Quality of Weight Loss Advice on Internet Forums

• Published in: The American journal of medicine Vol. 120; no. 7; pp. 604 - 609.e2
• Main Authors: Hwang, Kevin O., MD, Farheen, Kiran, MD, Johnson, Craig W., PhD, Thomas, Eric J., MD, MPH, Barnes, Ann S., MD, Bernstam, Elmer V., MD, MSE, MSa
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2007; Elsevier; Elsevier Sequoia S.A
• Subjects: Adult; Biological and medical sciences; Chat rooms; Counseling - standards; Diet; General aspects; Humans; Information; Internal Medicine; Internet; Medical sciences; Obesity; Overweight; Quality; Quality of Health Care; Retrospective Studies; Weight control; Weight Loss; Obesity; Internet; Weight loss; Overweight; Medicine; Quality; World wide web
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2007.04.017

Abstract Background Adults use the Internet for weight loss information, sometimes by participating in discussion forums. Our purpose was to analyze the quality of advice exchanged on these forums. Methods This was a retrospective analysis of messages posted to 18 Internet weight loss forums during 1 month in 2006. Advice was evaluated for congruence with clinical guidelines; potential for causing harm; and subsequent correction when it was contradictory to guidelines (erroneous) or potentially harmful. Message- and forum-specific characteristics were evaluated as predictors of advice quality and self-correction. Results Of 3368 initial messages, 266 (7.9%) were requests for advice. Of 654 provisions of advice, 56 (8.6%) were erroneous and 19 of these 56 (34%) were subsequently corrected. Forty-three (6.6%) provisions of advice were harmful, and 12 of these 43 (28%) were subsequently corrected. Messages from low-activity forums (fewer messages) were more likely than those from high-activity forums to be erroneous (10.6% vs 2.4%, P < .001) or harmful (8.4% vs 1.2%, P < .001). In high-activity forums, 2 of 4 (50%) erroneous provisions of advice and 2 of 2 (100%) potentially harmful provisions of advice were corrected by subsequent postings. Compared with general weight loss advice, medication-related advice was more likely to be erroneous ( P = .02) or harmful ( P = .01). Conclusions Most advice posted on highly active Internet weight loss forums is not erroneous or harmful. However, clinical and research strategies are needed to address the quality of medication-related advice.