Changes in body image and other psychological factors after intestinal bypass surgery for massive obesity.

A group of massively obese persons (predominantly women) was evaluated 6 months prior to intestinal bypass surgery and again while in the hospital awaiting surgery. A second follow-up group of massively obese persons was evaluated on the same measures in-hospital prior to surgery and then assessed periodically over the subsequent 1-year period. The 6-months-before-surgery group showed a general decline in concern with physical symptoms, anxiety, and social introversion at the in-hospital evaluation. The surgery follow-up group exhibited an increasing improvement, as weight loss progressed, in body image, feelings of physical and sexual attractiveness, and evaluation of one's personality. An improvement in mood also was seen. Body size estimation showed a realistic adjustment with weight loss. Both groups scored higher than average on a measure of the addictive personality. Follow-up of the nonresponders indicated that a substantial proportion of those persons had psychological or severe physical problems subsequent to surgery.