Whose tweets about obesity and weight loss gain the most attention: celebrities, political, or medical authorities?

Background: X (formerly Twitter) is a unique social medium where many famous people and health institutions post and interact with casual users. We aimed to explore reactions to tweets about obesity and weight loss from accounts representing celebrities, politicians, sportsmen, and health authorities.

Methods: We collected tweets from n = 2444 X profiles representing seven categories: celebrities, politicians, sportsmen, medical specialists, medical journals, medical universities, and health institutions. We retrieved tweets from the accounts and selected tweets about, e.g., obesity, overweight, body mass index, and weight loss. We conducted sentiment analysis, descriptive statistics, and multivariable quantile regression modeling. In quantile regression models, each tau represents a decile from 0.1 to 0.9 of the dependent variable (number of likes or retweets). Therefore, a tau value of 0.5 represents the 5th decile, the 50th percentile, and the median of the dependent variable.

Results: The final dataset consisted of n = 8989 tweets. Achieving a large number of likes (taus 0.7, 0.8, and 0.9) was positively associated with posts written by celebrities, politicians, medical journals, and universities, while it was negatively associated with tweets authored by health institutions or medical specialists. In the case of a significant number of retweets, a positive association was observed for all account types, except for health institutions, for which the relationship was negative. These relationships were independent of verification status, the number of followers, tweet length, and sentiment.

Conclusions: Tweets concerning obesity and weight loss originating from accounts representing health institutions garnered fewer likes and retweets compared to other types of accounts, including non-medical ones. A limitation of the study is the relatively small number of tweets emanating from non-medical accounts. A X informational campaign about obesity should engage non-medical accounts with many followers to reach as many users as possible.