Psychological predictors of body image concerns 3 months after bariatric surgery

Ashleigh A Pona; Leslie J Heinberg; Megan Lavery; Yossef S Ben-Porath; Julie Merrell Rish

doi:10.1016/j.soard.2015.05.008

Psychological predictors of body image concerns 3 months after bariatric surgery

Surg Obes Relat Dis. 2016 Jan;12(1):188-93. doi: 10.1016/j.soard.2015.05.008. Epub 2015 Jun 22.

Authors

Ashleigh A Pona¹, Leslie J Heinberg², Megan Lavery², Yossef S Ben-Porath³, Julie Merrell Rish⁴

Affiliations

¹ University of Missouri-Kansas City, Kansas City, Missouri.
² Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio.
³ Kent State University, Kent, Ohio.
⁴ Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, Ohio; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio. Electronic address: merrelj@ccf.org.

PMID: 26525368
DOI: 10.1016/j.soard.2015.05.008

Abstract

Background: Although studies have associated postoperative weight loss with improvement in body image dissatisfaction, some individuals continue to report body image concerns after bariatric surgery. These concerns are linked to increased depressive symptoms and decreased self-esteem in bariatric populations.

Objective: This study sought to explore preoperative factors that may predict early body image concerns 3 months after bariatric surgery.

Setting: Academic medical center.

Method: Data were analyzed from 229 patients evaluated for bariatric surgery who completed a 3-month postoperative psychology appointment and the Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form (MMPI-2-RF). Scales measuring depression, persecution, self-doubt, and inadequacy were examined. Medical records were reviewed for demographic characteristics, psychotropic medication usage, history of psychological treatment, and current or lifetime depression diagnosis.

Results: Patients who preoperatively scored higher on demoralization (F [1, 227] = 35.40, P< .001), low positive emotions (F [1, 227] = 4.18, P< .05), ideas of persecution (F [1, 227] = 15.24, P< .001), self-doubt (F [1, 227] = 27.47, P< .001), and inefficacy (F [1, 227] = 21.34, P< .001) were significantly more likely to report body image concerns 3 months after bariatric surgery. Similarly, body image concerns were more common in patients with a preoperative depression diagnosis (χ(2) = 8.76, P<.01), current psychotropic medication usage (χ(2) = 7.13, P<.01), and history of outpatient therapy (χ(2) = 8.34, P<.01) and psychotropic medication (χ(2) = 9.66, P< .001).

Conclusion: Bariatric surgery candidates with psychopathology and other psychological risk factors are more likely to report body image concerns early after bariatric surgery. Future research is warranted to determine whether this association remains further out from surgery.

Keywords: Bariatric surgery; Body image; Depression; MMPI-2-RF; Self-esteem.

MeSH terms

Adult
Aged
Bariatric Surgery*
Body Image / psychology*
Female
Follow-Up Studies
Humans
MMPI
Male
Middle Aged
Obesity, Morbid / psychology
Obesity, Morbid / surgery*
Postoperative Period
Prognosis
Retrospective Studies
Time Factors
Young Adult