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This episode contains references to suicide, self harm and disordered eating. Please take care while listening. When she was growing up, Kiera McDuff was one of those kids who spent their weekends being shuttled from one practice to another.
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I did taekwondo for over 12 years and I also did gymnastics and swimming and basically anything I could get my hands on.
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The swimming did not last.
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They wanted me there in the mornings before school and I was like, I can't, I can't do that. I'm sorry.
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Luckily for Kira, taekwondo was in the afternoon.
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I liked fighting.
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Kira took to martial arts quickly and she was good at it. She even competed internationally. But her success seemed to come with a price.
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I noticed something would probably have been off when I hit 13 or 14 and I just started getting injuries all the time.
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Injuries aren't uncommon in sports, especially when those sports involve getting kicked in the face. But these injuries were weird.
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I sneezed one time and my rib actually I got a costal cartilage, which is kind of like the rib pops out of place for a minute and it was just from sneezing. And then another thing that happened really frequently was my right shoulder would feel like it was almost falling out of its socket.
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And were those painful?
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Oh, yeah.
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Kira had a feeling that these injuries might be connected.
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I remember going to my physiotherapist and saying, hey, this keeps happening. I think there's something wrong. And their immediate knee jerk reaction was, oh, this is a overreactive, overhyper child. And they're saying something's wrong, but they're just looking for attention.
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So Kira went to another doctor and then another and they all kept saying the same thing.
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Why are you telling us about all these symptoms? I was like, because there's something bigger here.
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And the weird injuries just kept happening. She'd dislocate her shoulder opening a cupboard or roll her ankle getting off the couch.
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It felt incredibly frustrating. It was like I knew my body so well, but people believed that they knew it better. And I was younger so I didn't have the words to express what was going on.
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Finally, Kira started finding answers in an unlikely place.
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I was like, on social media and there were two sort of big things that triggered my, like, understanding of what was going on. And the first one was TikTok. Actually the, like, the, what's it called, the algorithm on TikTok. I really liked a lot of like, satirical stuff.
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I do different trumps too. I do Donald Trump shitting on other Trump impressions. So, like.
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But also it was a lot of Sort of day in the life. Like, oh, a day in the life of. Insert this career path here.
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Here's a day in the life working at Google as an account strategy, Day in the life as a graphic designer. Day in the life of a 25
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year old primary school teacher.
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And then some of it was like, what's it like to live with this chronic illness or this disability?
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About six months ago now, I was diagnosed with one of the craziest illnesses
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ever and I was really interested in that sort of. Sometimes they had things like tips or tricks that could help. What you do in the morning is
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incredibly important because of our dopamine deficiency
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we can get hooked on.
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So that was something that I looked at a lot. And then the longer I looked at it, the more it became specified because I would feed into the things that I related to.
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What happens when you have a disease that's invisible?
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And then it slowly became more and more
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focused.
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I guess touching your thumb to your forearm or popping your shoulders in and
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out, you get injured a lot easier
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because you don't feel when your body's in pain. And then eventually I was like, oh, this is somebody's TikTok explaining the diagnostic criterias of Ehlers Danlos. Four telltale signs that you might have
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hypermobile Ehlers Danlos syndrome.
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And I'm checking every box.
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Ehlers Danlos syndromes are a group of rare connective tissue disorders. There are 13 different kinds and some of them can be life threatening.
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I could have been dead at like 40 and we never would have known why.
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What happened to Kira on TikTok wasn't a coincidence. Almost every social media platform uses an algorithm to decide what kind of content they're going to show you. And the more you engage with a particular type of content, even if that just means lingering on it for longer than usual, the more of that content the algorithm will show you. Sometimes this can be dangerous. Like I've said before, I think my eating disorder was in many ways a byproduct of social media algorithms, specifically Instagram and Pinterest. But Kira's story presents an interesting possibility. What if algorithms can also save lives? I'm Ava Smithing from Paradigms and the Toronto Star. This is left to their own devices. Episode 2 A Tale of Two Algorithms. After she saw all those TikToks, Kira went to her doctor and asked him to look into the possibility that she might have Ehlers Danlos syndrome.
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And my doctor's response was, we normally don't look into this until somebody in your family has Basically just dropped dead. And I remember walking out of the doctor's office and just thinking, I don't want to die for my family to realize that there's something wrong.
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As Kira's condition continued to go untreated, her body started to deteriorate.
