Individuals With Food Addiction After Metabolic And Bariatric Surgery Show Higher Consumption of Ultra-Processed Foods, Sedentary Lifestyle, Anxiety, and Sub-Optimal Body Weight Trajectories

INTRODUCTION: Food addiction (FA) may impact weight-loss maintenance and metabolic outcomes after metabolic and bariatric surgery (MBS). This study assessed the clinical, dietary, behavioral, and anthropometric profiles of women in the postoperative period of MBS, according to the presence of FA. METHODS: A cross-sectional study of women ≥ 18 months post-MBS, with data collected via an online questionnaire. FA was assessed using the modified Yale Food Addiction Scale 2.0. Dietary intake was evaluated by the NOVA-UPF score and by dietary markers from the Brazilian Food and Nutrition Surveillance System. Anxiety was measured using the Generalized Anxiety Disorder 7 questionnaire. Multivariable models adjusted for confounders were used to test associations. RESULTS: 631 women were included, with a prevalence of FA of 19.7%. Women with FA exhibited higher anxiety frequency (69.4% vs. 32.5%, p < 0.001), lower engagement in physical activity (38.7% vs. 59.4%, p < 0.001), and higher consumption of ultra-processed foods (4.37 vs. 3.26, p < 0.001). The FA group had a lower percentage of total weight loss (TWL: 26.96% vs. 34.25%, p < 0.001) and a higher current BMI (31.75 kg/m² vs. 27.96 kg/m², p < 0.001). CONCLUSION: FA was associated with higher current BMI, lower %TWL, higher anxiety symptoms, higher consumption of UPF, and lower engagement in physical activity in women after MBS. These findings reflect associations rather than causal relationships and underscore the importance of continuous screening and multidisciplinary follow-up for women after surgery.