Food Addiction 5 and 10 Years Following Metabolic and Bariatric Surgery: a Prospective Observational Study

Obes Surg. 2025 May;35(5):1649-1656. doi: 10.1007/s11695-025-07803-x. Epub 2025 Apr 15.

Abstract

Background: Food addiction (FA) is prevalent among individuals undergoing metabolic and bariatric surgery (MBS), but few studies have investigated the prevalence and correlates of post-surgical FA over longer periods. We report an observational, longitudinal study investigating prevalence of post-surgical FA at 5 and 10 years following MBS.

Methods: Participants in the Oslo Bariatric Surgery Study (OBSS) completed the modified Yale Food Addiction Scale 2.0 (mYFAS) and measures of psychological functioning and weight outcomes (% total weight loss: %TWL and % weight recurrence: %WR) at 5 and 10 years follow-up.

Results: N = 173 of 224 (23% lost-to-follow-up) participants (73% women, 93.6% Roux-en-Y gastric bypass) completed the mYFAS 2.0 at 5 years and 10 years following MBS. The prevalence of FA was 12.9% at 5 years and 8.4% at 10 years after MBS. A higher number of FA symptoms at 5 years significantly predicted less %TWL and lower psychological functioning at 10 years. At 10 years, the majority of individuals with FA had moderate or severe symptoms and 3% were new-onset cases of FA. Higher FA at 10 years was concurrently associated with less %TWL, greater %WR, and lower psychological functioning at the 10-year follow-up (p's < 0.001).

Conclusions: The prevalence of FA decreased from 12.9 to 8.4% between 5 and 10 years following MBS. We observed prospective and concurrent associations between FA symptoms and poorer weight loss and mental health outcomes. The presence of post-operative FA may be an important target for continued assessment and follow-up care to improve longer-term outcomes.

Keywords: Food addiction; Metabolic and bariatric surgery; Obesity; Obesity treatment; YFAS.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Bariatric Surgery* / psychology
  • Female
  • Follow-Up Studies
  • Food Addiction* / epidemiology
  • Food Addiction* / etiology
  • Food Addiction* / psychology
  • Gastric Bypass
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Obesity, Morbid* / epidemiology
  • Obesity, Morbid* / psychology
  • Obesity, Morbid* / surgery
  • Prevalence
  • Prospective Studies
  • Weight Loss