Page 94 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 5
the appearance evaluation and BDI (r=-0.519, p<0.001) and body area satisfaction and BDI (r=-0.557, p<0.001).
Mediation effect of body image
Since in the D-group all variables (%TWL, depressive symptoms, appearance eval- uation and body area satisfaction) were significantly correlated, a mediation analy- sis was conducted for this group. The total indirect effect of %TWL on depressive symptoms was -0.15, which leads to the rejection of the null hypothesis that the total indirect effect is zero (p=0.003). Therefore, depressive symptoms are partly, via the mediators: appearance evaluation and body-area satisfaction, influenced by %TWL. This means that a higher %TWL results in less depressive symptoms, via more posi- tive feelings of attractiveness and higher body-area satisfaction. The specific indirect effect through appearance evaluation is -0.04 and through body-area satisfaction is -0.11 (Table 4). Of the mediators examined, both appearance evaluation (p=0.003) and body-area satisfaction (p<0.001) were important mediators. This relationship was not influenced by baseline BMI (p=0.267) or gender (p=0.996).
Table 4:
Mediation effect of appearance evaluation and body-area satisfaction on the association between depression and percentage total weight loss in the desire-group.
Indirect effects appearance evaluation body-area satisfaction total
Contrast
appearance evaluation vs.
body-area satisfaction
DISCUSSION
Coefficient
-0.04** -0.11*** -0.15***
0.07
Product of Coefficients
Standard error
0.02 0.04 0.04
0.05
Bootstrapping
Bias Corrected
95% Confidance interval Lower Upper
-0.10 -0.01 -0.20 -0.04 -0.23 -0.07
-0.02 0.18
The current study assessed body image, depressive symptoms, weight loss and the relationship between these factors in a large post-bariatric population, focusing on the desire for BCS. Our results show striking differences between patients who had BCS, patients who desired BCS and patients who did not desire BCS. Patients with a desire for BCS had a more negative body image than patients who already had BCS and patients without a desire for BCS. The patients with a desire also showed more depressive symptoms than patients without a desire. Moreover, in the population with
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