Factors Associated with Health-Related Quality of Life Among Greek Candidates for Bariatric Surgery: A Cross-Sectional Study

Background: This study examined demographic, anthropometric, and psychological factors associated with health-related quality of life (HRQoL) among Greek candidates for bariatric surgery. Methods: A total of 524 candidates for bariatric surgery (mean age = 41.49 years, SD = 11.18) were recruited from the Interbalkan Medical Centre of Thessaloniki between May 2019 and November 2024. Participants completed standardized measures assessing depressive symptoms, anxiety, disordered eating attitudes, psychological resilience, personality traits, and HRQoL. Eight theory-informed multiple linear regression models were fitted to examine cross-sectional associations with the SF-36 domains, adjusting simultaneously for 12 demographic, anthropometric, and psychological covariates. Heteroscedasticity-consistent (HC3) standard errors and false discovery rate (FDR) correction were applied. Results: Depressive symptoms were negatively associated with all eight SF-36 domains after multivariable adjustment and FDR correction. Higher BMI was associated with poorer scores across all four physical HRQoL domains, as well as Social Functioning and Vitality, while older age was negatively associated with all four physical domains. Anxiety symptoms were independently associated only with Mental Health. Psychological resilience was positively associated with General Health Perceptions and Vitality, whereas higher Neuroticism and Extraversion were associated with poorer and better mental and psychosocial HRQoL, respectively. Adjusted R2 values ranged from 0.245 to 0.548 across the eight SF-36 domains. Discussion: Depressive symptoms emerged as the most consistent correlate of HRQoL among Greek candidates for bariatric surgery, whereas BMI, age, resilience, anxiety, and personality traits demonstrated more domain-specific associations. These findings highlight the relevance of comprehensive preoperative assessment addressing both physical and psychological functioning. Conclusions: Longitudinal studies are needed to clarify temporal relationships and determine whether these characteristics are associated with postoperative HRQoL outcomes.