Nutrition, Health Behavior and Obesity Research Lab

Rational: Metabolic bariatric surgery (MBS) is an effective treatment for obesity and related chronic conditions; however, long-term success depends substantially on patients’ adherence to dietary and behavioral recommendations. Although clinical guidelines exist, there is currently no standardized framework defining “core” dietary-behavioral principles, nor a validated instrument to systematically assess adherence to these recommendations across clinical and research settings. This gap contributes to heterogeneity in outcome assessment, limited comparability across studies, and challenges in linking adherence patterns to long-term postoperative outcomes.

This multi-phase research program addresses these conceptual and methodological gaps through a structured scale-development framework:

Phase 1: A scoping review mapping existing instruments assessing dietary-behavioral adherence post-MBS and identifying conceptual and psychometric limitations.

Phase 2: An international qualitative descriptive study using virtual focus groups with registered dietitians experienced in MBS care. The study explores perceived core dietary-behavioral principles, their clinical rationale, and barriers and facilitators to adherence across postoperative stages and healthcare contexts.

Phase 3: Development of a standardized adherence assessment tool integrating findings from Phases 1 and 2, followed by comprehensive psychometric evaluation. The validation process includes assessment of content validity, construct validity (convergent, known-groups, and criterion validity), internal consistency, and test–retest reliability in a large Israeli postoperative MBS cohort.

Setting
International collaboration; qualitative phase conducted virtually. Quantitative validation to be conducted across clinical settings in Israel.

Research Team and students involved
International collaborators (Israel, U.S., Sweden, other EU countries)

Supervision
Dr. Tair Ben-Porat
Dr. Shiri Sherf-Dagan                                                                                                       

Status
Phase 2 (international qualitative phase) ongoing

Relevant links
https://osf.io/sny9q/overview                                                                                                                                            

https://osf.io/tcxyk/overview     

https://onlinelibrary.wiley.com/doi/10.1111/obr.70012