BACKGROUND
There has been a significant increase in trend in using social media as a platform to deliver weight management interventions. This illustrates a need to develop a holistic understanding of doctor-patient communication and peer-to-peer communication in social media interventions and their influences on weight management of people with overweight or obesity. Studies like this will highlight how social media can be more effectively integrated into weight management programs to enhance individuals’ short-term and long-term weight management behaviors.
OBJECTIVE
This study aimed to examine patients’ experiences with doctor-patient communication and peer interactions in a social media-based (WeChat) weight management program, and describe the interplay of three social influence factors—social support, social comparison, and surveillance—in their weight control practices. The program, designed and implemented by the research team located in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components that targeted people with overweight or obesity.
METHODS
We conducted in-depth interviews with 32 program participants of different ages (M = 35.6, SD = 7.7), gender (18 females), duration of program membership (M = 1.4 years), and weight loss outcomes (54% weight loss to 9% weight gain). All interview data were audio-recorded, transcribed, and translated using the translation-back-translation technique. Nvivo software was used to facilitate the coding process.
RESULTS
Results of a thematic analysis indicated the distinct functions of professionally led support and peer support. Professional support was presented in the form of knowledge infusion, efficacy enhancement, and provision of timely feedback. Peer support fostered empathy and sense of belonging and had a mutually reinforcing relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it also reinforced negative group norms and resulted in downturns in reference standards and collective inactivity. Social media surveillance prompted participants’ reactions to the gaze from medical professionals and peers that could be encouraging or inhibiting. Surveillance enhanced vigilance with weight control norms. However, its influence weakened when participants chose to fake weight data and turn off notifications. Findings from this study illustrated the interrelated and fluctuant influences of support, comparison, and surveillance.
CONCLUSIONS
The interactive traits of social media eased the practices of social support and social comparison and created new forms of surveillance. This study contributed to an in-depth understanding of social media influences on individuals’ weight control behaviors. Practical implications of the study concerned improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology.
CLINICALTRIAL
Clinical Trial ChiCTR1900025861.
Individual differences in resting-state connectivity and giving social support: implications for health
