Pre-operative concerns and post-operative satisfaction: comparing attitudes toward bariatric surgery and medication intervention for weight loss on Reddit.

BACKGROUND

Patient perceptions influence the success of bariatric surgery and pharmacologic weight loss therapies, yet many concerns never reach providers during clinic visits. Reddit, a popular online community, offers a window to explore these concerns outside clinical settings. We leveraged natural language processing (NLP) to compare user-submitted content across communities in surgical and non-surgical weight loss communities on Reddit.

METHODS

We extracted the top 500 posts and all comments from three Reddit communities: /r/GastricBypass (/r/GB), /r/GastricSleeve (/r/GS), and /r/Ozempic. NLP libraries were used to quantify sentiment and subjectivity. Latent Dirichlet Allocation (LDA) was used to perform topic modeling and identify themes. Significance was obtained with Kruskal-Wallis and chi-square (χ2) tests. A machine learning classifier categorized posts as pre- or post-intervention.

RESULTS

1500 posts and 45,972 comments were analyzed. Sentiment was largely neutral/positive (0.26 ± 0.35) and moderately subjective (0.48 ± 0.33). Comment sentiment was most positive in /r/GS and least in /r/GB (0.30 ± 0.33 vs 0.20 ± 0.31, respectively, P < 0.001). Post sentiment did not vary (P = 0.246). Five main themes emerged: eating behaviors/diet, weight loss progress, medication/medical issues, adverse effects, and support. Pain was the biggest adverse effect among surgical subreddits (24.3% within /r/GB and 16.8% /r/GS) compared to gastrointestinal (20.8%) and psychological (7.7%) symptoms in /r/Ozempic (P < 0.001). Most content was post-intervention (85.0%), and pre-intervention posts showed higher levels of anxiety and depression (4.0% vs 0.9%, P = 0.049).

CONCLUSIONS

Our findings reveal distinct patient concerns across weight loss intervention. NLP surveillance of online communities can help clinicians identify latent concerns, tailor counseling, and manage expectations.