Translational aspects of body image research for obesity-related quality of life and weight loss maintenance post-bariatric surgery

Marie L Caltabiano, Marie L Caltabiano

Abstract

Background: The Aim of the study was to examine obesity health-related quality of life and body image satisfaction in a group of individuals having undergone bariatric surgery.

Methods: One hundred and forty-two persons who had undergone bariatric surgery answered an online survey which included measures of well-being and body image. The Multidimensional Body Self-Relations Questionnaire-Appearance Scales (MBSRQ-AS 34) was used to assess body image in relation to appearance evaluation (AE), appearance orientation (AO), overweight preoccupation (OP), self-classified weight (SCW), and body areas satisfaction (BASS). Obesity-related quality of life was assessed with the obesity related well-being scale (Orwell 97).

Results: Hierarchical multiple regression indicated that 50.2% of the variance in well-being post-surgery was explained by body image variables [F(6,84) =18.54, P<0.01], with the strongest predictor being satisfaction with body areas (B=-0.360, P<0.01). Regression analysis of the data for the group of patients who had received the vertical sleeve surgery was also significant, [F(6,56) =10.16, P<0.001] with satisfaction with different body areas being the best predictor of well-being (B=-0.365, P<0.05), followed by OP (B=0.313, P<0.05) and SCW (B=0.281, P<0.05).

Conclusions: Body image concerns are more important predictors for well-being post bariatric surgery than weight lost. Psychological factors such as the perception of body areas, continued weight preoccupation and SCW rather an objective weight were better predictors of well-being, symptoms that impacted on well-being and on the subjective relevance of the symptoms to well-being. Recommendations for the translation of the present research findings for the surgical preparation of the bariatric patient and for post-surgery care are suggested.

Keywords: Bariatric surgery; body image; obesity-related well-being; weight lost.

Conflict of interest statement

Conflicts of Interest: The focused issue “Bariatric Surgery” was commissioned by the editorial office without any funding or sponsorship. The author has no conflicts of interest to declare.

