Severe Obesity, Psychopathologies, and Gut Microbiota: Insights into Bariatric Surgery Outcomes

Severe Obesity, Psychopathologies, and Gut Microbiota: Insights into Bariatric Surgery Outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Severe Obesity, Psychopathologies, and Gut Microbiota: Insights into Bariatric Surgery Outcomes Rohia ALILI, Patino-Navarrete Rafael, Claire Germain, Eugeni BELDA, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6904293/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background: Severe obesity is associated with alterations in gut microbiota (GM), yet the influence of co-occurring psychological factors on GM composition and weight-loss outcomes following bariatric surgery (BS) remains insufficiently understood. Objective: This study aimed to determine whether psychological variables—including adverse childhood experiences (ACEs), depression, and binge eating—are associated with baseline GM profiles and whether they collectively contribute to variability in postoperative weight-loss outcomes. Methods: We prospectively included 132 individuals with severe obesity (mean age=48.3±0.1 years, mean BMI=44.3±0.02 kg/m²), who underwent BS and had a follow-up of at least one-year post-BS. GM profiles were analyzed using nanopore sequencing technology. Baseline clinical and psychopathological phenotypes, including depression, eating disorders, and past traumatic history, were collected as well as weight-loss trajectories using K-means clustering. Results: ACEs, but not depression or binge eating, were significantly associated with reduced microbial richness (p=0.017), with a dose-response relationship observed based on the number of reported ACEs. Nineteen species-level genome bins (SGBs), including several Bifidobacterium spp., were depleted in patients with ACEs. Depression and eating disorders were not associated with distinct GM metagenomic signatures, yet no differences in GM richness. While, weight-loss outcomes were not influenced by psychological factors, distinct GM signatures were associated with different weight-loss trajectories. Conclusion: ACEs are associated with GM alterations in individuals with severe obesity but do not adversely affect weight-loss outcomes following BS. Rather, specific preoperative GM compositions, independent of psychological status, may potentially serve as predictive biomarkers for both short- and mid-term surgical success. These findings highlight the potential of integrating microbiome profiling into preoperative assessments to guide future personalized therapeutic strategies. Health sciences/Diseases/Nutrition disorders/Obesity Biological sciences/Microbiology/Bacteria Full Text Additional Declarations There is NO conflict of interest to disclose Table 1 and 2 are available in the Supplementary Files section. Supplementary Files Table1.docx Table 1 Table2.docx Table 2 SupplementalTable1.docx Table 1 SupplementaryMaterialsandMethodsandsupplementaltable2.pdf Supplementary Materials and Methods and supplemental table 2 Cite Share Download PDF Status: Under Review Version 1 posted Reviewer # 2 agreed at journal 23 Sep, 2025 Review # 1 received at journal 30 Jul, 2025 Reviewer # 1 agreed at journal 15 Jul, 2025 Reviewers invited by journal 15 Jul, 2025 Submission checks completed at journal 18 Jun, 2025 First submitted to journal 17 Jun, 2025 Unknown event 17 Jun, 2025 Editor assigned by journal 16 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6904293","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":485904306,"identity":"ddab20e0-b07e-44ef-8741-f6c4ae363d8a","order_by":0,"name":"Rohia 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Outcomes","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-obesity","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijo","sideBox":"Learn more about [International Journal of Obesity](http://www.nature.com/ijo/)","snPcode":"41366","submissionUrl":"https://mts-ijo.nature.com/cgi-bin/main.plex","title":"International Journal of Obesity","twitterHandle":"@intjobesity","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6904293/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6904293/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Severe obesity is associated with alterations in gut microbiota (GM), yet the influence of co-occurring psychological factors on GM composition and weight-loss outcomes following bariatric surgery (BS) remains insufficiently understood.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eObjective: This study aimed to determine whether psychological variables—including adverse childhood experiences (ACEs), depression, and binge eating—are associated with baseline GM profiles and whether they collectively contribute to variability in postoperative weight-loss outcomes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods: We prospectively included 132 individuals with severe obesity (mean age=48.3±0.1 years, mean BMI=44.3±0.02 kg/m²), who underwent BS and had a follow-up of at least one-year post-BS. GM profiles were analyzed using nanopore sequencing technology. Baseline clinical and psychopathological phenotypes, including depression, eating disorders, and past traumatic history, were collected as well as weight-loss trajectories using K-means clustering.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults: ACEs, but not depression or binge eating, were significantly associated with reduced microbial richness (p=0.017), with a dose-response relationship observed based on the number of reported ACEs. Nineteen species-level genome bins (SGBs), including several Bifidobacterium spp., were depleted in patients with ACEs. Depression and eating disorders were not associated with distinct GM metagenomic signatures, yet no differences in GM richness. While, weight-loss outcomes were not influenced by psychological factors, distinct GM signatures were associated with different weight-loss trajectories.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusion: ACEs are associated with GM alterations in individuals with severe obesity but do not adversely affect weight-loss outcomes following BS. Rather, specific preoperative GM compositions, independent of psychological status, may potentially serve as predictive biomarkers for both short- and mid-term surgical success. These findings highlight the potential of integrating microbiome profiling into preoperative assessments to guide future personalized therapeutic strategies.\u003c/p\u003e","manuscriptTitle":"Severe Obesity, Psychopathologies, and Gut Microbiota: Insights into Bariatric Surgery Outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-18 09:22:32","doi":"10.21203/rs.3.rs-6904293/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"This content is not available.","date":"2025-09-23T11:40:44+00:00","index":2,"fulltext":"This content is not available."},{"type":"editorInvitedReview","content":"This content is not available.","date":"2025-07-30T21:55:10+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2025-07-15T18:30:23+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2025-07-15T17:02:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-18T09:09:43+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Obesity","date":"2025-06-17T14:15:17+00:00","index":"","fulltext":""},{"type":"checksFailed","content":"","date":"2025-06-17T12:10:16+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-16T09:56:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-obesity","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ijo","sideBox":"Learn more about [International Journal of Obesity](http://www.nature.com/ijo/)","snPcode":"41366","submissionUrl":"https://mts-ijo.nature.com/cgi-bin/main.plex","title":"International Journal of Obesity","twitterHandle":"@intjobesity","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"ded6c645-5121-4459-a3f3-c569fba578c5","owner":[],"postedDate":"July 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":51584345,"name":"Health sciences/Diseases/Nutrition disorders/Obesity"},{"id":51584346,"name":"Biological sciences/Microbiology/Bacteria"}],"tags":[],"updatedAt":"2025-07-18T09:22:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-18 09:22:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6904293","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6904293","identity":"rs-6904293","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}