Digital labor as a social determinant of mental health: The case of performative extreme eating in Japan

Social media has transformed eating into a global spectacle, with online eating performances emerging as one of the major entertainment genres. While the impact of online performance on viewers is a growing public health concern, the well-being of the performers themselves remains underexplored. This narrative review analyzes “performative extreme eating”—the voluntary, deliberate consumption of excessive food for entertainment or digital labor—framing it as a challenge for mental, behavioral and occupational health. This narrative review synthesizes information from diverse sources through a non-systematic search of academic literature, supplemented by an analysis of journalistic reports and relevant cultural media to provide a comprehensive overview of the phenomenon, using Japan as a primary case study. Performative extreme eating often appears distinct from clinical eating disorders as it may lack the subjective distress or loss of control required for diagnosis. However, this performative facade can obscure serious underlying vulnerabilities, including undiagnosed binge eating disorder and bulimia nervosa. Our analysis of the Japanese context reveals how precarious digital labor acts as a social determinant of mental health, creating a public health blind spot exacerbated by nascent worker protections and policy inaction. Performative extreme eating is a pressing challenge at the intersection of digital culture, the gig economy, and occupational health. Addressing it requires a multi-pronged strategy: Targeted research on its prevalence and health effects, occupational health guidelines for performers, and thoughtful, evidence-based regulations. • Performative eating conceals underlying pathologies like bulimia nervosa. • Performative eaters constitute a form of precarious and high-risk digital labor. • A policy gap in Japan contrasts with actions in other East Asian nations. • Occupational health perspective is urgently needed to protect performers.