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I was overworking myself, and I was in such chronic pain, and my body didn't know how to force me to take a break. And the way it decided to do that was, I will incapacitate you. It was pretty much a whole body endeavor. My stomach would tense and then my shoulders would jump.
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She started having these violent seizures, and
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there were times where it was actually so bad that my throat would seize and I wouldn't be able to get in a breath. And that was. I think most of the times we went to the ER was times where I was in and out of consciousness because I just couldn't breathe.
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It all started to take a toll on Kira's mental health as well.
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Being in that situation and having that understanding and realization that something is so clearly wrong, and having people not be on the same page with you, it's. It's infuriating. And then in a different way, at a certain point, you start to believe that maybe they're right.
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But her doctors weren't right. And after years of agony, Kira finally found a physician who took her seriously. And they confirmed what Kira and the TikTok algorithm had known for months. She had something called hypermobility. Ehlers Danlos.
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When the doctor told me that was what it was, I pulled up my phone and I started texting my friends. I was like, we finally did it. Because everyone knew something was wrong. So when we finally figured out what it was, it was like a celebration.
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Kira says getting that diagnosis was life changing.
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The best part of it for me was finally having a word and finally having a way to explain to people why I was the way I was. Because the moment that I was able to say, I can't do this, I have Ehlers Danlos. Sometimes my body just hurts. Then all of a sudden, people take you seriously, and it's like having a key to something.
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Today, Kira is a music student at Mount Allison University in New Brunswick. And now that she has an official diagnosis, she's able to get accommodations from the university that make her life a little more comfortable.
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What would have happened if I wasn't diagnosed is pretty easy for me to see because my great grandmother, we believe, had it. And she never was diagnosed. And at the end of her life, she became basically immobilized. She spent the last few years of her life in really bad pain and nobody knew what was wrong. And I guess there's just a moment of, oh, if I was born, you know, in a different generation that easily could have been me. And people normally talk about, oh, this generation is so reliant on phones and stuff like that, but it's also like, oh, this generation is like, if you look at me getting better health care because I had access to social media, like, what the fuck is that?
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It's interesting to me to try to explain how different this is from when I grew up, because I grew up in the age of broadcast television. The algorithm was a bunch of guys in suits deciding what aired at 8:30pm on one of four TV networks. And then that was my choice between those four different things.
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Ethan Zuckerman is a communications professor at the University of Massachusetts Amherst and one of the world's top social media researchers. He's also the guy that invented the pop up ad, but I'm trying not to hold that against him.
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So an algorithm is just a set of rules. The algorithm, when we talk about it with social media, is basically saying, here is a set of possible posts I can put in front of you user. Which one should I give you?
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This sounds straightforward, but Zuckerman says we don't have a very good understanding of how these algorithms actually work. When we asked TikTok about their algorithm, they pointed us to a post on their website that says they want users to discover interesting and relevant content. They do this in a bunch of different ways. Most often, though, they use recommendation algorithms to suggest videos similar to ones you've already engaged with, which might just mean that you spent more time watching them than other types of videos. But this is how most social media algorithms work. So it doesn't totally explain why TikTok's algorithm is so compelling. According to internal TikTok documents, it only takes 260 videos, or about 35 minutes for their app to become habit forming. TikTok's spokesperson did not address this on the record. When we asked Meta about their algorithmic systems, they refused to provide a comment on the record.
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So we're talking about something that is immensely powerful in terms of shaping what media we pay attention to. We understand it very poorly, and it's a moving target. Every time we try to figure out what the algorithm is and how it works, it often squiggles away from us. So as a researcher trying to figure out the algorithm, what it does, how it works, it's the great white whale.
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Until social Media companies become more transparent, which they're unlikely to do unless they're forced to. We may never know how these algorithms work, but what we do know is that they're incredibly powerful. Algorithms may have saved Kira's life, but I know firsthand that they can also do a lot of damage.
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We have to pay attention to people for whom social media has been really, really bad, because those stories are real and they're often quite tragic.
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Maybe if I, like, take this. Can you hear me better now? Maybe.
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This is Cece Neltner. Are you from Kentucky?
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Yes, I am.
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Cece and I have a lot in common. I'm from Tennessee, born and raised.
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Hell, yeah.
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We're both from the South. Two best states in the nation.
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I know.
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And we're both tall and athletic. Even at my thinnest point, I was still technically overweight, which is so crazy.
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Yeah, right? Like, they call me atypical anorexia. I wasn't, like, underweight. Like, my body was failing, but I was still healthy.
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And we both wound up here, at least in part because of an algorithm.
