Fruit juice diet

Summary

The Oversight Board has upheld Meta’s decisions to keep up two posts in which a woman shares her first-hand experience of a fruit juice-only diet. The Board agrees that neither violate Facebook’s Suicide and Self-Injury Community Standard because they do not “provide instructions for drastic and unhealthy weight loss,” nor do they “promote” or “encourage” eating disorders. However, since both pages involved in these two cases were part of Meta’s Partner Monetization Program, the Board recommends that the company restrict “extreme and harmful diet-related content” in its Content Monetization policies.

About the cases

Between late 2022 and early 2023, two videos were posted to the same Facebook page, described as featuring content on life, culture and food in Thailand. In both, a woman is interviewed by a man about her experience of following a diet consisting only of fruit juice. The conversations take place in Italian.

In the first video, the woman says she has experienced increased mental focus, improved skin and bowel movement, happiness and a “feeling of lightness” since starting the diet, while she also shares that she previously suffered from skin problems and swollen legs. She brings up the issue of anorexia but states her weight has normalized, after she initially lost more than 10 kilograms (22 pounds) due to her dietary changes. Around five months later, the man interviews the woman again in a second video, asking how she feels almost a year into observing this fruit juice-only diet. She responds by saying she looks young for her age, that she has not lost any more weight except for “four kilos of impurities,” and she encourages him to try the diet. She also states she will become a “fruitarian” upon breaking her fast, but that she is thinking about starting a “pranic journey,” which, according to her, means living “on energy” in place of eating or drinking regularly.

Between them, the posts were viewed more than 2,000,000 times and received over 15,000 comments. The videos share details of the woman’s Facebook page, which experienced a significant increase in interactions following the second post.

After both posts were reported multiple times for violating Facebook’s Suicide and Self-Injury Community Standard, and following human review that assessed the content as non-violating, they remained on Facebook. A separate user in each case then appealed Meta’s decision to the Board.

Both the content creator’s Facebook page on which the two videos were posted and the Facebook page of the woman shown in the videos are part of Meta’s Partner Monetization Program. This means the content creator and presumably the woman being interviewed earn money from posts on their pages, when Meta displays ads on their content. For this to happen, the pages would have passed an eligibility check and the content would have had to comply with both Meta’s Community Standards and its Content Monetization policies. Within its Content Monetization policies, Meta prohibits certain categories from being monetized on its platforms, even if they do not violate the Community Standards.

Key findings

The Board finds that neither of these posts violate the Suicide and Self-Injury Community Standard because they do not provide “instructions for drastic and unhealthy weight loss when shared together with terms associated with eating disorders,” and do not “promote, encourage, coordinate, or provide instructions for eating disorders.” While the Board notes a fruit juice-only diet can cover eating practices with different health consequences, depending on its duration and intensity, the videos did not include any eating disorder signal or reference in the sense required to violate Meta’s rules. Even the woman’s passing mention of a diet-related “pranic journey” – which the Board understands to be an extreme “breatharian” diet, considered medically dangerous by experts – was descriptive in nature, without any mention of weight.

While Meta’s platforms should continue to be spaces in which users can share their lifestyle and diet experiences, the Board equally recognizes that content permissible under the Suicide and Self-Injury Community Standard may contribute to harm, even if it does not meet the threshold for removal. These harms could be particularly severe for some users, with adolescents, especially adolescent women and girls, vulnerable to developing an eating disorder. In this case, the Board finds the content in these videos promotes eating practices that may be dangerous in some circumstances.

The Board also notes that despite the generally broad scope of Meta’s Content Monetization policies, content relating to eating practices, including extreme and harmful diet-related content, is not subject to reduced or restricted monetization. As such, the Board agrees that both videos do not violate these policies. However, the Board recommends that Meta should amend these policies to better meet its human rights responsibilities, given the research showing that users, especially adolescents, are vulnerable to harmful diet-related content.

The majority of the Board considers the omission of “extreme and harmful diet-related content” as a restricted category in Meta’s Content Monetization policies a conspicuous and concerning one. With health and communications experts noting the ability of influencers to use first-hand narration styles to secure high engagement with their content – coupled with the ubiquity of wellness influencers – it is important that Meta should not provide financial benefits to create this type of content. For a minority of the Board, since demonetization may negatively impact expression on these issues, Meta should explore whether demonetization is the least intrusive means of respecting the rights of vulnerable users.

