How to Teach Teenagers Health Literacy in the Age of Online Influencers

Teenagers (ages 13 to 18) spend more than seven hours per day on screen media for entertainment — that’s excluding time used for school and homework. Children ages 8 to 12 spend more than four hours doing the same, according to a 2019 Common Sense Media survey.

This screen time includes browsing social media, chatting with friends, watching videos, and gaming. The media have always been a source of information for young people, said Beth Lanning, associate professor for Baylor University’s Robbins College of Health and Human Sciences. “It’s just the new medium through which they receive information.”

154 minutes

The average time spent per day among teenagers who use HVSM.

However, adolescents today have access to more content than in previous years, including information about their health. Making health information more accessible means a more educated population, Lanning said, but the immediacy of the internet poses a risk for the viral spread of misinformation.

“The thing that is difficult with this generation is how fast something can get out of hand,” she said.

To help prevent the health risks that may be associated with misinformation teenagers receive online, parents and other adults, from educators and athletic coaches, can play a pivotal role in guiding youths to be critical of the online content they consume.

How Teenagers Interact With Online Media

Teenagers today spend a significant amount of time online. In an Adweek infographic on the habits of Generation Z (those born between 1997 and 2012), 95% of those surveyed said they consumed content on YouTube regularly and 69% said they used Instagram with a similar frequency.

The research also explored the role of online content distributors (i.e., social media influencers). An influencer is an individual who creates digital content and has secured a large following on platforms like YouTube, Instagram, TikTok, and others.

Going back to that infographic on the habits of Generation Z, respondents said they trust social media influencers as much as, and sometimes more than, traditional celebrities.

This may be due in part to the way influencers interact with their audiences. By creating short videos on YouTube and TikTok and sharing posts on Instagram, creators can engage directly with their followers.

While these are mostly one-sided relationships, some teenagers feel a sense of community and develop a sort of trust with the influencers they follow, a personal connection known as parasocial interaction. Because teenagers are likely to have these relationships with social media influencers, it is important to make sure they have the media literacy skills to be critical of the content they consume.

How Social Media Affects Body Image

Body image issues can be influenced by a variety of factors. Research has shown that perceptions of weight are one factor that can put children and teenagers at risk.

Researchers examining weight status and body image perceptions in adolescents noted that greater body mass index (BMI) is associated with heightened weight concerns in both boys and girls. Likewise, they found that having a greater BMI during adolescence strongly predicts body dissatisfaction in young adulthood.

The issue of reducing obesity rates among children and adults is an intense public health focus. According to the Centers for Disease Control and Prevention, obesity is associated with multiple health conditions, including heart disease, stroke, Type 2 diabetes, and certain types of cancer.

According to Lanning, messages around the connection between weight and health can lead to misinformation and, by extension, body image issues.

“We’re very concerned about obesity, but … I think we need to be careful that the message doesn’t become that only thin people are healthy,” Lanning said.

Perceptions of what body types are considered healthy paired with the highly visual component of social media can contribute to negative body image issues among adolescents.

For example, one study examining the effects of social media use among male and female adolescents indicated that students who engaged in frequent use (more than two hours a day) of highly visual social media (HVSM) such as Instagram reported significantly higher body image concerns and internalizing symptoms than their peers who did not engage with HVSM.

Highly Visual Social Media (HVSM) use among teenagers

A 2018 study found that approximately 88% of teenage girls and 77% of teenage boys use highly visual social media (HVSM). Among teenagers who use HVSM, the average time spent per day is 154 minutes.

Go to a tabular version of “Highly Visual Social Media Use Among Teenagers.”

With a heighted focus on personal image among social media influencers, children and teenagers may feel compelled to emulate the celebrities they follow to achieve their perceived image of health.

The Influence of Online Health and Wellness Content

Among the vast landscape of content created by social media influencers, there is a significant number of videos, blogs, and photos focused on topics related to health and wellness. A quick search on YouTube for “what I eat in a day” or “my workout routine” provides an endless scroll of results.

This type of content may serve as a helpful resource for many individuals but can be dangerous for younger people who do not have strong media literacy or health literacy skills.

Many social media influencers who promote a healthy lifestyle as part of their personal brand may put out regular content about topics ranging from clean eating — a diet free from processed items and focused whole, natural foods — to natural beauty and skin care products.

Online content has also become a means of making a profit for many social media influencers. Brands partner with individuals who have large followings to promote health and wellness products, such as vitamin supplements, “detox” teas and weight loss products.

The potential problem lies in an individual’s ability to assess the credibility of this type of content, as well as their knowledge on how to safely apply health information to meet their personal needs.

Teenagers who engage with HVSM more than

two hours

 a day are more likely to have body image concerns and internalizing symptoms, such as anxiety.

In a U.K. study of the health information shared by influencers, researchers found that only one out of the nine most popular bloggers studied met the criteria for transparency, evidence-based references, trustworthiness and adherence to nutritional guidance, and bias.