2020 Annals of Translational Medicine. All rights reserved.

References

    1. Titler MG. Overview of the U.S. invitational conference "Advancing Quality Care through Translation Research". Worldviews Evid Based Nurs 2004;1 Suppl 1:S1-5. 10.1111/j.1524-475X.2004.04053.x
    1. AIHW: Australian Institute of Health and Welfare. Overweight and obesity. Accessed online on 28th Nov. Available online:
    1. AIHW: Australian Institute of Health and Welfare. Weight loss surgery in Australia 2014-15: Australian hospital statistics. Cat. no. HSE 186. Canberra: AIHW, 2017.
    1. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess 2009;13:1-190, 215-357, iii-iv. 10.3310/hta13410
    1. Saunders TJ, Tremblay MS, Després JP, et al. Sedentary Behaviour, Visceral Fat Accumulation and Cardiometabolic Risk in Adults: A 6-Year Longitudinal Study from the Quebec Family Study. PLoS One 2013;8:e54225. 10.1371/journal.pone.0054225
    1. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med 2013;273:219-34. 10.1111/joim.12012
    1. Magro DO, Geloneze B, Delfini R, et al. Long-term Weight Regain after Gastric Bypass: A 5-year Prospective Study. Obes Surg 2008;18:648-51. 10.1007/s11695-007-9265-1
    1. Lager CJ, Esfandiari NH, Subauste AR, et al. , Milestone weight loss goals (Weight normalization and emission of obesity) after gastric bypass surgery: Long term results from the University of Michigan. Obes Surg 2017;27:1659-66. 10.1007/s11695-016-2533-1
    1. Topart P, Becouarn G, Delarue J. Weight loss and nutritional outcomes 10 years after biliopancreatic diversion with duodenal switch. Obes Surg 2017;27:1645-50. 10.1007/s11695-016-2537-x
    1. Kowalewski PK, Olszewski R, Kwiatkowski A, et al. Life with a Gastric Band. Long-Term Outcomes of Laparoscopic Adjustable Gastric Banding-a Retrospective Study. Obes Surg 2017;27:1250-3. 10.1007/s11695-016-2435-2
    1. Bittner JG, Clingempeel NL, Wolf LG. Weight loss failure and reoperation after laparoscopic adjustable gastric banding and gastric bypass: A case-matched cohort study. Obes Surg 2017;27:2885-9. 10.1007/s11695-017-2691-9
    1. Monaco-Ferreira DV, Leandro-Merhi VA. Weight regain 10 years after Roux-en-Y gastric bypass. Obes Surg 2017;27:1137-44. 10.1007/s11695-016-2426-3
    1. Arapis K, Tammaro P, Parenti R., et al. Long-term results after Laparoscopic adjustable gastric banding for morbid obesity: 18 year follow-up in a single University unit. Obes Surg 2017;27:630-40. 10.1007/s11695-016-2309-7
    1. Adami GF, Scopinaro N, Cordera R. Adipokine Pattern After Bariatric Surgery: Beyond the Weight Loss. Obes Surg 2016;26:2793-801. 10.1007/s11695-016-2347-1
    1. Yang J, Feng X, Zhong S, et al. Gastric Bypass Surgery May Improve Beta Cell Apoptosis with Ghrelin Overexpression in Patients with BMI ≥ 32.5kg/m2. Obes Surg 2014;24:561-71. 10.1007/s11695-013-1135-4
    1. Dawes AJ, Maggard-Gibbons M, Maher AR, et al. Mental health conditions among patients seeking and undergoing bariatric surgery: A meta-analysis. JAMA 2016;315:150-63. 10.1001/jama.2015.18118
    1. Miras AD, Al-Njim W, Jackson SN, et al. Psychological characteristics, eating behavior, and quality of life assessment of obese patients undergoing weight loss interventions Scand J Surg 2015;104:10-7. 10.1177/1457496914543977
    1. Diener E. Guidelines for national indicators of subjective well-being and ill-being. Appl Res Qual Life 2006;1:151-7. 10.1007/s11482-006-9007-x
    1. World Health Organization (WHO, 2019) WHOQOL: Measuring quality of life. Accessed 17 May, 2019. Available online:
    1. Biter LU, van Buuren MM, Mannaerts GH, et al. Quality of life 1 year after laparoscopic sleee gastrectomy versus laparoscopic roux-en-Y gastric bypass: a randomized controlled trial focusing on gastroesophageal reflux disease. Obes Surg 2017;27:2557-65. 10.1007/s11695-017-2688-4
    1. Monpellier VM, Antoniou EE, Aarts EO, et al. Improvement of health-related quality of life after Roux-en-Y Gastric bypass related with weight loss. Obes Surg 2017;27:1168-73. 10.1007/s11695-016-2468-6
    1. Flølo TN, Andersen JR, Kolotkin RL, et al. Five-Year Outcomes After Vertical Sleeve Gastrectomy for Severe Obesity: A Prospective Cohort Study. Obes Surg 2017;27:1944-51. 10.1007/s11695-017-2605-x
    1. Porta A, Aiolfi A, Musolino C, et al. Prospective comparison and quality of life for single-incision and conventional laparoscopic sleeve gastrectomy in a series of morbidly obese patients. Obes Surg 2017;27:681-7. 10.1007/s11695-016-2338-2
    1. Marzocchi R, Moscatiello S, Villanova N, et al. Psychological Profile and Quality of Life of Morbid Obese Patients Attending a Cognitive Behavioural Program. Psychological Topics 2008;17:349-60.
    1. Laurino Neto RM, Herbella FA. Changes in quality of life after short and long term follow-up of Roux-en-Y gastric bypass for morbid obesity. Arq Gastroenterol 2013;50:186-90. 10.1590/S0004-28032013000200033
