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Published in: Obesity Surgery 10/2020

01-10-2020 | Obesity | Original Contributions

Body Image as a Potential Motivator for Bariatric Surgery: a Case-Control Study

Authors: D. J. S. Makarawung, V. M. Monpellier, F. van den Brink, L. Woertman, H. Zijlstra, A. B. Mink van der Molen, B. van Ramshorst, R. Geenen

Published in: Obesity Surgery | Issue 10/2020

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Abstract

Background

Not every eligible person opts for bariatric surgery. Body image concerns might be a reason to choose surgery. This case-control study evaluated differences in body image between a pre-bariatric surgery population and a weight-matched control group from the general population. We hypothesized that the pre-bariatric group would show less satisfaction with appearance, defined as a discrepancy between evaluating one’s appearance as less attractive while attaching more importance to appearance.

Methods

Data from 125 pre-bariatric patients were compared with 125 body weight-matched controls from the general population. The Multidimensional Body-Self Relations Questionnaire-Appearance Scales was used to assess appearance evaluation (AE), appearance orientation (AO), and their discrepancy score. Both groups were compared with norms from the non-body weight-matched general population.

Results

The pre-bariatric group had lower AE scores (mean 2.23 ± 0.65 vs. mean 2.54 ± 1.06) and higher AO scores (mean 3.33 ± 0.69 vs. mean 3.04 ± 0.90) than the control group. The discrepancy between AE and AO was larger in the pre-bariatric group (p < 0.001). Compared with the general population, both groups showed lower AE scores (d = − 1.43 and d = − 1.12, p < 0.001) and lower AO scores (d = − 0.23 and d = − 0.58, p < 0.001).

