How to Spot Health Misinformation Online

With our culture’s emphasis on appearance and health, it’s tempting to try anything that promises weight loss, improved health, or rapid results. But health misinformation and appealing claims can trick us into falling for scams or trying tactics that hurt our health instead of improve it. Conventional healthcare doesn’t always have the answers. But it’s important not to let our fears and concerns be exploited for profit.

See Diet Culture and Wellness Traps with Christy Harrison for a complete transcript of the Easy Prey podcast episode.

Christy Harrison is a registered dietician, a certified Intuitive Eating counselor, and a journalist who has covered food, nutrition, and health topics for over twenty years. She specializes in disordered eating and helping people recover from it. In addition, she has two podcasts, Rethinking Wellness and Food Psych. Both are dedicated to dismantling diet and wellness culture and helping people see through health misinformation and scams. Her new book, The Wellness Trap, explores these ideas further.

A Personal Journey

When Christy got out of school and started her journalism career, she was struggling with an eating disorder. She was obsessed with knowing what was in food, how it was grown, and knowing everything about it. That led into a career reporting on food, nutrition, and health.

Over the years, reporting on these topics led to quoting a lot of dieticians, nutritionists, and other nutrition professionals. She started to get interested in what they were doing. At the time, she was into food movements and sustainability. She wanted to help with the “obesity epidemic.” So she went back to school for public health nutrition at NYU.

Christy’s previous education was in journalism and French literature, nothing to do with science. But in studying public health nutrition, she started to learn about research methods. She began to notice huge gaps and holes in nutrition research. What the research said, what people were recommending, and what she was learning in her dietetics classes were all very different. That, to her, seemed like a big problem.

Eventually, Christy started working with the city’s Department of Health in nutrition education. Personally, she was in the early stages of recovering from her eating disorder. But professionally, she was working with people who reminded her of the disordered eating she had before she fully developed her eating disorder. They were obsessive about what they ate, walking for miles a day, reducing their food intake, and avoiding foods or entire food groups. It was a moment of revelation for Christy as she watched people doing what seemed harmful yet also reminded her of what she did in her most disordered days.

Intuitive Eating and Eating Disorder Prevention

While recovering, Christy discovered intuitive eating. She started to reconnect with her body, allow all foods, and not be so obsessive about what was in her food. At the same time, she was grappling with her work. The process of healing herself from disordered eating required her to not restrict her food in any way. But the work she did transmitted information that often led to restricting and disordered eating. Was that really what she wanted to be doing?

She became interested in helping other people recover from eating disorders and heal from disordered food relationships. An “anti-diet” approach was the gold standard for eating disorder recovery. But it was also the best approach for prevention. Doing more work there could help prevent eating disorders at a larger scale. This led her to start doing the work that has been the focus of her career for the last ten years.

The Standard Disclaimer

Whenever Christy makes a podcast appearance, writes a guest article, or creates anything for the general public, she includes a standard disclaimer. The information she provides is intended for informational and educational purposes only. It’s not a substitute for medical or mental health advice, and it doesn’t constitute a provider-patient relationship. She is explaining what she’s learned just for information and as a jumping-off point for you to do further research or talk to your doctor – she’s not acting as anyone’s individual dietician.

The Historical Roots of the Cultural Obsession with Diet

There are a wide variety of influences in the tangled root system of our cultural obsession with diet and health. Health misinformation and ideas about how to be healthy have been around as long as the concept of “health” in general. Some of these roots go back thousands of years, and most of them are influences you probably weren’t aware of.

Foundations in Ancient Greece

One root goes all the way back to ancient Greece. Ancient Greek culture demonized some foods by associating them with “lesser” groups of people and elevated other foods by associating them with “better” groups of people. Food was a way to differentiate yourself. The notion that “you are what you eat” – that what you eat is inextricable from health – also goes back to ancient Greece.

