Skip to Main content Skip to Navigation
Journal articles

A Twitter discourse analysis of negative feelings and stigma related to NAFLD, NASH and obesity

Abstract : Background: People with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are stigmatized, partly since 'non-alcoholic' is in the name, but also because of obesity, which is a common condition in this group. Stigma is pervasive in social media and can contribute to poorer health outcomes. We examine how stigma and negative feelings concerning NAFLD/NASH and obesity manifest on Twitter. Methods: Using a self-developed search terms index, we collected NAFLD/NASH tweets from May to October 2019 (Phase I). Because stigmatizing NAFLD/NASH tweets were limited, Phase II focused on obesity (November-December 2019). Via sentiment analysis, >5000 tweets were annotated as positive, neutral or negative and used to train machine learning-based Natural Language Processing software, applied to 193 747 randomly sampled tweets. All tweets collected were analysed. Results: In Phase I, 16 835 tweets for NAFLD and 2376 for NASH were retrieved. Of the annotated NAFLD/NASH tweets, 97/1130 (8.6%) and 63/535 (11.8%), respectively, related to obesity and 13/1130 (1.2%) and 5/535 (0.9%), to stigma; they primarily focused on scientific discourse and unverified information. Of the 193 747 non-annotated obesity tweets (Phase II), the algorithm classified 40.0% as related to obesity, of which 85.2% were negative, 1.0% positive and 13.7% neutral. Conclusions: NAFLD/NASH tweets mostly indicated an unmet information need and showed no clear signs of stigma. However, the negative content of obesity tweets was recurrent. As obesity-related stigma is associated with reduced care engagement and lifestyle modification, the main NAFLD/NASH treatment, stigma-reducing interventions in social media should be included in the liver health agenda.
Document type :
Journal articles
Complete list of metadata
Contributor : Odile Malbec Connect in order to contact the contributor
Submitted on : Tuesday, September 7, 2021 - 4:17:23 PM
Last modification on : Thursday, April 21, 2022 - 12:00:01 PM
Long-term archiving on: : Wednesday, December 8, 2021 - 8:02:57 PM


 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document




Jeffrey V Lazarus, Christine Kakalou, Adam Palayew, Christina Karamanidou, Christos Maramis, et al.. A Twitter discourse analysis of negative feelings and stigma related to NAFLD, NASH and obesity. Liver International, Wiley-Blackwell, 2021, Online ahead of print. ⟨10.1111/liv.14969⟩. ⟨inserm-03337151⟩



Record views