The aim of this study was to investigate the presence of executive difficulties due to a lack of the management of cognitive conflict, inhibition, and cognitive flexibility in this group of patients. If executive difficulties are at the basis of uncontrolled alimentary behavior, these will be present also after a dramatic weight loss and could led to a poor compliance of the patient after plastic surgery procedures.

We enrolled 21 consecutive post-bariatric patients. This clinical population was compared with a control group (n = 21) from the general population sharing the same clinical and demographic features. Psychiatric evaluation was performed. Executive difficulties were investigated through electroencephalography using the stroop task, sustained attention to response task, and task switching tests.

The patient group reported more frequently psychiatric disorders than control group. Patients had higher prevalence of lifetime major depression (58.3% vs. 14.3%), of lifetime panic disorder (36.1% vs. 4.8%) and generalized anxiety disorder (16.75% vs. 0%). Finally, patients were more frequently affected by body dismorphic disorder (chi2 = 8.867, P = .003). Electroencephalography confirmed the presence of executive difficulties sustained by a lack of the control of cognitive conflict and cognitive flexibility, and a difficulty of the inhibitory control in the patient group.

Electroencephalography confirmed for the first time the high prevalence of psychological/psychiatric problems in post-bariatric patients. Patients showing high values of executive difficulties will need a psychological/psychiatric support to sustain a positive outcome after post-bariatric plastic surgery.

The authors have not supplied their declaration of competing interest.