Page 88 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 5
in which the relationship between weight and depression was partially mediated by body image 28-33. In the population who already had BCS we expected a better body image and no relationship between weight and depressive symptoms.
MATERIALS AND METHODS
Standard treatment
Patients were all treated at the Nederlandse Obesitas Kliniek (Dutch Obesity Clinic). The NOK is the largest outpatient clinic for treatment of bariatric patients in the Neth- erlands. All patients follow pre- and postoperative group counselling by a specialized multidisciplinary team consisting of a dietician, a psychologist, a physical therapist and a medical doctor. The data used for this study were part of a large cross-sectional study. The study was approved by the Psychology Ethics Committee of Maastricht University (ECP 06_11_2014).
Patient selection
Patients were selected from a prospective database. Since BCS is usually performed 12 months after stabilization of the bodyweight, patients who had a primary bariatric procedure two to three years before the start of the study were selected for partici- pation. Study start was January 2nd 2015, to ensure follow-up was at least 2 years, patients who had undergone a bariatric procedure between October 2011 and No- vember 2012 were selected. Patients were excluded if body weight measures before and/or one year after bariatric surgery were not available.
There were 1,334 patients eligible for inclusion in the study; 1,024 patients were suc- cessfully contacted by electronic invitations. A total of 689 patients responded and 590/1024 patients (58%) agreed to participate, signed informed consent and were included in the study.
Data collection
Demographics and weight measurements before and at 12 and 24 months after bar- iatric surgery were collected from the prospective database. Body Mass Index (BMI), change in BMI (ΔBMI), percentage total weight loss (%TWL) and percentage excess weight loss (%EWL) were calculated according to current guidelines (35).
Results for the questionnaires were electronically collected after patients agreed to participation.
Questionnaires
Body contouring surgery
To assesses desire for BCS, patients were asked whether they wanted to undergo plastic surgery because of overhanging skin. It was also assessed if they had already
88