The Effect of Nurse Coaching on Eating Behavior, Weight Loss, and Quality of Life After Bariatric Surgery: A Quasi-Experimental Study

The Effect of Nurse Coaching on Eating Behavior, Weight Loss, and Quality of Life After Bariatric Surgery: A Quasi-Experimental Study | 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 Research Article The Effect of Nurse Coaching on Eating Behavior, Weight Loss, and Quality of Life After Bariatric Surgery: A Quasi-Experimental Study Kübra Yasak, Fatma Vural This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6900396/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Bariatric surgery leads to significant weight loss, but behavioral adherence remains crucial for long-term outcomes. Nurse coaching based on motivational interviewing may improve post-surgical lifestyle adaptation. Objectives To examine the effect of motivational interviewing-based nurse coaching on eating behavior, weight loss, and quality of life in patients after bariatric surgery. Methods This quasi-experimental study involved 32 patients who received biweekly nurse coaching sessions over six months. Data collection tools included the Obesity Surgery Quality of Life (OSQOL) scale and the Three-Factor Eating Questionnaire (TFEQ). Pre- and post-intervention scores were compared using paired t-tests, Pearson correlation, and linear regression analysis via SPSS v28. Results The average participant age was 44.87 ± 7.21 years; 87.5% were female. Statistically significant weight loss was observed post-intervention (p < 0.05). The psychosocial subdomain of OSQOL and all three TFEQ subscales (Cognitive Restraint, Emotional Eating, Uncontrolled Eating) showed significant improvements (p < 0.05). No correlation was observed between total weight loss and OSQOL/TFEQ total scores. Conclusions Nurse coaching significantly enhanced psychosocial well-being and eating behavior regulation in post-bariatric patients, supporting its integration into routine postoperative care. Bariatric Surgery Motivational İnterviewing Nurse Coaching Quality Of Life Eating Behavior Key Points Motivational interviewing enhances psychosocial recovery post-bariatric surgery. Nurse coaching positively influences eating behavior regulation. Behavioral support is crucial for long-term bariatric success. No direct correlation between weight loss and quality of life scores. Introduction Obesity is a chronic, multifactorial disease that adversely impacts physical, psychological, and social health [ 1 ]. As of 2016, more than 650 million adults worldwide were classified as obese, with increasing prevalence globally [ 1 ]. In Türkiye, obesity affects approximately 35% of the adult population [ 2 ]. Bariatric surgery has proven to be an effective intervention for morbid obesity, especially when non-surgical approaches such as diet, exercise, and medications are insufficient [ 3 ]. It results in substantial and sustained weight loss and improves conditions like type 2 diabetes and hypertension [ 4 ]. However, long-term success requires not only surgical outcomes but also behavioral adaptation [ 5 ]. Postoperative patients often struggle with challenges such as emotional eating and reduced quality of life [ 6 ]. Without behavioral support, the risk of weight regain increases [ 3 ]. Motivational interviewing (MI), a client-centered counseling approach, can improve intrinsic motivation for change [ 7 ]. When used in nurse coaching, MI supports patients in managing eating behavior and lifestyle habits [ 8 ]. However, its use remains limited in bariatric follow-up in Türkiye [ 9 ]. This study examines the effects of nurse coaching with MI on eating behavior, weight loss, and quality of life after bariatric surgery. Materials and Methods This quasi-experimental single-group pretest-posttest study included 32 individuals who had undergone bariatric surgery at least one year prior. Participants were recruited from a university hospital’s obesity clinic in Türkiye between January and June 2023. Eligible individuals were aged ≥ 18, had preoperative BMI ≥ 35 kg/m², and were able to participate in follow-up. The intervention consisted of six monthly nurse coaching sessions based on motivational interviewing (MI), delivered by a certified nurse. Sessions focused on promoting dietary behavior change, identifying weight maintenance barriers, and enhancing intrinsic motivation through individualized, goal-oriented support. Data Collection Tools Data were collected at baseline and six months post-intervention. Tools included:: Sociodemographic and Clinical Characteristics Form : ssessed age, gender, education, lifestyle habits, comorbidities, and surgery time. Obesity Surgery Quality of Life (OSQOL) Scale : Measured quality of life across five subdomains in bariatric patients. Three-Factor Eating Questionnaire (TFEQ) : Evaluated cognitive restraint, emotional eating, and uncontrolled eating behaviors. Ethical Considerations The study was approved by the Ethics Committee. All participants provided written informed consent. Participation was voluntary, and confidentiality of data was assured. Statistical Analysis Data were analyzed using IBM SPSS Statistics version 28. Descriptive statistics (mean, standard deviation, frequency, and percentage) were used for sociodemographic variables. Paired t-tests were applied to evaluate pre- and post-intervention differences. Pearson correlation and linear regression analyses were used to explore the relationships among eating behavior, quality of life scores, and weight loss. A significance level of p < 0.05 was considered statistically significant. Results A total of 32 individuals participated in the study. The mean age was 44.87 ± 7.21 years, with the majority being female (87.5%, n = 28), married (75%, n = 24), and with children (75%, n = 24). Regarding lifestyle habits, 37.5% (n = 12) were current smokers, and 75% (n = 24) reported alcohol consumption. Half of the participants (50%, n = 16) stated they had no chronic diseases. All participants had previously attempted non-surgical obesity treatments, including