The social media platform will effectively ban most weight loss-related content from appearing on its app starting next month, according to a sweeping new set of community guidelines published on its website last week. The app has become ground zero for weight-loss drug content, as patients looking for more information about popular medications such as Novo Nordisk A/S’s Wegovy and Eli Lilly & Co.’s Zepbound turn to social media for answers.

According to the new rules, the app will no longer allow the marketing of weight-loss products and will specifically restrict minors from viewing or sharing content that shows, describes and promotes “potentially harmful” weight management behaviors, including using weight-loss medications. The rules extend to sharing so-called “before-and-after” photos used to show the physical effects of a weight-loss transformation.

Creators, some who have racked up tens of thousands of followers posting content about drugs used to treat diabetes and obesity, say the broad set of restrictions will penalise a growing community keen to swap tips and find support for traditionally marginalised diseases.

Social media platforms, including TikTok, have faced backlash for letting weight-loss content proliferate seemingly unabated, just one of many concerns over how algorithms push potentially harmful content to younger users and do little to stop health misinformation from spreading. It’s not the first time TikTok, which is owned by Chinese parent company ByteDance Ltd., has attempted to crack down on weight-loss drug content. Users say enforcement has been inconsistent and that the new guidelines lack clarity about what is and isn’t allowed.

“This is 100% discrimination against people with obesity, people with type 2 diabetes, people with chronic conditions, people with health conditions,” Dave Knapp said Friday in a video posted to TikTok. Knapp regularly posts about news related to GLP-1 drugs and recently started a grassroots campaign urging Lilly to address shortages of its medications, including Mounjaro, which he takes to manage type 2 diabetes.

“If someone with multiple sclerosis goes on and starts talking about their medicine are you going to shut them down too?” Knapp said in an interview.

A TikTok spokesperson said that while the platform encourages open discussions on weight-loss drugs, obesity and related topics, the new guidelines are aimed at prohibiting content about disordered or dangerous eating and weight loss strategies.

Knapp and other creators said they support efforts to make TikTok safer by restricting content that may be harmful, such as the marketing of unapproved drug products. They pointed to videos hawking knock-off versions of Lilly’s experimental drug retatrutide that remain on the app. The drug is still in clinical trials and has not been submitted to the US Food and Drug Administration for review.

Kim Carlos, who’s been posting about obesity care and weight-loss drugs since 2022, said she’s never had an issue with TikTok before now. In the last week, any video that includes hashtags like #Ozempic, #Zepbound or even #GLP-1 are immediately flagged for review. Some have been taken down for violating community guidelines, she said, but TikTok has not given her specifics on how the videos have broken the rules.”The purpose is to help people,” Carlos said. She said she’s been careful to make sure her videos are about the health benefits of treating a chronic disease, and not just the number of pounds lost. Carlos also has started a podcast where she interviews doctors and even celebrity guests like Rosie O’Donnell. She worries about what the latest crackdown means for her ability to generate revenue for her podcast through livestreams and commission earned on TikTok’s e-commerce feature.

Carlos is now planning to try other sites, like Instagram, Facebook, YouTube and Clapper, a video-centric social media app that has been drawing new users as uncertainty around TikTok’s future looms.

“If this is how its going to be, where do we go?” she said.

Alexis Clingenpeel quit her job as a manager at a hotel last week to pursue TikTok full time. The 25-year-old, who had long struggled with obesity, grew a following on the app by posting about her own weight-loss journey. She later partnered with a telehealth company that prescribes the medications, which pays her to promote its services on the app. Clingenpeel said TikTok starting flagging and taking down her content this week, and she now lives in fear of getting permanently banned.

“TikTok is my livelihood and how I pay rent,” she said. “I could lose everything.”

Over the weekend, TikTok’s future in the US grew more uncertain. The House of Representatives voted Saturday to approve a foreign aid bill that includes legislation that would force ByteDance to divest ownership of TikTok or face a US ban. The Senate is expected to vote on the matter this week, and President Joe Biden has said he plans to sign it into law.

If the TikTok ban becomes law, ByteDance would have nearly a year to sell the app, though the company is expected to pursue all available legal challenges to it.

By Madison Muller

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