For a separate minority of Board Members, demonetization is necessary but not sufficient; they find that Meta should additionally restrict extreme and harmful diet-related content to adults over the age of 18, and explore other measures such as putting a label on the content, to include reliable information on the health risks of eating disorders.

The Oversight Board’s decision

The Oversight Board upholds Meta’s decisions to leave up the two posts.

The Board recommends that Meta:

• Restrict extreme and harmful diet-related content in its Content Monetization Policies to avoid creating financial incentives for influential users to create harmful content.

* Case summaries provide an overview of cases and do not have precedential value.

Full case decision

1. Decision summary

The Oversight Board upholds Meta’s decisions to leave up two videos posted on the same Facebook page featuring an interview with a woman about her experience observing a fruit juice-only diet. Both videos were monetized with in-stream ads, which means the content creator earned a share of ad revenue and Meta presumably benefited from ad revenue. Meta assessed the videos against the Community Standards and the Content Monetization Policies, as both apply to monetized content, and found the videos violated neither. In upholding Meta’s decisions, the Board finds that both decisions complied with Meta’s Suicide and Self-Injury Community Standard because the videos did not contain any reference to eating disorders, which is required to violate the policy. The Board additionally determines that these decisions complied with Meta’s current Content Monetization Policies.

However, the Board also finds that the content in these videos promotes eating practices that may be dangerous in some circumstances. For the majority of the Board, given the potential for harm, particularly for children and teenagers, Meta should remove the financial benefit for creating this type of content. To meet its human rights responsibilities, the majority of the Board recommends that Meta include “extreme and harmful diet-related content” as a restricted category in its Content Monetization Policies. For a minority of the Board, demonetization can negatively impact expression on these issues and Meta should explore whether demonetization is the least intrusive means of respecting the rights of vulnerable users. Some members are concerned that demonetization is a disproportionate restriction. For a separate minority, demonetization is necessary but not sufficient and Meta should additionally restrict extreme and harmful diet-related content to adults over the age of 18, and explore other measures such as putting a label on the content, to include information on the health risks of eating disorders.

2. Case description and background

These cases concern two videos posted on the same Facebook page, described as featuring content about life, culture and food in Thailand. The page has about 130,000 followers. In both videos, a man interviews a woman in Italian about her experience observing a fruit juice-only diet, eating nothing solid. Each video shares the woman’s Facebook page at the end. Based on research commissioned by the Board, the woman’s Facebook page has 17,000 followers and features content about the lifestyle of the woman, including her diet.

In the first video, posted in late 2022, the woman shares that she used to suffer from skin problems and swollen legs, which she described as huge and heavy. She claims that since starting the fruit juice-only diet, she has experienced increased mental focus, improved skin and bowel movement, happiness and a “feeling of lightness.” After saying that some users may comment that this is anorexia, the woman states that dietary changes are often accompanied by sudden weight loss, which explains why she initially lost more than 10 kilograms (22 pounds). The woman states her weight has now “normalized.” This post received 3,000 reactions, about 1,000 comments and over 200,000 views.

In the second video, posted in early 2023, the same man asks the same woman, who appears extremely thin, how she feels after observing the fruit juice-only diet for almost a year. The woman laments that she would soon break her fast and eat solid fruit. When asked about her weight, the woman states she has not lost any more weight, but “four kilos of impurities.” The woman shares that she looks young for her age because of the diet and encourages the man to try the diet. She also shares that she would now be a “fruitarian” and wants to begin “prana,” which she describes as not eating or drinking regularly but instead living “only on energy.” This post received about 8,000 reactions, about 14,000 comments and over two million views. According to research commissioned by the Board, the woman’s Facebook page experienced a significant increase in interactions following this second post.

Both posts were reported multiple times to Meta for violating its Suicide and Self-Injury Community Standard. A separate user in each case ultimately appealed to the Board. These users’ initial appeals to Meta to remove the content were immediately closed through automation because prior human reviews had found the content non-violating. The users then appealed the decisions further with Meta. In both cases, human reviewers again found both videos non-violating and left them on Facebook.

The Facebook page where the videos were posted is part of Meta’s Partner Monetization Program. This means that the content creator earns money from the content they post on their Facebook page when Meta displays ads on this content. This means the page passed an eligibility check and content posted on these pages must comply with both Meta’s Community Standards and its Content Monetization Policies in order to display ads on content. Review of monetized content based on Meta’s Community Standards and Content Monetization Policies happens after the content is posted. According to Meta, both videos complied with the Community Standards and Content Monetization Policies. The Facebook page of the woman featured in the two videos is also part of Meta’s Partner Monetization Program and is also presumably earning money for similar types of content posted on her page.

