Highlights
- •body image is an important indicator of patient's well-being
- •desire for body contouring surgery is related to a negative body image and depressive symptoms
- •higher weight loss is related in less depressive symptoms, via positive body image
- •body image should be considered a key outcome in post-bariatric patients.
Abstract
Background
Overhanging skin in postbariatric patients leads to a negative body image. In patients
with obesity, negative body image is related to more depressive symptoms and a higher
weight. This relationship might also be important in postbariatric patients, because
improvement of body image via body contouring surgery (BCS) could lead to better weight
loss results.
Objectives
To evaluate the relationship between body image, depressive symptoms, and weight loss
in a postbariatric population, focusing on desire for BCS.
Setting
Outpatient clinic.
Methods
One thousand twenty-four primary bariatric surgery patients were contacted, and 590
patients agreed to participate and filled in online questionnaires regarding body
image (Body Shape Questionnaire and Multidimensional Body-Self Relations Questionnaire-Appearance
Scales) and depression (Beck Depression Inventory-II). Differences between patients
who had BCS, patients who desired BCS, and patients who did not desire BCS were studied.
The mediating role of body image in the association between percentage total weight
loss and depressive symptoms was assessed via a 2-mediator model.
Results
There was a desire for BCS in 368 patients (62.4%); these patients had significantly
lower scores on appearance evaluation and body image satisfaction scales and showed
more depressive symptoms. Patients without a desire (n = 157, 26.6%) had lowest rates
of depressive symptoms and a more positive body image. Sixty-five patients (11.0%)
had undergone BCS. In the patients who desired BCS, percentage total weight loss was
negatively affected by depressive symptoms via appearance evaluation and body-area
satisfaction.
Conclusions
There are striking differences regarding body image satisfaction and depressive symptoms
when comparing postbariatric patients and without desire for BCS. Body image satisfaction
is associated with less depressive symptoms in all postbariatric patients. In patients
who desired BCS, body image is one of the mediators of the relationship between percentage
total weight loss and depressive symptoms. Therefore, body image should be taken seriously
and be part of outcome assessment in postbariatric patients.
Keywords
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Article info
Publication history
Published online: May 15, 2018
Accepted:
April 20,
2018
Received in revised form:
April 18,
2018
Received:
December 1,
2017
Identification
Copyright
© 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
