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Enhancing Postoperative Outcomes After Metabolic Bariatric Surgery: a Pilot Study of Inhibitory Control Training, Transcranial Direct Current Stimulation and Psychosocial Aftercare.

A correction to this paper has been published: the notice, 42584767, from Europe PMC.

Overview

Authors: Sarah Alica Rösch1,2, Carsten Thiele2,3,4,5, Therese Reinstaller6, Tino Zähle2,3,4,5, Kathrin Schag7,8,9, Katrin Giel7,8,9, Christian Plewnia7,10, Johann Steiner2,4,11,12,13, Florian Junne1,2,4, Susanne Vogt1,2
ORCID iDs: Sarah Alica Rösch
13 affiliations
  1. University Clinic for Psychosomatic Medicine and Psychotherapy, University Medicine, Otto-von-Guericke-University Magdeburg, Medical Faculty,Magdeburg, Germany
  2. Partner Site Halle-Jena-Magdeburg, German Center for Mental Health (DZPG),Magdeburg, Germany
  3. Department of Neurology, University Medicine, Otto-von-Guericke-University Magdeburg,Magdeburg, Germany
  4. Center for Behavioral Brain Sciences (CBBS),Magdeburg, Germany
  5. Institute for Medical Psychology, Otto-von-Guericke University,Magdeburg, Germany
  6. University Clinic for General, Visceral, Vascular and Transplant Surgery, University Hospital, Otto von Guericke University Magdeburg,Magdeburg, Germany
  7. Partner Site Tübingen, German Center for Mental Health (DZPG),Tübingen, Germany
  8. Department of Psychosomatic Medicine und Psychotherapy, Medical University Hospital Tübingen, Eberhard Karl University Tübingen,Tübingen, Germany
  9. Center of Excellence for Eating Disorders (KOMET), Tübingen, Germany
  10. Department of Psychiatry and Psychotherapy, Medical University Hospital Tübingen, Eberhard Karl University Tübingen,Tübingen, Germany
  11. Department of Psychiatry, University Medicine, Otto-von-Guericke-University Magdeburg,Magdeburg, Germany
  12. Laboratory of Translational Psychiatry, University Hospital, Otto-von-Guericke-University Magdeburg,Magdeburg, Germany
  13. Center for Health and Medical Prevention (CHaMP), Magdeburg, Germany
Institutions: Otto-von-Guericke-Universität Magdeburg (Germany); Deutsches Zentrum für Psychische Gesundheit (Germany); Center for Behavioral Brain Sciences (Germany); University of Tübingen (Germany)
Journal: Obesity surgery, volume 36, issue 8, pages 4316-4327
Dates: received 11 May 2026; accepted 29 June 2026; published online 15 July 2026; in print 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1007/s11695-026-08828-6 · PMID 42455493 · PMCID PMC13429539 · OpenAlex W7168380235
Open access: hybrid, a free copy (OpenAlex)
Status: code found, not verified yet
Categories: other (modality), human (organism), other condition (population), clinical / translational (subfield)
Methods: Statistics, Physiology & signal measures
Keywords: Transcranial direct current stimulation (tDCS), Metabolic bariatric surgery (MBS), Obesity, Impulsivity, Inhibitory control training, Neuromodulation, Non-invasive brain stimulation (NIBS), Prefrontal cortex, Self-regulation, Weight loss maintenance
MeSH: Bariatric Surgery*, Obesity, Morbid*, Transcranial Direct Current Stimulation*, Adult, Feasibility Studies, Feeding Behavior, Female, Humans, Impulsive Behavior, Inhibition, Psychological, Male, Middle Aged, Pilot Projects, Quality of Life, Treatment Outcome, Weight Loss (* major topic)
Topic: Eating Disorders and Behaviors (Clinical Psychology, Psychology), according to OpenAlex
Funding: Otto-von-Guericke-Universität Magdeburg (3121)
Citations: not cited yet (Europe PMC); 73 references in the paper
Notices: A correction to this paper has been published (42584767, from Europe PMC)

Abstract

Introduction: Heightened food-specific impulsivity, associated with prefrontal cortex hypoactivity, may impair outcomes following metabolic bariatric surgery (MBS). This pilot study examined the feasibility of transcranial direct current stimulation (tDCS) targeting the right dorsolateral prefrontal cortex (dlPFC) combined with an individualized food-specific inhibitory control training addressing behavioral impulsivity alongside psychosocial follow-up (FU) care to support early postoperative lifestyle adaptation.

Methods: Within 18 months post-MBS, n = 19 patients were randomized to 6 sessions of verum or sham tDCS over the right dlPFC combined with inhibition training and psychosocial group sessions. Acceptability, feasibility, food-specific impulsivity and diverse secondary outcomes (e.g., quality of life) were assessed 4 weeks (t1) and 3 months (t2) post-tDCS through (BS-specific) interviews, validated questionnaires and blood samplings.