The Board noted the following context in reaching its decision in this case. First, experts consulted by the Board explained that eating disorders are “complex mental health conditions characterized by abnormal eating behaviors, negative body image, and distorted perceptions of food and weight.” According to the American Psychiatric Association, orthorexia is an obsession with “clean” or “pure” foods. As noted by the National Eating Disorders Association, orthorexia is not formally recognized as an eating disorder in the Diagnostic and Statistical Manual 5.

While fruitarian and fruit juice-only diets are generally not classified as eating disorders, consuming only fruit juice for an extended period can be symptomatic of disordered eating. Fruit juice-only diets pose numerous health risks, a point highlighted by psychologists and dietetics and nutrition scholars who submitted public comments or were consulted by the Board. Impacts can vary depending on duration, the specifics of the diet and individual health. Additionally, some forms of prana diet involve eating, but one form of prana diet involves living only on one’s breath or life energy (also called “inedia” or “breatharianism”). According to experts consulted by the Board, this is considered an extreme form of diet with no legitimate health uses and is medically dangerous.

Second, a growing body of research indicates that social media use, particularly time and frequency of use as well as exposure to content promoting idealized body images such as “fitspiration” and “thinspiration” trends, leads to body dissatisfaction, disordered eating and negative mental health outcomes. As explained by a study examining the impact of social media use on teens and young adults, “adolescence is a vulnerable period for the development of body image issues, eating disorders and mental health.” Most eating disorders begin in adolescence. Medical experts and research documenting the rise in number of adolescents admitted into hospitals for eating disorders over the course of the pandemic cited increased time on social media as a contributing factor. Social media recommender algorithmsmay lead adolescents to more extreme diet-related content encouraging them to internalize thinness as a beauty ideal. Many young peopleturn to influencers for health and fitness-related advice on social media despite their lack of medical credentials. Many social media influencers provide health-related advice under the guise of “wellness,” connecting external beauty and perceived well-being.

3. Oversight Board authority and scope

The Board has authority to review Meta’s decision following an appeal from the person who previously reported content that was left up (Charter Article 2, Section 1; Bylaws Article 3, Section 1). When the Board identifies cases that raise similar issues, they may be assigned to a panel simultaneously to deliberate together. Binding decisions will be made with respect to each piece of content.

The Board may uphold or overturn Meta’s decision (Charter Article 3, Section 5), and this decision is binding on the company (Charter Article 4). Meta must also assess the feasibility of applying its decision in respect of identical content with parallel context (Charter Article 4). The Board’s decisions may include non-binding recommendations that Meta must respond to (Charter Article 3, Section 4; Article 4). When Meta commits to act on recommendations, the Board monitors their implementation.

4. Sources of authority and guidance

The following standards and precedents informed the Board’s analysis in this case:

I. Oversight Board decisions

The most relevant previous decisions of the Oversight Board include:

• Promoting Ketamine for non-FDA approved treatments (case decision 2023-010-IG-MR)
• Former President Trump’s suspension (case decision 2021-001-FB-FBR)

II. Meta’s content policies

This case involves Meta’s Suicide and Self-Injury Community Standard, in addition to the company’s Content Monetization Policies.

Under the Suicide and Self-Injury Community Standard, Meta defines “self-injury” as the “intentional and direct injuring of the body, including… eating disorders.” According to Meta, the policy allows people to discuss self-injury, including eating disorders, because the company wants to provide a “space where people can share their experiences, raise awareness about these issues, and seek support from one another.” Certain types of eating disorder-related content are prohibited, with two rules most relevant here. First, Meta removes content that “contains instructions for drastic and unhealthy weight loss when shared together with terms associated with eating disorders.” Second, Meta removes content that “promotes, encourages, coordinates, or provides instructions for eating disorders.”

Both videos, which featured in-stream ads, were also subject to Meta’s Content Monetization Policies. Within these policies, Meta prohibits certain categories of content from being monetized on its platforms, even though they do not violate the Community Standards. These categories of content may receive reduced monetization or are ineligible for monetization. They include broad areas such as “objectionable content” and “debated social issues,” but none of the multiple examples across categories mention any type of diet or eating practice.