There was also some discussion of body size in ancient Greece. But it wasn’t the demonetization of larger bodies that we see later. The ancient Greeks were most concerned with balance. Being too large was a problem, but being too thin was just as bad. There was some anti-fat bias, but not nearly as intense as what we see now.

Anti-Fat Bias and Slavery

Scholar Sabrina Springs wrote a book, Fearing the Black Body, that explores the connection between stigmatizing bodies and racism. Anti-fat bias started as people were trying to invent reasons to justify slavery. Associating larger bodies with Black people was a way to differentiate the races. Associating fatness with Black people and labeling fatness as bad provided one justification to continue enslaving Black people.

Anti-fat bias really came up around the same time as people were trying to figure out reasons to justify slavery … being larger-bodied was associated with blackness, and therefore was bad.

Christy Harrison

At the time, this messaging was not subtle. Women’s magazines would say things like, “You don’t want to look African, so lose weight and slim your body!” It was obviously and outrageously racist. These days, the racist aspect has gone underground, but still exists in subtler ways.

Getting Doctors On Board

Before this, doctors did not consider fatness a health issue. They considered it a cosmetic issue and a distraction from genuine health concerns. There is evidence that in the mid-to-late 1800s, doctors were frustrated by how many people wanted to lose weight.

But around the turn of the twentieth century, doctors started to get into the game of weight loss. People were starting to demand diets and weight loss solutions because of a cultural trend to be smaller, especially for middle-class white people. So the doctors gave in and started giving the people what they wanted. Research linking higher weight to poor health outcomes didn’t start showing up until doctors caved to a society demanding to be thinner. Even though research began to show that being heavier was unhealthy, it was based on this new anti-fat bias.

Starting an Industry

Eventually, insurance companies seized on the idea of weight as an indicator of health. And with the advent of industry in general in the United States, an industry based on diets, health information, and health misinformation took off. This is where we start to see scam weight loss products like diet pills and tapeworms, devices that didn’t help and actually harmed, and other health and wellness scams. By the 1920s, diet culture was rampant.

Since then, it has increased year after year. In the United States, the diet industry is worth something like $72 billion. Globally, it’s worth hundreds of billions. We now have several generations who grew up steeped in anti-fat bias, the prevalence of the diet industry, medical recommendations for weight loss, and ever-changing but always thin beauty ideals. Now with the internet, health misinformation is even easier to find and spread. And the industry perpetuates itself – there’s always something to feel bad about and something you can buy to fix it.

There’s always something you’re supposed to feel bad about, and always someone there to sell you this supposed solution.

Christy Harrison

There’s Nothing New in the Weight Loss Industry

As the old saying goes, there’s nothing new under the sun. A lot of what we see today in diet, weight loss, and health misinformation is iterating on past ideas.

The first blockbuster diet book was written in 1864 by an undertaker named William Banting. He decided to lose weight at a time when doctors still thought weight was only cosmetic. He went from doctor to doctor until he found one who would give him a diet. The very strict diet was an early low-carb diet – it consisted of meat, fat, alochol, and little else. Banting wrote a book about the diet and the process, and it sold tens of thousands of copies.

Since then, the low-carb trend has cycled. It was popularized by Atkins in the 1970s and then again in the 1990s. More recently, the paleo and keto diets are just iterations on the low-carb diet idea. Calorie counting first emerged in the early 1900s or 1910s, and since then it has cycled, too. Many diets over the years have been about counting calories, macros, points, or something similar. It’s all based on the same idea.

Social media amplifies the most controversial and extreme of these ideas. What maximizes industry money is what keeps people liking, clicking, and sharing. A good rule of thumb is to follow the money. Whether it’s good advice taken to far or just health misinformation, what sells on social media is the extreme. Social media has led to a huge proliferation of wild trends, like diets composed only of celery juice or raw meat.

Cure-Alls are Likely Health Misinformation

One giant warning sign that something is health misinformation or an outright scam is the idea of “one pill to cure all ills.” It doesn’t have to be a pill. It can be a diet, a juice, a protocol, or anything else. But the notion that there’s one thing that will cure a wide variety of different conditions should be suspicious.