diet and exercise, before undergoing bariatric surgery. The average time since surgery was 7.50 ± 2.97 years. Body Weight and Weight Loss Outcomes There was a statistically significant decrease in mean body weight post-intervention compared to baseline (p < 0.05). The average percentage of weight loss also increased, indicating effective postoperative maintenance in combination with the nurse coaching intervention. However, weight loss percentage did not significantly correlate with changes in quality of life (OSQOL) or eating behavior (TFEQ) total scores. Obesity Surgery Quality of Life (OSQOL) Among the five OSQOL subdomains, only the psychosocial well-being dimension showed a statistically significant improvement after the nurse coaching program (p < 0.05). No significant changes were observed in the subdomains related to physical function , sexual life , biopsychosocial burden , or complications . This finding suggests that the intervention was particularly beneficial for emotional and social aspects of postoperative life, rather than physical symptoms alone. Participants' data regarding OSQOL are given in Table 1 . Table 1 Comparison of Pre- and Post-Intervention Mean Scores of OSQOL OSQOL Subdimension Mean ± SD (Pre) Mean ± SD (Post) t / p Biopsychosocial Burden 66.62 ± 17.52 (29–82) 68.12 ± 15.57 (34–82) t= -1.775 p = .119 Psychosocial Well-being 28.75 ± 7.88 (11–35) 30.12 ± 6.95 (14–35) t= -2.582 p = .036 Physical Functioning 20.50 ± 7.28 (10–29) 20.25 ± 6.20 (11–28) t = .509 p = .626 Sexual Life 17.37 ± 5.34 (8–25) 17.75 ± 5.00 (9–25) t= -1.426 p = .197 Complications 20.00 ± 11.10 (8–35) 19.00 ± 9.62 (8–31) t = 1.528 p = .170 *p < 0.05 Three-Factor Eating Questionnaire (TFEQ) The overall TFEQ total score did not change significantly. However, when evaluated by subdomains, all three demonstrated statistically significant improvements: Cognitive Restraint : Participants exhibited better ability to consciously limit food intake after the intervention (p < 0.05). Emotional Eating : A notable reduction in eating in response to emotional stress was observed post-intervention (p < 0.05). Uncontrolled Eating : There was a significant decrease in the tendency to eat in an unregulated manner, especially in response to external cues (p < 0.05). These results indicate that while global eating behavior scores remained relatively stable, the intervention had measurable positive effects on specific maladaptive eating behaviors. Participants' data regarding TFEQ are given in Table 2 . Table 2 Comparison of Individuals' Pre- and Post-Intervention Mean Total and Subscale Scores of TFEQ TFEQ Subscale Mean ± SD (Pre) Mean ± SD (Post) t / p Cognitive Restraint 64.58 ± 11.47 (44.44–77.78) 77.08 ± 6.92 (66.67–88.89) t= -3.211 p = .015 Emotional Eating 65.97 ± 31.62 (16.67–100) 56.94 ± 29.05 (11.11–88.89) t = 3.870 p = .006 Uncontrolled Eating 54.16 ± 25.65 (11.11–96.30) 47.68 ± 25.76 (11.11–88.89) t = 2.966 p = .021 Total Score 61.57 ± 19.87 (33.33–85.80) 60.57 ± 18.94 (35.19–87.04) t = .933 p = .382 *p < 0.05 Associations Between Variables Correlation analyses showed no significant relationships between weight loss percentage and OSQOL or TFEQ total scores. Linear regression analysis also did not identify any predictive relationship between demographic factors and scale score changes. However, improvements in psychosocial quality of life were moderately correlated with decreases in emotional and uncontrolled eating behaviors. The regression analysis results of the participants regarding pre and post-intervention OSQOL and TFEQ are given in Tables 3 and 4 . Table 3 Investigation of Factors Predicting Pre-Intervention OSQOL Dimension and Sub-Dimension and TFEQ Total and Sub-Dimension Score Averages Biopsychosocial Burden Psychosocial Well-being Physical Functioning Complications Age B -2.018 − .935 − .585 -1.091 S.E. .551 .231 .185 .443 t -3.665 -4.057 -3.167 -2.462 p .011 .007 .019 .049 Cl (-3.36)-(-.671) (-1.49)-(-.37) (-1.03)-(-.13) (-2.17)-(-.00) R 2 .640 .688 .626 .502 R 2 = Linear Regression Analysis, p < 0.05 Table 4 Investigation of Factors Predicting Post-Intervention OSQOL Dimension and Sub-Dimension and TFEQ Total and Sub-Dimension Score Averages Biopsychosocial Burden Psychosocial Well-being Physical Functioning Complications Age B -1.792 − .794 − .530 − .962 S.E. .491 .223 .183 .377 t -3.652 -3.567 -2.897 -2.555 p .011 .012 .027 .043 Cl (-2.99)-(-.59) (-1.33)-(-.25) (-.97)-(-.08) (-1.88)-(-.04) R 2 .638 .626 .583 .521 R 2 = Linear Regression Analysis, p < 0.05 Discussion This study evaluated the effectiveness of nurse coaching based on motivational interviewing (MI) in improving eating behaviors, weight outcomes, and quality of life in post-bariatric surgery patients. Findings showed that while the intervention did not significantly impact total weight loss or overall quality of life scores, it led to meaningful improvements in psychosocial well-being and specific maladaptive eating behaviors. A significant improvement was observed in the psychosocial subdomain of the Obesity Surgery Quality of Life (OSQOL) scale. This suggests that MI-based coaching helped patients address emotional and social challenges common in the long-term postoperative period [ 4 ]. Similar improvements in emotional well-being and interpersonal functioning have been noted in previous studies involving behavioral interventions after bariatric surgery [ 10 ]. In contrast, no significant changes occurred in the OSQOL subdomains related to physical function, sexual life, or complications. Most participants were at least one year post-surgery, likely contributing to physical stabilization prior to the intervention. Thus, the psychological focus of MI may yield more pronounced effects in domains involving self-perception and emotional resilience [ 11 ]. Regarding eating behaviors, significant improvements were observed in all three TFEQ subscales: cognitive restraint, emotional eating, and uncontrolled eating. These results highlight the ability of motivational interviewing to enhance self-regulation and coping strategies