What can we learn from health influencers on social media?
The New York Times last month ran a story titled “TikTok Is Flooded With Health Myths. These Creators Are Pushing Back.”
TikTok has been the most downloaded app worldwide in 2022. More people are using social media platforms to get information on health and wellness. They’re relying on influencers—many of whom are not licensed healthcare professionals—to learn about diets, supplements, and mental health.
How can we separate science fact from fiction on social media? How worried should we be about pseudoscience health influencers spreading misinformation?
Science debunkers flock to TikTok
The NY Times article highlights science debunkers like Mustafa Dhahir, a practicing pharmacist and medical student based in Australia. Mr. Dhahir explains why a TikTok video claiming oral contraception causes a medley of symptoms, including changes in sexual attraction, is inaccurate:
“This guy is simply using scare tactics. One of the most annoying things when it comes to busting misinformation is that the people who spread the misinformation use hints of truth to spread their lies.”
Health and wellness on TikTok is a popular subject. Videos with the hashtag #HealthTok have racked up 967 million views.
The work of debunkers like Mr. Dhahir underscores the challenges of fighting misinformation on platforms like TikTok:
“When it comes to combating health misinformation in general, all social media platforms face a daunting task, given the sheer volume of inaccurate posts.”
It’s easy to spread false or misleading content on TikTok and other social media, and hard to validate a person’s credibility. A study of 194 fitness influencers found that only one in six had any certifications.
Health and science education is changing
I started Vitamin Z to share my research on health and wellness with broader audiences. I wanted to write about health from an evidence-based perspective.
I’ve been inspired by science educators like Andrew Huberman, professor of neurobiology at Stanford School of Medicine. I met him at a conference four years ago. He shared with me his ambition to teach neuroscience to a billion people. He’s well on his way, with over one million followers on Instagram and a top-10 science podcast.
Before, science teachers hoping to reach broader audiences were limited to publishing textbooks. A few science luminaries like Carl Sagan (“Cosmos”) had their own TV shows. Neil deGrasse Tyson has explained astrophysics on TV for years.
Today, health and science educators are using social media to reach people around the world. Education is shifting away from the traditional lecture-based model. More students are learning from interactive online programs like Khan Academy.
Scientists and educators are creating engaging, immersive, and collaborative learning programs that transform fun digital experiences into truly educational ones with social interaction at their core.
It’s easy to dismiss social media as a cesspool of misinformation. Yet some healthcare experts see an opportunity to leverage these platforms to reach more people and improve public health education.
The lines are blurring between healthcare providers and influencers
The Covid pandemic spurred the rise of a new generation of physician and science influencers. They used Twitter and Instagram to counter the flood of misinformation about Covid prevention, treatment and vaccines.
Mike Varshavski is a board-certified family medicine physician based in New York City. He’s a leading health influencer with four million Instagram followers and ten million subscribers on YouTube, where he’s known as Doctor Mike.
In a podcast interview with Lewis Howes, Doctor Mike talked about the evolving ways healthcare experts are using social media platforms to educate and influence public health:
“The lines are blurring between healthcare providers and influencers. Today, it’s become acceptable for MDs to put content on YouTube and Instagram and Twitter to educate not just their patients but the world. Previously, the lack of trained MDs on social media allowed misinformation to flourish.
Influence is not just expertise but also reach. We need to understand these platforms, how to post and use the algorithms. There are opportunities to educate the masses via memes and even video game characters.”
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Some physicians are hesitant to publish educational content on social media. They may fear losing their licenses or memberships in professional associations.
There’s been criticism of “clout chasing” doctors and nurses sharing their stories on social media (Buzzfeed News: “Doctors And Nurses Are Being Called Out For Being Cringe On TikTok, And TBH, They Deserve It.”)
Yet physicians like Dr. Vinay Prasad of UCSF believe Twitter and social media have become a useful public forum for criticism and thoughtful commentary on clinical studies. There’s an opportunity for healthcare leaders on social media to help more people understand science and how scientific research really works.
The roots of misinformation—and how to spot it
Why does misinformation about health spread so easily on social media?
One answer is the algorithms of platforms like TikTok, which amplify extreme views. Another reason may be distrust in physicians and other healthcare experts.
Dr. Danielle Belardo is a cardiologist based in Newport Beach, California. In a podcast interview on Conspirituality, she said:
“The root cause of distrust in doctors is the belief that physician recommendations and guidelines are based on pharma-sponsored research studies. People believe pharmaceutical companies are evil, and all natural foods and supplements are good.”
Dr. Belardo said this distrust of physicians and reliance on social media health influencers leads to adoption of health fads, like the carnivore diet and animal-based diet, that aren’t supported by clinical guidelines:
“Social media influencers will say your LDL cholesterol levels don’t matter. Medical science has shown this leads to atherosclerosis and heart disease.”
I spoke with Dr. Howard Leibowitz, a board-certified emergency medicine doctor based in LA. He said:
“People in LA latch onto diets easily and quickly. I don’t think that’s a great idea. Some of these diets I don’t personally think are healthy. A lot of it is driven by financial interests. I’d recommend people do their research and not jump into something too quickly.”
I spoke with Dr. Jeffrey Chen, co-founder of Radicle Science, which evaluates natural products with virtual, direct-to-consumer clinical trials. He said:
“Look at whether someone has an incentive to sell you something and make money off it. That driver distorts everything. It creates conflicts.
Think about the reputability of the person telling it to you. If it’s a MD who’s not trying to sell you anything, and has no financial interest, it’s more reliable than a blogger who talks about a product and gets a referral fee for anyone buying it.
Any article that talks about something without citing a clinical study is a red flag. People need to dig into the studies and look for credibility from scientists and doctors.”
Dr. Belardo said one way to spot pseudoscience is to note when people talk about mechanisms instead of outcomes:
“Outcomes are clinically relevant things: does it change your symptoms or disease process or how you feel?
Mechanisms are claims like ‘These microbiome supplements will help your leaky gut,’ but there’s no clinical evidence showing this. There’s not even consensus on what changes in the gut microbiome really mean.
We know people should get enough fiber, but we don’t know enough clinically to make more detailed recommendations on the microbiome. There’s why the home microbiome tests are totally bogus.”
Misinformation on social media is a real problem. But these platforms aren’t going away. Young people today live on YouTube and TikTok. It’s increasingly where they learn about the world. We need to meet them where they are.
TikTok and other social media companies have an obligation to crack down more effectively on false or misleading claims. And healthcare leaders have an opportunity to use these platforms to expand science education and explain important health issues to the masses.
I’d love to hear your thoughts. Who are your favorite health and wellness influencers on social media? How do you figure out whom to trust?
Thank you for reading this week’s edition of Vitamin Z.
Until next time,
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