Comparative analysis of bias and quality in YouTube videos on bariatric surgery and weight-loss medications

Background: Weight-loss surgery (WLS) remains the most effective treatment for clinically severe obesity, while weight-loss medications (WLM), particularly GLP-1 agonists, have recently gained widespread public attention. With YouTube serving as a major source of health information, the quality and tone of videos discussing these interventions warrant evaluation. This study compares the source, content quality, and perceived tone of YouTube videos related to WLS and WLM. Methods: Using an incognito browser, the first 200 “most relevant” YouTube videos for the search terms “weight loss surgery” and “weight loss medicine” were screened in October 2023. Eligible videos were categorized by source and content type. Video quality was assessed using the DISCERN instrument, and tone was classified as positive, neutral, or negative. Two independent reviewers scored all videos, with a third reviewer resolving disagreements. Descriptive statistics and nonparametric tests were used for comparisons, with statistical significance set at p < 0.05. Results: A total of 129 WLS and 111 WLM videos were analyzed. WLM videos demonstrated significantly higher view ratios (p < 0.0001) and more comments (p = 0.0014). WLM videos were predominantly commercial (76%) and informational (97%). Mean DISCERN scores were higher for WLM videos (46.69 ± 8.75; fair) compared with WLS videos (40.32 ± 8.70; poor; p = 0.0366). In contrast, WLS videos more frequently originated from academic centers (50%) and included patient experience content (49%). Tone differed significantly between groups (p < 0.01): 60% of WLS videos were positive, whereas WLM videos exhibited fewer positive (44%) and more negative tones (14%). Conclusions: WLM videos were of higher informational quality but conveyed a less positive overall tone, whereas WLS videos presented more positively but were of lower quality. These findings highlight substantial variation in publicly accessible YouTube content on weight-loss interventions and underscore the need for improved, high-quality patient education materials.