related to eating. Improved cognitive restraint suggests participants developed better control over their dietary choices [ 12 ]. The reductions in emotional and uncontrolled eating further support the utility of behavioral coaching in addressing long-standing eating patterns. Studies have shown that emotional eating is a strong predictor of postoperative weight fluctuations, and interventions targeting this behavior may prevent long-term weight regain [ 13 ]; [ 14 ]. Although this study did not find a direct correlation between weight loss and eating behavior or quality of life scores, previous research suggests that improvements in psychological factors contribute more to weight maintenance than to further reduction [ 15 ]. Regression analysis identified smoking and alcohol consumption as significant predictors of poorer psychosocial well-being and disordered eating. Smokers reported lower psychosocial scores, while alcohol use correlated with higher uncontrolled eating [ 16 ]. These lifestyle factors are known to undermine bariatric outcomes and highlight the need for tailored behavioral interventions during follow-up care. The study's strengths include its structured, MI-based nurse coaching protocol, use of validated instruments, and focus on long-term post-surgical outcomes. However, limitations include its single-group design, relatively small sample size, and reliance on self-reported data, which may introduce bias. The absence of a control group also limits the ability to draw causal conclusions. Despite these limitations, the study contributes important evidence supporting the integration of behavioral coaching into post-bariatric care. While surgical success is often measured by weight loss alone, sustained improvements require ongoing attention to psychological and behavioral dimensions [ 16 ]. Nurse-led coaching is a cost-effective and scalable method that may enhance long-term outcomes for bariatric patients. In conclusion, motivational interviewing-based nurse coaching improved emotional regulation, self-control over eating, and psychosocial quality of life in post-bariatric individuals. Incorporating behavioral interventions into standard follow-up care may strengthen the long-term success of bariatric surgery. Conclusion This study shows that nurse coaching based on motivational interviewing effectively improves psychosocial well-being and eating behaviors in post-bariatric surgery patients. While it did not significantly impact total weight loss, it enhanced emotional regulation, cognitive control, and reduced uncontrolled eating. Nurse-led behavioral coaching supports long-term lifestyle changes essential for maintaining weight loss and improving quality of life. Integrating such interventions into standard follow-up care offers a scalable, cost-effective strategy. Future studies with larger samples are needed to confirm these results. Nurse coaching should be recognized as a key component in the multidisciplinary care of bariatric patients. Declarations Conflict of Interest: The authors declare no competing interests. Ethical Approval: Approved by Ethics Committee (Protocol No: blinded). Consent to Participate: All participants provided written and verbal informed consent prior to participation. Funding Declaration: This research received no specific grant from any funding agency. Author Contribution K.Y. review literature.K.Y. and F.V. found study idea.K.Y. collected data, implement intervention and analyse data.K.Y. and F.V.prepared manuscript. References World Health Organization. Obesity and overweight. WHO Fact Sheet. 2016 [cited 2025 Jun 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight Satman İ, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinççag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults: the TURDEP-II study. Eur J Epidemiol. 2013;28(2):169–80. Khandalavala BN, Polk D, Koukol C, Khandalavala RV. Quality of life changes in bariatric surgery patients: a comparison of laparoscopic gastric bypass versus sleeve gastrectomy. Obes Surg. 2015;25(3):452–8. Silva BL, Gomes DL, Lima JG. Improvement in quality of life and psychological aspects after bariatric surgery. Obes Surg. 2018;28(1):313–8. Vegel L, Nyberg F, Sundbom M. Preoperative characteristics and postoperative complications do not predict long-term quality of life after bariatric surgery. Obes Surg. 2017;27(5):1238–43. Magro DO, Geloneze B, Delfini R, Pareja BC, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648–51. Miller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York: Guilford Press; 2013. Gudzune KA, Doshi RS, Mehta AK, Chaudhry ZW, Jacobs DK, Blaney S, et al. Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med. 2015;162(7):501–12. Aydin N, Yilmaz E, Yavuz M. The effect of motivational interviewing-based nurse coaching on lifestyle behaviors in bariatric surgery patients: a pilot study. J Clin Nurs. 2021;30(21–22):3225–33. Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2012;78(4):487–90. Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of weight loss after bariatric surgery: a review of the recent research. Obes Res Clin Pract. 2014;8(4):e299–313. Van Dorsten B. The use of motivational interviewing in weight loss. Curr Diab Rep. 2007;7(5):386–90. Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21(2):273–93. Meany G, Conceição E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev. 2014;22(2):87–91. Mundbjerg LH, Stolberg CR, Blom-Hansen NS, Kristensen N, Aasprang A, Lerdal A, et al. Effects of a multimodal prehabilitation programme in bariatric surgery: a randomized clinical trial. Obes Surg. 2018;28(11):3279–91. Sarwer DB, Wadden TA, Moore RH, Baker AW, Gibbons LM, Raper SE, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted 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. