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Quality of Weight Loss Advice on Internet Forums

      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.

      Keywords

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      References

        • Flegal K.M.
        • Carrol M.D.
        • Ogden C.L.
        • Johnson C.L.
        Prevalence and trends in obesity among US adults, 1999-2000.
        JAMA. 2002; 288: 1723-1727
        • National Heart, Lung, and Blood Institute Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults
        Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health publication No. 98-4083, Bethesda, MD1998
        • Snow V.
        • Barry P.
        • Fitterman N.
        • et al.
        Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians.
        Ann Intern Med. 2005; 142: 525-531
        • Bish C.L.
        • Blanck H.M.
        • Serdula M.K.
        • et al.
        Diet and physical activity behaviors among Americans trying to lose weight: 2000 Behavioral Risk Factor Surveillance System.
        Obes Res. 2005; 13: 596-607
        • Blanck H.M.
        • Khan L.K.
        • Serdula M.K.
        Use of nonprescription weight loss products: Results from a multistate survey.
        JAMA. 2001; 286: 930-935
        • Fox S.
        • Rainie L.
        The online health care revolution: how the Web helps Americans take better care of themselves. 2003 (Pew Internet & American Life Project, November 26, Available at: http://www.pewinternet.org/pdfs/PIP_Health_Report.pdf. Accessed March 3, 2006.)
        • Hesse B.W.
        • Nelson D.E.
        • Kreps G.L.
        • et al.
        Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the First Health Information National Trends Survey.
        Arch Intern Med. 2005; 165: 2618-2624
        • Fox S.
        Health information online: eight in ten internet users have looked for health information online, with increased interest in diet, fitness, drugs, health insurance, experimental treatments, and particular doctors and hospitals. 2005 (Pew Internet & American Life Project, May 17, Available at http://www.pewinternet.org/pdfs/PIP_Healthtopics_May05.pdf. Accessed January 4, 2006.)
        • Fox S.
        • Rainie L.
        Vital decisions: how Internet users decide what information to trust when they or their loved ones are sick. 2002 (Pew Internet & American Life Project, May 22, Available at: http://www.pewinternet.org/pdfs/PIP_Vital_Decisions_May2002.pdf. Accessed March 3, 2006.)
        • Fox S.
        • Fallows D.
        Internet health resources: health searches and email have become more commonplace, but there is room for improvement in searches and overall Internet access. 2003 (Pew Internet & American Life Project, July 16, Available at: http://www.pewinternet.org/pdfs/PIP_Health_Report_July_2003.pdf. Accessed March 3, 2006.)
        • Robinson K.M.
        Unsolicited narratives from the Internet: a rich source of qualitative data.
        Qual Health Res. 2001; 11: 706-714
        • Esquivel A.
        • Meric-Bernstam F.
        • Bernstam E.V.
        Accuracy and self correction of information received from an internet breast cancer list: content analysis.
        BMJ. 2006; 332: 939-942
      1. Sullivan D. Nielsen NetRatings search engine ratings. Available at: http://searchenginewatch.com/reports/article.php/2156451. Accessed March 27, 2006.

        • Sim J.
        • Wright C.C.
        The Kappa statistic in reliability studies: use, interpretation, and sample size requirements.
        Phys Ther. 2005; 85: 257-268
        • Byrt T.
        • Bishop J.
        • Carlin J.B.
        Bias, prevalence and kappa.
        J Clin Epidemiol. 1993; 46: 423-429
        • Cohen J.
        • Cohen P.
        Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences. Second ed. L. Erlbaum Associates, Hillsdale, NJ1983
        • Fox N.J.
        • Ward K.J.
        • O’Rourke A.J.
        The ‘expert patient’: empowerment or medical dominance?.
        Soc Sci Med. 2005; 60: 1299-1309
        • Fox N.
        • Ward K.
        • O’Rourke A.
        Pro-anorexia, weight-loss drugs and the internet: an ‘anti-recovery’ explanatory model of anorexia.
        Sociol Health Illn. 2005; 27: 944-971
        • Khan L.K.
        • Serdula M.K.
        • Bowman B.A.
        • Williamson D.F.
        Use of prescription weight loss pills among U.S. adults in 1996-1998.
        Ann Intern Med. 2001; 134: 282-286
        • Barrera M.
        • Glasgow R.E.
        • McKay H.G.
        • et al.
        Do Internet-based support interventions change perceptions of social support?.
        Am J Community Psychol. 2002; 30: 637-654
        • Verheijden M.W.
        • Bakx J.C.
        • van Weel C.
        • et al.
        Role of social support in lifestyle-focused weight management interventions.
        Eur J Clin Nutr. 2005; 59: S179-S186
        • Elfhag K.
        • Rossner S.
        Who succeeds in maintaining weight loss?.
        Obes Rev. 2005; 6: 67-85
        • Eysenbach G.
        • Powell J.
        • Englesakis M.
        • et al.
        Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interactions.
        BMJ. 2004; 328: 1166