With a Little Help from My (Virtual) Friends

With a Little Help from My (Virtual) FriendsThoughtsDr. Sherry Pagoto‘s presentation of her research at HxRefactored a few weeks ago has stayed on my mind. Her work examines whether and how interventions that are typically delivered face-to-face can be adapted to social media interactions such as Facebook groups or Twitter posts. To vastly oversimplify her work, the short answer is yes, you can distill at least some behavior change interventions to a social media protocol and still achieve positive results.

What really caught my attention though was Dr. Pagoto’s finding that when people who participate in the social media-based weight loss interventions talk about where they’re getting their best social support, they’re not always mentioning family or friends. Rather, many people find their Twitter followers more supportive of weight loss efforts than in-real-life (IRL) friends and Facebook friends (who are usually also IRL friends). Why might people trying to lose weight feel like they get better support from Twitter than from IRL?

Possible reasons:

Weight loss by one person impacts his or her friends. I jokingly tweeted that the deleterious effect of a friend’s diet on bar food consumption might lead people to be less supportive:

It’s one of those jokes that’s not really a joke: If you love doing something with a friend and suddenly that friend is no longer partaking, hanging out becomes less fun. That’s one reason why quitting smoking is so hard for people. Twitter friends, however, don’t necessarily have a shared bad habit to miss.

Your success makes me see my failure. Dr. Pagoto pointed out that seeing a friend engage with a weight loss program might lead people to uncomfortable self-reflection or a feeling of social pressure. If someone’s not ready to make a change, that could lead to less support of the weight-losing friend.

Misery loves company. This possible rationale is a little dark, but also has a ring of occasional truth. People might react negatively to a friend trying to lose weight because of jealousy or a desire to be “better” than the friend.

Self-disclosure is hard if you know someone. This rationale is more about the person losing the weight than the friends. They may find it easier to be honest and authentic on Twitter, a platform where they are less likely to know their connections in real life. People may be better able to discuss personal matters with a virtual coach than a live one. In fact, as part of the same panel at HxR, Geri Lynn Baumblatt from Emmi Solutions shared results from a study showing that people are willing to self-disclose personal medical information in a 10 minute IVR call–perhaps not what we’d expect. If people are being more authentic with Twitter friends than real life ones, they may be soliciting more supportive responses.

Why do you think people might turn to their virtual friends before their in-real-life ones for support with health behavior change? Where do you get your best support?


Pagoto, S. L., et al. (2015). Twitter-delivered behavioral weight-loss interventions: A pilot series. JMIR Research Protocols, 4(4), e123. Doi: 10.2196/resprot.4864

Pagoto, S. L. et al. (2016). Adapting behavioral interventions for social media delivery. Journal of Medical Internet Research, 18(1),  e24. DOI: 10.2196/jmir.5086