The Board’s analysis of the content policies was informed by Meta’s value of “Voice” which the company describes as “paramount,” as well as its value of “Safety.”

III. Meta’s human rights responsibilities

The UN Guiding Principles on Business and Human Rights (UNGPs), endorsed by the UN Human Rights Council in 2011, establish a voluntary framework for the human rights responsibilities of private businesses. In 2021, Meta announced its Corporate Human Rights Policy, in which it reaffirmed its commitment to respecting human rights in accordance with the UNGPs. The Board’s analysis of Meta’s human rights responsibilities in this case was informed by the following international standards:

• The right to freedom of opinion and expression: Article 19, International Covenant on Civil and Political Rights ( ICCPR); General Comment No. 34, Human Rights Committee, 2011; A/74/486; A/HRC/38/35)
• The right to health: Article 12, International Covenant on Economic, Social and Cultural Rights (ICESCR); General Comment No. 14, Committee on Economic, Social and Cultural Rights, 2000; A/HRC/53/65).
• Children's rights: Convention on the Rights of the Child ( CRC); General Comment no. 13, Committee on the Rights of the Child, 2011, para. 28)

5. User submissions

The author of the two posts was notified of the Board’s review and provided with an opportunity to submit statements to the Board. The author of the posts did not submit a statement. In their appeals to the Board, the users who reported the case content stated that the content promotes an unhealthy lifestyle and may encourage others, especially teenagers, to do the same. They described the content as “inaccurate” and presenting anorexia “as a good thing,” which can pose health risks to people exposed to the content.

6. Meta’s submissions

Meta told the Board that neither post violated the Suicide and Self-Injury rule that prohibits “content that contains instructions for drastic and unhealthy weight loss when shared together with terms associated with eating disorders.” According to Meta, the posts contained no reference to “drastic or unhealthy weight loss” nor to eating disorders. Additionally, Meta noted the woman described her experience “but does not instruct others to make the same choice.” When asked by the Board, Meta responded that neither post violated the policy line prohibiting “content that promotes, encourages, coordinates, or provides instructions for eating disorders,” again because the two videos did not reference any eating disorder.

Meta explained that it does not want to over-enforce or under-enforce on content “related to body image or health status, as [its] platforms can be an important space for people to share their own experiences and journeys around self-image and body acceptance.” The company therefore requires references to eating disorder signals or terminology for content to violate the policy.

Meta stated that the company does not consider fruitarian, fruit juice-only, and prana diets as eating disorders based on the American Psychiatric Association's classification of eating disorders, as well as the company’s ongoing expert engagement. Meta told the Board that its Safety Policy team regularly engages with experts and advisory groups to learn about eating disorder trends and to update its list of violating eating disorder signals. According to Meta, the Regional Operations team also plays a large role in shaping the eating disorder signals list, providing examples of how proposed terms are used on the platform. Meta’s Content Policy team uses insights from the Regional Operations team’s work to shape the overall policy.

The Board asked Meta nine questions in writing. Questions related to how the company defines eating disorders to enforce the policy; the rationale for requiring eating disorder terms to be referenced in the content to be considered violating; any financial incentive Meta has regarding the case content; and the process, internal research and stakeholders consulted, if any, for developing the policy. Meta answered all questions.

7. Public comments

The Oversight Board received eight public comments, including from dietetics and eating disorders specialists from the United States and Canada and Europe regions. These comments noted the health threats posed by this diet to public health and to minors' physical and mental health.

To read public comments submitted for this case, please click here.

8. Oversight Board analysis

The Board selected these cases to examine how Meta’s policies and enforcement practices address diet, fitness and eating disorder-related content on Facebook. The Board examined whether this content should be removed by analyzing Meta’s content policies, which includes the Facebook Community Standards and Content Monetization Policies, in addition to Meta’s values and human rights responsibilities.

8.1 Compliance with Meta’s content policies

I. Content rules

The Board finds that these two posts do not violate Meta’s content policies.

a. Suicide and Self-Injury Community Standard

The Board finds that the content in these cases does not violate Meta’s Suicide and Self-Injury Community Standard. The first relevant rule prohibits “content that contains instructions for drastic and unhealthy weight loss when shared together with terms associated with eating disorders,” and the second relevant rule prohibits content promoting, encouraging, coordinating or providing instructions for eating disorders.

