Page 86 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 5
BACKGROUND
ABSTRACT
Overhanging skin in post-bariatric patients leads to a negative body image. In pa- tients with obesity a negative body image is related to more depressive symptoms and a higher body weight. This relationship might also be important in post-bariatric patients, since improvement of body image, via body contouring surgery (BCS) could lead to better weight loss results. The objective was to evaluate the relationship be- tween body image, depressive symptoms and weight loss in a post-bariatric popula- tion, focusing on desire for BCS.
METHODS
1024 Primary bariatric surgery patients were contacted; 590 patients agreed to partic- ipate and filled in online questionnaires regarding body image (Body Shape Question- naire 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 (%TWL) and depressive symptoms was assessed via a two-mediator model.
RESULTS
There was a desire for BCS in 368 patients (62.4%); these patients had significant- ly lower scores on appearance evaluation and body image satisfaction scales and they 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, %TWL was negatively affected by depressive symptoms via appearance evaluation and body-ar- ea satisfaction.
CONCLUSION
There are striking differences regarding body image satisfaction and depressive symptoms when comparing post-bariatric patients by desire for BCS. Body image satisfaction is associated with less depressive symptoms in all post-bariatric patients. In patients who desired BCS, body image is one of the mediators of the relationship between %TWL and depressive symptoms. Therefore, body image should be taken seriously and be part of outcome assessment in post-bariatric patients.
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