Association Between Eating Behaviors (TFEQ-R18) and Obesity Severity in Pre-Bariatric Surgery Candidates: A...

This study aimed to investigate the relationship between eating habits, assessed using the Three-Factor Eating Questionnaire Revised 18 (TFEQ-r18), degree of obesity, and impact of these factors on morbid obesity in individuals requiring bariatric surgery.

A total of 55 adult patients, who presented to our clinic between 2020 and 2024 dates and were scheduled for obesity surgery, were included in the study, and their demographic and physical data were recorded.

They were administered the TFEQ-r18 questionnaire, which consists of 18 questions: six assessing Cognitive Restraint (CT), nine on Uncontrolled Eating (UE), and three on Emotional Eating (EE). The mean age was 34.0 ± 11.1 years; 11 (21.8%) were male. The mean weight was 113.9 ± 20.7 kg, and the body mass index (BMI) was 42.1 ± 6.9 kg/m². The mean score was 14.9 ± 3.4 (49.4%), the CR score was 21.1 ± 6.8 (44.8%), the UE score was 7.4 ± 3.0 (48.9%), and the EE score was 43.4 ± 8.8 (47.0%). Only the item "When I smell a delicious meal…" was associated with higher BMI (P = 0.046); other response groups showed similar BMI values (all P ≥ 0.050). Class III obesity rates did not differ across responses (p ≥ 0.050), and no significant differences were observed in total or subscale TFEQ-R18 scores across obesity classes (p ≥ 0.050). Likewise, no significant correlations were found between total/subscale or item scores and BMI (p ≥ 0.050).

In this pre-bariatric cohort, TFEQ-R18 subscales (cognitive restraint, uncontrolled eating, emotional eating) were not associated with BMI or obesity class, suggesting that trait-level eating scores alone may be insufficient for appraising obesity severity. Findings are limited by unadjusted analyses and the cross-sectional design; future covariate-adjusted and longitudinal studies are warranted.