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I was about 11, 12 ish when I first got my first phone. My mom gave it to me so I could communicate between her house as well as my dad's house, because my parents were divorced.
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Like a lot of us at that age. Life for 12 year old Cece wasn't easy.
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My stepmom and my dad, they were kind of, like, fighting a lot of. I was about to enter middle school, so, like, there's all that, like, emotional rage and angst, but also I was losing friends. I think they were trying to become popular and, like, get boyfriends and wear makeup and, you know, just things like that. So for me, I was kind of, like, left in the dirt.
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As she struggled with all of those hard teenage things, cece found solace on Instagram.
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I remember, you know, logging on and seeing my friends and seeing different things that inspired me, like art. And, you know, at that age, I was pretty young, so I liked, like, My Little Pony, stuff like that.
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And do you remember the post that was the first trigger for you? Like, I remember so specifically those triangle bikini advertisements, those neoprene dam swimsuits was the first thing that I think really got me. Is there something that sticks out like that?
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So with me, I was already going through, like, some weight issues. So my. My family and everybody, they were like, you know, you need to lose some weight. You need to start exercising. So for me, I went on Instagram. I might have just, like, looked up, like, ways to Lose weight or something.
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Here are three sacrifices that I must make to maintain my skinny body and
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to get even more skinny.
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And then after that, it was all kinds of stuff being fed to me.
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Do you want a flat stomach and
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toned abs in just 10 days?
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If you are serious about losing weight this year, I need you to listen to me.
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Being skinny is self respect.
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And if that offends you, maybe it's because it hits too close to home.
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And then a lot of, like, things that were influencing eating better, eating half the calories you're supposed to eat, how
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to eat only twice a day and
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live without your snack.
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Stop overeating.
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Eventually, I also make thinspo.
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Thinspo is short for thinspiration.
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Being skinny sends a message.
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You respect yourself.
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You prioritize yourself.
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Three benefits of being skinny.
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So it might show an outfit page or something, but the model in that page, like, you can see collarbones, you can see chest bones.
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Being skinny is a lifestyle, not a diet.
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I know it's kind of, like, weird to say, but it was just like, I want to look like that. That's beautiful to me.
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Cece looked at those photos and was led to the same conclusion that I had. If you want to look like that, you need to stop eating.
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And it really was just like, some blueberries here, some celery here, and then maybe for dinner, like a sandwich.
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Yeah. You ever see that post that's like, you burn more calories eating celery than you take in.
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Mm. Yep. Yeah, there was all kinds of, like, little, like, tricks and tips that I had that I would use and just became obsessive, too. Obsessive to the point like nothing else mattered.
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Cece set a limit for herself of 800 calories a day and then started an intense workout regimen. She was 12 years old.
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I would go in, like, the bathroom of, like, our house. So I would kind of work out in secret. I'd work out every night.
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She also had swim practice six nights
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a week, Monday through Saturday. And we'd practice for, I think, two hours each night.
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Not surprisingly, Cece got thinner and thinner and thinner.
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People are telling you, you look great. You look beautiful. You look so fit and thin and blah, blah, blah, but you're not eating, you're exercising to the point you feel like you're gonna collapse.
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Stop overeating.
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Deep down, Cece knew this wasn't healthy. But at the time, she didn't really care for me.
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Like, I had to be skinnier if that meant my heart was, like, failing. That was like Hell yeah. Like I'm winning at this. I'm doing what I need to do. I'm losing that weight. But I looked in the mirror. I still wasn't skinny enough. I was fat still. So it's like there was never a stopping point. Even if that meant dying on your bathroom floor, even if that meant like your heart failing. It didn't matter as long as I was skinny, as long as I looked like those images, those thin spill images, that's all that mattered to me.
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I just want to stop here and clarify something. I don't think eating disorders are caused by social media. Women were being subjected to unrealistic beauty standards long before Instagram and movies and magazines and moms and swim coaches are all a part of the problem. But social media is making things worse. A recent study of Norwegian teenagers found that most girls said Instagram and TikTok made them feel bad about their appearance. And from 2018 to 2022, the number of American youth who saw their doctor about an eating disorder more than doubled.
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Social media, like pushing that in young girls faces is just, it's toxic as heck.
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As cece fell deeper and deeper down a rabbit hole of thin spoke and extreme dieting tips, her body started to give out.
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8th grade hit and my vitals and everything were so low. When I went to the inpatient that night, my heartbeat sleeping was at 22.
