Accuracy, potential harm, weight stigma, and commercial influence in short-form social media content on incretin-based therapies for obesity.

BACKGROUND

Short-form video platforms such as TikTok and YouTube Shorts are major sources of health information, yet little is known about the reliability of what they carry on incretin-based therapies for obesity. We assessed the accuracy, safety, obesity-related stigma, and commercial nature of short-form videos on these medications.

METHODS

We conducted a cross-sectional content analysis on June 15, 2025. Videos were retrieved for six medication keywords on TikTok and YouTube Shorts, and the 100 most-viewed videos within each platform's retrieved pool were included (n = 200). Four physicians certified by the American Board of Obesity Medicine each coded a non-overlapping subset for clinical accuracy, hazard potential, obesity stigma, and commercial influence. A fifth senior physician reviewed all videos and issued final ratings. Six TikTok videos became unavailable before review, leaving 194 for content analysis.

RESULTS

TikTok videos had higher median view counts (964 650 [Q1-Q3 615 350-1 525 000] vs 24 526 [7 036-104 569], p < 0.001) and higher raw like and comment counts. Normalizing to views changed the picture. Likes per 1000 views did not differ (24.7 vs 20.4, p = 0.069), and comments per 1000 views were higher on YouTube Shorts (1.2 vs 0.8, p < 0.001), where videos were also older (720 vs 221 days, p < 0.001). Clinical accuracy did not differ significantly (23.4% [95% CI 16.0-32.9%] vs 39.0% [95% CI 30.0-48.8%], p = 0.062). Hazard potential was more common on TikTok (31.9% vs 17.0%, p = 0.015), but this came from promotion of compounded products, four times more frequent on TikTok (14.9% vs 4.0%, p = 0.009). Restricted to directly unsafe clinical content, the platforms did not differ (20.2% vs 13.0%, p = 0.176). Obesity stigma (p = 0.118) and commercial influence (p = 0.438) were comparable.

CONCLUSION

Most short-form videos about incretin-based obesity therapies carried no accurate clinical information, and accurate videos drew only 24% of cumulative views. Promotion of compounded products clustered on TikTok and accounted for the platform difference in hazard potential. Evidence-based, bias-free communication is needed if these platforms are to educate the public about obesity pharmacotherapy.