Quality, Reliability, and Content Characteristics of Metabolic Bariatric Surgery Videos on TikTok, YouTube, and Facebook: A Mixed-Methods Cross-Platform Analysis

INTRODUCTION: Social media platforms have become major sources of health information, including content related to metabolic bariatric surgery (MBS). While these platforms offer wide accessibility and high user engagement, concerns remain regarding the quality, reliability, and completeness of the information presented. Comparative evaluations across platforms integrating both quantitative quality assessment and qualitative insights are limited. METHODS: A cross-sectional mixed-methods content analysis was conducted on 45 publicly available videos (15 per platform) from TikTok, YouTube, and Facebook, identified using standardized search terms. Data extraction included video metadata, engagement metrics, uploader characteristics, and content features. Video quality and reliability were assessed using the Video Information and Quality Index (VIQI), Global Quality Score (GQS), and DISCERN instrument. Inter-rater reliability was evaluated using intraclass correlation coefficients. Additionally, thematic analysis of rater comments was performed to explore qualitative content patterns. RESULTS: Significant differences were observed across platforms in video duration, content characteristics, and engagement (p < 0.001). TikTok videos were shortest and demonstrated the highest median views and engagement rates, while YouTube videos were longest and Facebook videos showed moderate duration and engagement. Quality assessment revealed significantly lower VIQI, GQS, and DISCERN scores for YouTube compared with TikTok and Facebook (p < 0.001), with no significant difference between TikTok and Facebook. High-quality content (GQS ≥ 4) was absent on YouTube but present in 60-66.7% of TikTok and Facebook videos. Inter-rater reliability was good to excellent across all tools (ICC range: 0.81-0.88). Qualitative analysis demonstrated recurring themes of incomplete clinical information, limited discussion of risks, and a predominance of positively framed narratives, especially in short-form content. CONCLUSION: MBS-related content on social media varies significantly across platforms in terms of quality, reliability, and engagement. While TikTok and Facebook demonstrated higher overall quality scores than YouTube, all platforms exhibited important deficiencies in critical patient-centered information. High engagement does not equate to high informational quality. These findings highlight the need for improved content regulation, increased involvement of healthcare professionals, and development of standardized guidelines to enhance the educational value of bariatric surgery information on social media.