Christy has multiple chronic health conditions. They range from autoimmune to digestive to skin-related to hormonal. So many wellness programs and diets claim to be able to address all of these disparate areas. It’s appealing to anyone struggling with these issues because in many cases, conventional healthcare doesn’t have a lot of answers. Some conditions don’t have great treatments at all, and conventional healthcare definitely doesn’t have one solution for all the issues. These “one diet cures all” are very appealing to people with a lot of problems. But they are generally health misinformation.

All of these things that purport to be cure-alls, I think, are really the things to watch out for.

Christy Harrison

Cure-Alls Prey on People’s Feelings

Things claiming to address a variety of different conditions with one intervention prey on people’s desire for help and their lack of support from conventional healthcare. There are issues with mainstream medicine – that’s not health misinformation, that’s just a fact. But these scammy products and protocols twist that fact into a sales pitch.

A conspiratorial tone is another warning sign that you’ve encountered health misinformation. If you’ve been dismissed or not helped by conventional medicine, something promising you the cures doctors don’t want you to know both sounds appealing and seems true based on your experiences. It’s not necessarily true that anyone selling things is out to get you. We live in capitalism, people have to sell things. But when the sales pitch is based on your own fear, desperation, and feeling of not getting the help you need, it’s probably trying to sell you health misinformation.

If their sales pitch is based on fear and preying on ways that you’re not getting the help you need in conventional healthcare, I think that’s a real red flag.

Christy Harrison

How to Evaluate Evidence to Spot Health Misinformation

Social media amplifies anecdotal evidence. Anything new, extreme, or conspiratorial – the “they don’t want you to know this!” type – becomes popular. When all the evidence you see is anecdotal, it can be hard to determine what’s health misinformation and what’s actually true.

If it seems too good to be true, it probably is, and it’s probably going to go viral.

Christy Harrison

Even when it comes to scientific evidence, you need to use critical thinking. Research shows that people with a broad trust in science are actually more likely to be duped by health misinformation that sounds scientific. It’s important to have a basic understanding of how to tell a good peer reviewed clinical trial from something cherry-picking data or using bad methods.

Another thing to know is the differences between observational studies, animal studies, cell studies, and studies in computer models. All can provided starting points for scientists researching interventions in humans. But they can’t tell you anything about causation. Observational studies look at large groups of people, seeing if there’s a higher risk for a certain disease in people who do a certain behavior, for example. They can say if the behavior is correlated with the outcome, but it doesn’t mean the behavior causes it. Something else, like income level, education, or access to certain services, could explain both. And in cell and animal studies in particular, what happens in the trials is very different from what happens in human bodies.

How to Be Skeptical of Research

To help you be skeptical of research and spot health misinformation and just inflated claims, here are some tips. Remember that correlation isn’t causation. Just because a study found a link between two things doesn’t mean one caused the other. Also check that the study was conducted well. Was it a randomized controlled trial, and was the sample size large enough to get meaningful results?

Look at the scientists conducting the studies, as well. Did they have a financial interest in the outcomes? Just because something is funded by a company doesn’t mean it’s bad. But in general, scientific research funded by pharmaceutical, supplement, or diet companies tends to come to conclusions more favorable to the product or practice being studied. If there’s early evidence funded by an interested party, it’s important for other scientists without that financial interest to replicate it and see if it holds up.

If there is independent research that confirms it, great. Vaccines, for example, have a lot of research funded by the companies that make them, but there is also a lot of evidence from non-interested parties. With other types of trials, like supplements and vitamins, a lot of the research is industry-funded. The industry then uses a single study done by financially-motivated scientists to tout their product as the next miracle cure.

A Note on Nutrition Research

Most nutrition research is observational. It looks at large groups of people, called “populations,” and asks questions like, “Among those who drink a cup of coffee a day, what are the outcomes?” One study may show the people who drink a cup of coffee a day have a certain outcome that’s good, while a different study with different people years later may find outcomes that aren’t so good. That doesn’t mean that the information about drinking coffee is health misinformation or that the studies are bad. It likely just means that the participants’ health is being affected by other factors that the scientists didn’t account for.

