Social media influencers now shaping health decisions; can lead to unsafe self-diagnosis: British Medical Journal

Social media influencers are now shaping health decisions in ways that can lead to unsafe self-diagnosis, unnecessary tests, and heavy spending, a new analysis in The British Medical Journal has found.

The paper says many influencers share medical advice without training, while platforms rarely require them to disclose financial interests or explain risks. As per the analysis titled 'Health information in age of social media and influence,' more than 70 per cent of young adults in the US follow influencers, and over 40 per cent have bought health products promoted by them.

Researchers identify four key sources of bias in influencer health content. This includes lack of medical expertise, industry influence, entrepreneurial interests, and personal beliefs. These biases often guide posts on Instagram, YouTube, TikTok, and other platforms.

The analysis provides examples of influencer posts that may lead to unsafe or unnecessary health decisions. Chloe Kardashian, a US media personality with around 300 million Instagram followers, posted on Instagram: "I love @nurtecoct so much… I just take #NurtecODT and it can start to relieve my migraine pain within 1 hour." The researchers noted that Nurtec (rimegepant) is a prescription migraine medication, and direct-to-consumer promotion of such drugs can be accessed in regions where it is normally prohibited.

Similarly, Dr Eric Berg, a US chiropractor with 14 million YouTube subscribers, posted about vitamin D supplementation: "Today we gonna talk about why an average person should be taking 10,000 IU of vitamin D3 as a maintenance dosage every single day." Researchers said this promotes high-dose supplementation while Berg sells his own vitamin D and other supplements, some of which have received legal warnings for lead content exceeding safety limits.

Influencers are persuasive because followers often form emotional or one-sided connections with them. According to the authors, this closeness “can reinforce or undermine shared understandings” and makes medical claims feel credible even when the evidence is weak.

The paper notes that influencers are not always harmful. Doctors, nurses, and patient-advocates also use social media to correct misinformation and share experiences that help others navigate long-term or stigmatised conditions. But without safeguards, even supportive online communities can unintentionally spread unverified ideas or deepen distrust in medical systems.

Several countries have begun regulating health-related influencer content. Australia bans paid health testimonials; India requires influencers to disclose medical credentials; South Africa demands clear sponsorship labels and evidence-based claims; and China limits health content to verified professionals. Evidence on how well these rules work is still limited.

Experts also argue that regulation alone will not be enough. They say platforms must rethink how information is organised and promoted.

They explain that influencers sit at the “intersection of expertise, marketing, and entertainment,” and many grow their audiences through familiarity and personal branding. Some even turn myth-busting into performance, making corrections themselves part of the entertainment economy.

They note that social media companies profit from attention, not accuracy, and that “emotionally charged or moral content circulates more widely than evidence-based information.”

The experts conclude that influence today is “ecological,” shaped by technology, commerce, and group discussions. Regulation remains important, they say, but building trust through verified communities, clinician-supported spaces, and participatory public health campaigns will be essential to making online health information safer.