Ranjana Srivastava warns doctors baffled by wellness influencers but ignoring them at their peril
Social media influencers are dangerously misleading patients on health advice, with doctors warning that unqualified figures are driving people to abandon life-saving treatments in favour of fads, extreme diets and unproven remedies.
Dr Ranjana Srivastava, an Australian oncologist, described a malnourished, anaemic patient who had stopped eating red meat after seeing a claim on Instagram that it “dilutes chemo”. Another patient had forsaken all dairy, while a third wondered why his blood sugar was uncontrolled on a “hand-squeezed juice only” regimen. “Quirky diets are concerning enough, but life-threatening issues can arise when patients heed influencers over qualified professionals,” Dr Srivastava said. She noted that every oncologist she knows is encountering patients who believe the anti-parasitic drug ivermectin can cure cancer.
The problem is compounded by the sheer reach of these figures. A large study of nearly 7,000 wellness influencers found that all had more than 100,000 followers and nearly one in ten had more than a million – numbers that most doctors can only dream of. Yet only 17 per cent of these influencers were conventional doctors, dentists or nurses. Mental health professionals accounted for just 4 per cent and qualified dietitians 6 per cent, a striking gap given the prevalence of mental health and diet advice online. Instead, the most common categories were life coaches promising transformation (31 per cent), business owners hawking a product (28 per cent), and a “motley crew” of chiropractors, authors, activists and so-called “functional” health practitioners. Sixteen per cent did not offer any credentials at all, relying instead on “lived experience” such as “ADHD mom” or “Cancer Warrior”.
Who is listening — and at what cost?
The audience for these figures is vast. Half of all US adults under 50 now get their health information from wellness influencers. In Australia, two-thirds of teenagers rely on social media for health advice, and neither they nor their parents know how to separate fact from fiction. In the UK, 80 per cent of social media users view health and sexual health advice on these platforms, with 42 per cent saying TikTok is the most accessible source. A Glasgow University study found that, eight times out of nine, self-appointed wellness “experts” on social media gave untrustworthy or non-evidence-based advice on weight management.
Dr Srivastava warned that the consequences can be severe. She pointed to rising vaccine refusal linked to rampant misinformation, and patients with one good chance of controlling their cancer being tempted by influencers peddling alternative schemes. The harms are not limited to physical health. Research cited by the briefing notes that following health influencers can increase distress, depression, anxiety and negative moods, particularly among young people, and that compulsive exercise and dieting driven by unrealistic ideals can disrupt the positive relationship between healthy behaviours and mental health. Meanwhile, wellness companies and influencers exploit consumers financially by selling expensive products that lack scientific backing and may contain harmful or poorly regulated substances.
The influence of unqualified advisers is also eroding trust in conventional medicine. A 2021 global survey found that 72 per cent of people in Great Britain rated doctors as trustworthy, and another poll put the figure at 91 per cent. But the COVID-19 pandemic shook confidence: 49 per cent of UK respondents in one study said the pandemic decreased their trust in the NHS’s ability to handle health crises. At the same time, only 17 per cent of UK adults report getting health information from conventional doctors, compared with 31 per cent from life coaches and 28 per cent from business owners selling products.
Meeting the challenge — regulation and the doctor’s role
Doctors are uncertain how to respond. Dr Srivastava acknowledged a “hint of smugness” that patients will eventually return to professionals, but said that given the rise of influencers, “we dismiss them at our peril”. She advocates a more proactive approach: taking time to understand patients’ perspectives, supporting professionally credible influencers, and tailoring information to educate the public about the hazards of unqualified health advisers – starting with posters in different languages in waiting rooms.
In the UK, regulators are beginning to act. The Online Safety Bill aims to treat “demonstrably false” health misinformation as a priority, though concerns remain that it may not tackle “lawful but harmful” content or the algorithmic amplification of dubious claims. The Advertising Standards Authority actively monitors wellness advertising, using AI to identify ads that breach codes, and has banned unsupported weight-loss claims and unverified supplements. However, a lack of coordinated monitoring of dangerous health misinformation persists, and media literacy among the public remains low. The briefing also notes that the increasing use of AI chatbots for health advice presents a new frontier, with AI sometimes “hallucinating” clinical details.
Dr Srivastava’s own approach offers a model. “To be an oncologist is to see the worst of harm caused by wellness influencers,” she said, “but I never changed a patient’s mind with outrage. Where I have had limited success is by dispassionately explaining the evidence, humbly acknowledging the things medicine doesn’t know or do well, and gently offering to leave the door open. This may be the best way I know of being a wellness influencer.”
