Page 95 - When surgery alone won’t cut it - Valerie Maureen Monpellier

a desire for BCS, a higher %TWL was related in less depressive symptoms, via more positive feelings of attractiveness and higher body-area satisfaction. Thus, the rela- tionship between weight loss and depressive symptoms was partly explained by body image. In all patients a better body image was related to less depressive symptoms. There was a desire for BCS in more than 60% of the study population, which is in con- cordance with previous research 3,6-9. The patients who desire BCS showed a higher prevalence of depressive symptoms compared to patients who did not desire BCS. Several studies have shown higher appearance evaluation and body-area satisfaction after bariatric surgery and BCS 20,23,32,45. Our ‘desire’ population had more concerns about their body, felt less attractive and less satisfied with their appearance compared to patients who had no desire for BCS and patients who already had BCS. The char- acteristics of the desire-group (negative body image and more depressive symptoms) are known to negatively impact bodyweight in patients with obesity 28-33.
Surprisingly, the patients who had undergone BCS showed some similarities with the patients who desired BCS. They both show higher appearance concerns and were both more pre-occupied with overweight stigmata. Research has shown that after bariatric surgery and body contouring, appearance evaluation and body area satis- faction improve, but the overweight pre-occupation might remain 20,23. Thus, it could well be that the patients who desire BCS and the patients who have had BCS are basically the same type of patients, but body image in the BCS group have improved partly as a consequence of the body contouring procedure(s). Though these data are correlational and therefore causal conclusions cannot be drawn.
Interestingly more than a quarter of the studied patients did not have a desire for BCS; this group differs considerably from patients who already had BCS and the patients with a desire for BCS. These patients are less focused on their appearance and less preoccupied by overweight cognitions; even though they had the lowest weight loss and highest current BMI. Patients with a desire for BCS were even more preoccupied although they lost more weight and had a comparable BMI.
In the group with a desire for BCS, %TWL, depressive symptoms, appearance eval- uation and body area satisfaction were all significantly correlated. Higher weight loss was related to less depressive symptoms and a more positive body image. And in all three groups more positive feelings of physical attractiveness and higher satisfaction with the body were related to less depressive symptoms. Thus, even in the population without a desire for BCS a more negative body image is related to negative affect, like in the obese (pre-bariatric) population 28,30.
Our hypothesis was that, like in patients with obesity, body image would partly medi- ate the relationship between weight loss and depressive symptoms in the post-bar- iatric patients who had not undergone BCS 30,31. Our results show that only in the
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