1
|
Pozzi M, Marcaccini G, Giardino FR, El Araby MM, Nisi G, Grimaldi L, Cuomo R. Flowchart in Post-Bariatric Surgery: A Research for the Appropriate Type and Timing of Plasties Reshaping the Body. Aesthetic Plast Surg 2024; 48:1790-1796. [PMID: 38110738 DOI: 10.1007/s00266-023-03763-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Obesity is a chronic disease with significant health implications. Bariatric surgery is an effective treatment for obesity-related conditions. However, the timing of post-bariatric body contouring surgery remains uncertain. MATERIALS AND METHODS We conducted a retrospective study of 1336 patients who underwent bariatric surgery. We analyzed weight trends and variations after different types of bariatric procedures. The Pittsburgh Index was used to evaluate body contouring outcomes. RESULTS The majority of patients were women, and sleeve gastrectomy was the most common procedure. Weight loss varied depending on the surgery type, with different outcomes for male and female patients. The Pittsburgh Index remained stable in most cases. CONCLUSION Our findings suggest that the timing of body contouring surgery should be tailored to the type of bariatric procedure performed. Abdominoplasty is recommended as a last procedure for sleeve gastrectomy patients, while gastric bypass patients are suitable candidates for early abdominoplasty. Biliopancreatic diversion patients should stabilize their weight before abdominoplasty. The Pittsburgh Index is a valuable tool for assessing the timing of post-bariatric plastic surgery. Further research is needed to optimize surgical planning and outcomes. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Collapse
Affiliation(s)
- Mirco Pozzi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Gianluca Marcaccini
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Francesco Ruben Giardino
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Mohamed Marzouk El Araby
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giuseppe Nisi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Luca Grimaldi
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Roberto Cuomo
- Unit of Plastic and Reconstructive Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| |
Collapse
|
2
|
Humar P, Robinson B. Preparing Patients for Body Contouring Surgery and Postoperative Surveillance for Deep Venous Thrombosis. Clin Plast Surg 2024; 51:1-6. [PMID: 37945066 DOI: 10.1016/j.cps.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
This article highlights the importance of the preoperative evaluation and considerations necessary in preparing patients for body contouring surgery after massive weight loss (MWL). The importance of evaluating such factors as body mass index stabilization, medical comorbidities, nutritional optimization, social factors, deep venous thrombosis prophylaxis, and postoperative surveillance is critically important. Patients undergoing body contouring surgery after MWL are at increased risk of thromboembolic events, and prophylactic measures should be taken to minimize this risk. Overall, a thorough preoperative evaluation is essential to ensure patient safety, optimize surgical outcomes, and address the unique challenges presented by the MWL patient population.
Collapse
Affiliation(s)
- Pooja Humar
- Department of Plastic Surgery, University of Pittsburgh, 3550 Terrace Street, 6B Scaife Hall, Pittsburgh, PA 15261, USA
| | - Brent Robinson
- Department of Plastic Surgery, University of Pittsburgh, 3550 Terrace Street, 6B Scaife Hall, Pittsburgh, PA 15261, USA.
| |
Collapse
|
3
|
Alhuzaim WM, Alajlan RM, Alshehri RA, Alanazi RM, Alsarhan LK, Alamri HK. Post-gastric Sleeve Surgery Chronic Symptoms From a Sample of Patients in Saudi Community. Cureus 2023; 15:e42000. [PMID: 37593300 PMCID: PMC10428182 DOI: 10.7759/cureus.42000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND A common bariatric procedure known as gastric sleeve surgery can cause significant weight loss and co-morbid condition alleviation. However, patients could experience persistent problems such as gastrointestinal, musculoskeletal/neural, and psychiatric disorders after surgery. This study aims to identify the most prevalent chronic symptoms following sleeve gastrectomy among a sample of Saudi patients and the impact these symptoms have on patients' lives. METHODOLOGY Patients who underwent gastric sleeve surgery at the Ensan Clinic, a facility specializing in gastroenterology, were the subjects of this retrospective cohort analysis. The study population consisted of patients who underwent gastric sleeve surgery, showed up for follow-up after the procedure, and met the inclusion and exclusion criteria. The data collection sheet is divided into seven sections. Sociodemographic information was required in the first section, gastric sleeve surgery information in the second, vital signs in the third, lab results in the fourth, past medical history in the fifth, current treatments in the sixth, and postoperative complications and chronic symptoms in the seventh and final sections. RESULTS In 117 patients, the study evaluated the effects of gastric sleeve surgery. Participants had an average age of 40.21 years, and 61.5% were female. Regarding persistent symptoms after surgery, a sizable percentage of patients mentioned digestive issues such as GERD (44.4%), dyspepsia (60.7%), vomiting (23.1%), nausea (39.3%), and abdominal distention (45.3%). A total of 34.2% of patients reported experiencing anxiety, compared to 11.1% who said they had depression or 2.6% who said they had social issues. A few patients reported experiencing neurological or musculoskeletal issues, including exhaustion (7.7%), faintness (5.1%), back or joint discomfort (7.7%), and shortness of breath (8.5%). CONCLUSION After undergoing gastric sleeve surgery, a sizable proportion of patients complained of various chronic symptoms and nutritional inadequacies, primarily gastrointestinal problems and musculoskeletal/neurological issues. The study's findings show a connection between these symptoms and surgery.