    1. Lindekilde N, Gladstone BP, Lubeck M, et al. The impact of bariatric surgery on quality of life: a systematic review and meta-analysis. Obes Rev 2015;16:639-51. 10.1111/obr.12294
    1. Cash TF. Crucial considerations in the assessment of body image. In: Cash TF, Smolak L. editors, Body image: A Handbook of Science Practice, and Prevention. New York, Guiford Press, 2011:129-37.
    1. Ghai A, Milosevic I, Laliberte M, et al. Body image concerns in obese women seeking bariatric surgery. Ethnic Inequal Health Soc Care 2014;7:96-107. 10.1108/EIHSC-11-2013-0044
    1. Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg 2004;14:392-8. 10.1381/096089204322917936
    1. Geller S, Levy S, Goldzweig G, et al. Psychological distress among bariatric surgery candidates: The roles of body image and emotional eating. Clin Obes 2019;9:e12298. 10.1111/cob.12298
    1. Pona AA, Marek RJ, Heinberg LJ, et al. Psychological correlates of body image dissatisfaction before and after bariatric surgery. Bariatr Surg Pract Patient Care 2017;12:184-9. 10.1089/bari.2017.0021
    1. Sarwer DB, Wadden TA, Moore RH, et al. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis 2010;6:608-14. 10.1016/j.soard.2010.07.015
    1. Williams GA, Hudson DL, Whisenhunt BL, et al. Short-term changes in affective, behavioural and cognitive components of body image after bariatric surgery. Surg Obes Relat Dis 2018;14:521-6. 10.1016/j.soard.2017.12.026
    1. Alegría CA, Larsen B. "That's who I am: a fat person in a thin body": weight loss, negative self-evaluation, and mitigating strategies following weight loss surgery. J Am Assoc Nurse Pract 2015;27:137-44.
    1. Faccio E, Nardin A, Cipolletta S. Becoming ex-obese: Narrations about identity changes before and after the experience of the bariatric surgery. J Clin Nurs 2016;25:1713-20. 10.1111/jocn.13222
    1. Riva G. Neuroscience and eating disorders: The allocentric lock hypothesis. Med Hypotheses 2012;78:254-7. 10.1016/j.mehy.2011.10.039
    1. Perdue TO, Schreier A, Neil J, et al. A Concept Analysis of Disturbed Body Image in Bariatric Surgery Patients. Int J Nurs Knowl 2020;31:74-81. 10.1111/2047-3095.12220
    1. Song AY, Rubin JP, Thomas V, et al. Body Image and Quality of Life in Post Massive Weight Loss Body Contouring Patients. Obesity 2006;14:1626-36. 10.1038/oby.2006.187
    1. Pecori L, Cervetti G, Marinari GM, et al. Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring. Obes Surg 2007;17:68-73. 10.1007/s11695-007-9008-3
    1. de Zwaan M, Georgiadou E, Stroh CE, et al. Body image and quality of life in patients with and without body contouring surgery following bariatric surgery: a comparison of pre- and post-surgery groups. Front Psychol 2014;5:1310. 10.3389/fpsyg.2014.01310
    1. Ivezaj V, Grilo CM. The complexity of body image following bariatric surgery: A systematic review of the literature. Obes Rev 2018;19:1116-40. 10.1111/obr.12685
    1. Bertoletti J, Aparicio MJ, Bordignon S, et al. Body image and bariatric surgery: A systematic review of literature. Bariatr Surg Pract Patient Care 2018;14:81-92. 10.1089/bari.2018.0036
    1. Mannucci E, Ricca V, Barciulli E, et al. Quality of life and overweight: The obesity related well-being (Orwell 97) Questionnaire. Addict Behav 1999;24:345-57. 10.1016/S0306-4603(98)00055-0
    1. Brown TA, Cash TF, Mikulka PJ. Attitudinal Body-Image Assessment: Factor analysis of the Body-Self Relations Questionnaire. J Pers Assess 1990;55:135-44. 10.1207/s15327752jpa5501&2_13
    1. Cash TF, Morrow JA, Hrabosky JI, et al. How has body image changed? A cross-sectional investigation of college women and men from 1983 to 2001. J Consult Clin Psychol 2004;72:1081-9. 10.1037/0022-006X.72.6.1081
    1. Carels RA, Burmeister J, Oehlhof M, et al. Internalized weight bias: ratings of the self, normal weight, and obese individuals and psychological maladjustment. J Behav Med 2013;36:86-94. 10.1007/s10865-012-9402-8
    1. Dixon JB, Dixon ME, O'Brien PE. Body image: appearance orientation and evaluation in the severely obese. Changes with weight loss. Obes Surg 2002;12:65-71. 10.1381/096089202321144612
    1. Price HI, Gregory DM, Twells LK. Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study. BMC Obes 2014;1:28. 10.1186/s40608-014-0028-y
    1. Varns JA, Fish AF, Eagon C. Conceptualization of body image in the bariatric surgery patient. Appl Nurs Res 2018;41:52-8. 10.1016/j.apnr.2018.03.008
    1. Klassen AF, Cano SJ, Alderman A, et al. The BODY-Q: A patient-reported outcome instrument for weight loss and body contouring treatments. Plast Reconstr Surg Glob Open 2016;4:e679. 10.1097/GOX.0000000000000665
    1. Ristanto A, Caltabiano ML. Psychological Support and Well-being in Post-Bariatric Surgery Patients. Obes Surg 2019;29:739-43. 10.1007/s11695-018-3599-8

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