Variation in psychological well-being and body image in patients before and after bariatric surgery
DeMeireles A, Cassidy R, Ross R, Stricklen A, Carlin AM, Finks JF, and Ghaferi AA. Variation in psychological well-being and body image in patients before and after bariatric surgery. Surgical Endoscopy and Other Interventional Techniques 2017; 31(Suppl 1):S7.
Surgical Endoscopy and Other Interventional Techniques
Introduction: Massive weight loss with bariatric surgery has the potential to improve body image and psychological well-being. However, traditional instruments used to measure health related quality of life (HRQL) have not been tailored to bariatric patients. Therefore, we sought to utilize a new patient-reported outcome (PRO) instrument to assess psychological well-being and satisfaction with body image before and after bariatric surgery. Methods: We administered the Body-Q survey to two cohorts of patients in the Michigan Bariatric Surgery Collaborative (MBSC)\-pre-bariatric surgery (n=287) and one-year post-bariatric surgery (n=1669). The Body-Q is a patient-reported outcome instrument designed to measure patient perceptions of weight loss. It has been validated in large populations of patients who have undergone bariatric surgery or body contouring procedures to assess PROs in this subset of patients. We linked the survey data to prospectively collected data from the MBSC to assess associations between body image/psychological well-being and clinical characteristics and outcomes such as age, gender, race, income, marital status, BMI, percent excess body weight loss (% EBWL), and comorbidity burden. Results: Higher preoperative body image scores were associated with black race only (p<0.01). Higher preoperative psychological well-being scores were associated with male gender (p<0.001) and black race (p<0.010. There was no association with BMI or other demographic factors in the preoperative setting. Postoperative body image was positively (ie, higher scores) associated with male gender (p<0.001), lower BMI (p<0.0001), and higher mean %EBWL (p<0.0001). Postoperative psychological well-being was positively associated with male gender (p<0.001), black race (p<0.01), lower BMI (p<0.01), and higher mean %EBWL (p<0.0001). When patients were divided into terciles by their body image and psychological well-being scores, the mean %EBWL in the highest scoring terciles were 65.7% and 63.4%, respectively, as compared to 51.9% and 56.2% in the lowest terciles, repectively. Conclusions: There are large variations in psychological and body image outcomes in patients both before and after bariatric surgery. Recognition of these differences and factors contributing to lower reported levels of psychological well-being and body image may help providers provide appropriate counseling in the perioperative period.