Star power eclipses science in obesity discussions on social media

Despite their rarity, celebrity tweets generate up to 20 times the engagement of health institutions, reshaping strategies for effective public health campaigns on social media.

Whose tweets about obesity and weight loss gain the most attention: celebrities, political, or medical authorities? Image Credit: DavideAngelini / Shutterstock

In a recent study published in the International Journal of Obesity, researchers explored the reactions of X (formerly ‘Twitter’) users to obesity- and weight loss-associated tweets (n = 8,989, collected between December 3 and December 11, 2022) from celebrities, politicians, and medical authorities (specialists, journals, and health institutions). They conducted descriptive statistics, sentiment analysis, and multivariable quantile regression modeling and found that tweets posted by celebrities, medical journals, politicians, and universities received predominantly positive feedback.

In contrast, tweets from health institutions such as the World Health Organization (WHO) and the National Institutes of Health (NIH) received substantially less feedback, most of which was negative, despite significantly higher obesity, body mass index (BMI), and weight loss-associated posts from these sources. The study also highlights that verified accounts garnered more responses, regardless of content, and that tweets with longer text generally received more reactions. This study thus elucidates the relative influence of various social media information sources, suggesting that celebrities, politicians, and universities form an ideal sensitization and education platform for the dissemination of weight-related public health information.

Background

Weight-associated medical conditions such as overweight and obesity are public health concerns, substantially increasing the risk of cardiovascular diseases (CVDs), cancers, and shortened life expectancy. Alarmingly, the prevalence of undesired weight gain and obesity is on the rise, more than doubling since 1990 – currently, 890 million adults are estimated to live with the condition. In combination with poor dietary decisions, today’s increasingly sedentary lifestyle is expected to increase this prevalence further, making disseminating scientifically verified anti-weight gain information imperative.

X (formerly ‘Twitter’) forms a unique social platform for the interaction of celebrities and professionals with casual lay people. Given the gradually increasing amount of adult social media investment (estimated at 2 hours and 27 minutes daily, as of 2022), platforms such as X form ideal information dissemination platforms. This is especially true for overweight individuals, who are known to spend more time on social media platforms compared to their regular- or underweight counterparts.

‘Tweets’ (posts) on X receive highly variable user feedback in the form of likes/dislikes, comments, and retweets. Popular media personalities such as celebrities, politicians, and sportspersons are generally observed to garner more traction than medical entities (organizations and institutions) despite the latter’s higher frequency of relevant posts (weight-associated) and greater scientific validity.

Understanding these dynamics and identifying key dissemination avenues (social media personalities/accounts) may help greatly expedite public health education efforts. Unfortunately, previous analyses of X-based dissemination routes remain limited, particularly concerning obesity and weight loss.

About the Study

The present study explores user reactions to obesity—and weight-loss-associated tweets from seven different sources: 1. celebrities, 2. politicians, 3. medical specialists, 4. sportsmen, 5. medical universities, 6. medical journals, and 7. health institutions. To identify these accounts, researchers applied a snowballing approach, leveraging platform-recommended ‘similar accounts’ to build their dataset. The study aims to use the quanta (number of responses, comments, and retweets) and polarity (positive or negative) of user responses as proxies to identify ideal platforms for obesity-centric public health outreach and education.

Data was collected between December 3 and December 11, 2022, and leveraged a snow-balling approach (platform recommended ‘similar accounts’) to identify approximately 1,000 celebrity accounts comprising 500 sportsmen, 250 politicians, and 250 medical specialists. Popular medical journal accounts were identified from the Scimago Journal & Country’s Top 100 medical journals list. The Scimago platform was used to identify famous medical institutions, including the World Health Organization (WHO), the National Institute of Health, and the United States (US) Centers for Disease Control and Prevention (CDC).

Any posts (tweets) pertaining to weight-associated metrics and outcomes were eligible for study inclusion. These include keywords such as ‘body mass index,’ ‘obesity,’ ‘weight loss,’ and ‘fat burn,’ amongst others. The R (version 3.6.1) platform was used for statistical analyses, comprising descriptive statistics, sentiment analyses, and multivariable quantile regression modeling. The researchers analyzed user reactions across different deciles of tweet engagement, from the median (50th percentile) to the highest-performing posts (90th percentile).

Study Findings

After screening for retweets and duplicates, the final analysis dataset comprised 8,989 tweets from 545 timelines. Notably, health institutions were observed to post relevant tweets most frequently, accounting for almost half (n = 4,216) of the dataset. Medical journals followed with 2,297 posts. In stark contrast, politicians (n = 248) and sportspersons (n = 59) rarely made weight-associated posts despite higher fanbases (followers) and overall tweeting volume.

“A majority of tweets in our sample came from medical journals and medical specialists, while only a tiny proportion was from non-medical individuals. It seems understandable that non-medical accounts dedicate only a small portion of their tweets to obesity or weight loss.”

Surprisingly, despite the low overall number of relevant celebrity posts compared with those from medical institutions, traction was substantially higher for the former cohort – celebrity posts received coefficients of over 1,000/post compared to only 50/post for the latter. This unexpected discrepancy suggests that celebrity posts were more likely to be viewed by a substantially wider audience despite their infrequency and apparent rarity, highlighting celebrities as strategic collaborators for spreading anti-weight gain information.

Furthermore, responses to celebrities (politicians, sportspersons, and medical specialists) and universities were generally positive, receiving orders of magnitude more likes and retweets than medical journals. In contrast, feedback on tweets posted by medical institutions was typically negative, as validated through sentiment score analysis. Negative emotions in tweets often generated more engagement than formal, academic language, consistent with prior studies on social media dynamics. These findings were most robust in verified accounts, suggesting lay peoples’ faith in the content they read from famous social media personalities.

Conclusions

The present study underscores the vast discrepancies in the number of tweets posted and subsequent user responses to weight-loss- and obesity-associated posts on the popular social media platform X. Study findings highlight that despite representing only a fraction of the total quantity of obesity-associated posts, celebrities garnered substantially more traction and outreach compared to medical professionals. Furthermore, irrespective of the contents of individual posts, celebrity posts were generally associated with positive user feedback, while those from medical institutions received adverse reactions and limited retweeting.

Together, these findings highlight celebrities as ideal targets for disseminating medical, obesity-related advice. The researchers recommend involving verified non-medical accounts and avoiding politically charged messaging to ensure widespread impact across diverse audiences.