Collapse
Affiliation(s)
- Waleed M Alhuzaim
- Gastroenterology, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Raghad M Alajlan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rahaf A Alshehri
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Razan M Alanazi
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Leen K Alsarhan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Hala K Alamri
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| |
Collapse
|
4
|
Aitzetmüller-Klietz MM, Raschke L, Hirsch T, Kückelhaus M, Wiebringhaus P, Aitzetmüller-Klietz ML, Harati K. Factors Influencing Quality of Life after Massive Weight Loss-What Makes the Difference? Healthcare (Basel) 2023; 11:healthcare11081147. [PMID: 37107981 PMCID: PMC10138039 DOI: 10.3390/healthcare11081147] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Although weight reduction in obesity and morbid obesity has been shown to improve associated comorbidities, there is currently no information on what influences quality of life after a large reduction in body weight. The present study looks at differences in patients' quality of life classified by mode and amount of weight loss. MATERIAL AND METHODS A cross-sectional study was designed using a validated German version of the BODY-Q questionnaire. The internet-based questionnaire was distributed to patients via social media. RESULTS 460 patients (443 female, 17 male) were interviewed for this study via "Surveymonkey". The comparison of conservative and surgical weight loss showed no significant difference in the patients' quality of life (p > 0.05). A high BMI correlates negatively with body image (p = 0.023 *), as does the specific assessment of most body regions. For example, a negative correlation was found between a high BMI and satisfaction with skin appearance (p < 0.001 *) and satisfaction with the inner thigh (p = 0.011 *). CONCLUSION Increased weight loss is associated with a greater ability to maximise quality of life. The type of weight loss, whether conservative or surgical, can be neglected based on the present study. Bariatric surgery cannot be considered a universal solution to obesity. Body contouring interventions should also become a focus of therapy.
Collapse
Affiliation(s)
- Matthias Michael Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Laura Raschke
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Tobias Hirsch
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Maximilian Kückelhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Philipp Wiebringhaus
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Marie-Luise Aitzetmüller-Klietz
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| | - Kamran Harati
- Division for Plastic Surgery, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Waldeyerstrasse 1, 48149 Muenster, Germany
- Department for Plastic and Reconstructive Surgery, Institute for Muskuloskeletal Medicine, Westfaelian Wilhelms-University Muenster, 48149 Münster, Germany
- Plastic, Reconstructive, and Aesthetic Surgery, Hand Surgery, Fachklinik Hornheide, Dorbaumstrasse 300, 48157 Muenster, Germany
| |
Collapse
|
5
|
Assessment of motivating and demotivating factors to undergo bariatric surgery in high-risk populations with correlation to generalized anxiety disorder and influence of others: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:140-145. [PMID: 36845774 PMCID: PMC9949805 DOI: 10.1097/ms9.0000000000000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/25/2022] [Indexed: 02/28/2023] Open
Abstract
Very few research have looked at the causes and influences that push individuals into bariatric surgery. Although bariatric surgery is effective in boosting self-esteem, little is known about the precise physical characteristics people want to alter. Methods This study was a descriptive, correlational cross-sectional study to achieve the objectives of the study. All overweight and obese population in Jeddah, Saudi Arabia. Study instrument was designed based on the data present in the latest literature. Study tool consisted of: (1) sociodemographic data, (2) motives of bariatric surgery, (3) concerns about bariatric surgery, (4) people affecting the decision of seeking bariatric surgery, and (5) general anxiety disorder scale. Results The study included 567 participants. More than half of the study participants were females (n=335, 59.1%). The mean age among study participants was 27.88 years. Most of the participants selected themselves as the main person (n=329). In the second place comes "person who had the surgery" (n=72). A family member was prevalent among 59 participants and a friend among 57 participants. The partner has the least frequency. The most common reason was self-esteem among 26% followed by body image among 20%. The most frequent factor was "I am satisfied with my current weight loss method) among 220 participants followed by "I am afraid of any surgery and will avoid it unless absolutely needed" among 51 participants. Conclusion Bariatric surgery patients want to improve their health and live longer. Several people are dissatisfied with their bodies and seek cosmetic surgery. Patients desire bariatric surgery for their own and their loved ones', physicians', and peers' reasons. This study supports emphasizing the reasons why Jeddah, Saudi Arabia residents choose bariatric surgery and the demotivating issues.
