taken a range of measures over the past several months to address criticism regarding the availability of extreme weight loss content on the platform. In early June, the platform suspended search results for the viral hashtag #SkinnyTok, after drawing criticism from health experts and European regulators. The hashtag had been associated primarily with videos promoting extreme weight loss, calorie restriction and negative body talk, often presented as wellness advice.

A TikTok spokesperson also told CBS News on Thursday that searches for words or phrases such as #Anorexia would lead users to relevant assistance, including localized eating disorder helplines, where they can access further information and support.

“I think we’re understanding more and more about how this content shows up and so even when you ban a particular hashtag, for example, it’s not long until something similar jumps up in its place,” Doreen Marshall, who leads the American nonprofit National Eating Disorders Association [NEDA], told CBS News. 

“This is going to be an evolving landscape both for creating content guidelines, but also for the platforms themselves and, you know, while some progress has been made, there’s clearly more that can be done,” Marshall said. 

TikTok is not the only social media platform that has faced criticism for the accessibility of extreme weight loss content. 

In 2022, 60 Minutes reported on a leaked internal document from Meta that showed the company was aware, through its own research, of content on its Instagram platform promoting extreme weight loss and fueling eating disorders in young people.

At the time, Meta, the parent company of Facebook and Instagram, declined 60 Minutes’ request for an interview but its global head of safety, Antigone Davis, said, “We want teens to be safe online” and that Instagram doesn’t “allow content promoting self-harm or eating disorders.”  

Last year, 60 Minutes reported that the Google-owned YouTube video platform, which is hugely popular among teenagers, was also serving up extreme weight loss and eating disorder content to children.

Responding to that report, a YouTube representative said the platform “continually works with mental health experts to refine [its] approach to content recommendations for teens.”

Available resources:

National Eating Disorder Association

If you or someone you know is experiencing concerns about body image or eating behaviors, NEDA has a free, confidential screening tool and resources at www.nationaleatingdisorders.org

F.E.A.S.T. is a nonprofit organization providing free support for caregivers with loved ones suffering from eating disorders.

Americans should eat more beans, peas and lentils and cut back on red and processed meats and starchy vegetables, all while continuing to limit added sugars, sodium and saturated fat.

That’s the advice released Tuesday by a panel of nutrition experts charged with counseling the U.S. government about the 2025 edition of the dietary guidelines that will form the cornerstone of federal food programs and policy.

But the 20-member panel didn’t weigh in on the growing role of ultraprocessed foods that have been linked to health problems, saying there’s not enough evidence to tell people to avoid them. And the group steered clear of updating controversial guidance on alcohol consumption, leaving that analysis to two outside reports expected to be released soon.

Overall, the recommendations for the 2025-2030 Dietary Guidelines for Americans sound familiar, said Marion Nestle, a food policy expert.

“This looks like every other set of dietary guidelines since 1980: eat your veggies and reduce consumption of foods high in salt, sugar and saturated fat,” Nestle said in an email. “This particular statement says nothing about balancing calories, when overconsumption of calories, especially from ultra-processed foods, is the biggest challenge to the health of Americans.”

The nutrition panel concluded that a healthy diet for people aged 2 years and older is higher in vegetables, fruits, legumes, nuts, whole grains, fish and and vegetable oils that are higher in unsaturated fat.

It is lower in red and processed meats, sugar-sweetened foods and beverages, refined grains and saturated fat. It may also include fat-free or low-fat dairy and foods lower in sodium and may include plant-based foods.

The panel, which met for nearly two years, was the first to focus on the dietary needs of Americans through what they called a “health equity lens,” said Dr. Fatima Cody Stanford, a Massachusetts General Hospital obesity expert who was part of the group. That meant considering factors such as household income, race, ethnicity and culture when recommending healthy diets. It will help ensure that the guidance “reflects and includes various population groups,” she said in an email.

Ultraprocessed foods include the snacks, sugary cereals and frozen meals that make up about 60% of the American diet.

