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How teens hide harmful behaviors online

Posted 12/1/2016 by SARA LEE, MD
Pediatrician, UH Rainbow Babies & Children’s Hospital
Assistant Professor, Case Western Reserve University School of Medicine

Sara Lee

Sara Lee, MD

In today’s digital world, kids and teens often sort out their identities online. And some social media platforms have a darker side, often hidden from parents’ view.

Two new studies examine these risks. One found YouTube videos in favor of eating disorders – some with more than a million views. Another identifies secret hashtags teens use to chat about cutting and other self-harm behaviors. The findings make it clear: Young people need supervision in the wired world just as much as they do offline.

How harmful behaviors go viral

In some ways, behaviors can spread the way germs do, health experts say. Viewing harmful pictures can trigger teens prone to hurt themselves to do so. And so-called thinspiration – photos of extremely thin bodies – makes eating disorders seem normal. Social media creates a community of support around a certain behavior, such as cutting or bingeing and purging.

How teens hide harmful behaviors online

The new research focuses largely on teens and tweens – though any child old enough to use social media faces a risk. And it affects nearly every platform. These include Twitter, Instagram, YouTube, Facebook, Pinterest and Snapchat. Some young people hide harmful online behaviors from adult eyes by:

  • Using creative hashtags. These searchable words or phrases – preceded by the # sign – allow users to easily link and search posts.
  • Creating more than one account. Some sites, such as Instagram, allow usernames instead of real names. Teens might create one account they show parents and another for friends.

What parents can do


Watch for these vague hashtags, linked to the following communities:

Self-harm: #blithe, #cat, #selfinjuryy, #selfharmmm, #secretsociety123

Pro-eating disorders: #thinspo, #proana

Substance use: #legalizeit, #bupe

Just because tweens and teens can type, text and click faster than you doesn’t mean you can’t teach them how to act responsibly. “Parents can do a lot to identify problematic online behaviors, provided they get tech-savvy enough to do so,” says Sara Lee, MD, a pediatrician at University Hospitals Rainbow Babies & Children’s Hospital. To start:

  • Sign up yourself. You can’t begin to know how troublesome behaviors ripple through social media without your own profile. Dr. Lee says, “Create one on every site your child uses – and make a family rule to connect with each other.”
  • Learn the lingo. Site rules force users’ hashtags to be more creative. For instance, Instagram banned #selfharm and then #selfharmm, so those talking about cutting now use #selfharmmm. Check the list below for some red-flag words and phrases. “Share intel with other parents who have teens of similar ages,” advises Dr. Lee.
  • Suggest positive options. In addition to pro-anorexia videos, researchers found videos that support recovery from eating disorders. Positive sites – such as – have branched out to social media, too.
  • Communicate. The digital world is always changing – and it changes fast. Keep the lines of communication open with your teenagers to help keep them safe.
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