Collapse
|
6
|
Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis. Aesthetic Plast Surg 2021; 45:1064-1075. [PMID: 33095301 DOI: 10.1007/s00266-020-02016-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/11/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Our main objective is to evaluate the effect of body contouring surgery (BCS) on the magnitude and durability of weight loss after bariatric surgery. METHODS Medline, EMBASE, Cochrane, and Scopus search were conducted from the time of their inception to June 2020. We included comparative studies that assessed weight progression, in terms of Body Mass Index change (∆BMI), Total Body Weight Loss (TBWL%), and Excess Weight Loss (%EWL) for the post-bariatric patient population and the effect of BCS on weight progression. RESULTS Eleven articles were included. The pooled sample size was 2307, of which 691 were cases who underwent BCS post-bariatric surgery, and 1616 were comparative controls. The mean follow-up time for cases and controls were 61.6 ± 23.8 months and 52.2 ± 23.8 months, respectively. Nine studies reported results of BMI changes, six provided %EWL, and five used %TBWL. Significant improvement in weight loss was observed in the BCS group when measured by either ∆BMI (3 kg/m2 points decrease, p 0.023), %TBWL (6% increase, P < 0.0001), or %EWL (14% increase, P < 0.0001). Sub-group analysis showed that increased follow-up time was associated with higher TBWL% (p 0.02). CONCLUSION The evidence provided in this review strongly supports the added long-term benefits of body contouring surgery for selected patients after massive weight loss following bariatric surgery. Having a multidisciplinary team that involves a bariatric and a plastic surgeon as well as nutritionists and psychologists for the management of patients with obesity going through the bariatric pathway is recommended. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
|
7
|
Jiang Z, Zhang G, Huang J, Shen C, Cai Z, Yin X, Yin Y, Zhang B. A systematic review of body contouring surgery in post-bariatric patients to determine its prevalence, effects on quality of life, desire, and barriers. Obes Rev 2021; 22:e13201. [PMID: 33565201 DOI: 10.1111/obr.13201] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/29/2020] [Accepted: 12/10/2020] [Indexed: 02/05/2023]
Abstract
Many post-bariatric patients have impaired health-related quality of life (HRQoL) due to excess skin following weight loss; however, it is inconclusive whether body contouring surgery (BCS) improves this impairment. We aimed to comprehensively summarize existing evidence of the effect of BCS on the HRQoL (primary outcome) and determine the prevalence of, the desire for, and barriers to BCS (secondary outcomes). Randomized controlled trials, cohort, cross-sectional, case-control, and longitudinal studies were systematically searched in PubMed, Embase, the Cochrane Central, and Web of Science. After screening 1923 potential records, 24 studies (representing 6867 participants) were deemed eligible. Only 18.5% of respondents from cross-sectional studies underwent BCS, with abdominal BCS as the most common procedure. Most participants desired BCS but listed "cost" and "lacking reimbursement" as the main barriers. Results suggest that most post-bariatric patients who underwent BCS experienced improvements in their HRQoL, which could be seen in almost every dimension evaluated, including body image and physical and psychosocial functions. Therefore, both bariatric and plastic surgeons should regard BCS not only as an aesthetic supplement but also as a vital part of functional recovery in the surgery-mediated weight loss journey and, thus, provide it to more post-bariatric patients.
