Abstract / Summary
Abstract Purpose: To examine pre- and postoperative psychosocial and behavioral factors associated with long-term outcomes following metabolic and bariatric surgery (MBS). Patients and methods: In a prospective cohort of 120 individuals who underwent MBS, preoperative psychosocial and behavioral variables were collected. Five-year outcomes were obtained via self‑report questionnaire including weight measures (%TWL, %EWL, BMI), BAROS QoL indices, eating behavior, physical activity, and alcohol consumption.
Results: The cohort comprised 120 patients (94 women, 26 men); mean age 37.4 years; mean preoperative BMI 41.0 kg/m². Procedures performed were RYGB (n = 106) and SG (n = 14). At five years mean %EWL was 80.3±26.4. Preoperative binge-eating disorder (BED) showed a tendency of association with lower %EWL. Postoperative binge‑eating behavior (BEB) was strongly associated with lower weight loss and QoL, and higher prevalence of snacking behavior. Alcohol consumption increased from baseline to follow‑up but was not associated with weight‑loss or QoL outcomes.
Conclusion: Preoperative BED was not predictive of weight reduction or QoL, while postoperative BEB was a robust marker of worse weight‑loss and QoL. Results suggest limitations in current categorical diagnostic criteria for BED in identifying underlying predictive eating behaviors, probably indicating a need for better dimensional assessment allowing earlier targeted interventions.