help protect our health the co-modification of health

in other than the united states who's been to the us here united states if you all turned on the telly where you've got those adverts where there's drug adverts and this is what you this is the drug that you need to have and then you get a long list of side effects so that's direct to consumer advertising of prescription drugs other than the united states and new zealand there's a ban on that direct to consumer advertising So you can't advertise it, except I've got a piece coming out in the BMJ about this in the next couple of weeks.

Social media allows people to subvert because it's very hard to regulate.

If you think TV is quite easy to regulate, TV in this country is regulated by Ofcom.

So as a broadcaster, radio, TV, you're regulated by Ofcom.

YouTube isn't regulated by Ofcom.

Podcasts are outside the Ofcom code.

I sign up?

And how have you watched it? health information change across those 20 years?

We've always had hyperbolic sensationist headlines.

We had the MMR scare, and that was published in The Lancet, a medical journal that then was picked up by the press and carried on and carried on and carried on.

So one thing I'm always very conscious of is it's easy to criticise.

And I straddle this really weird world where I am sort of part-ish of the medical profession, but I'm not in clinical practice, but I'm actually mainstream media.

So I'm in this, I wear these sort of two strange hats.

But what I am conscious of is before we attack over there, we need to get our own house in order.

Ozempic influences.

And how have you watched it? health information change across those 20 years?

We've always had hyperbolic sensationist headlines.

We had the MMR scare, and that was published in The Lancet, a medical journal that then was picked up by the press and carried on and carried on and carried on.

So one thing I'm always very conscious of is it's easy to criticise.

And I straddle this really weird world where I am sort of part-ish of the medical profession, but I'm not in clinical practice, but I'm actually mainstream media.

So I'm in this, wear this, these sort of two strange hats.

But what I am conscious of is before we attack over there, we need to get our own house in order.

You have a sort of set pathway in mind that you think you

You're

up at six in the morning.

If you're on live on air at 10 o'clock at night, you don't get off till half 10.

You're flying.

You don't sleep very well because your adrenaline's pumping and then it's sort of eat, sleep, repeat.

And I left for various reasons, but I sort of figured I wasn't... specifically a news journalist, I much prefer more in-depth stuff, which I was doing on Newsnight, but also sort of leading Newsnight's COVID coverage.

And when I left, I thought, I'll just go back to doing documentaries.

Yeah.

So let's get your comments about that.

So th- there's lots of different level.

We know storytelling is important, and we know stories resonate.

Humans, we, we like a story.

And as a TV reporter, um, particularly when I was at ITV News, actually when I was at the BBC as well, in the B- uh, when I was a, a reporter for the BMJ doing their investigative journalism, I didn't have to worry about case studies so much.

I could just hit, hit doctors and academics hard with the, with the evidence and the information.

Totally different when you work in mainstream media.

Yeah.

How was the research that informed this decision a very good example of bad data?

So what happened, it was the swine flu pandemic.

This was the first big investigation I'd ever done.

It was 2009 and there was a group of independent academics called the Cochrane Collaboration that had been commissioned to update our knowledge on a drug called Tamiflu.

And this drug had been stockpiled to the tune of half a billion.

And it's all premised on the idea that this drug Tamiflu, it was going to reduce serious illness and death, but by about 50% and hospitalisation, so people going into hospital by similar numbers.

And if you think about a pandemic, one of the things that you want to do, A, you want to stop people dying and get very sick, but you want to stop them going into hospital as well because that stops the burden on the hospital.

Why is that safeguard necessary? And are companies getting around

And importantly, like, what kind of psychological vulnerabilities in, in people are they exploiting in order to persuade people?

So first of all is why do people go to social media in the first place? And overwhelmingly it seems that it's when they don't feel seen by the health service or they can't get an appointment.

And where there are gaps in health service, there's always someone willing to step in.

They don't feel seen, they don't feel heard, they're waiting a long time for a diagnosis, particularly in women's health that seemed to be the case.

They don't feel their concerns are validated.

And that opens up the territory for influencers, and they develop what's called parasocial relationships.

Now, old sort of advertising back in the day, you know, if you see Roger Federer who was advertising a product, i- it was distant, it was shiny, it was glossy adverts.

Tell me about what we're seeing in that space.

Mm.

And also, and but they were also having to sort of think like a journalist.

So what's the benefits? What's the harms of these treatments? Also, why is this person telling me this? And that's one of the first things you ask as a journalist is why is this person coming to me [laughs] with this story now? What's their incentive? But the turning point really was when I was at my auntie's birthday, sorry, my, one of my cousin's friends came to me and she'd just announced she'd bought an AMH test online, anti-Mullerian hormone.

And I was like, "Why have you done that?" And she said, "Well, I wanna see how fertile I am." And I was like, "Well, is it really gonna do that?" And she said, "Well, that's what the clinics on, the influencers said on Insta said." And I said, "Well, it's not really gonna tell you that." And so she'd actually gone and bought a test that had been advertised by influencers on Instagram, and I thought, I've just gotta write about this.

I've got to explore it.

And I started off genuinely sort of with quite an open mind, but then I just followed down different pathways to see where things would take me, to see where things would, would end up.

So it, it was quite a journey really.

Yeah

Deb Cohen, welcome to Life Matters.

Thank you for having me on.

It's a pleasure to, to talk to you.

Why are we going to the internet and not to an actual doctor?

Well, it's a really good question, and I think there's context specific-

What kind of techniques are health influencers using to gain our trust online? There's

something called parasocial relationships, and you're absolutely right to mention about this global marketplace.

One issue I'm actually looking at for the British Medical Journal at the moment, and I do touch on it in the book, is the ban on direct-to-consumer advertising on prescription drugs.

And I know Australia has that ban too.

I think New Zealand doesn't.

The United States doesn't.

But actually, the firewalls about what's marketed are breaking down because of social media.

What is the way through here?

for research, but then you will get bombarded immediately afterwards, even if you're not somebody who is experiencing it.

So I think you pick up on two really interesting points there.

To address the one about the US is we've got a direct-to-consumer advertising ban of prescription drugs.

It's really only the US and New Zealand where you're allowed to advertise.

But now that I wouldn't say the laws are redundant because it's the Medicines Act that prohibits it, but it becomes a lot harder to regulate.

You've got influencers now talking about, let's say, weight loss drugs or hormone therapy.

We've all probably, well, I've definitely been bombarded with them.

What should people be thinking about in that respect?