Collapse
Affiliation(s)
- Zhiyuan Jiang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Guixiang Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jinming Huang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chaoyong Shen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhaolun Cai
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaonan Yin
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Yin
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
8
|
Luker J, Tajran J, Marquette L, Tepper D, Carlin A, Darian V, Siddiqui A. Long-Term Weight Loss with Body Contour Surgery After Roux-en-Y Gastric Bypass. Obes Surg 2021; 31:3159-3164. [PMID: 33851305 DOI: 10.1007/s11695-021-05405-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Bariatric surgery is accepted as an evidence-based treatment for morbid obesity. Many patients seek out body contour surgery afterwards to correct acquired deformities. This study seeks to better define the impact of body contour surgery on long-term weight loss. METHODS This study is a single-center retrospective review of 78 patients who underwent body contouring surgery post-Roux-en-Y gastric bypass compared with 221 matched control patients who underwent Roux-en-Y gastric bypass only. Data was collected for patients at least 7 years post-Roux-en-Y gastric bypass. RESULTS Patients who underwent both bariatric surgery and body contour surgery maintained mean long-term weight loss of 58 kg. The matched control group mean weight loss over the same time interval was 42 kg. The difference was statistically and clinically significant (p = 0.005). Change in body mass index, percent total weight loss, and percent excess body mass index loss were all statistically significant between the 2 groups. CONCLUSION Patients who underwent body contour surgery better maintained long-term weight reduction in comparison to those who only had gastric bypass. Further understanding of the etiology of this association is important for patients contemplating body contouring surgery.
Collapse
Affiliation(s)
- Jenna Luker
- Division of Plastic Surgery, Henry Ford Hospital, 2799 West Grand Blvd, Suite k-16, Detroit, MI, 48202, USA
| | - Jahan Tajran
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Lauren Marquette
- Division of Plastic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Donna Tepper
- Division of Plastic Surgery, Henry Ford Hospital, 2799 West Grand Blvd, Suite k-16, Detroit, MI, 48202, USA
| | - Arthur Carlin
- Division of Bariatric Surgery, Henry Ford Hospital, Detroit, MI, USA
| | - Vigen Darian
- Division of Plastic Surgery, Henry Ford Hospital, 2799 West Grand Blvd, Suite k-16, Detroit, MI, 48202, USA
| | - Aamir Siddiqui
- Division of Plastic Surgery, Henry Ford Hospital, 2799 West Grand Blvd, Suite k-16, Detroit, MI, 48202, USA.
| |
Collapse
|
9
|
Geller S, Levy S, Hyman O, L. Jenkins P, Abu-Abeid S, Goldzweig G. Body Image, Emotional Eating and Psychological Distress among Bariatric Surgery Candidates in Israel and the United States. Nutrients 2020; 12:nu12020490. [PMID: 32075087 PMCID: PMC7071170 DOI: 10.3390/nu12020490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The present study aimed to examine the relations between body image dissatisfaction (BID) and psychological distress variables among bariatric surgery candidates from two distinct cultures in Israel and in the United States. METHODS A sample of consecutive pre-surgical bariatric candidates was recruited from a Bariatric Center in Israel (N = 114) and a Bariatric Center in the Unites States (N = 81). Body image dissatisfaction (BID-BSQ8), suicidal ideation (SBQ-R), depressive symptoms (PHQ-9), anxious symptoms (PHQ-7), and emotional eating behaviors (EES), were measured. Mediation models were assessed using path analysis. RESULTS BID was positively correlated with suicidality, depression, and anxiety in both samples. The relations between BID depression and anxiety were mediated by emotional eating in both cultures. However, the relation between BID and suicidality that was mediated by emotional eating in the Israeli sample, was reflected in a direct link between BID and suicidality in the US sample. CONCLUSION Our findings confirm the adverse effect of BID on psychological distress among surgery candidates in both cultures, emphasizing the intercultural similarities related to emotional eating behavior. Physicians and other health professionals are encouraged to be more attentive to this specific behavior.
