Page 90 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 5
Table 1:
Overview of questionnaires used with score range and explanation of scoring.
Body Shape Questionnaire
Total score 16 - 96 higher score means more concerns about shape Multidimensional Body-Self Relations Questionnaire-Appearance Scales
appearance evaluation appearance orientation body-area satisfaction scale overweight preoccupation self-classified weight
Beck Depression Inventory II Total score
Statistical analyses
1 -5 1 -5 1 -5 1 -5 1 -5
0 - 63
higher score indicates more positive evaluation higher score indicates more investment
higher score indicates more satisfaction
higher score indicates more preoccupation higher score indicates higher body weight
higher score means more depressive symptoms
Descriptive statistics were calculated to summarize baseline characteristics. Indepen- dent samples t-tests and chi-square tests were used to compare the characteristics of the patients who were included and the patients who were excluded, to ensure this did not influence the results.
Subsequently, the included population was divided into three groups:
1. patients who already underwent BCS = BCS-group
2. patients who desired BCS = D-group
3. patients without a desire for BCS = ND-group
Differences in age, weight change before and after bariatric surgery, body image, and depressive symptoms between the three groups were calculated using one-way ANOVA. Gender and type of bariatric surgery were compared using a chi-square anal- ysis.
Subsequently, the relationship between depressive symptoms and %TWL was as- sessed with a mediation analysis. A mediation analysis assesses how an independent variable affects a dependent variable, through intervening variables (the mediators) 44. In this study, the mediating role of body image on the relationship between %TWL and depressive symptoms was assessed via a two-mediator model (Figure 1). The appear- ance evaluation scale and body-area satisfaction scale were chosen as mediators. First, because these scales reflect how patients feel about their bodies; lower scores reflect more negative body image 39. Secondly, because these variables are known to change after bariatric surgery and BCS 20,23,32,45. Pearson’s correlations between %TWL, depressive symptoms and body image (appearance evaluation and body-ar- ea satisfaction scale) were calculated for each of the groups. In case of significant correlations, a mediation analysis was conducted for that specific group. Baseline BMI and gender were included as covariates in this analysis. Bootstrapping was used to obtain confidence intervals (CIs) 44. Mediation was considered to have occurred if the 95% bias corrected CIs for the effects generated did not contain zero. Findings of other analysis were considered statistically significant if the p-value was <0.05.
All analyses were performed using SPSS, version 23 (IBM Corp. Released 2015. IBM
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