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That's low. Like really low. A healthy 13 year old girl's sleeping heart rate is between 40 and 80 beats per minute.
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I was in this hospital all of a sudden, doctors coming in every day just to talk to me about like how to gain weight. Like that is so uncomfortable. Thinking about being on this meal plan where I have to eat at least three times a day with like snacks in between and stuff like that is so scary because I wasn't used to that.
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Do they ever give you a feeding tube?
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Yeah, I had it multiple times. And like after I went into that hospital, I got out and things only got worse. I still wasn't happy with my body. I felt worse because now I had like three weeks of being force fed and I felt bad about my body. I felt bad about going back into school, I felt bad about a lot. And for the next like three years after that I was in and out of hospitals. I was in residentials. My mental health started declining. I started more of like self harming things like that. It just, it spiraled.
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As time went on, cece came to a heartbreaking conclusion. She wanted a way out.
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I just felt like there was no point in trying to get better. There was no point because I didn't really want to get better, but everyone was telling me, like, now I wasn't worth anything if I wasn't better. Like, it's like, who am I? Like, am I supposed to be skinny and look good for you guys, or am I supposed to, like, eat all this food? And it's just like, I didn't know.
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Cece made plans to take her own life.
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Before I tried to go through with that, I just texted my friend and I was like, I am so sorry about everything. I love you. You're amazing, you know? And she immediately called my mom. And then my mom, like, came down, called the police, everything. Like, the next minute I know there's like, all these ambulances, these guys, I'm in the basement, and just like. I don't know, it was just kind of like a.
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How would you say you're doing now? Loaded question. CECE is 20 now, and it's been years since she contemplated suicide. But social media, that thinspo loving algorithm, it's always there waiting to suck you back in.
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Yeah, I mean, now I feel like. Like things are definitely better. I still deal with insecurity. Like, my boyfriend could probably tell you, I get insecure, like, all of the time. And it's just. It's like it's still there. Like, I still will get trigger every once in a while. And then I just like, it, like, kind of pours down on me where I'm like, okay, I can't eat down because I'm like that. Or someone said one little thing, you know, like, kind of just like little, like, triggered out of nowhere.
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Yeah, I think recovery is a loaded term because it's like, I'm not better. My mind isn't any nicer to me now. I just have been taught how to balance.
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I teach a graduate class called Fixing Social Media. And something that we spend an enormous amount of time on is what I refer to as the bell curve effect.
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This is Ethan Zuckerman again. I was curious what he would make of these two wildly divergent stories. A teenager who almost lost her life because of an algorithm, and another who may well have been saved by one.
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When we look at scholarly research on social media, at one edge of the bell curve, there's a small number of people for whom social media is really bad. Like cc, it leads them down into negative body image. They end up experiencing anorexia. Really just horrible, terrible stuff. There is some percentage of people for whom the Internet is just a really really bad place. There is also on the other side of the curve for the cures of
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the world,
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circumstances in which social media is life changing for the good.
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But Zuckerman says for most people, social media doesn't actually have much of an effect at all.
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When we talk about social media, we almost always talk about cece. What we don't talk about is Jim, who's in the middle of the bell curve, and social media is part of his life. He spends some time on Instagram, he hangs out on Snapchat, he uses YouTube, and they just don't have that much influence on him. For the vast majority of people, social media has almost no effect on their overall happiness and mental health.
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Even if CeCe and Kira are outliers, their stories prompt an important question. How do we prevent young people from being harmed on social media while still making sure they can access all the good stuff?
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If you accept this idea that social media is really bad for a small number of people, it's really good for a small number of people, and it's probably not all that relevant for a large number of people, prohibition no longer makes a ton of sense. Right. So no one under 16 can use social media isn't a great idea. It helps Cece, maybe, but it really hurts Kira.
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That means the solutions might need to be a little more nuanced.
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It would have been great to have tools where someone could have gone in and said, you know what, after three fitness influencers, we're not going to do any more fitness influence this day. Or, you know what, maybe Instagram's not going very well for you. We're going to limit to 15 minutes a day. More tools, more control for me, feels like the way to handle this.
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And what if making social media safe is just the first step? What if we could actually use algorithms to make our lives better? What if everyone could experience the version of social media that Kira did?
