Online health communities’ portrayal of obesity on social media platforms in South Africa

Abstract

Background: The rapidly increasing prevalence of obesity in South Africa, intertwined with extensive changes in diet, life expectancy and nutritional status has led to a complex framing of obesity on social media. This has prompted prioritisation of treatment and prevention interventions. To leverage social media for obesity prevention, we need to understand how discourse on obesity is presented in the media. This study was conducted to understand how obesity is constructed and represented on social media in South Africa. Methods: A cross sectional mixed methods study design with qualitative and quantitative content analysis of Facebook and Twitter platforms in South Africa, from 1 July 2019 to 31 December 2019. The study used Meltwater software for data collection and data were extracted by the researcher yielding 13 500 posts and tweets. Data were cleaned and coded in Microsoft Excel. The study utilised both quantitative content analysis and qualitative framing analysis to add insight into the nature of obesity discourse on social media. Results: Social media portrayals of obesity in South Africa suggest a complex health issue. The discourse varies with evidence of stigmatising portrayals of obesity largely blaming individuals for unhealthy lifestyles and poor diets leading to obesity. Sentiment on the messages is mixed, with evidence of positive, neutral and negative reactions to obesity. Engagement with obesity messaging is both passive and interactive. There is a mix of voices creating obesity content on social media including health advocacy groups, health experts, researchers and media personalities. Conclusions: This study documented media portrayals of obesity. With social media intricately embedded in the social lives of South Africans, there is a high likelihood that obesity prevention efforts will turn to social media to reach out to the public. Future research and media-based prevention efforts need to leverage social media to fully understand the discourse around obesity