Both rules therefore require that there must be an eating disorder reference to be considered violating. Meta’s internal guidance contains a non-exhaustive list of eating disorder signals that are considered violating. It includes references to recognized eating disorders, slang terms and physical descriptions, with significant focus on hashtags.

The Board finds that the videos in these cases do not mention any eating disorder signal or eating disorder reference in the sense required to violate the policy. The Board found these to be challenging cases, and notes that a fruit juice-only diet could cover a wide range of eating practices with different health consequences depending on the duration and level of intensity of the practice. The Board believes there are harmful eating practices that do not meet the threshold to be removed as eating disorders, and both videos fall within that margin.

The woman also mentioned a prana diet in the second post, which she described as living “only on energy.” Based on the woman’s description of the diet, the Board understands this would be an extreme “breatharian” diet, which experts consulted by the Board considered medically dangerous. However, the passing reference to prana was not accompanied by any mention of weight, and was expressed descriptively, which is not the same as promotion, encouragement or instructing others to engage in the same practice.

The Board therefore finds the two posts do not violate Meta’s Suicide and Self-Injury policy. As discussed in the analysis of Meta’s human rights responsibilities below, the Board finds that while the scope of prohibited content subject to removal in this area should be narrow to allow for critical discussion of these topics, Meta should also adopt the least intrusive means to address harmful but non-policy violating content posted by influential users.

b. Content Monetization policies

As the content in these cases featured in-stream ads, the Content Monetization Policies apply. Meta only disclosed this aspect of the case after the Board asked about any financial incentives the company might have in relation to the case content. Before users can monetize content they post on Meta’s platforms, they must abide by the Partner Monetization Policies. This requires both an initial eligibility check on the entity and that each post by the entity complies with both the Community Standards and the Content Monetization Policies.

Content Monetization Policies are distinct from the Community Standards. The Community Standards apply to all content on Meta’s platforms, while Content Monetization policies apply only to content that users wish to monetize. Meta prohibits many types of content from being monetized even if the content is otherwise allowed on Meta’s platforms.

Within these policies, certain categories of content receive reduced monetization or cannot be monetized altogether. Categories that may be either restricted or ineligible for monetization include content depicting or discussing “debated social issues,” content with “objectionable activity,” “strong language,” and "explicit content" such as “injury, gore, or bodily functions or conditions.” Content ineligible for monetization includes “content that contains medical claims that have been disproven by an expert organization,” with the specific example of anti-vaccination claims.

Despite the generally broad scope of the monetization policies, content relating to eating practices, including extreme and harmful diet-related content, is not subject to reduced or restricted monetization. As such, the Board agrees with Meta’s assessment that both videos do not violate Meta’s Content Monetization Policies. However, the Board recommends below that Meta should amend these policies to better meet its human rights responsibilities given research showing that users, especially children, are vulnerable to harmful diet-related content.

8.2 Compliance with Meta’s human rights responsibilities

The Board finds that Meta's decisions to allow these posts on Facebook is consistent with the company’s human rights responsibilities. However, the majority of the Board finds that extreme and harmful diet-related content is related to public health harms, specifically for some groups such as children, and a rights-respecting approach means the company should not incentivize its production and spread by providing financial benefits to influential users to post such content. The Board notes that Meta already acknowledges in its Content Monetization Policies that some “content appropriate for Facebook in general is not necessarily appropriate for monetization.” This means that Meta has decided not to profit from certain types of content even if these do not violate the Community Standards. Examples of such content are “objectionable activity,” “debated social issues,” “strong language,” and “explicit content,” among others.

Freedom of expression (Article 19 ICCPR)

Article 19 of the ICCPR provides for broad protection of expression. This right includes the “freedom to seek, receive and impart information and ideas of all kinds.” Access to information is a key part of freedom of expression. Article 12 of the International Covenant on Economic, Social and Cultural Rights guarantees the right to health, including the right to access health-related education and information (ICESCR Art. 12; Committee on Economic, Social and Cultural Rights, General Comment No. 14 (2000), para. 3).

Where restrictions on expression are imposed by a state, they must meet the requirements of legality, legitimate aim, and necessity and proportionality (Article 19, para. 3, ICCPR). These requirements are often referred to as the “three-part test.” The Board uses this framework to interpret Meta’s voluntary human rights commitments, both in relation to the individual content decision under review and Meta’s broader approach to content governance. As the UN Special Rapporteur on freedom of expression has stated, although “companies do not have the obligations of Governments, their impact is of a sort that requires them to assess the same kind of questions about protecting their users' right to freedom of expression” ( A/74/486, para. 41).

