Instant Genius - The hidden ways the Internet and social media are shaping healthcare

Episode Date: January 30, 2026

From famous actors and pop stars to the legions of social media influencers with millions of views, it seems almost everyone has something to say about the best ways to boost our health and wellbeing. But is this trend leading to many of us bypassing traditional sources of health advice and care such as GP practices and government health services and instead turning to the Internet, social media and private online pharmacies to seek out information, diagnoses, and, in some cases, even prescription medicines? In this episode, we’re joined by Deborah Cohen, an award-winning medical broadcaster and author to talk about her latest book, Bad Influence – How the Internet Hijacked Our Health. She tells us how the COVID 19 pandemic kickstarted a worldwide boom in consumer healthcare that shows no sign of stopping, why celebrities and social media stars hold so much influence over important decisions that can hugely impact our lives, and points out some of the red flags we can look out for when searching for health advice online. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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delivering digital precision with analogue warmth. So you can experience exceptional sound at home. Music just as the artist intended. Visit name audio.com. to learn more. Hello and welcome to Instant Genius, a bite-sized master class in podcast form. Every Monday and Friday, you'll hear world-leading scientists and experts talking about the most fascinating ideas in science and technology today.

I'm Jason Goodyear, commissioning editor at BBC Science Focus. From famous actors and pop stars to the legions of social media influences with millions of views. It seems almost everyone has something to say about the best ways to boost our health and well-being. But is this trend leading to many of us bypassing traditional sources of health advice and care, such as GP practices and government health services, and instead turning to the internet, social media and private online pharmacies to seek out information, diagnoses, and in some cases, even prescription medicines? In this episode, we're joined by Deborah Cohen,

an award-winning medical broadcaster and author to talk about her latest book, Bad influence, how the internet hijacked our health. She tells us how the COVID-19 pandemic kickstarted a worldwide boom in consumer healthcare that shows no sign of stopping, while celebrities and social media stars hold so much influence over important decisions that can hugely impact our lives

and points out some of the red flags we can all look out for we're searching for health advice online. So welcome to the podcast. Thanks so much for joining us. Thank you for having me. good to be here. So today we're talking about your latest book, Bad Influence, How the Internet Hijacked Our Health. So first off, can you give us a sort of overarching view of what the book's about, you know, so that's a very interesting title? So it's really about how our health is being

commodified and commercialised. And if you think about what a lot of the social media platforms are about, they're about keeping our entertainment, you know, being entertaining and grabbing our attention. attention economy, but also there's a massive commercial element to it. So in effect, in some ways, they're like shopping platforms. And one thing that I was interested in is what happens to health. When you put it on these shopping platforms, if you like, you put it on these platforms. We know health is influenced by commercial factors. We've had, it's influenced by the research that's commissioned, the commercial incentives there, the drug industry, devices industry, food, tobacco, alcohol, fossil fuels.

And my thinking around this was we've got a whole new industry here at play, which is tech coupled with content creators, influences, podcasters. I guess the irony of us sitting here talking about on a podcast, talking about podcasters. But a lot of these have commercial incentives. And the question I had is what impact this was having on our health. Yeah, so that's really interesting. I think like anyone who's even had a sort of cursory glance at social media, we'll see that there's an awful lot of content out there giving health advice these days.

You know, an overwhelming amount, really. Where does this come from? Do we know when it started? Commercial impact on health has been around forever and a day, but there's been a few things that have happened at the same time. We've seen a rise in consumer health. So supplements, we've heard a lot about supplements. but there's all sorts of other things like diagnostic tests.

So we remember in the pandemic when we were doing those lateral flow tests, shoving those things up on noses to see whether we had COVID and getting our results, but also lots of wearables. And there was a movement back in the early 2000s, the quantified self movement, which was started by the editors of Wired magazine. But it's moved on a lot since then. We have, you know, all watches that track all everything. We've got all these tests that are freely available.

