In this chapter update I look to explore not only how communities that are traditionally considered ‘fringe’ in mainstream society continue to exist in online spaces but that these groups are thriving. These groups continue to grow and influence with many now choosing not to hide their status but actively look to attract attention and gain further support. Some of these groups can be truly altruistic, as we see with mental well-being groups looking to normalize mental well illness; however, others are actively leading to ill-health, such as online groups that promote anti-vaccination or alt-right conspiracy theorists. I present some additional cases in the current chapter and how each case draws on elements of sharing, personal validation from group leaders, and community-driven validation to help understand how online groups continue to grow and attract new members. Future research should explore the proliferation of online groups from fringe and alternative to mainstream and influential, especially where a significant health impact on society could be seen as a result of their influence.