Conclusions

People with morbid obesity have on average less body image satisfaction. The results indicate that part of the motivation of people that choose bariatric surgery may be due to relatively low global appearance evaluation combined with considering appearance more important. Knowledge about motivations can be used to communicate realistic expectations regarding treatment outcome.
Literature
1.
go back to reference Colquitt J, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014; Colquitt J, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;
7.
go back to reference Mainous AG, Johnson SP, Saxena SK, et al. Inpatient bariatric surgery among eligible black and white men and women in the United States, 1999–2010. Am J Gastroenterol. 2013;108:1218–23.CrossRef Mainous AG, Johnson SP, Saxena SK, et al. Inpatient bariatric surgery among eligible black and white men and women in the United States, 1999–2010. Am J Gastroenterol. 2013;108:1218–23.CrossRef
8.
go back to reference Feingold A, Mazzella R. Gender differences in body image are increasing. Psychol Sci. 1998;9:190–5.CrossRef Feingold A, Mazzella R. Gender differences in body image are increasing. Psychol Sci. 1998;9:190–5.CrossRef
9.
go back to reference Halliwell E, Dittmar H. Associations between appearance-related self-discrepancies and young women’s and men’s affect, body satisfaction, and emotional eating: a comparison of fixed-item and participant-generated self-discrepancies. Personal Soc Psychol Bull. 2006;32:447–58.CrossRef Halliwell E, Dittmar H. Associations between appearance-related self-discrepancies and young women’s and men’s affect, body satisfaction, and emotional eating: a comparison of fixed-item and participant-generated self-discrepancies. Personal Soc Psychol Bull. 2006;32:447–58.CrossRef
10.
go back to reference Muth JL, Cash TF. Body-image attitudes: what difference does gender make? J Appl Soc Psychol. 1997;27:1438–52.CrossRef Muth JL, Cash TF. Body-image attitudes: what difference does gender make? J Appl Soc Psychol. 1997;27:1438–52.CrossRef
11.
go back to reference Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421–40.CrossRef Wardle J, Cooke L. The impact of obesity on psychological well-being. Best Pract Res Clin Endocrinol Metab. 2005;19:421–40.CrossRef
14.
go back to reference Sarwer DB, Polonsky HM. Body image and body contouring procedures. Aesthetic Surg J. 2016:1–9. Sarwer DB, Polonsky HM. Body image and body contouring procedures. Aesthetic Surg J. 2016:1–9.
15.
go back to reference Munoz DJ, Lal M, Chen EY, et al. Why patients seek bariatric surgery: a qualitative and quantitative analysis of patient motivation. Obes Surg. 2007;17:1487–91.CrossRef Munoz DJ, Lal M, Chen EY, et al. Why patients seek bariatric surgery: a qualitative and quantitative analysis of patient motivation. Obes Surg. 2007;17:1487–91.CrossRef
16.
go back to reference Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14:392–8.CrossRef Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14:392–8.CrossRef
17.
go back to reference Fischer L, Wekerle A, Sander J, et al. Is there a reason why obese patients choose either conservative treatment or surgery? Obes Surg. 2017;27:1684–90.CrossRef Fischer L, Wekerle A, Sander J, et al. Is there a reason why obese patients choose either conservative treatment or surgery? Obes Surg. 2017;27:1684–90.CrossRef
18.
go back to reference Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4:6–10.CrossRef Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4:6–10.CrossRef
22.
go back to reference Woertman L, van den Brink F. Tevreden met het uiterlijk, maar de perfectie lokt. Psychol Gezondh. 2008;36:262–71.CrossRef Woertman L, van den Brink F. Tevreden met het uiterlijk, maar de perfectie lokt. Psychol Gezondh. 2008;36:262–71.CrossRef
23.
go back to reference Cash TF. Multidimensional Body–Self Relations Questionnaire (MBSRQ). Encycl Feed Eat Disord. Singapore: Springer Singapore; 2015. p. 1–4. Cash TF. Multidimensional Body–Self Relations Questionnaire (MBSRQ). Encycl Feed Eat Disord. Singapore: Springer Singapore; 2015. p. 1–4.
25.
go back to reference Cash TF, Pruzinksy T. Body images: development, deviance and change: Guilford Press; 1990. Cash TF, Pruzinksy T. Body images: development, deviance and change: Guilford Press; 1990.
26.
go back to reference Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach: Guilford Publications; 2017. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach: Guilford Publications; 2017.
27.
go back to reference Cohen J. Statistical power analysis for the behavioral sciences. 1988. Cohen J. Statistical power analysis for the behavioral sciences. 1988.
28.
go back to reference Cash TF. Body-image attitudes among obese enrollees in a commercial weight-loss program. Percept Mot SkillsPercept Mot Skills. 1993;77:1099–103.CrossRef Cash TF. Body-image attitudes among obese enrollees in a commercial weight-loss program. Percept Mot SkillsPercept Mot Skills. 1993;77:1099–103.CrossRef
31.
go back to reference Weinberger N-A, Kersting A, Riedel-Heller SG, et al. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obes Facts. 2016;9:424–41.CrossRef Weinberger N-A, Kersting A, Riedel-Heller SG, et al. Body dissatisfaction in individuals with obesity compared to normal-weight individuals: a systematic review and meta-analysis. Obes Facts. 2016;9:424–41.CrossRef
33.
go back to reference Van Hout GC, Van Oudheusden I, Krasuska AT, et al. Psychological profile of candidates for vertical banded gastroplasty. Obes Surg. 2006;16:67–74. Van Hout GC, Van Oudheusden I, Krasuska AT, et al. Psychological profile of candidates for vertical banded gastroplasty. Obes Surg. 2006;16:67–74.
40.
go back to reference Jensen JF, Petersen MH, Larsen TB, et al. Young adult women’s experiences of body image after bariatric surgery: a descriptive phenomenological study. J Adv Nurs. 2013;70:1138–49.CrossRef Jensen JF, Petersen MH, Larsen TB, et al. Young adult women’s experiences of body image after bariatric surgery: a descriptive phenomenological study. J Adv Nurs. 2013;70:1138–49.CrossRef
42.
go back to reference Chao H-L. Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis. PLoS One. 2015;10:1–12. Chao H-L. Body image change in obese and overweight persons enrolled in weight loss intervention programs: a systematic review and meta-analysis. PLoS One. 2015;10:1–12.
43.
go back to reference Santos I, Mata J, Silva MN, et al. Predicting long-term weight loss maintenance in previously overweight women: a signal detection approach. Obesity. 2015;23:957–64.CrossRef Santos I, Mata J, Silva MN, et al. Predicting long-term weight loss maintenance in previously overweight women: a signal detection approach. Obesity. 2015;23:957–64.CrossRef
46.
go back to reference Jumbe S, Hamlet C, Meyrick J. Psychological aspects of bariatric surgery as a treatment for obesity. Curr Obes Rep. 2017; Jumbe S, Hamlet C, Meyrick J. Psychological aspects of bariatric surgery as a treatment for obesity. Curr Obes Rep. 2017;
50.
go back to reference Wilson RE, Latner JD, Hayashi K. More than just body weight: the role of body image in psychological and physical functioning. Body Image Elsevier Ltd. 2013;10:644–7.CrossRef Wilson RE, Latner JD, Hayashi K. More than just body weight: the role of body image in psychological and physical functioning. Body Image Elsevier Ltd. 2013;10:644–7.CrossRef
51.
go back to reference Poelemeijer YQM, Liem RSL, Våge V, et al. Perioperative outcomes of primary bariatric surgery in North-Western Europe: a pooled multinational registry analysis. Obes Surg. 2018;28:3916–22.CrossRef Poelemeijer YQM, Liem RSL, Våge V, et al. Perioperative outcomes of primary bariatric surgery in North-Western Europe: a pooled multinational registry analysis. Obes Surg. 2018;28:3916–22.CrossRef
Metadata
Title
Body Image as a Potential Motivator for Bariatric Surgery: a Case-Control Study
Authors
D. J. S. Makarawung
V. M. Monpellier
F. van den Brink
L. Woertman
H. Zijlstra
A. B. Mink van der Molen
B. van Ramshorst
R. Geenen
Publication date
01-10-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04685-z

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