Result: Retention (67 – 80%) and satisfaction (M> 4.38, 1 – 5) were high, improvements in eating behavior and impulse control moderate (M = 3.56, 1 – 5) and side effects negligible (M= 1.46, 1 – 5). Both groups showed moderate improvements in behavioral impulsivity, self-reported perceived hunger and quality of life, body-mass-index and endocrine markers.

Conclusion: Potential effects may have been attenuated through the small, highly motivated, treatment-seeking sample and the rapidly evolving early postoperative phase. Future fully powered trials should include neurobiological outcome measures that may capture tDCS-induced neural changes earlier and extend FU intervals to clarify efficacy and optimize postbariatric stimulation protocols. Incorporating dismantling designs would further help to disentangle the specific contributions of tDCS, the inhibitory control training and psychosocial care.

Supplementary Information: The online version contains supplementary material available at 10.1007/s11695-026-08828-6.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

No file of the authors' code could be read here: it is described below, and read at its source.

OSF 4aktp

License: none: the authors keep all their rights
State: unreachable at the last attempt, verified on 29 September 2026
Evidence: found in the paper
Software Heritage: not checked
Found in: “Data Availability”
Not found: README, license file, CITATION.cff, environment file, tests, continuous integration, documentation
Availability: 5 checks, the latest on 29 September 2026: unreachable at the last attempt (HTTP 401)
  • 29 September 2026: unreachable at the last attempt (HTTP 401)
  • 28 September 2026: unreachable at the last attempt (HTTP 401)
  • 28 September 2026: unreachable at the last attempt (HTTP 401)
  • 27 September 2026: unreachable at the last attempt (HTTP 401)
  • 27 September 2026: unreachable at the last attempt (HTTP 401)
At the source: osf.io/4aktp/

The paper's code and data availability statement is in the Data section.

Tracing map

Proposed by the machine: these links were found in the paper and verified at the source, without human review. The map will receive a Zenodo DOI once one of the paper's authors has validated it with their ORCID.

What the map holds:

  • 1 repository of the authors' code, each at its verified commit, with its license and how the link was found in the paper;
  • 0 scripts, each with its path and the digest of its content;
  • no match between paragraphs and code yet;
  • neither the text of the paper nor the code itself.

Its JSON (tracing-map.json) is deposited on Zenodo with its DOI once the map is validated.

Data

No dataset and no data link were found in the paper.

Data Availability

The datasets generated and/or analyzed during the current study due to privacy and ethical restrictions but are available from the corresponding author upon reasonable request. All analysis scripts are publicly available at the Open Science Framework (https://osf.io/4aktp/).

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 2, 28 September 2026

  • Publisher: n/a → Springer Science+Business Media

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 10 authors, 10 keywords, 16 MeSH terms, 1 funder, 68 references, 1 integrity notice.

Cite

This paper

Rösch, S. A., Thiele, C., Reinstaller, T., Zähle, T., Schag, K., Giel, K., Plewnia, C., Steiner, J., Junne, F., & Vogt, S. (2026). Enhancing Postoperative Outcomes After Metabolic Bariatric Surgery: a Pilot Study of Inhibitory Control Training, Transcranial Direct Current Stimulation and Psychosocial Aftercare. Obesity surgery, 36(8), 4316-4327. https://doi.org/10.1007/s11695-026-08828-6

BibTeX

@article{rosch2026enhancing,
author = {Rösch, Sarah Alica and Thiele, Carsten and Reinstaller, Therese and Zähle, Tino and Schag, Kathrin and Giel, Katrin and Plewnia, Christian and Steiner, Johann and Junne, Florian and Vogt, Susanne},
title = {{Enhancing Postoperative Outcomes After Metabolic Bariatric Surgery: a Pilot Study of Inhibitory Control Training, Transcranial Direct Current Stimulation and Psychosocial Aftercare}},
journal = {Obesity surgery},
year = {2026},
month = jul,
volume = {36},
number = {8},
pages = {4316--4327},
publisher = {Springer Science+Business Media},
issn = {0960-8923},
doi = {10.1007/s11695-026-08828-6},
url = {https://doi.org/10.1007/s11695-026-08828-6},
pmid = {42455493},
pmcid = {PMC13429539}
}

RIS

TY - JOUR
AU - Rösch, Sarah Alica
AU - Thiele, Carsten
AU - Reinstaller, Therese
AU - Zähle, Tino
AU - Schag, Kathrin
AU - Giel, Katrin
AU - Plewnia, Christian
AU - Steiner, Johann
AU - Junne, Florian
AU - Vogt, Susanne
TI - Enhancing Postoperative Outcomes After Metabolic Bariatric Surgery: a Pilot Study of Inhibitory Control Training, Transcranial Direct Current Stimulation and Psychosocial Aftercare
T2 - Obesity surgery
J2 - Obes Surg
PY - 2026
DA - 2026/07/15
VL - 36
IS - 8
SP - 4316
EP - 4327
SN - 0960-8923
PB - Springer Science+Business Media
DO - 10.1007/s11695-026-08828-6
UR - https://doi.org/10.1007/s11695-026-08828-6
LA - en
ER -

CSL-JSON

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