Journalists and health reporters seize on this kind of thing. A lot of health and nutrition reporters, like Christy, are hunting for the “perfect diet” because they want to find it themselves. And there’s also a financial incentive. The news articles that get clicked on, get shared, and go viral tend to be fearmongering, unexpected, or the kind that make people say, “Look, I was right,” or “I’ve been wrong, I need to change my habits.” Look skeptically at any headline about new nutrition research. Take it all with a grain of salt.

Becoming Less Susceptible to Health Misinformation

Being susceptible to health misinformation is a systemic issue. It’s not all on you, the individual. To best protect ourselves, there needs to be systemic changes. There should be more regulation of health misinformation shared on social media. There should be more regulation of supplement companies and other branches of “alternative” medicine. We should probably hold tech companies responsible for misinformation going viral. Regulatory and legislative changes are needed to protect people.

There are all these unproven, untested things out there and providers who are maybe trying to do good, but are leading people very far astray.

Christy Harrison

But there are things we can do to become more skeptical and less vulnerable. First, be skeptical of any health and wellness information unless it’s coming from your medical provider who you have a good relationship with and trust and who knows you and your history. Someone online, even if they have an MD, is providing information for educational purposes. It’s not an individual consultation with someone who knows you.

SIFT Before You Act

Before you act, pause. Christy is a fan of the SIFT method, developed by information literacy researcher Mike Caulfield. It stands for Stop, Identify the Source, Find other coverage, and Trace claims, quotes, and media back to its original context. Stopping is a great first step. Don’t overhaul your diet or your life based on one piece of information – look into it first and see what’s there.

Next, investigate the source. What are the credentials of the person claiming this? Do they have a financial interest? What do they stand to gain from spreading this information? Are they a legitimate member of the scientific or medical community? Are the recommendations based on animal studies or early research? Is the data correlation and not causation?

Find other coverage can me finding what other reputable sources have to say about the topic. But it can also mean looking at what reputable sources say about this source. Are they really out on the fringes? Is this topic a matter of serious scientific debate, or is it an established fact? If it’s out on the fringes, it’s often best to let it go and not pursue any further.

Finally, trace claims, quotes, and media back to their original context. If the claims sound scientific, do they hold water? Is what the article said the same conclusion as the study they quote? Was a quote completely taken out of context? Does the person making this claim originally have a scientific background?

Investigate Before You Change Your Life

If you’re thinking about changing your diet, your lifestyle, or engaging in some wellness practice, it’s probably a good idea to do a little bit more research and dig a little deeper before adopting it.

Christy Harrison

You wouldn’t buy a car sight unseen. So why would you change your diet or start a wellness practice before you make sure there’s real evidence behind it? Do a SIFT check before you make major changes. If anything doesn’t check out, let go and walk away.

If you find an emotional pull to the idea even after the SIFT check didn’t check out, ask yourself why. What do you want there? What is your underlying goal of following this? You might actually be needing empathy and support from your medical providers. Or maybe you’re experiencing a symptom and you want relief. Whatever it is, look for a way to purse it in a way that isn’t scammy, harmful, or potential health misinformation.

If it’s preying on your fear, trying to inspire fear, anxiety, or other negative emotions about your health or well-being to make a sell, that’s manipulation. Don’t trust that at all. If it’s appealing because it promises fast results, it’s trying to appeal to your desire for relief. Unfortunately, most evidence-based practices tend to be incremental and slower, and there is no magic pill scenario. If that’s what it’s promising you, it’s probably health misinformation.

