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Is this today's biggest public health threat?

MDlinx Aug 22, 2024

TikTok has transformed the way people learn and talk about health. On one hand, the social media platform has increased awareness and stigma about countless physical and mental health conditions. But more and more evidence is revealing that the vast majority of health information shared on TikTok is false. 

Recent research from MyFitnessPal and Dublin City University, for example, found that only 2% of videos posted about nutrition are accurate.

MyFitnessPal. Concerning New Statistics Highlight Inaccurate Nutrition Trends on TikTok. April 11, 2024.

 

 

Content creators selling snake oil

 

Young people—especially women—love the app for its brief, engaging reels and increasingly look to it to find health information. In fact, one survey found that 1 in 5 Americans turn to TikTok for medical advice before reaching out to a physician.

Kirkpatrick CE, Lawrie LL. TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study. JMIR Infodemiology. 2024;4:254663.

Health misinformation isn’t anything new. It’s been around for decades. As Jada Willis, PhD, an associate professor at the Burnett School of Medicine at Texas Christian University, says: “It's literally where the term ‘snake oil’ comes from.” 

 

 

But TikTok has turned the spread of misinformation into a major public health threat. “The platform allows anyone to share content, even health related content. Even worse is that the algorithm can feature bad content to more viewers if there’s a larger number of comments or reactions to the post,” Matthew Landry, PhD, RDN, a registered dietitian and assistant professor of population health and disease prevention at the University of California, Irvine, told MDLinx

Here’s how TikTok is changing how people think about health—and how doctors can keep their patients safe. 

 

The consequences can be serious

 

A report recently published in the journal Otolaryngology–Head and Neck Surgery found that  roughly half of popular TikTok videos about sinusitis were posted by nonmedical influencers, and that less than half of these videos (46.7%) were factual.

Dimitroyannis R, Fenton D, Cho S, et al. A Social Media Quality Review of Popular Sinusitis Videos on TikTok. Otolaryngology–Head and Neck Surgery. 2024;170(5):1456–1466.

 

Another study found that 1 in 5 TikTok videos likely contain misinformation, and a report evaluating TikTok videos about gynecologic cancer discovered that most weren’t reliable.

Kirkpatrick CE, Lawrie LL. TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study. JMIR Infodemiology. 2024;4:254663.

Morton M, Haight PJ, Khadraoui W, et al. “More than a song and dance”: Exploration of patient perspectives and educational quality of gynecologic cancer content on TikTok. Gynecologic Oncology. 2023;175:81–87.

 

But people believe what they see. Nearly 4 in 10 people say they trust information about health issues they see on TikTok, according to polls conducted by the Kaiser Family Foundation.

Montero A, Sparks G, Presiado M, et al.. KFF Health Misinformation Tracking Poll: Health and Election Issues on TikTok. Kaiser Family Foundation. June 13, 2024.

 

The consequences of this can be significant. Health misinformation can prevent people from seeking treatment for chronic diseases like cancer and diabetes. It can also trigger mental health issues like anxiety and depression and cause people to diagnose themselves with a condition they don’t actually have.

Office of the Surgeon General. Confronting Health Misinformation: The US Surgeon General’s Advisory on Building a Healthy Information Environment. 2021.

 

Take a look at the COVID-19 pandemic: We now know that false information about the coronavirus and vaccines caused people to not get vaccinated, reject public health measures like social distancing and masking, and use unproven treatments like Ivermectin.

Office of the Surgeon General. Confronting Health Misinformation: The US Surgeon General’s Advisory on Building a Healthy Information Environment. 2021.

 

Thanks to trends that have gone viral on TikTok, people are using supplements instead of antibiotics to treat infections, eating raw meat because they’ve been told it helps them absorb nutrients better, and trying various crash diets

 

The biggest problem I see with both current and past health trends is taking extreme measures that are not only an unhealthy shock to the body, but also unsustainable.

 

Sketchy nutrition reels

 

Cesar Sauza, MS, RDN, a registered dietitian and clinical nutrition manager at AltaMed Health Services, isn’t surprised to see that only around 2% of the nutrition content on TikTok is accurate. During his dietitian consults, he spends a lot of time trying to dispel various nutrition myths. “Patients frequently bring up information they either saw on social media or [that] someone else told them—who saw it on social media—and there is a lot of self-diagnosing and self-treating when it comes to nutrition-related conditions,” Sauza says.

 

Many of the diets his patients ask about are extremely restrictive and can lead to risks like malnutrition and dehydration. Several people have requested prescription for weight loss medications—one of the biggest trends that’s been amplified on social media—but most haven’t tried to lose weight through lifestyle changes. This has led to a shortage in weight loss medications, Sauza says.

According to Dr. Landry, many content creators share diets or nutrition plans as if they’ve been heavily researched—or as if they will lead to the same results in everyone. Nutrition needs to be individualized: What works for one person may not work for another.

Shyam S, Lee KX, Tan ASW, et al. Effect of Personalized Nutrition on Dietary, Physical Activity, and Health Outcomes: A Systematic Review of Randomized Trials. Nutrients. 2022;14(19):4104.

“Some content creators without solid education and training in nutrition may also be unaware of unintended consequences of including or excluding certain foods from their diet,” Dr. Landry says. 

 

Harmful messages about food and nutrition can contribute to body image and self-esteem issues and can increase people’s risk of developing an eating disorder, research shows.

Dane A, Bhatia K. The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people. PLOS Global Public Health. 2023;3(3):e0001091.

“Restrictive diets can lead to disordered eating patterns and an unhealthy relationship with food, especially among adolescents and young adults,” Dr. Landry adds.

 

Sauza has found that his patients who haven’t been exposed to nutrition content on TikTok tend to have the greatest success. “They don’t have these nutrition myths, fads, and information overload holding them back from making meaningful changes,” he says.

 

How doctors can keep patients safe

 

Certified healthcare providers have the power to combat health misinformation. Ask your patients about their concerns and, instead of judging them, listen and respond with empathy.

Office of the Surgeon General. Confronting Health Misinformation: The US Surgeon General’s Advisory on Building a Healthy Information Environment. 2021.

Then, offer guidance and lead them to verified sources of accurate information. 

 

Dr. Landry recommends encouraging patients to make sure that content creators are qualified medical professionals, such as board-certified physicians or registered dietitian nutritionists. Another tip is to look for popular buzzwords like “toxins” or “detox,” as these can signal some red flags, Dr. Landry adds. Second-guess any posts that seem extreme or absolute: “A post that encourages you to always or never eat or do something is usually not sound advice,” Dr. Landry says.

What this means for you

Health misinformation on TikTok abounds, putting your patients at risk. It’s a good rule of thumb to remind them that social media is not a reputable source of information, especially when it comes to health. Instead, it’s best to dig into the research and follow up with a professional. Tell your patients to trust their gut—if something sounds too good to be true, it probably is.

 

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