We've got online pharmacies that we can go and buy various prescription drugs from that you used to have to go to see your GP or go and see a doctor to get prescribed. There's a whole rise, more podcasts that are sponsored. There's a whole rise in consumer health. And that sort of boon in many ways started to increase a lot during the pandemic where people were at home and they couldn't go and see their GP. necessarily. And at the same time, you know, there are problems within the NHS, people are going to see doctors. So it's created a sort of a readiness, if you like. It's fertilised the ground for

this market to take off. Yeah, so do we have any data, you know? How commonly are people turning to the internet and to social media for their health information and advice? We know it's increasing. I mean, surveys from offcom suggest more and more people are turning to the internet for advice. And the internet, obviously, that's quite broad brush. There's some very good internet content, not least this podcast, obviously. But increasingly, there's people are turning to social media. And that might be TikTok, that might be Instagram for their health information or YouTube. And it's difficult to unpick and unpack and navigate your way around that. And one of the questions that I ask as a journalist is for a treatment or a test or whatever.

what are the benefits of this treatment? What are the harms? What's the evidence for it? And then I think in this era is who is selling me this? Why are they selling me it? Why are they telling me about it? Are the commercial incentives here? And do they have conflicts of interest? And I think as consumers of health, it's quite hard to unpick and unpack a lot of that stuff and navigate your way around working out whether something is worth having or whether something is worth buying or whether something is worth taking. Are they sort of more like demographic groups that are more likely to engage with this sort of thing? Or is it a case of just pretty much a bit of everyone? I think it's a bit of everyone. I mean, the younger generations perhaps are used to having everything over their phone.

And one academic, John Powell, who's at Oxford University, sort of described this as the prosumer effect. So when the internet first came about, he thought there'd be a massive disruption and providers of healthcare. And his view was, no, the powerful people remain the powerful people, and the patients remain the patients, there was still this imbalance. But with the advent of social media, with lots of changes around how people access all sorts of services, there's been a big change. And he describes this pursuer effect where people aren't just consuming content.

They're also creating it themselves. So they're taking content that's been created and modifying it for their own audiences, and to see what goes viral. So that's had an impact. But actually, lots of people turn to social media for their health. And my age group were Gen X's. They were the inspiration in many ways behind this. And my friends were asking me,

they were turning to social media for things about, you know, ADHD diagnoses or whether they should have these four body scans. Or, you know, in some age groups, whether they should be taking testosterone or hormone replacement therapy. And they were turning to social media for this advice and for advice about symptoms. And that really was the trigger for it. So of course, though, we all know that it takes, you know, a long time to qualify as a medical practitioner of various kinds. But these people, all they need to do is, you know, sign up with an email address.

And then they can start putting health information out there. So as somebody who's consuming this, is there anything that we can do to sort of critique what these people are putting out there? You know, because they could be saying anything, essentially. Yeah, and one thing I think we should always ask, and it sounds really quite skeptical, but I think a bit of healthy skepticism goes a long way, is why should I believe you? Why should I be listening to you? and some people have very perfectly valid stories that they want to tell and talk about their health journey. But when it comes to advocating treatments or tests or wearables or anything else like that, why should I be listened to you?

And you know, you might ask that about me. Why should I listen to you and what you have to say? But I think that should always be at the back of our mind. And one of the issues we have, I think, as well is that some medical practitioners, perhaps, are making money out of what they recommend too. So it's a very, very difficult space, I think, to navigate for people to find unconflicted impartial health information. Yeah, I think one personally speaking, anyway, one sort of big red flag for me is product placement or people being given. things for free or whatever, or even being paid to promote things. And if that's a pair of headphones, you know, a bicycle or something, not so bad. But when it comes to health advice,

I think that's something that I certainly worry about. And rightly so, as doctors and I initially trained to be a doctor, you know, we are supposed to declare conflicts of interest. So if you see, if you get a medical journal, you will see at the bottom of that journal article, of interest, if I have taken money from any company that might have impacted the advice. And the general medical council has quite strict advice for doctors. You can't just recommend the drug that you might have worked with a drug company. And obviously, these relationships, we need doctors and medical practitioners to do research, but there's all sorts of different roles they have within drug companies.

You are not supposed to just advocate that treatment. You're supposed to give a whole range of treatment options, not just that one. but when it comes to content creators and influences, that isn't necessarily the case. It's not always transparent that they've got commercial relationships. And I think one of the issues is we've got strict laws in the UK and most of the world, actually, other than the United States and New Zealand, about direct-to-consumer advertising, say, of prescription drugs. So that might be things like the weight loss drugs.

