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In 2015, Kim Kardashian published a post to her followers on Instagram (now numbering 140 million) extolling the benefits of Diclegis (doxylamine succinate–pyridoxine), a morning sickness drug. Kardashian, who was pregnant, was reportedly paid $500 000 (£400 000; €450 000) for the post.1 The investment apparently paid off because within a few months sales of the drug had increased by 21%.2
The US Food and Drug Administration was less impressed and reprimanded the manufacturer Duchesnay because the post did not disclose the drug’s side effects.3 In 2017, Kardashian promoted Diclegis on Instagram again but this time included the required information.4
Companies have long recognised that using trusted individuals—key opinion leaders, as they used to be known—is an effective way to promote their products.
“The phenomenon has, however, been supercharged by the internet,” says Jonathan Moreno, professor of medical ethics and the history and sociology of science at the University of Pennsylvania.
Millions of followers
Today, social media influencers can command thousands or even millions of followers. Instagram, with one billion users, a third of whom are aged 25-34,5 is a particularly attractive proposition for medical or wellness companies that want to reach young, perhaps impressionable, people.
“If you are on social media a lot, and you’ve got a medical problem, and you’re young, you’re extremely susceptible to what a good looking person going through the same thing as you is doing,” says Moreno.
In the UK, no one commands the same kind of social media following—or fees—as Kardashian. Nonetheless, opportunities are available for online influencers who want to work with health brands.
Josh Wolrich, an NHS surgeon who joined Instagram to chart his weight loss, now has 155 000 followers. His account emphasises the importance of a healthy relationship with food and condemns what he calls “the diet culture that comes with weight loss.”
“Picky” about what to promote
He also accepts sponsorship from businesses, charging a minimum of £400 for each post. As a full time doctor, he says that he can afford to be “very picky” about what he’s paid to promote.
One recent deal was with Nuffield Health, which owns several gyms: “I was happy to work with them to promote a message of not exercising...