How We Can Hurt Ourselves With Diets

When we restrict a food or a group of foods, we feel deprived. Then when we are around that food, we eat large amounts and feel like we can’t control ourselves. That’s not a failure of willpower – it’s our body’s reaction to being deprived. But we feel like terrible people with no willpower. That feeling is a lack of self-efficacy, and it is extremely harmful. Self-efficacy, or feeling in control of your life, is a key component to happiness and wellbeing. If we feel like we can’t control ourselves and don’t have willpower, it undermines our ability to be happy.

Anti-fat bias also hurts us all. It makes people feel like failures and have a negative self-image if they gain weight or are a certain size. The same and stigma people experience increase as they go up on the weight spectrum. For higher-weight people, sometimes they can’t go anywhere without someone making a negative comment about their weight. Doctors often tell them to lose weight even if they came in for something unrelated, like a cold. Diet culture and anti-fat bias undermines people’s wellbeing by stigmatizing them.

Even on a physical level, weight stigma, chronic dieting, and weight cycling – repeatedly losing weight and gaining it back – are all really bad for your health. Weight stigma and weight cycling are both independent risk factors for heart disease, diabetes, early mortality, and some forms of cancer. High weight gets blamed for these conditions, but in reality weight stigma and repeatedly trying to lose weight are more to blame than the weight itself!

We do see in the evidence that people who are higher weight, stay stable, and don’t have large fluctuations in their weight are generally better off health-wise than people who have large [weight] fluctuations at any size.

Christy Harrison

How to Change Your Diet Safely

You’ve decided you need to change your diet. Before you start making changes, ask why. What made you think you needed to do this? Was it something you read or heard – and if so, did you check to make sure it wasn’t health misinformation? Did you look in the mirror or see a photo and see something you didn’t like? Was it your doctor telling you to do so – and if so, was it something you should listen to or were they stigmatizing your size? Doctors are experts in many areas of physiology, but they don’t study nutrition much in medical school. They might make assumptions about how you eat based on your size.

If you want to change how you eat because you feel like you’re in a restrict-binge cycle – restricting food or a certain food, then bingeing on it because you feel deprived – something in your relationship with food isn’t right. Christy remembers feeling like it wasn’t normal to be unable to control herself around a plate of cookies at a party, even though she ate so “healthy” most of the time. If this is your problem, think about your relationship with food in a more holistic sense. It’s not just “I’m good most of the time but sometimes I’m bad and binge.” From a larger perspective of a restrict-binge cycle, the fact that you’re trying hard to only eat “healthy” might be leading to the rebound. The solution may be causing the problem.

If something is off limits, it’s like this siren song that you can’t resist when you finally get around it. You just feel like you have to eat it all.

Christy Harrison

The Bottom Line

Many people Christy sees say they want to eat better. She starts by asking, “Why do you feel you’re not ‘eating well’ in the first place?” For some people it’s a self-care issue. For others, they don’t have time to eat “better” or they can’t afford to. That’s a logistical or economic issue, not a diet issue. If your problem is you’re too busy at work and barely have time to go home to sleep, a diet won’t fix the problem. Not shaming yourself for your food choices is a good place to start.

Ultimately, there is no “one size fits all” solution. It depends on how you’re relation to food, health, and wellness and what else is going on in your life. If you’re trying to solve a self-care issue by beating yourself up over what you eat, it may be helpful to look at the bigger picture. If you’re trying to solve a bingeing issue by being more restrictive, that may be contributing to the problem – you may need to ease up and find more balance. And if you’re hoping to someday find the “perfect diet,” unfortunately, there isn’t one. But there is a lot of health misinformation out there, so it’s important to be aware.

Hear more from Christy Harrison on the Rethinking Wellness podcast, where she talks about diet culture, disinformation, dubious diagnoses, scams, and other stuff going on in contemporary wellness culture. Find it at rethinkingwellness.substack.com or wherever you get your podcasts. You can also listen to the archives of the Food Psych podcast, which talked about recovery from disordered eating and finding a more inuitive and peaceful relationship with food, wherever you get your podcasts. Christy’s newest book, The Wellness Trap, can be found at christyharrison.com/thewellnesstrap or wherever you buy books.