But that's really hard to regulate. the content creators that I've spoken to have relationships with online pharmacies to encourage people to go on these drugs, they're incentivised. And that actually technically is illegal, but it's very hard for the regulators to regulate that. So that's prescription drugs, but right along the path, you know, whether it's wearables, whether it's supplements, there are financial relationships going on. One refrain I heard quite a lot from content creators is it's a product that I use myself. Well, that still isn't. It's, I only recommend the products I like. Well, what happens if the evidence changes? We know in science that evidence is iterative. It constantly changes. Or you suddenly

hear that there's major side effects from the treatment or the test that you're, you're recommending. What does that do to the advice? It's very hard to be impartial if you were on the payroll of a company or a pharmacy to then talk about that particular product. And I'm not sure that refrain totally holds true. Yeah, so you mentioned these weight loss jabs there that you write about in the book. I mean, these are everywhere at the moment, really big news, you know, countless celebrities are using them, saying that, you know, how great the effects are.

But one slightly, I don't know, kind of alarming issue is that we can just bypass GPs now. and specialists and by what are powerful drugs online, essentially based on an actor or a singer's recommendation. Yeah, and it's changing, and I think he's changing very much. And what I'm interested in, and I think we're only learning this. I mean, I say at the start of the book,

we've got this global experiment in public health at the moment. I think we're only starting to reckon with the impacts of this and what are the impacts on health and the health service. and the health service, because if things go wrong, you might get stuff privately, but if things go wrong, it ends up in the NHS. And it has an impact on the NHS. And one doctor spoke about the number of young women that she's treating, in particular, with these weight loss drugs that have bought it on the illicit market,

and they're having inflammation of the pancreas is one of the side effects. And that's quite an unpleasant condition. And then there's sort of allegations around people making up their weight to go and get the weight lost drugs. And there are attempts to clamp down on that. But what the internet does is it provides loopholes. And across the board, really, with prescription drugs, whether that's testosterone or steroid treatments or whether it's the weight loss drugs, there's a whole illicit market around it. And with testosterone, which I write about is there's little emojis that signal what people have a lot. available and they direct them off the social media platforms onto other platforms to do the deal,

if you like. Yeah, so that's sort of blown it because in the past you would have maybe seen, you know, sort of slightly suspicious, dodgy people in gyms doing this sort of thing. But now, like, all you have to do is log onto a social media account. And the access is right there, you know, so is the problem getting worse? It's definitely changing. I mean, I was on tube only yesterday and there's adverts for testosterone, you know, testosterone treatment, targeting men, you know, have you got low energy? Well, actually the evidence for testosterone and energy is flimsy. There isn't good evidence that it does that. So there's a whole rise of consumer health. So not only if you're talking about, you know, it's the old sort of nod and winks

in the gyms that people would go and get their testosterone, social media has provided a platform for people to get it and take it off platform to get it elsewhere, but even online pharmacies and clinics are now able to sort of advertise testosterone as a treatment. So it's just part of this growing rise of commodification and commercialization of health. Ambition comes in all shapes and sizes. At First Citizens Bank, we roll with your goals because we're built for what you're building. Fit for your ambition for Citizens Bank. There's a moment when things start to feel uncertain, not urgent, just a quiet question in the background. What helps is finding a place where it all feels a little more clear.

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for more information. kind of big topic that's talked about a lot and discussed on social media and various other outlets is this concept of longevity that seems to have really, really taken hold. And you see all sorts of sort of crazy things that people are coming up with, you know, they're taking like 50, 60 tablets a day, all sorts of things. And then you're also possibly selling them as well on their, on their website. But what, these seem to me to be slightly sort of free. fringe beliefs, fringe activities. So why does social media seem to like attract these kind of,

I don't want to say anti-scientific, but you know what I mean? They sort of, by virtue of saying something slightly different from what traditional medical professionals are saying, somehow like perversely seems to give them more appeal. Well, I think science is slow moving. You know, we do clinical trials because we need to know the way of showing cause and effect, isn't it?

if you do a robust, randomized clinical trial. And for people in the longevity space, they don't necessarily want to wait for trials. So they might use, and it's fascinating looking at some of the forums around longevity, and there are some major podcasters in this space that talk about longevity, but they rely on mechanistic theories. And we have got a long history in healthcare that what works, in a lab doesn't necessarily work when you put it into the human body, or they'll rely on

animal studies. And again, studies we want to look at as humans is the human studies, what works in a rat isn't necessarily going to work in a human or even a primate, even a non-human primate. But there's a real sense that evidence-based medicine is old-fashioned. And I've actually, when in some of the conversations I've had around the book. I've been accused of, oh, you're not one of those old-fashioned medical types, are you, that requires robust evidence? And there's a sense that it moves too quickly. And it's quite a macho, if you think about it, it's quite a macho sort of culture, some of it around it. They want to kind of move fast. It's the tech bros. They break things and reiterate, well, healthcare doesn't work like that. And one academic put it to me,

Oxford academic put it to me. In science, we, or in medical science, certainly we have the normal hypothesis. We assume something doesn't work until shown otherwise. Now, in some of the tech world, there's a sense that it works until shown it doesn't, until it, so get it on the market, get it out there quickly, and we'll wait for the market to decide. But that's not how we do science. So there's all this sort of different kinds of mechanistic thinking. But In some parts of the longevity space, humans are seen as these big complex computers, that if you just get the right code, that you can increase life. And we know things are a bit more complicated than that.

