Navigating the influencer landscape: The positive and negative effects of social media influencers on adolescents

In a recent review published in Social Science & Medicine, researchers assess previous research on the impact of social media influencers (SMI) on adolescent health. The study findings indicate that although SMIs can harm mental and physical health, their influence can encourage healthier habits and promote effective health messaging.

The reach of social media influencers

As smartphone and social media use becomes pervasive, SMIs have an important role in contributing to information consumed by the general public people. SMIs are often considered role models who are more authentic and trustworthy than experts; however, many have commercial interests and are not experts in the topics they create content on.

Adolescents are particularly susceptible to misinformation, as they are in a formative period that will strongly influence their adult lives. SMIs may promote unrealistic lifestyles or body types, thus leading to negative body image. SMIs may also promote or advertise harmful products like alcohol or tobacco, which could exacerbate health challenges that adolescents currently face, like high obesity rates and mental health issues.

About the study

Many previous reviews in this area have explored links between adolescent health and social media without considering the role of influencers, while some included all populations regardless of age.

The present study addresses the research gap in analyses that focused specifically on adolescents, who are a uniquely vulnerable population. This perspective allows the identification of research priorities to mitigate the potential limitations of social media influence while developing more effective ways to reach adolescents with health messaging and interventions.

Researchers identified 51 papers on the influence of SMIs on adolescents between 13 and 19 years of age concerning nutrition, mental health, sexual health, physical activity, and substance use. These papers were obtained from 11 electronic databases, including PubMed, Web of Science, and Scopus.

The included studies defined and classified SMIs in various ways; however, all definitions had commonalities, such as having a large number of followers and high engagement through content.

Influencers differed in the topics that they covered, whether they were profit-oriented in terms of corporate sponsorships, which social media platforms they utilized, and how many followers they had. Western countries and girls were overrepresented in these papers.

Influencers can promote unrealistic body images and unhealthy content

Many SMIs focus on appearance, food, and nutrition. In young women and adolescent girls, SMIs can adversely impact body image by promoting body ideals and thin, muscular body types.

Overweight individuals are stigmatized by these actions, which can lead to bullying and stereotype development. Negative self-perceptions and body dissatisfaction can also drive unhealthy habits and lead to substance use and eating disorders.

Food content created by SMIs often focuses on unhealthy foods, and influencers may have advertising contracts with recognizable food brands. Content on unhealthy food is more memorable. Adolescents may also not realize that they are consuming advertising and not organic content.

Other SMIs create content on cigarettes and e-cigarettes, alcohol, marijuana, vaping, and hookah. These influencers may film themselves performing ‘tricks’ or advertising products.

When SMIs endorse products like tobacco, they improve attitudes toward smoking or endorse the view that vaping is less harmful than smoking cigarettes. Although many tobacco influencers are followed by adolescents, there are no age restrictions on the content they post.

Health influencers can also have far-reaching impacts, particularly if they provide inaccurate information and treatment advice. Moreover, SMIs may promote non-evidence-based or debunked treatment methods.

Many ‘followers’ form parasocial relationships with influencers who share personal insights into their lives. Since SMIs share information about their lives, they generalize their own experiences through biased accounts, particularly regarding mental health. This often leads to self-diagnosis by adolescents, who may then suffer from misdiagnosis and incorrect treatment.

SMIs and effective health messaging

SMIs form strong bonds with their followers and share relatable content with their audience. Some studies found that when influencers created anti-tobacco content, these messages were viewed more positively than those in traditional health campaigns.

An important policy recommendation is to ensure that adolescents are not exposed to harmful content, particularly unhealthy products. However, the inherent authenticity of influencers can be harnessed to tailor messaging to various media environments and target audiences.

Future studies can address the research gaps highlighted in this review. The focus on the Global North, as well as on girls, shows how boys, diverse people, and those from developing countries have been excluded from this field of study. Research should also examine if the motivations of SMIs are profit-based or altruistic.

Sexual health content has not been well-studied, thus reflecting the need for further studies to examine the role of SMIs in this area.

Conclusions

The rising influence of SMIs is associated with both challenges and opportunities. Thus, the role of researchers and policymakers is to mitigate the harmful effects of misinformation and work with influencers to communicate positive and beneficial messages.