I. Legality (clarity and accessibility of the rules)

The principle of legality requires rules limiting expression to be accessible and clear, both to those enforcing the rules and those impacted by them (General Comment No. 34, para. 25). Rules restricting expression “may not confer unfettered discretion for the restriction of freedom of expression on those charged with [their] execution” and must “provide sufficient guidance to those charged with their execution to enable them to ascertain what sorts of expression are properly restricted and what sorts are not” ( Ibid). Applied to platform rules that govern online speech, the UN Special Rapporteur on freedom of expression has said they should be clear and specific ( A/HRC/38/35, para. 46). People using Meta’s platforms should be able to access and understand the rules and content reviewers should have clear guidance regarding their enforcement.

The Board assessed two rules within Meta’s Suicide and Self-Injury policy: (i) content containing instructions for drastic and unhealthy weight loss when shared together with terms associated with eating disorders; and (ii) content promoting, encouraging, coordinating or providing instructions for eating disorders. Both require a reference to eating disorders, and Meta provides its reviewers with internal guidance to make that determination.

Although Meta states that this list is “non-exhaustive” and does not focus on a particular format, the examples provided in the list are almost exclusively in hashtag format. Content moderators implementing this policy who refer to the internal guidelines may focus their enforcement and removal on this more explicit type of content. For the Board, this gives the impression that the categories of prohibited content that seem relatively broad in the public standards are, in practice, more limited in scope. Such apparent inconsistency raises serious legality concerns, though, as applied to these posts, the public rules provided sufficient notice to users and the Community Standards and internal rules provided sufficient guidance to content moderators.

II. Legitimate aim

Under Article 19, para. 3 of the ICCPR, expression may be restricted for a defined and limited list of reasons. In these cases, the Board finds that the Suicide and Self-Injury Community Standard that prohibits eating disorder content serves the legitimate aim of protecting public health and respecting the rights of others to physical and mental health, especially of children.

III. Necessity and proportionality

The principle of necessity and proportionality provides that any restrictions on freedom of expression “must be appropriate to achieve their protective function; they must be the least intrusive instrument amongst those which might achieve their protective function; [and] they must be proportionate to the interest to be protected” ( General Comment No. 34 , para. 34).

The Board finds that the current approach in the Suicide and Self-Injury policy to require an eating disorder signal is a proportionate restriction on freedom of expression in order to safeguard public health and respect the right to health of others, while also enabling users to discuss and debate health-related matters on Meta’s platforms. Without this requirement, Meta believes, and the Board concurs, that the policy could be overbroad in scope and could unduly restrict freedom of expression and access to information on matters of public health, including information about unhealthy diets and eating disorders.

The Board finds that Meta’s platforms should continue to be a space where users can share their positive and negative experiences regarding specific lifestyles and diets. Importantly, as noted by the experts consulted by the Board, eating disorders are a mental disorder and eating habits and diets can be symptomatic of an eating disorder but not a conclusive indicator of one. The Board therefore finds that removal of the case content would not be consistent with the right to freedom of expression and the right to access, seek and share health information.

At the same time, the Board also recognizes that content that is permissible under this policy may contribute to harm, even if the content does not meet the threshold for harm that warrants removal. The harms in this case may be particularly severe for some users, including children. In their appeals to the Board, the reporting users stated that the content promotes an unhealthy lifestyle and may encourage others, especially teenagers, to do the same. They described the content as “inaccurate” and presenting anorexia “as a good thing,” which can pose health risks to people exposed to the content. As noted by the public comments and the experts consulted by the Board, adolescents are especially vulnerable to developing an eating disorder, as most eating disorders begin in adolescence.

The UN Committee on the Rights of the Child has stated that children’s rights involve freedom from all forms of violence including self-harm, which includes eating disorders ( General Comment no. 13, (2011), para. 28). The Committee further highlighted risks related to children being exposed to “actually or potentially harmful advertisements” online ( General Comment no. 13, (2011), para. 31).

The UNGPs establish that businesses should prevent and mitigate adverse human rights impacts directly linked to their products, services and business (Principle 13). Relatedly, Article 17 of the Convention on the Rights of the Child recognizes the importance of the media for the “social, spiritual and moral well-being and physical and mental health” of children. The UN Committee on the Rights of the Child has indicated that Article 17 “delineates the responsibility of mass media organizations. In the context of health, these can…include promoting health and healthy lifestyles among children… promoting access to information; not producing communication programs and material that are harmful to children and general health [among other responsibilities]” ( General Comment No. 15, para. 84).

