Background and Aims Obesity is often accompanied by symptoms of disordered eating. Although bariatric metabolic surgery can alleviate these symptoms, there are significant individual differences in postoperative outcomes, and effective predictive indicators are lacking. Liver and kidney function, along with lipid profiles, are closely related to metabolic status and may serve as useful markers for preoperative risk stratification and prognosis prediction. This study was conducted to explore the relationship between preoperative metabolic indicators and symptoms of disordered eating, thereby identifying postoperative recovery patterns among obese patients to support individualized management strategies.Methods A total of 41 obese patients who underwent sleeve gastrectomy at Shanghai Sixth People's Hospital between September 2020 and June 2023 were enrolled, along with 36 healthy volunteers recruited during the same period. Participants completed the Eating Disorder Inventory-2 (EDI-2) questionnaire, and serum samples were collected to assess liver function, kidney function, and lipid levels prior to surgery. The Mantel test was used to analyze correlations between metabolic indicators and EDI-2 scores. Latent profile analysis (LPA) was conducted using the indicators significantly correlated with EDI-2 scores to identify subgroups within the obese cohort. Linear mixed models were then applied to examine the trajectories of postoperative symptom changes across subgroups.Results Levels of cystatin C, cholinesterase, gamma-glutamyl transferase, triglycerides,and apolipoprotein E were significantly higher in the obese group compared to the healthy group (all P<0.05), and EDI-2 total score was also significantly elevated (P<0.05); the prealbumin level in the healthy group was significantly higher than that in the obese group (P<0.05). These six indicators were positively correlated with EDI-2 score (all r>0.20, P<0.05). Based on these markers, the LPA classified the obese group into two subgroups, with subgroup 2 exhibiting higher levels of most metabolic indicators than subgroup 1. During the 18-month postoperative follow-up, both subgroups showed reductions in EDI-2 score, but symptom improvement in subgroup 2 occurred later (month 6) compared to subgroup 1 (month 4).Conclusion Preoperative levels of cholinesterase, gamma-glutamyl transferase, prealbumin, triglycerides, and apolipoprotein E may serve as predictive indicators for improvement in disordered eating symptoms. Recovery patterns after bariatric surgery vary among obese patients with different metabolic profiles, highlighting the need for tailored intervention strategies.