Nadya Okamoto had the perfect costume for her friend’s Rihanna-themed birthday party: a likeness of the pregnant pop star in black lingerie, based on her iconic outfit at Paris Fashion Week.
Okamoto was not pregnant but her belly was distended: “I literally had a watermelon-sized bloat,” she said.
The 26-year-old TikTok creator is vocal about her digestive issues. A video Okamoto posted of the Rihanna costume, showing her “bloated, poo-filled belly,” has amassed 3.8 million views.
“This made me feel so much better!!” one commenter wrote. “I’ve had a bloated stomach since I was little and I was so insecure about it today.”
Okamoto is one of many young, female creators who are documenting and discussing bloating on the app, filming their distended bellies. Some attribute the issue to menstruation or constipation, while many others just describe it as mysterious and painful.
Around 158,000 TikTok posts feature the #bloating or #bloated hashtags. The company did not respond to multiple requests for comment about the rise or reach of the trend.
Women have discussed bloating across various forums for many decades, but the recent uptick is part of a broader focus on gut health, arising from research about the importance of good bacteria in the gut. Many recent TikTok videos about bloating encourage viewers not to dismiss it as normal or benign. And plenty of wellness influencers now promote “gut-healthy” products or share hacks for improving digestive issues.
Several gastroenterologists said that anecdotally, they have seen an increase in patients who report symptoms of bloating.
“It just strikes me that people are much more concerned about bloating and distension than they have been in the past,” said Dr. William Chey, chief of the gastroenterology division at the University of Michigan Medical Center. “It’s a really frequent complaint that I care for in 2024, and it seemed like it was very much more of a sideshow in years past.”
Experts offered a guess as to why that may be: The consumption of ultraprocessed foods with high quantities of gluten or fructose has increased in recent decades. The trend could also be a result of greater awareness or discussions of bloating, they said.
“Partially because of social media, talking about GI symptoms in general is becoming much less taboo, much more the norm,” said Dr. Kyle Staller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital. “Being that bloating is both common and bothersome, people are really starting to air their grievances online.”
Dr. Satish Rao, a professor of medicine at Augusta University, said some physicians may also be taking reports of bloating more seriously than they did decades ago because patients document their distended stomachs on their phones.
“From the patient’s own evidence, you can actually say, ‘Yeah, you know, there is something not right,’” he said, adding that he has seen a steady rise in bloating cases over the last 20 years.
One likely catalyst for the proliferation of bloating videos on TikTok was a Los Angeles billboard that a company called BelliWelli launched in 2022. It bore a now-popular phrase: “Hot girls have IBS.”
BelliWelli makes snack bars advertising “zero bloat” for people with gut issues. Katie Wilson, the company’s founder and CEO, said a line formed by the billboard — people wanted to take photos.
“It was women sticking out their stomachs. It was a reclaiming, like it is cool to be bloated,” she said. (A majority of people with irritable bowel syndrome report bloating as a symptom, and women are more likely to have these issues.)
The phrase went viral on social media.
Wilson said the campaign also had a secondary message: “It’s not normal to be uncomfortable day in and day out.”
That message resonates with Alex Hanan, 23, an intensive care unit nurse in Boston. Her TikTok video about foods that have made her feel bloated — such as caffeine on an empty stomach and protein bars — has 1.2 million views.
“It’s something that people maybe don’t even realize that they have, which is yet another reason why I talk about it,” she said.
Not all gastroenterologists agree that bloating is any more common now than in years past, however.
“I can’t say that I’ve seen some remarkable uptick. I’ve just seen a steady, constant flow of people with bloating,” said Dr. Brennan Spiegel, a professor of medicine and director of Health Services Research at Cedars-Sinai Medical Center.
Spiegel and Chey co-authored a 2022 study, which found that almost 1 in 7 Americans said they’d experienced bloating in the prior week, but Spiegel said there is not good data on trends over time.
Some degree of bloating is normal, according to doctors — especially after a large meal — but experiencing it chronically may be a sign of a medical issue such as IBS or lactose intolerance.
Bloating can be difficult to treat.
“We try and treat some of the usual culprits like constipation, but so many patients even after treating those things are still bothered,” Staller said. “I think that is the real reason why we see so many people coming to say, ‘What can I do? What’s the mystery here?’”
That element of mystery has led plenty of people on TikTok to test or promote remedies that aren’t well supported by science, including probiotics and supplements.
“Unfortunately, we don’t yet have enough science to know for sure whether, when and how best to take probiotics,” Spiegel said.
Okamoto is among those who does not know the cause of her bloating, which she said has bothered her since childhood. She suspects constipation or a gluten intolerance may be contributing and said lowering her gluten intake has helped. But she hasn’t found a clear answer yet, even after seeing multiple doctors.
Okamoto said she has tried just about everything — medication, probiotics, fiber supplements, even an enema.
“Someone told me to swallow two tablespoons of olive oil and I fully did that on TikTok and then just felt sick,” she said.
Some bloating can be reduced via dietary changes.
After screening for constipation, doctors often check for food sensitivities by putting people on diets with minimal FODMAPs — sugars that are poorly absorbed by the small intestine. This usually involves eliminating categories such as dairy, wheat, beans or certain fruits and vegetables, then reintroducing them to see which cause issues.
In some cases, trapped gas can cause bloating, so people can take an over-the-counter pill like Gas-X, or a peppermint oil capsule. But neither is a long-term solution.
In other cases, bloating may be caused by an abnormal reflex that causes the diaphragm to descend and the abdominal wall to relax and push out. Swallowing too much air when eating or sleeping could also be a culprit, so doctors may recommend chewing food slowly and avoiding carbonated beverages, gum, mints or hard candies.
But there’s a big difference, Spiegel said, between mild and severe bloating.
“Having some stomach aches, some bloating — they’re so common, it’s almost part of being a human,” he said. “When it becomes a problem, though, is when it’s really affecting your quality of life.”