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-6900396","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475595942,"identity":"82ef3a34-efa1-4c94-ad4c-023073defd4e","order_by":0,"name":"Kübra Yasak","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8UlEQVRIiWNgGAWjYBACCQYeGJON8QGEnUC8FmYDuJYDRGphkyBKi+SM3GMffjAclpdvP5ZW8abiMAM/e44B88c9uLVIS+Qlz+xhOGy44UzasZtzzhxmkOx5Y8Bw4BluLXISOcZAtx1m3MCQ3nabt+0wg8GNHKAWPC4DaWH8w3DYfn7/87Zi3n+HGewJaZEGamEG2pLYcCPtGDNvA9AWCQJaJHveJTPLGKQnb7jxLFlyzrF0HokzzwoOnMGjReJ47mHGNxXWtvP70ww/vKmxluNvT974oAKPFggwaIYzwVFDUAMQ1BGhZhSMglEwCkYsAAAa9lJVqUNI5QAAAABJRU5ErkJggg==","orcid":"","institution":"Dokuz Eylül University","correspondingAuthor":true,"prefix":"","firstName":"Kübra","middleName":"","lastName":"Yasak","suffix":""},{"id":475595943,"identity":"19747be6-1d89-4d10-8678-7c772947ca87","order_by":1,"name":"Fatma Vural","email":"","orcid":"","institution":"Dokuz Eylül University","correspondingAuthor":false,"prefix":"","firstName":"Fatma","middleName":"","lastName":"Vural","suffix":""}],"badges":[],"createdAt":"2025-06-15 23:38:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6900396/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6900396/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90235796,"identity":"85bf5acc-6c84-4570-8c59-12a39ed95a5e","added_by":"auto","created_at":"2025-08-30 16:16:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":880342,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6900396/v1/ea2a3768-ed72-4ac8-acd8-9ce1e7de648f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Effect of Nurse Coaching on Eating Behavior, Weight Loss, and Quality of Life After Bariatric Surgery: A Quasi-Experimental Study","fulltext":[{"header":"Key Points","content":"\u003cul type=\"disc\"\u003e\n \u003cli\u003eMotivational interviewing enhances psychosocial recovery post-bariatric surgery.\u003c/li\u003e\n \u003cli\u003eNurse coaching positively influences eating behavior regulation.\u003c/li\u003e\n \u003cli\u003eBehavioral support is crucial for long-term bariatric success.\u003c/li\u003e\n \u003cli\u003eNo direct correlation between weight loss and quality of life scores.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eObesity is a chronic, multifactorial disease that adversely impacts physical, psychological, and social health [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. As of 2016, more than 650\u0026nbsp;million adults worldwide were classified as obese, with increasing prevalence globally [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In T\u0026uuml;rkiye, obesity affects approximately 35% of the adult population [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBariatric surgery has proven to be an effective intervention for morbid obesity, especially when non-surgical approaches such as diet, exercise, and medications are insufficient [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. It results in substantial and sustained weight loss and improves conditions like type 2 diabetes and hypertension [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, long-term success requires not only surgical outcomes but also behavioral adaptation [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePostoperative patients often struggle with challenges such as emotional eating and reduced quality of life [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Without behavioral support, the risk of weight regain increases [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMotivational interviewing (MI), a client-centered counseling approach, can improve intrinsic motivation for change [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. When used in nurse coaching, MI supports patients in managing eating behavior and lifestyle habits [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. However, its use remains limited in bariatric follow-up in T\u0026uuml;rkiye [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This study examines the effects of nurse coaching with MI on eating behavior, weight loss, and quality of life after bariatric surgery.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eThis quasi-experimental single-group pretest-posttest study included 32 individuals who had undergone bariatric surgery at least one year prior. Participants were recruited from a university hospital\u0026rsquo;s obesity clinic in T\u0026uuml;rkiye between January and June 2023. Eligible individuals were aged\u0026thinsp;\u0026ge;\u0026thinsp;18, had preoperative BMI\u0026thinsp;\u0026ge;\u0026thinsp;35 kg/m\u0026sup2;, and were able to participate in follow-up. The intervention consisted of six monthly nurse coaching sessions based on motivational interviewing (MI), delivered by a certified nurse. Sessions focused on promoting dietary behavior change, identifying weight maintenance barriers, and enhancing intrinsic motivation through individualized, goal-oriented support.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData Collection Tools\u003c/h2\u003e \u003cp\u003eData were collected at baseline and six months post-intervention. Tools included::\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eSociodemographic and Clinical Characteristics Form\u003c/b\u003e: ssessed age, gender, education, lifestyle habits, comorbidities, and surgery time.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eObesity Surgery Quality of Life (OSQOL) Scale\u003c/b\u003e: Measured quality of life across five subdomains in bariatric patients.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eThree-Factor Eating Questionnaire (TFEQ)\u003c/b\u003e: Evaluated cognitive restraint, emotional eating, and uncontrolled eating behaviors.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e The study was approved by the Ethics Committee. All participants provided written informed consent. Participation was voluntary, and confidentiality of data was assured.