Yeah, so let's shift gears and talk about something else that you brought up, which I thought was really fascinating. And that's sociogenic illnesses. So I think a lot of people won't have heard that tone before. What does that mean? So it's fascinating. I think it's one of the most mind body in healthcare is so, so important. Our mind affects so much of how we experience symptoms, well, how we experience everything.

But in medicine, we've had a bit of a culture of separating mind and body. It's Cartesian dualism. And social media is a way. There's another way of looking at it. It's called the Nasebo effect. And Nasebo effect is the opposite of placebo. So placebo effect, if we think something, we really believe something is going to help us, it might help us alleviate symptoms.

Nasebo effect is the opposite of that. If we think something will make us ill, it might make us ill. And there's examples of this effect being spread across social media. Sociogenic illnesses has happened since time immemorial. There's the dancing plague. It was known pejoratively as hysteria. but examples were the dancing plague in the past where people literally danced themselves to exhaustion,

it was catching. We might have heard, you know, people might have read The Crucible by Arthur Miller. That was possibly examples of mass sociogenic illness. And there's some examples in the book around that happening around the HPV vaccination in Colombia where people experienced what they thought was a side effect, of the HPV vaccination, so they were fitting, collapsed fitting, and that was spread on YouTube

and people after they'd had the HPV vaccination experienced the same effect. And when neurologists, when they did massive forensic investigations into this effect, they found there was nothing organic. It was perhaps sociogenic illness. But sociogenic illness in itself tends to happen when against the backdrop of stress and trauma So when they investigated further, in some of these cases where, you know, it seemed to be sociogenic illness, people have had trauma and it's been an expression of stress and trauma. So that shows you the power of the mind of the body. The mind is experiencing the stress, the trauma, if you like, but the body is exhibiting very real physical symptoms.

And some of that has been tracked to that being spread across media platforms. So kind of related really, loosely at least, anyway, to everything we've been talking about is there's so much information out there now. You know, you're saying maybe some people do have a little bit of an issue getting a doctor's appointment or there's a waiting list for a certain procedure or treatment that they need. And given that there's so much information, is there a tendency for us to start sort of self-diagnosing? Yeah, and you can understand why, you know, if you are struggling to get medical help or you don't feel listened to, you don't feel heard by their health service, then of course there's a temptation to sort of look at it online and there's absolutely nothing wrong with people being empowered. The problem is, is what that empowerment looks like. And sometimes what I've seen within the book, people looking for, solidarity for validation, turn to social media, but then that is used as a reason to sell something. So you are selling a service. So you think you're being heard and listened to, but actually you're being sold as supplement. And that need can be exploited. One thing again, I've heard

repeatedly said by people I've interviewed, is the algorithm knows me better than me. So all of a sudden you might have ADHD coming up into your feed. And people have felt, oh my goodness me, it's telling me something. And maybe that is the case. Maybe it prompts people to go and seek help and care and treatment. But on the other hand, you have to look at where some of those descriptions are coming from, who's describing those symptoms, where the questionnaires for ADHD are coming from, what the commercial incentives are.

And in some cases, certainly with ADHD, influences have changed their symptoms. according to what is trending. And you might see your condition through a social media prism. And so there are challenges with that. And one health psychologist said to me, the algorithms know your anxieties or your neuroses better than you do. So if you hover over a video, you're more likely to get that in your feed. So one example I looked at is somebody that had, I spoke to that had gut problems, bowel problems, and the medical profession couldn't find any root cause for it. So she went to explore online.