Lanning said this can be problematic when a social media influencer has a body type associated with being healthy.

“Just because a celebrity has a personal trainer and a personal chef [who] does all their cooking doesn’t mean that they’re an expert on nutrition,” she said. “Kids will think, ‘If I do that, if I use this special cleansing diet, then that’s the way I’m going to look.’”

In addition to the risk of taking in misinformation, children and teenagers may lack the knowledge to understand that diets, exercise, and other health practices affect individuals differently and should be cleared by a clinician.

“If you’ve got a child who is overweight and could [have] borderline Type 2 diabetes … they could really hurt themselves,” Lanning said.

Holding Social Media Influencers Accountable for Health Content

Along with teaching children and teenagers how to be critical of media and health information, several organizations are taking steps to reduce the harm of misinformation in health and wellness content online.

  • In September 2019, Instagram introduced a new policy that would ban ads promoting weight loss products and cosmetic procedures to users under the age of 18.
  • The Register of Health & Wellness Influencers was founded in June 2019. This was done to proactively manage growing concerns on the conduct and content produced by health and wellness influencers.
  • Multiple health brands are launching initiatives to better inform and train influencers to talk about their products before signing promotion deals for branded content.
  • Health professionals are building audiences online to share information about health issues related to teenagers, including mental health and the risks of vaping. “Health literacy has to be addressed in partnership with the audience that you’re trying to target,” Lanning said.

Teaching Teenagers About Health Literacy and Media Literacy

The ability for younger individuals be more critical of the health and wellness content they consume online lies at the intersection of health literacy and media literacy.

Health literacy

“is the ability to take health information and utilize it in a health care system or in connection with the decisions one makes about their health.”

— Beth Lanning, associate professor for Baylor University’s Robbins College of Health and Human Sciences

Media literacy

“is the ability to access, analyze, evaluate, and create media in a variety of forms.”

—The Center for Media Literacy

Together, these skill sets can help teenagers “to be critical consumers instead of just being consumers of health information,” Lanning said.

The focus on building these skills has become more relevant for adolescents, as they are increasingly turning to the internet for health information, according to a paper on the challenges and opportunities for health literacy in adolescents. The researchers stressed the importance of functional literacy (e.g., knowing a medical term for search purposes), critical literacy (e.g., identifying credible sources), and interactive literacy (e.g., transferring learned information to appropriate health behaviors).

How to Have Conversations About Social Media Influencers and Body Image With Teenagers

Parents can serve as guides for children and teenagers on how to consume health content responsibly. A 2019 study showed that active use of social media by parents led them to significantly mediate social media influencers’ effects on their children. Health literate adults have the opportunity to help young people learn how to think critically and have influence over how they see themselves.

Lanning provided some advice for facilitating dialogue to help teenagers build media literacy and health literacy skills and guide them in making smarter choices based on the content they consume.

  • Discourage associating physical appearance and weight as the sole measurement of health, which can contribute to body image issues and miss the nuance of how an individual’s health is affected by a number of factors.
  • Find ways to enter a teenager’s world, watch online content, and engage in their interests.
    • While it’s impossible to follow every social media influencer, engaging in social media and acknowledging popular content can help guide conversations.
  • Ask questions about the content your teenagers are watching rather than immediately passing judgment.
    • Instead of telling them directly to not do something, try asking “Have you heard about this trend? What do you think about it?”
  • Let the teenager take the lead in conversations and listen to their ideas.
    • By putting them in the driver’s seat, you empower your teenager and encourage them to become an advocate for health issues that affect them.

Media Literacy: Checklist for Assessing Health Content

To help adolescents become more critical of the media they consume, encourage them to ask the following questions about health and wellness content.

Is this post a paid promotion?

What brand or organization is behind the product? How is this piece of content trying to make you feel?

Is this social media influencer a trusted expert on the topic?

Do they have credentials or formal training on the topic (i.e., Are they a physician? Do they have a license in nutrition?)

Does the person creating the content provide sources for the information they are sharing?

For example, do they provide links to articles or research in the description of the video? Are they from a reputable source, such as a peer-reviewed journal?

Do any of the claims they make feel far-fetched?

For example, if a product being promoted by a social media influencer promises instant results, it is probably too good to be true.

Does the content promote a one-size-fits-all solution?

Every individual is different and will have varying responses to diet changes, fitness routines, and health and wellness products.

Resources for Further Reading

The following section contains tabular data from the graphics in this post.

Percentage of People Using Social Media by Gender

Type of Social MediaFemaleMale
Facebook (Non-HVSM)

Percentage of Users on Social Media for 2+ Hours Per Day

HVSMFacebook (Non-HVSM)

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Citation for this content: The MPH online program from Baylor University’s Robbins College of Health and Human Sciences