The Board has consistently held that Meta should explore the least intrusive means of addressing harmful content on its platforms. The Board has specifically noted that “developing effective mechanisms to avoid amplifying speech that poses risks” is part of that responsibility ( Former President Trump’s suspension case). In this case, the Board recognizes that monetization policies impact users’ freedom of expression as well as other human rights. For the majority of the Board, providing a financial benefit to influential users for producing content that promotes harmful diets incentivizes the creation and amplification of such content. Removing this incentive is within the company’s control and is consistent with Meta’s current approach to other types of content that do not violate the Community Standards but which the company restricts under the Content Monetization Policies.

Communications scholars and health experts have emphasized that the ability of influencers to appeal and to persuade is found in their adoption of communication styles that give the perception of being just like regular individuals. As seen in this content, rather than directly call on users to do specific acts, influencers narrate their personal story or show through first-hand experience the supposed benefits of diet and lifestyle changes. This style helps influential users to produce content that will receive high engagement, which is particularly appealing when they seek to monetize content. Considering the ubiquity of wellness influencers on Meta’s platforms, as well as the broad set of content that Meta does not seek to profit from under its Content Monetization Policies, the omission of harmful diet content is conspicuous and concerning.

The Board has previously recommended that Meta revise its Branded Content policies to “clarify the meaning of the ‘paid partnership’ label and ensure content reviewers are equipped to enforce Branded Content policies where applicable" (Promoting Ketamine for non-FDA approved treatments case). In a similar vein, the majority of the Board recommends in the present case that Meta include “extreme and harmful diet-related content” as a restricted category in its Content Monetization Policies.

This decision has elicited varying minority opinions. For one group of the minority, demonetization may negatively impact freedom of expression. For this minority, even assuming that Meta has a responsibility to mitigate the risk of potential indirect harm to vulnerable users through demonetization, this approach could amount to a broad restriction of expression that would diminish the opportunity of users to seek and share information. Demonetization is therefore subject to the requirements of proportionality. Meta should explore whether demonetization is the least intrusive means of ensuring respect for the rights of vulnerable users.

For a separate minority, demonetization is necessary but not sufficient; Meta should additionally restrict extreme and harmful diet-related content to adults over the age of 18, and explore other measures such as putting a label on the content with reliable information on the health risks of eating disorders. For these Board Members, given the growing body of research (outlined in section 2 above) showing that social media use and exposure to idealized bodies, “thinspiration” and “fitspiration” trends leads to body dissatisfaction, disordered eating and a multitude of other negative mental health outcomes, particularly for adolescent women and girls, it is necessary and proportionate for Meta to amend the Suicide and Self-Injury Community Standard. The ubiquity of beauty, diet and fitness-related content on social media, together with recommender algorithms that group and further promote it, make the risk of such content to young users’ mental and physical health real and severe. Ensuring Meta’s policies address harmful diet-related content is especially necessary given the reality that influential users often frame extreme dietary practices in “wellness” or “clean” eating terms, without ever explicitly referring to an eating disorder. For these Board Members, Meta’s current approach in the Suicide and Self-Injury Community Standard fails to address this reality. Restricting extreme and harmful diet-related content to adults and providing more information to users on potential health effects ensures the impact on freedom of expression is least intrusive while also addressing the risk of harm to children.

9. Oversight Board decision

The Oversight Board upholds Meta’s decisions to leave up both posts on Facebook.

10. Recommendations

Content policy

1. To not create financial incentives for influential users to create harmful content, Meta should restrict extreme and harmful diet-related content in its Content Monetization Policies.

The Board will consider this implemented when Meta’s Content Monetization Policies have been updated to include a definition and examples of what constitutes extreme and harmful diet-related content, in the same way that it defines and explains other restricted categories under the Content Monetization Policies.

*Procedural note:

The Oversight Board’s decisions are prepared by panels of five Members and approved by a majority of the Board. Board decisions do not necessarily represent the personal views of all Members.

For this case decision, independent research was commissioned on behalf of the Board. The Board was assisted by Duco Advisors, an advisory firm focusing on the intersection of geopolitics, trust and safety, and technology. The Board was also assisted by Memetica, an organization that engages in open-source research on social media trends, which also provided analysis.