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We need to do a better job of helping people find communities of support. So if you find yourself facing a chronic illness, if you find yourself with an identity that's well outside of the mainstream, you have really strong motivations to find your people on the social Internet. And you will find for a lot of people, particularly for a lot of queer youth, stories about how social media became their refuge. And I think, I fear in many ways that if what we end up with is a fear of social media notion that social media on average is harmful for young people, we don't look for the therapeutic uses, we don't look for the benefits, we do What Australia is doing right now and essentially says, if you're under 16, you simply can't use this. That's really bad news for a whole lot of people who, like Kira, might have had that opportunity to find their people and find their community on social media.
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From a technical standpoint, it's entirely possible to tweak social media algorithms to encourage. Encourage community or improve mental health.
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The challenge with doing it through the algorithm is there's a very fine line between giving people what they want and that they benefit from and giving people something that's addictive and they can't turn away from. You know, there was likely a moment for CC where fitness and wellness was a positive, and then it turned over time into something that became an obsession, and that ended up being damaging for her.
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And because Instagram and TikTok make money by keeping their users on for as long as possible, there's not really an incentive for them to change the way their algorithms work.
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Right now, the algorithms do a very good job of keeping people as devoted users of the platform, but it's counter to our human rights of having control over our information environment.
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And.
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And at some point, we're going to have to have a serious conversation about what are our rights to have control over the algorithms that are feeding us information.
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I want to switch gears a little.
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So when you think about Meta, you know, who owns Instagram, who owns Facebook, how do you feel for CeCe Nettner? Knowing that her story is a bit of an outlier doesn't do anything to soften her anger towards the social media companies.
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It makes me uncomfortable because these are men who are, like, extremely wealthy, who don't give a shit, excuse my language, about these young girls who are going through puberty. You know, anybody who is susceptible to this, they don't really care about the individual users. And the fact that they're just men who are kind of trying to just make some money. It's. It's very uncomfortable to think about.
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In the summer of 2022, CECE filed a lawsuit against Meta, alleging that Instagram pushed her towards harmful content without her consent. When asked why Instagram would show this kind of content to teenagers, Meta declined to provide a comment.
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I mean, obviously Meta and everybody, they've got the biggest lawyers, the most money in the world, so, like, the only way to knock them down is with our voice and showing people, like, exposing people to what they are doing to youth, to. I mean, to everyone.
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Cece's case is still before the courts. Coming up on Left to Their Own devices.
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I got a phone call from somebody at Facebook who said his boss was facing an existential crisis. Would I be willing to meet Mark Zuckerber? This is a company with almost limitless resources, but it's enabling the worst of the worst. This isn't just one teen suicide. All 20, all 30, all 40 of these are connected.
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If you take away social media tomorrow, this will still be a pervasive problem.
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The anxious generation is the parents generation right now.
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And so I literally sit in my room all day and watch porn when I was like 11. It felt like I was in like
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a jail house without the key and I just could not get out.
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They are killing kids and I don't care if it's one kid or 10
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million kids, it is killing kids.
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Left to their own Devices is hosted and produced by me, Ava Smithing. The show is written, produced, mixed and sound designed by Mitchell Stewart. Our story editor is Kathleen Goldhar. The executive producers for Paradigms are James Millward, Helen Hayes, Taylor Owen and Mitchell Stewart. The executive producer for the Toronto Star is JP Fozo. If you want early access to upcoming episodes of Left to Their Own Devices, subscribe to the Toronto star@thestar.com.
Podcast: Left To Their Own Devices
Host: Ava Smithing (Toronto Star)
Date: September 26, 2025
This episode explores the profound influence of social media algorithms on young people's lives, through intimate stories that show both their lifesaving potential and their capacity for harm. Host Ava Smithing shares her own perspective and guides listeners through the journeys of two young women, Kira and Cece, whose adolescent experiences were shaped (for better and worse) by the digital worlds they inhabited. Alongside social media scholar Ethan Zuckerman, the episode examines the mechanics, mystery, and ethical dilemmas of algorithmic feeds—and the challenge of keeping children safe while retaining the potential for connection, discovery, and even survival.
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The episode is frank, sometimes raw, and marked by the unfiltered voices of young people living through the algorithmic re-scripting of childhood—all guided with empathy by Ava Smithing. In a digital world where the same system can save or destroy depending on the user, "A Tale of Two Algorithms" asks: What do we owe the next generation as we hand them the most powerful informational tools in human history?
Bottom Line:
Algorithms shape youths' lives in deeply consequential, often unseen ways—with outcomes ranging from life-saving diagnosis to life-threatening obsession. Effective solutions demand nuance, agency, and real accountability from platforms—not just blanket bans or resignation.