Association Between Food Addiction Symptoms, Clinical and Nutritional Factors, Mental Health, Sleep, and Physical Activity in Candidates for Bariatric Surgery

Abstract Food addiction (FA) has been associated with obesity and unfavorable outcomes in the context of bariatric surgery (BS), particularly during the preoperative period. Emotional factors, sleep quality, and physical activity (PA) may influence this behavior; however, these variables have rarely been investigated in an integrated manner. Objective: To investigate the association between FA, symptoms of anxiety, depression, stress, sleep quality, physical activity, and clinical and nutritional factors in candidates for bariatric surgery. Methods: This cross-sectional correlational study included 125 candidates for bariatric surgery treated at a referral hospital in the state of Pará, Brazil. The Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), Depression, Anxiety and Stress Scale-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and sociodemographic, clinical, anthropometric, and physical activity questionnaires were administered. Results: The prevalence of FA was 34.4% and was associated with higher levels of depression (p < 0.001), anxiety (p = 0.002), and stress (p = 0.001). Physical activity was negatively associated with severe FA (p = 0.046). A high prevalence of poor sleep quality was observed, which was associated with worse emotional outcomes but not directly associated with FA. Conclusion: Food addiction is common in the preoperative period of bariatric surgery and is associated with emotional factors.