THE OBESITY CARE LINE IN THE BRAZILIAN UNIFIED HEALTH SYSTEM: PRE-BARIATRIC CARE PROTOCOLS AND THEIR EFFECTS ON EATING BEHAVIOR

Abstract

Obesity is a multifactorial chronic disease that represents a major challenge for the Brazilian Unified Health System (SUS). When clinical treatment fails to achieve satisfactory outcomes, bariatric surgery may be indicated as a therapeutic strategy for weight reduction and the management of obesity-related comorbidities. However, treatment success depends on multidisciplinary preparation and sustainable changes in eating behavior. This study aimed to analyze preoperative care protocols within the obesity care pathway of the SUS and discuss their effects on the eating behavior of patients eligible for bariatric surgery. An integrative literature review with a qualitative and descriptive-analytical approach was conducted based on current federal regulations and scientific articles published between 2021 and May 2026, retrieved from PubMed, SciELO, the CAPES Journals Portal, and the Virtual Health Library. The analyzed studies showed that preoperative follow-up may still present bureaucratic characteristics and a focus on weight-loss targets, with limited attention to emotional and behavioral factors. Associations were identified between emotional eating, cognitive restraint, loss of control over eating, eating disorders, and an increased risk of postoperative weight regain. The findings suggest that incorporating Behavioral Nutrition strategies combined with continuous psychological support may strengthen preoperative preparation and contribute to improved outcomes following bariatric surgery.