Misleading Health-Related Information Promoted Through Video-Based Social Media: Anorexia on YouTube

Abstract

IntroductionThe amount of information being uploaded onto social video platforms, such as YouTube, Vimeo, and Veoh, continues to spiral, making it increasingly difficult to discern reliable health information from misleading content. There are thousands of YouTube videos promoting misleading information about anorexia (eg, anorexia as a healthy lifestyle).ObjectiveThe aim of this study was to investigate anorexia-related misinformation disseminated through YouTube videos.MethodsWe retrieved YouTube videos related to anorexia using the keywords anorexia, anorexia nervosa, proana, and thinspo on October 10, 2011.Three doctors reviewed 140 videos with approximately 11 hours of video content, classifying them as informative, pro-anorexia, or others. By informative we mean content describing the health consequences of anorexia and advice on how to recover from it; by pro-anorexia we mean videos promoting anorexia as a fashion, a source of beauty, and that share tips and methods for becoming and remaining anorexic. The 40 most-viewed videos (20 informative and 20 pro-anorexia videos) were assessed to gauge viewer behavior.ResultsThe interrater agreement of classification was moderate (Fleiss’ kappa=0.5), with 29.3% (n=41) being rated as pro-anorexia, 55.7% (n=78) as informative, and 15.0% (n=21) as others. Pro-anorexia videos were favored 3 times more than informative videos (odds ratio [OR] 3.3, 95% CI 3.3-3.4, P<.001).ConclusionsPro-anorexia information was identified in 29.3% of anorexia-related videos. Pro-anorexia videos are less common than informative videos; however, in proportional terms, pro-anorexia content is more highly favored and rated by its viewers. Efforts should focus on raising awareness, particularly among teenagers, about the trustworthiness of online information about beauty and healthy lifestyles. Health authorities producing videos to combat anorexia should consider involving celebrities and models to reach a wider audience. More research is needed to study the characteristics of pro-anorexia videos in order to develop algorithms that will automatically detect and filter those videos before they become popular.

The Health-Related Uses and Gratifications of YouTube: Motive, Cognitive Involvement, Online Activity, and Sense of Empowerment

“…As previously stated, users who utilize YouTube for communicating health information with others are likely to actively discuss the information with others to be more capable of coping with their health-related concerns. However, discussing the vast amount of health information online (e.g., YouTube) may make users feel difficulties in clearly discerning which information is appropriate and trustworthy (Berland et al, 2001;Greenberg, D'Andrea, & Lorence, 2004;Syed-Abdul et al, 2013). Specifically, they are likely to feel confused about overflowing health information on YouTube that differs in when, where, or how to cope with health-related concerns.…”

“…On the other hand, existing research has also indicated that informative health information and misleading health information regarding immunization (Keelan, Pavri-Garcia, Tomlinson, & Wilson, 2007), tanning bed use (Hossler & Conroy, 2008), or anorexia (Syed-Abdul et al, 2013) coexisted on YouTube and that misleading information could have a detrimental impact on users' health care.…”

Risks and Threats of Social Media Websites: Twitter and the Proana Movement

“…In recent years, different studies outlined the growing popularity of "pro-anorexia" websites and even their potential harmful effects [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Our study aimed to investigate the spread and the topics of the "pro-anorexia" accounts on Twitter.…”

“…In recent years, different studies analyzed the spread of pro-eating disorders groups on Internet [14][15][16][17], focusing in particular on social media such as Facebook, Myspace [18], YouTube [19] and Flickr [20]. The potential harmful effect of this online content has been studied in both healthy subjects and anorexics [21,22].…”

Proanorexia Communities on Social Media

“…For example, a recent study revealed that proana YouTube videos were more favored by viewers than were informative videos describing the health consequences of anorexia. 5 Due to the rapid increase of social media's popularity, it is virtually impossible to control or censor existing online content. In addition, health campaigns might not find their targets on the Internet.…”