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Objective: This study was undertaken to explore the experiences and concerns of people living with epilepsy by analyzing discussions in an online epilepsy community, using large language models (LLMs) to identify themes, demographic patterns, and associations with emotional distress, substance use, and suicidal ideation., Methods: We analyzed 56 970 posts and responses to them from 21 906 users on the epilepsy forum (subreddit) of Reddit and 768 504 posts from the same users in other subreddits, between 2010 and 2023. LLMs, validated against human labeling, were used to identify 23 recurring themes, assess demographic differences, and examine cross-posting to depression- and suicide-related subreddits. Hazard ratios (HRs) were calculated to assess the association between specific themes and activity in mental health forums., Results: Prominent topics included seizure descriptions, medication management, stigma, drug and alcohol use, and emotional well-being. The posts on topics less likely to be discussed in clinical settings had the highest engagement. Younger users focused on stigma and emotional issues, whereas older users discussed medical treatments. Posts about emotional distress (HR = 1.3), postictal state (HR = 1.4), surgical treatment (HR = .7), and work challenges (HR = 1.6) predicted activity in a subreddit associated with suicidal ideation, whereas emotional distress (HR = 1.5), surgical treatment (HR = .6), and stigma (HR = 1.3) predicted activity in the depression subreddit. Substance use discussions showed a temporal pattern of association with seizure descriptions, implying possible opportunities for intervention., Significance: LLM analysis of online epilepsy communities provides novel insights into patient concerns often overlooked in clinical settings. These findings may improve patient-provider communication, inform personalized interventions, and support the development of patient-reported outcome measures. Additionally, hazard models can help identify at-risk individuals, offering opportunities for early mental health interventions., (© 2024 The Author(s). Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Background: Bariatric surgery is an emerging effective treatment option for adolescents suffering from morbid obesity. However, the surgery is often in high demand with long waiting periods. No prior research regarding the significance of waiting periods for bariatric surgery in adolescents was found. Our study aimed to evaluate changes in weight trends in adolescent candidates for bariatric surgery during the waiting period between acceptance and admission to the bariatric process (pre-surgical preparation, surgery, and follow-up)., Methods: Fifty-one adolescent bariatric surgery candidates were accepted and subsequently admitted to the bariatric process. BMI data was retrieved from medical files and direct measurements, and BMI-change trends during the waiting period were compared with naturalistic trends (i.e., prior to the first evaluation for bariatric surgery)., Results: Naturalistic BMI-trends showed an average gain of 0.3 BMI points per-month. After acceptance to the bariatric process and during the waiting period, this figure dropped, and candidates for surgery lost an average of 0.06 BMI points per-month. Waiting periods lasted an average of 5.2 months. Shorter waiting periods were associated with better weight reduction and maintenance., Conclusions: A significant reduction in weight-gaining trends occurred during the waiting period for bariatric surgery in adolescents, which may reflect motivational and lifestyle changes due to expectancy for surgery. Decision makers may aim for short waiting periods in order to capitalize on this effect. Further research needs to be conducted in order to clarify the effects of waiting periods for bariatric surgery in adolescents.

Introduction: Adolescent obesity is markedly increasing worldwide and bariatric surgery is emerging as an effective treatment option. However, a subset of patients fails to achieve significant weight loss or show post-surgical weight regain. Efforts have been made to identify different post-surgical weight trajectories and their possible predictors. Furthermore, the role of pre-surgical intervention programs in optimizing post-surgical results has been a subject of debate., Objectives: This study aimed to evaluate the impact of a 3-month lifestyle-oriented pre-surgical program for adolescent candidates for bariatric surgery on pre-surgical weight loss (body mass index (BMI) on completion - BMI at admission), and to identify predictors of different post-surgical weight loss trajectories., Methods: Forty-eight adolescent bariatric surgery candidates were enrolled in a lifestyle- and behavior-oriented bariatric program consisting of a 3-month pre-surgical outpatient intervention and a 6-month post-surgical follow-up., Results: Mean BMI decreased by 1.82 points (SD = 1.83) during the program's pre-surgical intervention phase, a 3.8% average drop in participants' BMI; post-surgical weight loss trajectories were significantly associated in a curvilinear model with pre-surgical weight loss; optimal post-surgical results were associated with moderate pre-surgical weight loss, and inversely associated with maternal history of obesity, early-life weight loss attempts, and comorbid learning disorders., Conclusions: Moderate weight loss in a pre-surgical lifestyle-oriented intervention program predicts optimal post-surgical weight loss. Additionally, by assessing risk factors and pre-surgical weight loss patterns, it may be possible to identify sub-populations of adolescents undergoing bariatric surgery at risk of achieving sub-optimal long-term results.