The panel considered more than 40 studies, including several that showed links between ultraprocessed foods and becoming overweight or developing obesity. But the nutrition experts had concerns with the quality of the research, leaving them to conclude that the evidence was too limited to make recommendations.

That decision is likely to bump up against the views of Robert F. Kennedy, Jr., the nominee to lead the U.S. Health and Human Services Department, who has questioned potential conflicts of interest among members of the dietary guidelines panel and vowed to crack down on ultraprocessed foods that contribute to chronic disease.

The panel also didn’t revise recommendations that suggest limiting alcohol intake to two drinks or less a day for men and one drink or less a day for women.

In 2020, the last time the guidance was updated, the government rejected the advice of scientific advisers to recommend less alcohol consumption.

Two groups — the National Academies of Science, Engineering and Medicine and a committee of the government agency that oversees substance abuse — are expected to release reports in the coming months on the effects of moderate alcohol use to inform the guidelines.

The advisory panel acknowledged that the diets of most Americans don’t meet the current guidelines. More than half of all U.S. adults have one or more diet-related chronic health conditions and 18 million U.S. households have insecure sources of food, according to the report.

“Nutrition-related chronic health conditions and their precursors continue to threaten health through the lifespan,” the report concludes. “Which does not bode well for the future of health in the United States.”

The scientific report informs the dietary guidelines, which are updated every five years. Tuesday’s recommendations now go to HHS and the Agriculture Department, where officials will draft the final guidance set for release next year.

Starting Wednesday, the public will have 60 days to comment on the guidance. HHS and USDA officials will hold a public meeting Jan. 16 to discuss the recommendations.

The new guidance, which will be finalized by the incoming Trump administration, is consistent with decades of federal efforts to reduce diet-related disease in the U.S., said Dr. Peter Lurie, president of the advocacy group Center for Science in the Public Interest.

“Broadly, I think these are well-formulated recommendations that the incoming administration would do well to adopt,” Lurie said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The majority of strokes could be prevented, according to new guidelines aimed at helping people and their doctors do just that.

Stroke was the fourth leading cause of death in the U.S. in 2023, according to the Centers for Disease Control and Prevention, and more than half a million Americans have a stroke every year. But up to 80% of strokes may be preventable with better nutrition, exercise and identification of risk factors.

The first new guidelines on stroke prevention in 10 years from the American Stroke Association, a division of the American Heart Association, include recommendations for people and doctors that reflect a better understanding of who gets strokes and why, along with new drugs that can help reduce risk.

The good news is that the best way to reduce your risk for stroke is also the best way to reduce your risk for a whole host of health problems — eat a healthy diet, move your body and don’t smoke. The bad news is that it’s not always so easy to sustain.

Dr. Sean Duke, a stroke doctor at the University of Mississippi Medical Center, blames the forces in society that keep people sedentary and eating poorly, like cell phones and cheap, unhealthy food. “Our world is stacked against us,” he said.

Here’s what to know about stroke and the new guidelines:

A stroke happens when blood flow to part of the brain is blocked or if a blood vessel in the brain bursts. That deprives the brain of oxygen which can cause brain damage that can lead to difficulty thinking, talking and walking, or even death.

Eating healthy can help control several factors that increase your risk for stroke, including high cholesterol, high blood sugar, and obesity, according to the heart association.

The group recommends foods in the so-called Mediterranean diet such as fruits, vegetables, whole grains and olive oil, which can help keep cholesterol levels down. It suggests limiting red meat and other sources of saturated fat. Instead, get your protein from beans, nuts, poultry, fish and seafood.

Limit highly processed foods and foods and drinks with a lot of added sugar. This can also reduce your calorie intake, which helps keep weight in check.

Getting up and walking around for at least 10 minutes a day can “drastically” reduce your risk, said Dr. Cheryl Bushnell, a neurologist at Wake Forest University School of Medicine who was part of the group that came up with the new guidelines. Among the many benefits: Regular exercise can help reduce blood pressure, a major risk factor for stroke.

