Nutritional adherence after bariatric surgery: psychological, behavioral and clinical implications for long-term outcome maintenance

Objectives. This review examines the role of nutritional adherence in sustaining long-term outcomes following bariatric surgery, with a particular focus on the psychological, behavioral and clinical factors involved. Methodology. A literature review was conducted using articles published between 2015 and 2025, retrieved from databases such as PubMed, Scopus and ScienceDirect. Observational studies, meta-analyses and narrative reviews were included focused on postoperative dietary compliance. Search terms included "bariatric surgery", "nutritional adherence" and "long-term follow-up." Results. The current evidence indicates a gradual decline in dietary adherence after the first postoperative year. Compliance is shaped by psychological factors, behavioral patterns and clinical determinants. Multidisciplinary support and sustained clinical follow-up have been shown to improve weight maintenance and reduce the likelihood of weight regain. Conclusions. Postoperative nutritional adherence is a critical determinant of long-term bariatric success. The implementation of structured follow-up protocols within multidisciplinary teams enhances dietary compliance and supports the sustained metabolic benefits of bariatric interventions.