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were analyzed using IBM SPSS Statistics version 28. Descriptive statistics (mean, standard deviation, frequency, and percentage) were used for sociodemographic variables. Paired t-tests were applied to evaluate pre- and post-intervention differences. Pearson correlation and linear regression analyses were used to explore the relationships among eating behavior, quality of life scores, and weight loss. A significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 32 individuals participated in the study. The mean age was 44.87\u0026thinsp;\u0026plusmn;\u0026thinsp;7.21 years, with the majority being female (87.5%, n\u0026thinsp;=\u0026thinsp;28), married (75%, n\u0026thinsp;=\u0026thinsp;24), and with children (75%, n\u0026thinsp;=\u0026thinsp;24). Regarding lifestyle habits, 37.5% (n\u0026thinsp;=\u0026thinsp;12) were current smokers, and 75% (n\u0026thinsp;=\u0026thinsp;24) reported alcohol consumption. Half of the participants (50%, n\u0026thinsp;=\u0026thinsp;16) stated they had no chronic diseases. All participants had previously attempted non-surgical obesity treatments, including diet and exercise, before undergoing bariatric surgery. The average time since surgery was 7.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.97 years.\u003c/p\u003e\n\u003ch3\u003eBody Weight and Weight Loss Outcomes\u003c/h3\u003e\n\u003cp\u003eThere was a statistically significant decrease in mean body weight post-intervention compared to baseline (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The average percentage of weight loss also increased, indicating effective postoperative maintenance in combination with the nurse coaching intervention. However, weight loss percentage did not significantly correlate with changes in quality of life (OSQOL) or eating behavior (TFEQ) total scores.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eObesity Surgery Quality of Life (OSQOL)\u003c/h2\u003e \u003cp\u003eAmong the five OSQOL subdomains, only the \u003cb\u003epsychosocial well-being\u003c/b\u003e dimension showed a statistically significant improvement after the nurse coaching program (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No significant changes were observed in the subdomains related to \u003cb\u003ephysical function\u003c/b\u003e, \u003cb\u003esexual life\u003c/b\u003e, \u003cb\u003ebiopsychosocial burden\u003c/b\u003e, or \u003cb\u003ecomplications\u003c/b\u003e. This finding suggests that the intervention was particularly beneficial for emotional and social aspects of postoperative life, rather than physical symptoms alone.\u003c/p\u003e \u003cp\u003eParticipants' data regarding OSQOL are given in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Pre- and Post-Intervention Mean Scores of OSQOL\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOSQOL Subdimension\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Pre)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Post)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et / p\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBiopsychosocial Burden\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e66.62\u0026thinsp;\u0026plusmn;\u0026thinsp;17.52 (29\u0026ndash;82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e68.12\u0026thinsp;\u0026plusmn;\u0026thinsp;15.57 (34\u0026ndash;82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003et= -1.775\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;.119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePsychosocial Well-being\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e28.75\u0026thinsp;\u0026plusmn;\u0026thinsp;7.88 (11\u0026ndash;35)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e30.12\u0026thinsp;\u0026plusmn;\u0026thinsp;6.95 (14\u0026ndash;35)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003et= -2.582\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;.036\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePhysical Functioning\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e20.50\u0026thinsp;\u0026plusmn;\u0026thinsp;7.28 (10\u0026ndash;29)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e20.25\u0026thinsp;\u0026plusmn;\u0026thinsp;6.20 (11\u0026ndash;28)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et\u0026thinsp;=\u0026thinsp;.509\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;.626\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eSexual Life\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003e17.37\u0026thinsp;\u0026plusmn;\u0026thinsp;5.34 (8\u0026ndash;25)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e17.75\u0026thinsp;\u0026plusmn;\u0026thinsp;5.00 (9\u0026ndash;25)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003et= -1.426\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003ep\u0026thinsp;=\u0026thinsp;.197\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComplications\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e20.00\u0026thinsp;\u0026plusmn;\u0026thinsp;11.10 (8\u0026ndash;35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e19.00\u0026thinsp;\u0026plusmn;\u0026thinsp;9.62 (8\u0026ndash;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u0026thinsp;=\u0026thinsp;1.528\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;.170\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eThree-Factor Eating Questionnaire (TFEQ)\u003c/h3\u003e\n\u003cp\u003eThe overall TFEQ total score did not change significantly. However, when evaluated by subdomains, all three demonstrated statistically significant improvements:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCognitive Restraint\u003c/b\u003e: Participants exhibited better ability to consciously limit food intake after the intervention (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eEmotional Eating\u003c/b\u003e: A notable reduction in eating in response to emotional stress was observed post-intervention (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eUncontrolled Eating\u003c/b\u003e: There was a significant decrease in the tendency to eat in an unregulated manner, especially in response to external cues (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThese results indicate that while global eating behavior scores remained relatively stable, the intervention had measurable positive effects on specific maladaptive eating behaviors.