Nederlandse Obesitas Kliniek, Huis ter Heide, Utrecht, the Netherlands; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands.
Surg Obes Relat Dis. 2018 Oct;14(10):1507-1515. doi: 10.1016/j.soard.2018.04.016. Epub 2018 Jun 7.
Overhanging skin in postbariatric patients leads to a negative body image. In patients with obesity, negative body image is related to more depressive symptoms and a higher weight. This relationship might also be important in postbariatric patients, because improvement of body image via body contouring surgery (BCS) could lead to better weight loss results.
To evaluate the relationship between body image, depressive symptoms, and weight loss in a postbariatric population, focusing on desire for BCS.
Outpatient clinic.
One thousand twenty-four primary bariatric surgery patients were contacted, and 590 patients agreed to participate and filled in online questionnaires regarding body image (Body Shape Questionnaire and Multidimensional Body-Self Relations Questionnaire-Appearance Scales) and depression (Beck Depression Inventory-II). Differences between patients who had BCS, patients who desired BCS, and patients who did not desire BCS were studied. The mediating role of body image in the association between percentage total weight loss and depressive symptoms was assessed via a 2-mediator model.
There was a desire for BCS in 368 patients (62.4%); these patients had significantly lower scores on appearance evaluation and body image satisfaction scales and showed more depressive symptoms. Patients without a desire (n = 157, 26.6%) had lowest rates of depressive symptoms and a more positive body image. Sixty-five patients (11.0%) had undergone BCS. In the patients who desired BCS, percentage total weight loss was negatively affected by depressive symptoms via appearance evaluation and body-area satisfaction.
There are striking differences regarding body image satisfaction and depressive symptoms when comparing postbariatric patients and without desire for BCS. Body image satisfaction is associated with less depressive symptoms in all postbariatric patients. In patients who desired BCS, body image is one of the mediators of the relationship between percentage total weight loss and depressive symptoms. Therefore, body image should be taken seriously and be part of outcome assessment in postbariatric patients.
超重皮肤会导致后减重患者出现负面的身体形象。在肥胖患者中，负面的身体形象与更多的抑郁症状和更高的体重有关。这种关系在减重后患者中也可能很重要，因为通过身体整形手术（BCS）改善身体形象可能会导致更好的减肥效果。
评估后减重人群的身体形象、抑郁症状和体重减轻之间的关系，重点关注对 BCS 的需求。
门诊诊所。
联系了 1024 名原发性减重手术患者，其中 590 名患者同意参与并在线填写了身体形象（身体形状问卷和多维身体自我关系问卷-外貌量表）和抑郁（贝克抑郁量表-II）问卷。研究了接受 BCS、希望接受 BCS 和不希望接受 BCS 的患者之间的差异。通过 2 个中介模型评估身体形象在总体重减轻百分比与抑郁症状之间的关联中的中介作用。
有 368 名患者（62.4%）有接受 BCS 的愿望，他们在外表评价和身体形象满意度量表上的得分明显较低，并且表现出更多的抑郁症状。没有愿望的患者（n=157，26.6%）抑郁症状发生率最低，身体形象更为积极。有 65 名患者（11.0%）接受了 BCS。在希望接受 BCS 的患者中，总体重减轻百分比通过外表评价和身体区域满意度受到抑郁症状的负面影响。
比较后减重患者和无 BCS 愿望的患者，在身体形象满意度和抑郁症状方面存在显著差异。在所有后减重患者中，身体形象满意度与较少的抑郁症状相关。在希望接受 BCS 的患者中，身体形象是总体重减轻百分比和抑郁症状之间关系的中介因素之一。因此，应认真对待身体形象，并将其作为后减重患者的结果评估的一部分。
