Body image in early-onset obese patients

Body uneasiness in overweight and obese Italian women seeking weight-loss treatment

OBJECTIVE

It is known that the psychopathology of eating disorders is associated with body image disturbances, but little is known concerning the body image of obese subjects. The aim of this study was to assess body uneasiness in overweight and obese women in relation to their age, degree of obesity, the percentage and distribution of body fat mass, and eating disordered behaviours.

METHOD

The study population consisted of 99 overweight and obese women with a mean age of 34.3 +/- 10.1 years and a mean body mass index (BMI) of 31.3 +/- 5.4 kg/m2, who completed two self-report questionnaires: the Bulimic Investigation Test Edinburgh (BITE) to assess disordered eating behaviours and the Body Uneasiness Test (BUT) to assess body image uneasiness. Pearson correlations were used to determine the associations between the BUT scores and age, anthropometric measures (BMI, waist and hip circumferences, waist/hip ratio, percentage of body fat mass) and the BITE scores. The most significant determinants of the BUT scores were also determined using a multiple linear regression model.

RESULTS

Disordered eating behaviours were found in 7.1% of the patients. Neither BUT nor BITE scores correlated with age, but BITE scores correlated with BMI and hip circumference (p < 0.05). The overall BUT score increased with increasing BITE scores and higher indices of all of the anthropometric measures (p < 0.001) except for the percentage of body fat mass. Multiple linear regression analyses showed that, among the considered parameters, the only significant determinants of body uneasiness were disordered eating behaviours.

CONCLUSIONS

Our results confirm that body uneasiness in an obese clinical population is closely associated with disordered eating behaviours, and suggest that it is not dependent on age, the degree of obesity, or the percentage or distribution of body fat mass.

Does obesity surgery improve psychosocial functioning? A systematic review

OBJECTIVE

The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL).

PURPOSE

A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y.

RESEARCH METHODS AND PROCEDURES

The relevant literature was identified by a search of computerized databases. All articles published in English and German since 1980 were reviewed. Based on the requirements of the evidenced-based guidelines of the Agency for Health Care Policy and Research and the Scottish Intercollegiate Guidelines Network, each study was rated by a level of evidence.

RESULTS

In all, 171 publications were reviewed. Using the above inclusion/exclusion criteria, 63 articles including two systematic reviews were identified. A total of 40 studies focused on psychosocial outcome after obesity surgery.

CONCLUSION

Mental health and psychosocial status including social relations and employment opportunities improve for the majority of people after bariatric surgery thus leading to an improved QoL. Psychiatric comorbidity, predominantly affective disorders, and psychopathologic symptoms decrease postsurgically. A substantial percentage of bariatric surgery patients suffer from binge eating disorder or binge eating symptoms. The effect of bariatric surgery on the outcome of binge eating symptoms largely depends on the type of operation. With the exception of patients with a severe psychiatric comorbidity, the concern that obesity surgery will reinforce psychic symptoms and lead to a reduction in the QoL seems to be unfounded.