Information Sources and Needs in the Obesity and Diabetes Twitter Discourse

Obesity and diabetes epidemics are affecting about a third and tenth of US population, respectively, capturing the attention of the nation and its institutions. Social media provides an open forum for communication between individuals and health organizations, a forum which is easily joined by parties seeking to gain profit from it. In this paper we examine 1.5 million tweets mentioning obesity and diabetes in order to assess (1) the quality of information circulating in this conversation, as well as (2) the behavior and information needs of the users engaged in it. The analysis of top cited domains shows a strong presence of health information sources which are not affiliated with a governmental or academic institution at 41% in obesity and 50% diabetes samples, and that tweets containing these domains are retweeted more than those containing domains of reputable sources. On the user side, we estimate over a quarter of non-informational obesity discourse to contain fat-shaming -- a practice of humiliating and criticizing overweight individuals -- with some self-directed toward the writers themselves. We also find a great diversity in questions asked in these datasets, spanning definition of obesity as a disease, social norms, and governmental policies. Our results indicate a need for addressing the quality control of health information on social media, as well as a need to engage in a topically diverse, psychologically charged discourse around these diseases.