NHS leaders have written to Instagram CEO Kevin Systrom urging him to prevent the promotion of Apetamin on the platform.

The open letter described the appetite stimulant as an “unlicensed and dangerous drug”, which continues to be sold online despite objections.

A BBC Three documentary, Dangerous Curves, aired on April 21, 2021 exploring the risks of those taking Apetamin, and the NHS was swift to join the conversation on April 30. On behalf of all staff and patients, the letter read “we strongly urge you to demonstrate a duty of care for your customers, and clamp down now on this dangerous content”.

Some Instagram accounts market Apetamin as a supplement for an extreme hour-glass figure, but its misuse can lead to severe fatigue, jaundice and even liver failure. Most commonly, accounts target “impressionable” young women and girls, who want to achieve the specific physique of high-profile influencers. The letter condemned this beauty ideal as “an unobtainable and biologically unsafe body shape and type”. 

The NHS professionals raised concerns about young users’ vulnerability to developing eating disorders or body dysmorphia. They warned that taking Apetamin could result in serious harm to any individual. The letter also cited Instagram’s own community guideline that forbids the “glorification or encouragement of self-injury, including eating disorders”. The app most recently faced criticism over the link between social media and body image, after an algorithm mistake promoted harmful diet content to vulnerable users.

Instagram claimed to have removed the accounts at fault, as a spokesperson explained that buying and selling nonmedical or prescription drugs is strictly against its policies. As the letter highlighted, however, several accounts promoting Apetamin remain.

The letter continued by asking Instagram to confirm its action plan to monitor the platform’s content. It asked “what steps Instagram currently takes to protect users from content likely, or with the potential to, trigger or exacerbate body dysmorphic disorder, eating disorders and other conditions”.

The NHS finally extended the discussion, by asking Instagram its stance on the role of social media in supporting young people’s mental health services. Sir Simon Stevens, NHS chief executive, recommended that social media firms should take more financial responsibility, considering the connection of “damaging online content”.