In Web We Trust: The Promised Cannabidiol Effects on Obesity as a Matter of Language and Marketing on Webpages.

Background: Today more and more people search the web for health-related information, risking to come across misinformation and biased content that may affect their treatment decisions. Cannabidiol (CBD) is among the products for which beneficial effects have been claimed, often at the expense of the risks; further keeping in mind unreliable information reported on products themselves.

Objective: This study evaluated the quality of information retrieved by Google on the potential effects of CBD on weight management, also comparing Italian and English contents, hypothesizing generally low quality and language-driven differences in offered information.

Methods: Queries regarding cannabidiol and obesity-related terms were entered into Google, ranking the first 50 webpages from both merged Italian and English results for analysis.

Results: Of the outputs, 37 Italian and 27 English websites addressed the topic and were not related to medical literature. As expected, a substantial proportion of information was of low quality, with English sites performing better (29.6%) than Italian ones (54%, p = 0.052) in terms of "JAMA benchmarks" for trustworthiness of information. Also, while most English sites were "Health portals" (40.7%) with neutral stance toward CBD (74.1%), Italian ones were predominantly "commercial" (78.4%, p = 0.001) and promoting CBD use (89.2%, p < 0.001).

Conclusion: Findings suggest the need for better online information, especially in non-Englishspeaking countries, as scarce and unequal information can lead people to make poor health choices, with potentially harmful consequences.