Research findings suggest that individuals with substance use disorder (SUD) often exhibit emotion misregulation. However, there has been limited investigation into emotion regulation difficulties concerning behavioral addictions, particularly in the context of eating disorders. Chronic overeating leading to severe obesity is classified as an impulse control disorder due to its resemblance to addictive behaviors characterized by loss of control. For this study, 16 morbidly obese patients (BMI > 40 or > 35 with diabetes or prediabetes) underwent Pylorus-preserving single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-SG) surgery, and their weight-loss outcomes were analyzed to evaluate the efficacy of the procedure. Following one year of follow-up, MMPI-2 was administered to assess psychological phenomena, particularly focusing on emotion regulation. The MMPI-2 Restructured Clinical Scales (RC) were utilized, with scales RCd, RC2, and RC7 examining affective functioning and emotional regulation difficulties. Additionally, PSY-5 scales INTR/LPE and NEGE were evaluated for emotional regulation deficiencies. Results indicated strong correlations between RCd, Rc2, and Negative Emotionality/Neuroticism (NEGE) scales with AAS, suggesting low positive emotions and demoralization indicators associated with recognized dependent behavioral patterns. These findings implied emotion misregulation akin to SUD-related patterns despite the absence of substance abuse, which typically would be detected through laboratory panels conducted during follow-up intervals. Expanding the sample size and adopting a multicenter approach could enhance the significance and generalizability of these findings.

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