And there were lots of food allergy tests that came up. And that's what the algorithm plugged into. And it seemed to chime with how she felt. And in many ways, we call that confirmation bias. And so that's the pathway she took. She went down rabbit holes, buying food intolerance tests. And there's no evidence for these. the kind of test she used, there's no evidence, and she eliminated loads and loads of stuff

out of a diet. And that has harms because some of the stuff she eliminated out of diet, a healthy food, for example, bananas and things like that. So I think what people understand generally with medicines, with drugs, that there might be side effects, you have benefits and your harms, but I think it's sometimes harder for people to understand, or we understand less, that doing tests have harms. And having a diagnosis potentially, has harms. They're not benign things in and of itself. So if you go down the route of, you know, testing for food intolerances where there's, you know, these tests don't test for that, you eliminate a load of stuff out your diet. That's potentially harmful. Yeah. So obviously this is

a huge issue. But, you know, are these social media platforms, because it's different from traditional media, isn't it? Like they're not newspapers, for example. It's like they're just allowing other people to make their own channels, you know, so that it's a subtle difference, but a big one in a lot of ways, you know, are they doing anything to sort of, to try and rein this stuff in? Or, I mean, even can they? I think it's very, very hard. And, you know, the media, mainstream media does not get it right the time. We've had sensationalist headlines in the mainstream media benefits of, how often is he say, oh, coffee causes cancer, the next day coffee reduces your risk of cancer. Eggs as well. Eggs are like,

one day, they're great, one day, they've had. You know, there was a whole point where we had all these antioxidants like cranberries and blueberries and everything else. So the mainstream media has not got it right at times as well. But I think the issue, but there's an element of accountability with mainstream media. I think the problem here is the selling and it can be, you know, people are selling stuff in. And it's also the intensity of the algorithm. So if you read a newspaper story in the past, you'd read a newspaper story, you'll see a bulletin on the news and that's it.

And then you sort of move on and you might go and research it. If you start to look at, you know, one of these stories on one of your algorithms, you'll just get more and more and more and more stuff. And it's not very well regulated at all. And it's very, very hard to regulate. One example, there was last year. year it was, some content creators were reprimanded for advertising weight loss services that involve drugs and that is banned. We're not, you know, we've got direct to consumer advertising

ban on prescription drugs. But when I spoke to content creators in the weight loss space, they haven't heard about, you know, this reprimand. So when people are reprimanded, it's not filtering down to, it's sort of business as usual. So, you know, you wonder what the impact is of these reprimands. Yeah, so we've talked about an awful lot there. Of course, there's an awful lot more in the book, so anyone who's interested should definitely check that out. But sort of by way of closing,

Javut's sort of a cheat sheet that we can kind of arm ourselves with to prevent ourselves against some of these effects. I think if someone's only talking about the benefits, they're not telling you the full story. whenever you decide to take a treatment, you look at the balance of the benefits and the harms, find out if they're referencing academic research. Challenge, you know, that's one of the great things about social media is it's meant to be interactive, you know, challenge people and say, what's the evidence for your claim? And then think, well, will I benefit from this? What are the risks?

What are the alternatives from what someone is telling me? Are they declaring any conflicts of interest. What's the impact of doing nothing? And when it comes to more of the measuring biomarkers, so things like glucose or sleep or things like that, ask the question, is this measurement telling me anything meaningful about my health? Because not every single biomarker does tell you something meaningful about your health.

If changing this biomarker or this metric, what impact will that have on my health? How do I go about it? Are the side effects from changing this biomarker? So there's all these sorts of questions in many ways while we're navigating these spaces, we're becoming our own health professional, sort of having to do the jobs ourselves. And these are the sorts of questions. And the whole point of the book really was to help people think about what impacts evidence,

what impacts healthcare decisions, how decisions are made in healthcare. If you are becoming your own doctor online, what are the questions you need to ask? And what is the thinking? what goes into thinking around diagnoses, around if you do a screening test, if you're healthy, if you're ordering a diagnostic test, if you're deciding to take a drug, and then self-experimentation. I am my own experiment. Well, is that really valid? So it's sort of trying to help people think and critically and ask these sort of critical questions. Thank you for listening to this episode of Vincent Genius, brought to you from the team behind BBC Science Faker.

That was Deborah Cohen. To discover more about the topics we've just discussed, check out her book, Bad Influence, How the Internet Hijacked Our Health. If you liked what you just heard, then please do consider subscribing to Incid Genius on your preferred podcast platform.

If you'd like to see our guests and hosts in person, then why not check out our YouTube channel at ScienceFocus. The current issue of BBC Science Fakers magazine is out now. Pick up a copy wherever you buy your favourite magazines, or download us on your app store of choice. You can also find us on Apple News or online at sciencefocus.com. This podcast is sponsored by Name, Audio and Focal. The texture and emotional depth of music can be lost through digital sources or poor signal.

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