Of course, more is better: The heart association recommends at least 150 minutes of moderate aerobic or 75 minutes of vigorous activity — or some combination — per week. How you do it doesn’t matter so much, experts said: Go to the gym, take a walk or run in your neighborhood or use treadmills or stepper machines at home.

Diet and exercise can help control weight, another important risk factor for strokes. But a new class of drugs that can drastically reduce weight have been approved by regulators, providing new tools to reduce stroke risk since guidelines were last updated.

The guidelines now recommend that doctors consider prescribing these drugs, including those sold under the brand names Ozempic, Wegovy, Mounjaro and Zepbound, to people with obesity or diabetes.

But while those drugs can help, people still need to eat well and get exercise, cautions Dr. Fadi Nahab, a stroke expert at Emory University Hospital.

The new guidelines for the first time recommend doctors screen patients for other factors that could increase stroke risk, including sex and gender and non-medical factors such as economic stability, access to health care, discrimination and racism. For example, the risk for having a first stroke is nearly twice as high for Black adults in the U.S. as it is for white adults, according to the CDC.

“If somebody doesn’t have insurance or they can’t get to a doctor’s office because of transportation issues or they can’t get off work to get health care … these are all things that can impact the ability to prevent stroke,” Bushnell said.

Doctors may be able to point to resources for low-cost health care or food, and can give ideas about how to be active without breaking the bank for a gym membership.

The guidelines also now recommend doctors should screen for conditions that could increase a woman’s risk for stroke, such as high blood pressure during pregnancy or early menopause.

Three of the most common stroke symptoms include face weakness, arm weakness and difficulty speaking. And time is important, because brain damage can happen quickly and damage can be limited if a stroke is treated quickly. Stroke experts have coined an acronym to help you remember: FAST. F for face, A for arm, S for speech, and T for time. If you think you or a loved one could be having a stroke, call 911 right away.

___

AP data journalist Kasturi Pananjady contributed to this story.

___

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

SAO PAULO — SAO PAULO (AP) — Group of 20 leaders agreed Friday to join efforts to fight disinformation and set up an agenda on artificial intelligence as their governments struggle against the speed, scale and reach of misinformation and hate speech.

The ministers, who gathered this week in Maceio, the capital of the northeastern state of Alagoas, emphasized in a statement the need for digital platforms to be transparent and “in line with relevant policies and applicable legal frameworks.”

It is the first time in the G20’s history that the group recognizes the problem of disinformation and calls for transparency and accountability from digital platforms, João Brant, secretary for digital policy at the Brazilian presidency, told The Associated Press by phone.

G20 representatives also agreed to establish guidelines for developing artificial intelligence, calling for “ethical, transparent, and accountable use of AI,” with human oversight and compliance with privacy and human rights laws.

“We hope this will be referenced in the leaders’ declaration and that South Africa will continue the work,” Renata Mielli, adviser to Brazil’s ministry of science, technology and innovation, said. The G20 Leaders’ Summit is scheduled for November, in Rio de Janeiro.

Mielli, Brazil’s negotiator in the AI working group, said there were disagreements from countries including China and the United States, but declined to provide details. In the end, she said, a consensus prevailed that the world’s richest countries should collaborate to reduce global asymmetry in AI development.

This week’s meeting took place in the aftermath of X’s ban in Brazil, ordered by Supreme Court Justice Alexandre de Moraes after a monthslong feud with its owner, tech billionaire Elon Musk.

Since last year, X has clashed with de Moraes over its reluctance to block some users, mostly far-right activists accused of undermining Brazilian democracy. Musk has called the Brazilian justice a dictator and an autocrat due to his rulings affecting his companies in Brazil.

Brazil currently has the presidency of the 20 leading rich and developing nations and President Luiz Inácio Lula da Silva has put issues that concern the developing world — such as the reduction of inequalities and the reform of multilateral institutions — at the heart of its agenda.