Integrated health article
Prospective changes in body image dissatisfaction among adolescent bariatric patients: the importance of body size estimation

https://doi.org/10.1016/j.soard.2011.10.017Get rights and content

Abstract

Background

Body image dissatisfaction (BID) is pervasive among patients presenting for bariatric surgery but improves significantly postoperatively. These findings have been determined primarily from studies of adults. The objective of the present study was to examine the changes in BID among adolescents with extreme obesity from baseline/preoperatively to 6 and 12 months after receiving bariatric surgery at a pediatric medical center using body size estimation.

Methods

BID was prospectively assessed among 16 adolescent bariatric patients (mean age 16.3 ± 1.2 years, mean body mass index [BMI] 66.2 ± 12.0, 67% female) using a standard visual/perceptual measure (i.e., Stunkard Figure Rating Scale). Participants identified their current and ideal body size, with a discrepancy score (current minus ideal) indicating BID. The body size estimation ratings were compared with attitudinal (i.e., Impact of Weight on Quality Of Life–Kids: Body Esteem and Self-Perception Profile for Adolescents: Physical Appearance) body image scores, BMI, and total weight-related quality of life.

Results

A significant reduction occurred in the current body size (from 7.9 to 6.4, P <.001) from baseline to 6 months but not from 6 to 12 months. The current body size was related to BMI and percentage of excess weight loss but not attitudinal body image at each follow-up point. A smaller discrepancy (current minus ideal) was associated with greater total weight-related quality of life (r = −.68), with a trend toward significance for body esteem (r = −.65) at 12 months.

Conclusion

Adolescents undergoing bariatric surgery experience a significantly decreased BID within the first 12 months after surgery, with the most substantial change occurring from baseline to 6 months. The postoperative weight-related quality of life is more closely associated with the body size discrepancy than with the current body size.

Section snippets

Methods

The present investigation used data from a prospective, longitudinal study observing the psychosocial adjustment of adolescents undergoing Roux-en-Y gastric bypass at a large Midwestern pediatric hospital. The hospital institutional review board approved the present study.

Results

Repeated measures analysis of variance with a Greenhouse-Geisser correction revealed a significant change in the current body size estimation over time (F2,24 = 44.19, P <.001). Post hoc tests using the Bonferroni correction revealed a significant decrease in the current body size estimation from baseline to 6 months postoperatively (P <.001), but no difference from 6 to 12 months (Table 1). As hypothesized, there was a quadratic effect with the most substantial reduction in current body size

Discussion

The present study fills a gap in the published data by providing an initial look at changes in BID among adolescent bariatric patients from baseline to 12 months after surgery. These findings can help further our understanding of the association between BID and important postoperative outcomes, such as WRQOL. As hypothesized, adolescent bariatric patients reported a significantly reduced BID (as indicated by a decrease in the discrepancy between the current and ideal figure rating scale

Conclusion

Adolescents undergoing bariatric surgery experience significant reductions in BID within the first 12 months after surgery, most substantially within the first 6 months, as indicated by their current and ideal body size estimation. The size adolescent bariatric patients perceive themselves to be (i.e., perceived current body size estimation) might contribute less to how they feel about themselves at 1 year postoperatively than how closely they come to meeting their body size ideal. The

Disclosures

The lead author (M.B.R.) was supported by funds from the Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA), and Department of Health and Human Services (DHHS), under the T32HP10027 National Research Award. The information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred from, the BHPR, HRSA, DHHS, or the United States Government. This research was

Acknowledgment

We thank Christina Ramey, Lindsay Wilson, Ashley Morgenthal, and Faye Riestenberg for assistance with data collection and participant retention efforts.

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