Dear HIFA colleagues,
This week's BMJ looks at the role of famous influencers on public and individual health.
1. Evidence based medicine in the age of influence (Editor's choice)
BMJ 2025; 391 doi: https://doi.org/10.1136/bmj.r2545 (Published 04 December 2025)
Cite this as: BMJ 2025;391:r2545
Rebecca Coombes, head of journalism at BMJ, writes: 'Social media influencers are a popular source of health information to millions of people — and they are increasingly a more available and trusted source of help and advice than doctors. From global celebrities such as Kim Kardashian, with her 360 million Instagram followers, to patient voices such as Tilly Rose (doi:10.1136/bmj.r2501), these influencers enjoy freedoms unavailable to medical professionals. Subject to minimal regulation and with unlimited time to nurture trust, they can use marketing techniques and share personal experiences without fear of crossing a line.'
2. Responding to public health challenges of medical advice from social media influencers
BMJ 2025; 391 doi: https://doi.org/10.1136/bmj-2025-086061
Raffael Heiss and colleagues note four biases among influencers:
The first source of bias is a lack of expertise or relevant knowledge... A prominent example is celebrity Kim Kardashian, who encouraged her 360 million Instagram followers to have full body screening with magnetic resonance imaging.
A second source of bias is industry influence. Companies may provide free products, pay for promotional posts on social media or blogs, use affiliate marketing (commission for sales through unique links), or engage influencers in long term collaborations as brand ambassadors...
Third, many influencers pursue their own entrepreneurial interests. To gain attention, they often use threat inducing content that drives engagement...
Finally, influencers — including patients and trained physicians — may be shaped by personal biases. These include lifestyle choices or ideological beliefs that are not supported by reliable evidence, such as in homeopathy or anti-vaccine misinformation...
Such biased or misleading advice—amplified by parasocial bonds and direct engagement—can cause physical, psychological, financial, and systemic harm...
Coordinated action by governments and platforms is essential to protect users and to strengthen users’ ability to evaluate medical advice from influencers...
3. Health information in age of social media and influence
BMJ 2025; 391 doi: https://doi.org/10.1136/bmj.r2419 (Published 03 December 2025)
Cite this as: BMJ 2025;391:r2419
Tina Purnat and David Scales write: 'Regulating and moderating platforms and influencers is necessary, but fostering trust through verified communities, clinician endorsed forums, and participatory public health campaigns will be indispensable.'
COMMENT (NPW): All the above are commentaries. A few years ago there was a systematic review on this topic: The impact of social media influencers on health outcomes by John Powell & Tabitha Pring
https://www.sciencedirect.com/science/article/pii/S0277953623008298
They concluded that 'social media influencers have both negative and positive impacts on health outcomes, with negative impacts seen consistently in studies of body image dissatisfaction. Further research is needed to harness the potential positive health impact of social media influencers, while mitigating against harmful effects'
I would add that tighter regulations are needed not only to recuce disinformation from influencers, but also (and especially) from political leaders.
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org