{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:25:34Z","timestamp":1786940734596,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Eating disorders (EDs) are complex conditions with medical and psychosocial implications. Social media (SM) exposure has been associated with increased body image concerns and maladaptive eating behaviors. Pro\u2010eating disorder (pro\u2010ED) communities exist across SM platforms and often perpetuate ED\u2010related identities and behaviors. As Ozempic gains prominence as a weight\u2010loss medication, online discourse surrounding its use has grown considerably. This study aims to characterize attitudes and perspectives toward Ozempic within the pro\u2010ED community on X.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Using netnography, publicly available tweets containing the terms \u201cOzempic\u201d and \u201cedtwt\u201d posted between August 2024 and July 2025 were retrieved. Content analysis was conducted by two independent reviewers using an iterative, consensus\u2010based approach to analyze naturally occurring online discourse without direct user engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The initial search yielded 451 tweets; after applying exclusion criteria, 255 were included in the analysis. Three main categories were identified: personal narrative, information sharing and risk warning, and attitudes and perceptions. Personal narratives reflected curiosity and information seeking (19.2%), desire or intent to use (11.8%), access (9.0%), and active use or experimentation (11.4%). Information sharing and risk warnings accounted for 3.5% of posts. Attitudes and perceptions included ethical and moral judgments (8.2%), normalization and cultural saturation (28.6%), and rejection and critique (8.2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The findings demonstrate that Ozempic is actively integrated within pro\u2010ED discourse on X, where discussions often normalize its use for weight loss and express sustained interest in its use. This highlights the need for greater awareness of how these medications are circulated within vulnerable online communities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/eat.70190","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:06:33Z","timestamp":1786939593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring Perspectives on Ozempic: A Netnographic Qualitative Evaluation of the Pro\u2010Eating Disorder Community on X (Formerly Twitter)"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1499-1928","authenticated-orcid":false,"given":"Daisy","family":"Sun","sequence":"first","affiliation":[{"name":"Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1766-9935","authenticated-orcid":false,"given":"Tovah","family":"Yanover","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3108-5525","authenticated-orcid":false,"given":"Helena","family":"Katona","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3218-0168","authenticated-orcid":false,"given":"Jennifer","family":"Couturier","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"issue":"9","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1111\/dom.13361","article-title":"Semaglutide for Type 2 Diabetes Mellitus: A Systematic Review and Meta\u2010Analysis","volume":"20","author":"Andreadis P.","year":"2018","journal-title":"Diabetes, Obesity & Metabolism"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.3389\/fpsyg.2017.01356","article-title":"Pro\u2010Ana Versus Pro\u2010Recovery: A Content Analytic Comparison of Social Media Users' Communication About Eating Disorders on Twitter and Tumblr","volume":"8","author":"Branley D. B.","year":"2017","journal-title":"Frontiers in Psychology"},{"issue":"4","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s00431-015-2487-7","article-title":"The Urgent Matter of Online Pro\u2010Eating Disorder Content and Children: Clinical Practice","volume":"174","author":"Custers K.","year":"2015","journal-title":"European Journal of Pediatrics"},{"issue":"10","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"e27153","DOI":"10.2196\/27153","article-title":"Detrimental Effects of Online Pro\u2013Eating Disorder Communities on Weight Loss and Desired Weight: Longitudinal Observational Study","volume":"23","author":"Feldhege J.","year":"2021","journal-title":"Journal of Medical Internet Research"},{"key":"e_1_2_11_6_1","first-page":"8","article-title":"What Is Ethnographic About Digital Ethnography? A Sociological Perspective","volume":"2","author":"Forberg P.","year":"2023","journal-title":"Frontiers in Sociology"},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s40337-023-00827-7","article-title":"Visions of Recovery: A Cross\u2010Diagnostic Examination of Eating Disorder Pro\u2010Recovery Communities on Tiktok","volume":"11","author":"Greene A. K.","year":"2023","journal-title":"Journal of Eating