Obesity poses a significant challenge to societies and healthcare systems worldwide. Metabolic bariatric surgery (MBS) has emerged as a proven primary intervention for severe obesity. This cross-sectional study investigated the interplay between sociodemographic and psychological factors and their influence on attitudes toward eating and body mass index (BMI) among candidates undergoing MBS. Recruitment took place over a period of more than five years. Sociodemographic and BMI data were collected, and psychological evaluations were conducted using standardized self-report questionnaires and clinical interviews. Data were analysed using Pearson and Spearman correlations, multiple linear regression, and bootstrapped mediation analysis. After exclusion of those who did not meet surgical suitability criteria, declined participation, or had incomplete data, the study included 515 participants. Significant associations were found between lower educational attainment, unmarried status, and higher BMI. High neuroticism was linked to increased BMI, depression, and anxiety. Resilience was moderately negatively correlated with anxiety and depressive symptoms and showed a small but statistically significant indirect (partial mediating) effect on the relationship between neuroticism and anxiety or depressive symptoms, although its small magnitude and the cross-sectional design preclude causal interpretation. The findings demonstrate that several variables play substantial roles in eating attitudes and influence BMI in this population. Notably, resilience emerges as a significant psychological factor. However, further research is warranted to fully elucidate its role and impact. These insights provide valuable guidance for refining preoperative assessments.

Background: This study examined demographic, anthropometric, and psychological factors associated with health-related quality of life (HRQoL) among Greek candidates for bariatric surgery. Methods: A total of 524 candidates for bariatric surgery (mean age = 41.49 years, SD = 11.18) were recruited from the Interbalkan Medical Centre of Thessaloniki between May 2019 and November 2024. Participants completed standardized measures assessing depressive symptoms, anxiety, disordered eating attitudes, psychological resilience, personality traits, and HRQoL. Eight theory-informed multiple linear regression models were fitted to examine cross-sectional associations with the SF-36 domains, adjusting simultaneously for 12 demographic, anthropometric, and psychological covariates. Heteroscedasticity-consistent (HC3) standard errors and false discovery rate (FDR) correction were applied. Results: Depressive symptoms were negatively associated with all eight SF-36 domains after multivariable adjustment and FDR correction. Higher BMI was associated with poorer scores across all four physical HRQoL domains, as well as Social Functioning and Vitality, while older age was negatively associated with all four physical domains. Anxiety symptoms were independently associated only with Mental Health. Psychological resilience was positively associated with General Health Perceptions and Vitality, whereas higher Neuroticism and Extraversion were associated with poorer and better mental and psychosocial HRQoL, respectively. Adjusted R² values ranged from 0.245 to 0.548 across the eight SF-36 domains. Discussion: Depressive symptoms emerged as the most consistent correlate of HRQoL among Greek candidates for bariatric surgery, whereas BMI, age, resilience, anxiety, and personality traits demonstrated more domain-specific associations. These findings highlight the relevance of comprehensive preoperative assessment addressing both physical and psychological functioning. Conclusions: Longitudinal studies are needed to clarify temporal relationships and determine whether these characteristics are associated with postoperative HRQoL outcomes.