Abstract
Introduction: Together with sociodemographic and clinical features, locus of control and self-efficacy may impact the processes underlying changes in eating habits. Objectives: To study the relationships of sociodemographic and clinical characteristics, locus of control, general self-efficacy and eating self-efficacy with the perception of adherence to healthy eating among patients undergoing treatment for overweight. Methodology: A convenience sample of 74 overweight (BMI = 25.0 kg/m2) individuals (77.0% females, mean age = 41 years, SD = 11) attending nutrition consultations was studied regarding sociodemographic and clinical data, stages of change towards healthy eating, health locus of control (Health Locus of Control Scale), eating self-efficacy (General Eating Self-Efficacy Scale) and general self-efficacy (Self-Concept Clinical Inventory’s self-efficacy factor). Results: Approximately two-thirds (67.6%) of participants were in the “Action/Maintenance” stage towards healthy eating. In the total locus of control scale, general self-efficacy and eating self-efficacy, participants showed average scores slightly higher than the midpoint of the respective scales. In a binary logistic regression model, sociodemographic, clinical, locus of control and self-efficacy variables significantly predicted being in the action/maintenance stage towards healthy eating (p < 0.001; Nagelkerkle’s R2 = 48.4%). A higher proportion of weight loss (adjusted Exp(ß) = 1.074, p = 0.017) and higher eating self-efficacy (adjusted Exp(ß) = 1.317, p = 0.005) were significantly associated with higher odds of being in the “Action/Maintenance” stage. Conclusions: Most participants attending nutrition consultations to treat overweight considered following a healthy diet. Higher eating self-efficacy and greater weight loss associated to being in the “Action/Maintenance” stage towards healthy eating.

Abstract
Background/Objectives: Obesity is a major contributor to cardiovascular disease, yet traditional risk assessment methods may overlook behavioral and circadian influences that modulate metabolic health. Chronotype, physical activity, sleep quality, eating speed, and breakfast habits have been increasingly associated with cardiometabolic outcomes. This study aims to evaluate the associations between these behavioral factors and both anthropometric and biochemical markers of cardiovascular risk among obese candidates for bariatric surgery. Methods: A cross-sectional study was conducted in a sample of 286 obese adults (78.3% females, mean 44.3 years, SD = 10.8, mean BMI = 42.5 kg/m2, SD = 6.2) followed at a central Portuguese hospital. Chronotype (reduced Morningness-Eveningness Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), physical activity (Godin-Shephard Questionnaire), eating speed, and breakfast skipping were assessed. Cardiovascular risk markers included waist-to-hip ratio (WHR), waist-to-height ratio, A Body Shape Index (ABSI), Body Roundness Index, atherogenic index of plasma (AIP), triglyceride-glucose index (TyG), and homeostatic model assessment for insulin resistance (HOMA-IR). Results: Men exhibited significantly higher WHR, ABSI, HOMA-IR, TyG, and AIP. Eveningness was associated with higher insulin (r = -0.168, p = 0.006) and HOMA-IR (r = -0.156, p = 0.011). Poor sleep quality was associated with higher body fat mass (r = 0.151, p = 0.013), total cholesterol (r = 0.169, p = 0.005) and LDL cholesterol (r = 0.132, p = 0.030). Faster eating speed was associated with a higher waist circumference (r = 0.123, p = 0.038) and skeletal muscle mass (r = 0.160, p = 0.009). Conclusions: Male sex, evening chronotype, and poor sleep quality were associated with more adverse cardiometabolic profiles in individuals with severe obesity. These findings support the integration of behavioral and circadian factors into cardiovascular risk assessment strategies.