\u003c/p\u003e \u003cp\u003eParticipants' data regarding TFEQ are given in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of Individuals' Pre- and Post-Intervention Mean Total and Subscale Scores of TFEQ\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTFEQ Subscale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Pre)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD (Post)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et / p\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCognitive Restraint\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e64.58\u0026thinsp;\u0026plusmn;\u0026thinsp;11.47 (44.44\u0026ndash;77.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e77.08\u0026thinsp;\u0026plusmn;\u0026thinsp;6.92 (66.67\u0026ndash;88.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003et= -3.211\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional Eating\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e65.97\u0026thinsp;\u0026plusmn;\u0026thinsp;31.62 (16.67\u0026ndash;100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e56.94\u0026thinsp;\u0026plusmn;\u0026thinsp;29.05 (11.11\u0026ndash;88.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003et\u0026thinsp;=\u0026thinsp;3.870\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUncontrolled Eating\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e54.16\u0026thinsp;\u0026plusmn;\u0026thinsp;25.65 (11.11\u0026ndash;96.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e47.68\u0026thinsp;\u0026plusmn;\u0026thinsp;25.76 (11.11\u0026ndash;88.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003et\u0026thinsp;=\u0026thinsp;2.966\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u0026thinsp;=\u0026thinsp;.021\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e61.57\u0026thinsp;\u0026plusmn;\u0026thinsp;19.87 (33.33\u0026ndash;85.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e60.57\u0026thinsp;\u0026plusmn;\u0026thinsp;18.94 (35.19\u0026ndash;87.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u0026thinsp;=\u0026thinsp;.933\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;.382\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e*p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eAssociations Between Variables\u003c/h3\u003e\n\u003cp\u003eCorrelation analyses showed no significant relationships between weight loss percentage and OSQOL or TFEQ total scores. Linear regression analysis also did not identify any predictive relationship between demographic factors and scale score changes. However, improvements in psychosocial quality of life were moderately correlated with decreases in emotional and uncontrolled eating behaviors.\u003c/p\u003e \u003cp\u003eThe regression analysis results of the participants regarding pre and post-intervention OSQOL and TFEQ are given in Tables\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInvestigation of Factors Predicting Pre-Intervention OSQOL Dimension and Sub-Dimension and TFEQ Total and Sub-Dimension Score Averages\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBiopsychosocial Burden\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePsychosocial Well-being\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysical Functioning\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eComplications\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-2.018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.585\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.091\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eS.E.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.551\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.443\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003et\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-3.665\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e-4.057\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-3.167\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-2.462\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e.049\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-3.36)-(-.671)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(-1.49)-(-.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(-1.03)-(-.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e(-2.17)-(-.00)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eR\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.640\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.688\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.626\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e.502\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eR\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;Linear Regression Analysis, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInvestigation of Factors Predicting Post-Intervention OSQOL Dimension and Sub-Dimension and TFEQ Total and Sub-Dimension Score Averages\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBiopsychosocial Burden\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePsychosocial Well-being\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysical Functioning\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eComplications\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eB\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-1.792\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.794\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.962\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eS.E.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.491\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.377\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003et\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e-3.652\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e-3.567\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e-2.897\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e-2.555\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.011\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.027\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e.043\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCl\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e(-2.99)-(-.