Clinical Evaluation of the Turkish Version of the Eating Behavior after Bariatric Surgery (EBBS) Scale and its Association with Postoperative Weight Outcomes

Long-term weight loss after metabolic bariatric surgery largely depends on patients’ adherence to postoperative dietary and lifestyle recommendations, yet tools to clinically assess such adherence across different cultures remain limited. The Eating Behavior after Bariatric Surgery scale is a contemporary measurement tool developed to assess postoperative behavioral patterns, including nutrition-related behaviors, self-monitoring, and physical activity. This study aimed to translate this scale into Turkish and to explore its clinical relevance by examining associations with postoperative weight-related outcomes. This cross-sectional study included 298 patients who had undergone metabolic bariatric surgery. Sociodemographic and surgical characteristics, pre- and postoperative weight measures, and subscale scores were collected. The translation and cultural adaptation of the scale involved forward–back translation and expert review, without formal psychometric validation. Relationships between the subscale scores and weight-related outcomes were examined using correlation analyses and multiple linear regression to evaluate clinical relevance. Mean total weight loss was 33.5 ± 16.2 kg. The subscale scores indicated highest adherence for drink consumption (5.3 ± 0.9) and lowest for general behaviors (3.3 ± 1.4). Correlation analyses showed significant associations between the subscales and weight-related outcomes. In regression analysis, preoperative weight and time since surgery positively predicted postoperative total weight loss percentage, whereas food consumption adherence was negatively associated with postoperative total weight loss percentage (R²=0.245; p < 0.01). In this study, higher adherence scores in the food consumption domain were unexpectedly associated with lower postoperative total weight loss, highlighting the complex relationship between self-reported eating behaviors and weight outcomes. These findings suggest that the Turkish version of the scale may provide clinically informative insights into postoperative eating behaviors, while highlighting the complex relationship between self-reported adherence and weight outcomes. The Turkish version of the EBBS enables a structured clinical assessment of postoperative eating and lifestyle behaviors in patients who have undergone metabolic bariatric surgery. EBBS domain scores demonstrated domain-specific associations with postoperative weight-related outcomes, supporting their clinical relevance rather than formal psychometric validity. Higher self-reported adherence in the food consumption domain was unexpectedly associated with lower postoperative total weight loss, underscoring the complex and non-linear relationship between self-reported eating behaviors and weight outcomes after surgery.