Cross-Sectional Analysis of Food Addiction and Body Image Dissatisfaction in Bariatric Candidates

Dr Lakshmi Nagendra, Associate Professor, Department of Endocrinology, JSS Medical College, Mysore

“Recent findings from a cross-sectional study emphasized that obesity management in bariatric surgery candidates should extend beyond surgical intervention to include integrated psychological and behavioral care, which is essential for addressing addictive eating patterns and supporting sustained, long-term weight loss.”

Compulsive intake of highly palatable foods, driven by reward mechanisms, is commonly observed in individuals with severe obesity and may contribute to maladaptive eating patterns. Among bariatric surgery candidates with obesity, food addiction symptoms can affect body image, mental well-being, and long-term weight outcomes. This cross-sectional study assessed the relationship between food addiction and body image dissatisfaction in adults with obesity preparing for bariatric surgery.

The study, published in J Eat Disord, was conducted at the Multidisciplinary Outpatient Clinic for Surgical Obesity at the Hospital de Clínicas, Federal University of Paraná, Brazil.  The Modified Yale Food Addiction Scale 2.0 was used to assess the food addiction symptoms, while the Body Shape Questionnaire was used to evaluate the  body image dissatisfaction level. Obesity severity was quantified using body mass index calculated from measured height and weight. Statistical analyses included chi-square or Fisher’s exact tests for categorical variables, Mann–Whitney tests for continuous variables, and binary logistic regression to examine the association between food addiction and body dissatisfaction after adjusting for age, sex, body mass index, and race or ethnicity.

The analysis included 124 participants with severe obesity. Most participants were female (80%), with a mean age of 40 years and a mean body mass index of 46 kg/m², reflecting severe obesity. Body dissatisfaction was observed in 69% of participants, while 21% showed symptoms of food addiction. Individuals with moderate to severe body dissatisfaction had significantly higher odds of food addiction symptoms compared with those reporting no or low dissatisfaction.

These findings suggest that psychological factors linked to obesity, including body dissatisfaction and addictive eating behaviors, should be addressed alongside surgical treatment to support improved long-term outcomes.

(Source: Maia CHBJ, Ferreira GM, da Silveira Campos RM, et al. Association between food addiction and body image dissatisfaction in bariatric surgery candidates: a cross-sectional study. J Eat Disord. 2025;13:254. doi:10.1186/s40337-025-01431-7.; https://pmc.ncbi.nlm.nih.gov/articles/PMC12595855/pdf/40337_2025_Article_1431.pdf)