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(-1.33)-(-.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e(-.97)-(-.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e(-1.88)-(-.04)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eR\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e.638\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e.626\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e.583\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e.521\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eR\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;Linear Regression Analysis, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study evaluated the effectiveness of nurse coaching based on motivational interviewing (MI) in improving eating behaviors, weight outcomes, and quality of life in post-bariatric surgery patients. Findings showed that while the intervention did not significantly impact total weight loss or overall quality of life scores, it led to meaningful improvements in psychosocial well-being and specific maladaptive eating behaviors.\u003c/p\u003e \u003cp\u003eA significant improvement was observed in the psychosocial subdomain of the Obesity Surgery Quality of Life (OSQOL) scale. This suggests that MI-based coaching helped patients address emotional and social challenges common in the long-term postoperative period [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Similar improvements in emotional well-being and interpersonal functioning have been noted in previous studies involving behavioral interventions after bariatric surgery [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn contrast, no significant changes occurred in the OSQOL subdomains related to physical function, sexual life, or complications. Most participants were at least one year post-surgery, likely contributing to physical stabilization prior to the intervention. Thus, the psychological focus of MI may yield more pronounced effects in domains involving self-perception and emotional resilience [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRegarding eating behaviors, significant improvements were observed in all three TFEQ subscales: cognitive restraint, emotional eating, and uncontrolled eating. These results highlight the ability of motivational interviewing to enhance self-regulation and coping strategies related to eating. Improved cognitive restraint suggests participants developed better control over their dietary choices [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe reductions in emotional and uncontrolled eating further support the utility of behavioral coaching in addressing long-standing eating patterns. Studies have shown that emotional eating is a strong predictor of postoperative weight fluctuations, and interventions targeting this behavior may prevent long-term weight regain [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]; [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Although this study did not find a direct correlation between weight loss and eating behavior or quality of life scores, previous research suggests that improvements in psychological factors contribute more to weight maintenance than to further reduction [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRegression analysis identified smoking and alcohol consumption as significant predictors of poorer psychosocial well-being and disordered eating. Smokers reported lower psychosocial scores, while alcohol use correlated with higher uncontrolled eating [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These lifestyle factors are known to undermine bariatric outcomes and highlight the need for tailored behavioral interventions during follow-up care.\u003c/p\u003e \u003cp\u003eThe study's strengths include its structured, MI-based nurse coaching protocol, use of validated instruments, and focus on long-term post-surgical outcomes. However, limitations include its single-group design, relatively small sample size, and reliance on self-reported data, which may introduce bias. The absence of a control group also limits the ability to draw causal conclusions.\u003c/p\u003e \u003cp\u003eDespite these limitations, the study contributes important evidence supporting the integration of behavioral coaching into post-bariatric care. While surgical success is often measured by weight loss alone, sustained improvements require ongoing attention to psychological and behavioral dimensions [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Nurse-led coaching is a cost-effective and scalable method that may enhance long-term outcomes for bariatric patients.\u003c/p\u003e \u003cp\u003eIn conclusion, motivational interviewing-based nurse coaching improved emotional regulation, self-control over eating, and psychosocial quality of life in post-bariatric individuals. Incorporating behavioral interventions into standard follow-up care may strengthen the long-term success of bariatric surgery.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study shows that nurse coaching based on motivational interviewing effectively improves psychosocial well-being and eating behaviors in post-bariatric surgery patients. While it did not significantly impact total weight loss, it enhanced emotional regulation, cognitive control, and reduced uncontrolled eating. Nurse-led behavioral coaching supports long-term lifestyle changes essential for maintaining weight loss and improving quality of life. Integrating such interventions into standard follow-up care offers a scalable, cost-effective strategy. Future studies with larger samples are needed to confirm these results. Nurse coaching should be recognized as a key component in the multidisciplinary care of bariatric patients.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eApproved by Ethics Committee (Protocol No: blinded).