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In their natural state, wild-bred tilapia are an excellent source of protein and omega-3 fatty acids – not to mention its fresh taste and lack of cholesterol; that makes it a popular choice among people who don’t typically like fish. However, the tilapia you might find in the frozen food section is a far cry from tilapia in their natural habitat.
Tilapia is now the fourth most-consumed seafood in the United States, after shrimp, tuna and salmon – however the tilapia you find in the markets and restaurants are farm-bred fish, meaning they have very little difference from factory products, which have a reputation for extremely lacking in the nutritional department. In fact, the similarities between farm-bred fish and farm-bred chickens and cows are uncanny…
1) Omega-6 content
The high omega-6 to omega-3 ratio is one of the main reasons why farm-bred tilapia is an unhealthy item to include in your diet. Omega-3s are considered “good” fatty acids, however an imbalance of too much omega-6 has been linked to systemic inflammation in the blood vessels, which contribute to heart disease and other diseases like arthritis and asthma.  
2) Polluted waters
Do you know where your fish comes from? Americans now eat 475 million pounds of tilapia per year, four times more than they did a decade ago. The vast majority of this fish is farmed in pens or cages in Latin America and China. China is notorious for pollution. Chemicals and vetinary drugs are widely used and many of China’s farms are situated in heavily industrialized regions. Because this fish is extremely easy to breed, even in toxic conditions, chances are the waters where they are grown have been polluted in one way or another by factory and household run offs. Even if the water has been deemed “free from chemicals”, the waters in these fish ponds may not be properly cleaned / filtered.
The regular pumping of fish ponds with antibiotics doesn’t help either, bringing rise to antibiotic resistant bacterial strains. Any kind of meat that has been treated with antibiotics can pose a dangerous threat to marine life, as well as human health. The residual traces of these chemicals can affect our body’s immune system, making it more susceptible to a variety of infections.  
4) Dioxin levels
Dioxins are one of the most common pollutants found in the fatty tissues of meat, especially meat from farmed-fish. They come from industrial processes like paper manufacturing, as well as natural occurrences like fires and volcanic eruptions. Fish pond waters are excellent places for dioxins to settle, and in highly populated tilapia ponds, the risk for consuming fish meat with dioxin is pretty high. Dioxins can cause skin lesions and discolorations and problems with the immune, nervous, endocrine, and reproductive systems. It most dangerous effect on human health is resulting in different types of cancer, making it a “known human carcinogen” according to the IARC.  
5) Poor nutrition
Farm-bred fish are known for having less protein and less omega-3 fatty acids – the two things that made wild tilapia an excellent dietary component. However, when tilapia are bred in close quarters, they have higher fat content and less protein – making them as unhealthy as inorganic meat and game. Farmed tilapia are often fed GMO corn and soy pellets, not exactly an excellent nutritional source for any living creature, and not something that fish are even supposed to eat! We are affected not only by the food we eat, but by the food our food eats. 
6) Environmental Damage
Intensive fish farming is destructive to natural environments. Dr. Salvador Montenegro, director of Nicaragua’s Center for Aquatic Resource Investigation, compared its effect to allowing millions of chickens to defecate in a lake – potentially leaving dead lakes and extinct species. 
7) Tilapia From China Are Sometimes Fed Chicken Sh*t
I wish I was making this up. A July 2009 report  from the USDA on the safety of food imports from China noted that “It is common practice to… spread livestock and poultry waste on fields or use it as fish feed.” Tilapia, cod, scallops, shrimp, prawns, crab, and other fish (mostly frozen and prepared products) are the largest and fastest growing category of foods that are imported from China.
UPDATE: If you can obtain tilapia that can be verified to have been raised in a clean environment and fed properly, you may avoid many of these problems. Look for fish raised in an aquaponic/hydroponic environment. The good ones will let you tour their facility to show you that they really are raising healthy food. One commenter also stated that Costa Rica is raising tilapia in a proper manner.
 Young, K. (2009). Omega-6 (n-6) and omega-3 (n-3) fatty acids in tilapia and human health: a review. http://www.tandfonline.com/doi/abs/10.1080/09637480903140503
 Nelson, J. & Zeratsky, R. (2008). Catfish and tilapia: healthy or harmful? http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-blog/tilapia/bgp-20056256
 Labella, A., et. al. (2013). High incidence of antibiotic multi-resistant bacteria in coastal areas dedicated to fish farming. http://www.ncbi.nlm.nih.gov/pubmed/23518445
 Cabello, F. (2006). Heavy use of prophylactic antibiotics in aquaculture: a growing problem for human and animal health and for the environment. http://onlinelibrary.wiley.com/doi/10.1111/j.1462-2920.2006.01054.x/full
 Hayward, D., Wong, J. & Krynitsky, A. (2007). Polybrominated diphenyl ethers and polychlorinated biphenyls in commercially wild caught and farm-raised fish fillets in the United States. http://www.ncbi.nlm.nih.gov/pubmed/16769049
 WHO. Dioxins and their effects on human health. http://www.who.int/mediacentre/factsheets/fs225/en/
 Imports From China and Food Safety Issues. USDA, 2009. http://www.ers.usda.gov/media/156008/eib52_1_.pdf
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