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This story is part of CBC Health’s Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you have not yet subscribed, you can do so via click here.
Tripods and cameras are scattered among the weights and benches at a Mississauga gym. It’s common to find fitness influencers at First Health Club, recording videos of themselves pumping iron to post on social media.
Among them is Chelsey Berestecki, 25, a young mother who only started posting fitness content on TikTok and Instagram a few months ago, after years of consuming such content while trying to lose weight.
“When I had my son in 2017, I gained a lot of weight during pregnancy. I was 260 pounds,” she said. “Over the past four years, I have lost over 100 pounds.”
“I would look at TikTok influencers in the fitness industry and feel like this is the kind of life I want to live.”
It’s a feeling she says often pushed her to eat healthier and go to the gym, even when she didn’t want to.
Just a few months after she started posting, she already has over 8,000 followers (and counting) on TikTok.
Although it has been positive for her, online fitness content often has a negative message. Messages can be misleading. At worst, they can actively cause harm, for example by encouraging extreme diets or recommending exercises that are not safe for everyone.
Despite the growing popularity of fitness influencers, their impact on health has not been well researched. Burgeoning research is now beginning to fill in the blanks – and even provide solutions.
One man’s meat, another man’s poison
A recent study from the journal Body image gives us a first impression. After examining 200 videos from popular TikTok fitness hashtags, such as #fitness, #gymtok, #fittok, Australian researchers found 60 percent of videos posted by fitness influencers contained misleading or harmful information.
Authors say the vast majority of people posting the videos had no significant training on what they were posting about. Most videos also perpetuated negative messages, including sexualization, objectification (for both men and women), body shaming and excessive dieting.
“The promotion of calorie deficits in general was quite disturbing to see,” said Samantha Pryde, lead author of the study and a PhD candidate at Flinders University in Adelaide, Australia. She says many videos promoted extreme calorie deficits, below public health recommendations, for weight loss.
“Ninety-five percent of the people posting the videos had no relevant health, fitness or nutrition data,” she said.
Social media makes it easier for viewers to feel like they have a personal connection with the influencer. That artificial closeness can make statements like “I did this to lose weight” or “This is what I ate one day” sound like compelling, personal advice, Pryde says.
“It’s almost like another friend is telling them, instead of some random person on TV or in a magazine,” Pryde said
Personal trainer Jennifer Mulgrew, who trains across the gym in Mississauga, understands how powerful personal advice can be. She has a tripod set up on the other side of the gym, which also records her exercises; not to post on social media, but to send to customers as a reference for the correct form. She says she cringes when she sees some exercises posted online.
“I can just see a back injury happening or a shoulder injury happening,” she said.
Many influencers haven’t done their homework and learned about different muscle groups and how they work together, Mulgrew says. “They basically wanted to launch a bunch of exercises on TikTok, or go viral and make a big name for themselves.”
But Mulgrew admits she still scrolls through fitness hashtags regularly. She sees some redeeming qualities.
“The one thing I like about the influencer world,” she said, “is that more and more people are moving toward a healthy lifestyle.”
Body image concerns
The Australian study is the first to examine the credibility of fitness influencers, or the content they post on TikTok. But there has been plenty of research into the impact of social media on healthy body image.
A 2023 studywhich examined a sample of more than 21,000 young people from Australia, Canada, Chile, Mexico, the United Kingdom and the United States, found that more time spent on social media was associated with a greater likelihood of body dissatisfaction.
“Our research results are not surprising to many people” said Karen Hock, lead author of the study, and doctoral candidate at the University of Waterloo’s School of Public Health Sciences.
“When you see posts online about fitspiration,” she said, “and if you’re not muscular like the images you see, [that’s] is associated with body dissatisfaction because you don’t meet the ideal standards you see online.”
She wants to learn more about the ways in which social media platforms select the videos they show to users, especially when the content is presented without the user searching for it or even clicking on it.
“More research needs to be done on social media algorithms themselves, as the algorithms can amplify concerns about body image.”
From editing their faces in apps to having plastic surgery, social media is fueling a movement among teens to change the way they look to meet unrealistic beauty standards.
Influencing the influencers
But it might be possible to encourage influencers to create content that causes less harm.
There is data to suggest how that might work. A team from the Harvard TH Chan School of Public Health conducted an experiment last year: They trained a group of influencers on best practices for promoting evidence-based mental health information, sharing digital “takeits,” conducting virtual training sessions and inviting some to an in-person summit in Boston.
They then tracked how the content of the videos changed for about a month, comparing the trained influencers to a control group of influencers who had not received the same training. They found that those who participated in the training were much more likely to demonstrate evidence-based content.
“We know we have the opportunity to influence the influencers,” said Matt Motta, the lead author of a study based on the results.
“We take scientific evidence and give it to people and say, we know you’re not supposed to misinform,” said Motta, who is also a professor at Boston University’s School of Public Health.
“We have found that creators are very willing partners.”
Motta thinks this model can be exported to the realm of diet and exercise. Despite unique challenges, such as endorsements from companies selling products like diet pills, Motta is optimistic about the potential impact.
“This is a problem that can be solved,” he said.
“It just requires buy-in from all these partners.”
Other efforts are underway to promote evidence-based health information on social media. For example, the World Health Organization and TikTok announced last month years of cooperation to promote evidence-based health content and give creators access to training programs.
For content consumers, experts say moderation and skepticism are key when sifting through fitness content.
“We spend a lot of time getting health, nutrition and fitness information on social media and that in itself isn’t a problem,” says Pryde, the author of the TikTok content analysis.
“If you’re looking for that information, you need to find credible sources.”
Even fitness influencers themselves, like Berestecki, are taking this approach.
“I actually take everything with a grain of salt.”