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Participate:\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll participants provided written and verbal informed consent prior to participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eK.Y. review literature.K.Y. and F.V. found study idea.K.Y. collected data, implement intervention and analyse data.K.Y. and F.V.prepared manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. Obesity and overweight. WHO Fact Sheet. 2016 [cited 2025 Jun 16]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\u003c/span\u003e\u003cspan address=\"https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSatman İ, Omer B, Tutuncu Y, Kalaca S, Gedik S, Din\u0026ccedil;\u0026ccedil;ag N, et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults: the TURDEP-II study. Eur J Epidemiol. 2013;28(2):169\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhandalavala BN, Polk D, Koukol C, Khandalavala RV. Quality of life changes in bariatric surgery patients: a comparison of laparoscopic gastric bypass versus sleeve gastrectomy. Obes Surg. 2015;25(3):452\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSilva BL, Gomes DL, Lima JG. Improvement in quality of life and psychological aspects after bariatric surgery. Obes Surg. 2018;28(1):313\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVegel L, Nyberg F, Sundbom M. Preoperative characteristics and postoperative complications do not predict long-term quality of life after bariatric surgery. Obes Surg. 2017;27(5):1238\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagro DO, Geloneze B, Delfini R, Pareja BC, Pareja JC. Long-term weight regain after gastric bypass: a 5-year prospective study. Obes Surg. 2008;18(6):648\u0026ndash;51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiller WR, Rollnick S. Motivational interviewing: helping people change. 3rd ed. New York: Guilford Press; 2013.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGudzune KA, Doshi RS, Mehta AK, Chaudhry ZW, Jacobs DK, Blaney S, et al. Efficacy of commercial weight-loss programs: an updated systematic review. Ann Intern Med. 2015;162(7):501\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAydin N, Yilmaz E, Yavuz M. The effect of motivational interviewing-based nurse coaching on lifestyle behaviors in bariatric surgery patients: a pilot study. J Clin Nurs. 2021;30(21\u0026ndash;22):3225\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLivhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2012;78(4):487\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWimmelmann CL, Dela F, Mortensen EL. Psychological predictors of weight loss after bariatric surgery: a review of the recent research. Obes Res Clin Pract. 2014;8(4):e299\u0026ndash;313.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVan Dorsten B. The use of motivational interviewing in weight loss. Curr Diab Rep. 2007;7(5):386\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOgden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21(2):273\u0026ndash;93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMeany G, Concei\u0026ccedil;\u0026atilde;o E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev. 2014;22(2):87\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMundbjerg LH, Stolberg CR, Blom-Hansen NS, Kristensen N, Aasprang A, Lerdal A, et al. Effects of a multimodal prehabilitation programme in bariatric surgery: a randomized clinical trial. Obes Surg. 2018;28(11):3279\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSarwer DB, Wadden TA, Moore RH, Baker AW, Gibbons LM, Raper SE, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Bariatric Surgery, Motivational İnterviewing, Nurse Coaching, Quality Of Life, Eating Behavior","lastPublishedDoi":"10.21203/rs.3.rs-6900396/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6900396/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eBariatric surgery leads to significant weight loss, but behavioral adherence remains crucial for long-term outcomes. Nurse coaching based on motivational interviewing may improve post-surgical lifestyle adaptation.\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e \u003cp\u003eTo examine the effect of motivational interviewing-based nurse coaching on eating behavior, weight loss, and quality of life in patients after bariatric surgery.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis quasi-experimental study involved 32 patients who received biweekly nurse coaching sessions over six months. Data collection tools included the Obesity Surgery Quality of Life (OSQOL) scale and the Three-Factor Eating Questionnaire (TFEQ). Pre- and post-intervention scores were compared using paired t-tests, Pearson correlation, and linear regression analysis via SPSS v28.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe average participant age was 44.87\u0026thinsp;\u0026plusmn;\u0026thinsp;7.21 years; 87.5% were female. Statistically significant weight loss was observed post-intervention (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The psychosocial subdomain of OSQOL and all three TFEQ subscales (Cognitive Restraint, Emotional Eating, Uncontrolled Eating) showed significant improvements (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No correlation was observed between total weight loss and OSQOL/TFEQ total scores.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eNurse coaching significantly enhanced psychosocial well-being and eating behavior regulation in post-bariatric patients, supporting its integration into routine postoperative care.\u003c/p\u003e","manuscriptTitle":"The Effect of Nurse Coaching on Eating Behavior, Weight Loss, and Quality of Life After Bariatric Surgery: A Quasi-Experimental Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-26 08:35:15","doi":"10.21203/rs.3.rs-6900396/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1930175c-72f7-45f1-bc97-5fd7c3be6784","owner":[],"postedDate":"June 26th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-30T16:08:20+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-26 08:35:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6900396","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6900396","identity":"rs-6900396","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}