Internal medicine

Pathology

Psychological well-being

Obesity

Clinical psychology

Surgery

Prospective cohort study

Longitudinal study

Body mass index

Weight loss

Medicine

Annals of Surgery

In Brief Objective: We sought to use a bariatric-tailored patient-reported outcome (PRO) instrument to assess psychological well-being and satisfaction with body image before and after bariatric surgery, and its association with clinical outcomes. Background: Weight loss after bariatric surgery has the potential to improve body image and psychological well-being. Traditional instruments used to measure these PROs have, however, not been tailored to patients who have undergone bariatric surgery. Methods: In this multicenter, prospective, longitudinal cohort study we administered the Body-Q survey (a validated, customized PRO instrument) to patients in the Michigan Bariatric Surgery Collaborative just before bariatric surgery and at 1-year postoperatively. We linked the survey data to prospectively collected clinical outcome data to assess associations between body image or psychological well-being and patient characteristics and clinical outcomes (ie, percent excess body weight loss and complications). Results: The preoperative and postoperative surveys were completed by 4068 patients for body image and 4062 patients for psychological well-being. Overall mean scores for body image and psychological well-being improved significantly from 26.2 ± 21.4 and 70.8 ± 20.1, respectively, before surgery to 57.7 ± 21.1 and 78.1 ± 22.1 after surgery. For both body image and psychological well-being, we found several patient-level factors such as sex, race, income level, and baseline body mass index that were statistically significant predictors of increases in scores. All P values less than 0.05. Conclusions: Psychological well-being and body image vary widely across patients before bariatric surgery with significant increases in both measures 1 year postoperatively. Some patient populations do not experience the same increases at 1 year. 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 postoperative period.

A Longitudinal Analysis of Variation in Psychological Well-being and Body Image in Patients Before and After Bariatric Surgery