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Social media influencers have become an important source of medical advice for millions of users – but their recommendations are often shaped by multiple biases. This article examines four key sources of bias in influencers’ medical advice: 1) lack of medical expertise, 2) industry influence, 3) entrepreneurial interests, and 4) personal beliefs. Amplified by parasocial relationships and direct engagement with followers, such advice can lead to physical, psychological, financial, and systemic harm. The paper concludes by outlining policy and platform-level actions to reduce risks and strengthen users’ ability to critically evaluate health advice from influencers.

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Key messages:

• Social media influencers are a growing source of medical advice but can be misleading

• Influencers’ reliability is often undermined by four key biases: lack of expertise, industry influence, entrepreneurial interests, and personal beliefs

• Such biased or misleading advice—amplified by parasocial bonds and direct engagement—can cause physical, psychological, financial, and systemic harm

• Coordinated action by governments and platforms is essential to protect users and to strengthen users’ ability to evaluate medical advice from influencers

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Citation:

Heiss, R., Woloshin, S., Dave, S., Engel, E., Gell, S., & Willis, E. (2025). Responding to public health challenges of medical advice from social media influencers. The BMJ. 391. doi: https://doi.org/10.1136/bmj-2025-086061