Disorders"},{"key":"e_1_2_11_8_1","article-title":"To Ban or Not to Ban: How Do You Solve the Problem of Thinspo?","author":"Greenfield R.","year":"2012","journal-title":"Atlantic"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.bodyim.2016.02.008","article-title":"A Systematic Review of the Impact of the Use of Social Networking Sites on Body Image and Disordered Eating Outcomes","volume":"17","author":"Holland G.","year":"2016","journal-title":"Body Image"},{"issue":"9","key":"e_1_2_11_10_1","article-title":"FDA\u2010Approved Pharmacotherapy for Weight Loss Over the Last Decade","volume":"14","author":"Idrees Z.","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_11_11_1","volume-title":"Bulimia Nervosa","author":"Jain A.","year":"2022"},{"issue":"5","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1002\/erv.1009","article-title":"Impact of Exposure to Pro\u2010Eating Disorder Websites on Eating Behaviour in College Women","volume":"18","author":"Jett S.","year":"2010","journal-title":"European Eating Disorders Review"},{"key":"e_1_2_11_13_1","unstructured":"Lichfield J.2008.\u201cFrance Bans Websites Promoting Anorexia \u2018Cult\u2019.\u201dThe Independent Independent Digital News and Media.https:\/\/www.independent.co.uk\/news\/world\/europe\/france\u2010bans\u2010websites\u2010promoting\u2010anorexia\u2010cult\u2010809617.html."},{"issue":"3","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18031041","article-title":"The Paradox of Tik Tok Anti\u2010Pro\u2010Anorexia Videos: How Social Media Can Promote Non\u2010Suicidal Self\u2010Injury and Anorexia","volume":"18","author":"Logrieco G.","year":"2021","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"e_1_2_11_15_1","volume-title":"Binge Eating Disorder","author":"Mars J. A.","year":"2026"},{"issue":"2","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/acps.13527","article-title":"Gone Too Soon: Studying Mortality in Eating Disorders","volume":"147","author":"Micali N.","year":"2023","journal-title":"Acta Psychiatrica Scandinavica"},{"issue":"4","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1007\/s10447-022-09483-z","article-title":"Exploring the Experiences of People Who Engage With Pro\u2010Eating Disorder Online Media: A Qualitative Inquiry","volume":"44","author":"Mincey K. A.","year":"2022","journal-title":"International Journal for the Advancement of Counselling"},{"key":"e_1_2_11_18_1","volume-title":"Anorexia Nervosa","author":"Moore C.","year":"2022"},{"issue":"5","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.2196\/jmir.2023","article-title":"Disordered Eating in a Digital Age: Eating Behaviors, Health, and Quality of Life in Users of Websites With Pro\u2010Eating Disorder Content","volume":"14","author":"Peebles R.","year":"2012","journal-title":"Journal of Medical Internet Research"},{"issue":"4","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.cpr.2010.12.005","article-title":"Potential Risks of Pro\u2010Eating Disorder Websites","volume":"31","author":"Rouleau C. R.","year":"2011","journal-title":"Clinical Psychology Review"},{"issue":"4","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","DOI":"10.2196\/78025","article-title":"Utilization of Netnography as a Health Care Research Methodology: Scoping Review","volume":"27","author":"Sadat A.","year":"2025","journal-title":"Journal of Medical Internet Research"},{"issue":"4","key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1007\/s11013-020-09674-6","article-title":"Mukbang and Disordered Eating: A Netnographic Analysis of Online Eating Broadcasts","volume":"44","author":"Strand M.","year":"2020","journal-title":"Culture, Medicine and Psychiatry"},{"issue":"7","key":"e_1_2_11_23_1","doi-asserted-by":"crossref","DOI":"10.2196\/24340","article-title":"Examining the Pro\u2010Eating Disorders Community on Twitter via the HASHTAG #PROANA: Statistical Modeling Approach","volume":"8","author":"Sukunesan S.","year":"2021","journal-title":"JMIR Mental Health"},{"issue":"6","key":"e_1_2_11_24_1","first-page":"686","article-title":"The Effects of Viewing Pro\u2010Eating Disorder Websites: A Systematic Review","volume":"59","author":"Talbot T. S.","year":"2010","journal-title":"West Indian Medical Journal"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/eat.70190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.70190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:06:40Z","timestamp":1786939600000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.70190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,16]]},"references-count":23,"alternative-id":["10.1002\/eat.70190"],"URL":"https:\/\/doi.org\/10.1002\/eat.70190","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"value":"0276-3478","type":"print"},{"value":"1098-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,16]]},"assertion":[{"value":"2026-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"eat.70190"}}