Interplay of Support, Comparison, and Surveillance in Social Media Weight Management Interventions: Qualitative Study

Abstract

Background: There has been a significant increase in the trend of using social media as a platform to deliver weight management interventions. This illustrates a need to develop a holistic understanding of doctor-patient communication and peer-to-peer communication in social media interventions and to determine their influences on weight management for people with overweight or obesity. Such studies will highlight how social media can be more effectively integrated into weight management programs to enhance individuals' short-term and long-term weight management behaviors. Objective: The aim of this study was to examine patients' experiences with doctor-patient communication and peer interactions in a social media-based (WeChat) weight management program, and to describe the interplay of three social influence factors-social support, social comparison, and surveillance-in their weight control practices. The program, designed and implemented by the research team located in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components that targeted people with overweight or obesity. Methods: We conducted in-depth interviews with 32 program participants of different ages (mean 35.6, SD 7.7 years), gender (18 women), duration of program membership (mean 1.4 years), and weight loss outcomes (54% weight loss to 9% weight gain). All interview data were audio-recorded, transcribed, and translated using the translation-backtranslation technique. Nvivo software was used to facilitate the coding process. Results: Results of thematic analysis indicated the distinct functions of professionally led support and peer support. Professional support was presented in the form of knowledge infusion, efficacy enhancement, and provision of timely feedback. Peer support fostered empathy and sense of belonging, and had a mutually reinforcing relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it also reinforced negative group norms, and resulted in downturns in reference standards and collective inactivity. Social media surveillance prompted participants' reactions to the gaze from medical professionals and peers that could be encouraging or inhibiting. Surveillance enhanced vigilance with weight control norms; however, its influence weakened when participants chose to fake weight data and turn off notifications. Findings from this study illustrated the interrelated and fluctuating influences of support, comparison, and surveillance. Conclusions: The interactive traits of social media eased the practices of social support and social comparison, and created new forms of surveillance. This study contributes to an in-depth understanding of social media influences on individuals' weight control behaviors. Practical implications of the study concern improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology.

The impact of a social-media-based weight management program: insights from the community campaign “obesity does not suit me”

“…This research leads to a better understanding of how social media affects people's weight-control habits. Improved methods for preserving constructive patterns in social media interactions and avoiding disruptive reactions to surveillance technologies are among the study's practical consequences (Chang, Chattopadhyay, Li, Xu, & Li, 2021).…”

The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study

“…In a study by Xiao et al [ 33 ], participants reported feeling more willing to use and satisfied when using the WeChat platform for routine BP monitoring. Chang et al [ 34 ] examined participants’ experiences of physician-patient communication and peer interaction in a social media–based (WeChat) weight management program. The interactive nature of social media mitigates the practice of social support and social comparison and creates new forms of supervision [ 34 ].…”

“…Chang et al [ 34 ] examined participants’ experiences of physician-patient communication and peer interaction in a social media–based (WeChat) weight management program. The interactive nature of social media mitigates the practice of social support and social comparison and creates new forms of supervision [ 34 ]. However, such communication in a public group carries a potential privacy risk.…”

Emergency Response and Risk Communication Effects of Local Media during COVID-19 Pandemic in China: A Study Based on a Social Media Network

“…Emergency response and risk communication were important for the control of COVID-19 in China, and the use of social media played a prominent role in this process [33,43,44]. The timely release of domestic and global pandemic situations, practical health guidelines, and coping strategies developed by the government can greatly shape the confidence and ability of the whole society in response to the pandemic [11,33,[45][46][47]. This study aims to analyze the regional differences in China by reviewing the development of emergency response and risk communication in different parts of China, so as to provide a reference for future crisis management.…”