Collapse
Affiliation(s)
- Shulamit Geller
- School of Behavioral Sciences, the Academic College of Tel Aviv-Yaffo, 14, Rabenu Yeruham St, Tel Aviv-Yaffo 6818543, Israel;
- Correspondence: ; Tel.: +97-236-802-533
| | - Sigal Levy
- Statistics Education Unit, the Academic College of Tel Aviv, Tel Aviv-Yaffo 6818543, Israel;
| | - Ofra Hyman
- Outpatient Psychiatry, Bassett Medical Center, Cooperstown, NY 13326-1394 USA;
| | - Paul L. Jenkins
- Bassett Healthcare Research Institute, Bassett Medical Center, Cooperstown, NY 13326-1394, USA;
| | - Subhi Abu-Abeid
- Bariatric Surgery Unit, General Surgery Division, the Tel Aviv Sourasky Medical Center, Tel Aviv-Yaffo 6423906, Israel;
| | - Gil Goldzweig
- School of Behavioral Sciences, the Academic College of Tel Aviv-Yaffo, 14, Rabenu Yeruham St, Tel Aviv-Yaffo 6818543, Israel;
| |
Collapse
|
10
|
Sellberg F, Ghaderi A, Willmer M, Tynelius P, Berglind D. Change in Children's Self-Concept, Body-Esteem, and Eating Attitudes Before and 4 Years After Maternal RYGB. Obes Surg 2019; 28:3276-3283. [PMID: 29911273 PMCID: PMC6153582 DOI: 10.1007/s11695-018-3348-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction The aim of the present study was to look at longitudinal changes in children’s self-concept, body-esteem, and eating attitudes before and 4 years after maternal RYGB surgery. Methods Sixty-nine women and 81 appurtenant children were recruited from RYGB waiting lists at 5 hospitals in Sweden. Families were visited at home pre-surgery, 9 months, and 4 years post-maternal RYGB to measure BMI. Furthermore, all participating family members completed questionnaires. Mothers’ questionnaires measured eating behavior, depression, anxiety, and sleep quality, and children’s questionnaires measured body-esteem, self-concept, and eating attitudes. Results Thirty-five/sixty-nine mothers and 43/81 children participated in all 3 measurements. Mothers reduced their BMI from pre-surgery (39.2) to 9 months (27.0) and 4 years post-surgery (27.4). Children’s prevalence of overweight/obesity was lower 9 months post-surgery (48.8%) but at the same levels again 4 years post-surgery (58.1%), compared to pre-surgery (58.1%). The same rebound pattern was seen among children’s eating attitudes, mothers’ symptoms of depression and anxiety, and sleep quality. We found no correlations between mothers’ BMI or eating behavior and children’s BMI or eating behavior. Conclusion Children’s prevalence of overweight/obesity and eating attitudes improves soon after their mothers’ RYGB, but then return to pre-surgery levels at 4 years post-surgery, as do mothers’ sleep quality and symptoms of depression and anxiety, even though their weight loss was maintained. Electronic supplementary material The online version of this article (10.1007/s11695-018-3348-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fanny Sellberg
- Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden. .,Department of Public Health Sciences, Karolinska Institutet, Solnavägen 1E, 113 65, Stockholm, Sweden.
| | - Ata Ghaderi
- Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Mikaela Willmer
- Department of Health and Caring Sciences, University of Gävle, 801 76, Gävle, Sweden
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Box 45436, 104 31, Stockholm, Sweden
| | - Daniel Berglind
- Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicine, 171 77, Stockholm, Sweden
| |
Collapse
|
11
|
Sun Y, Peng B, Lei GL, Shen H, Wei Q, Yang L. Book Review. Eur J Obstet Gynecol Reprod Biol X 2019. [PMCID: PMC6817679 DOI: 10.1016/j.eurox.2019.100057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
|
12
|
Geller S, Levy S, Goldzweig G, Hamdan S, Manor A, Dahan S, Rothschild E, Stukalin Y, Abu-Abeid S. Psychological distress among bariatric surgery candidates: The roles of body image and emotional eating. Clin Obes 2019; 9:e12298. [PMID: 30708399 DOI: 10.1111/cob.12298] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/27/2018] [Accepted: 01/08/2019] [Indexed: 01/21/2023]
Abstract
The increased risk of psychological distress among bariatric surgery candidates may be attributed, at least in part, to body image dissatisfaction (BID). The aim of the present study was to test the hypotheses that body image could be correlated with the psychological distress variables, and that emotional eating behaviours could mediate the relationship between body image and psychological distress. A sample of consecutive participants seeking bariatric surgery (N = 169, 67% females, mean age, 41.8 years [SD = 11.46], mean body mass index 42.0 kg/m2 [SD = 11.0]) was recruited from a university-based bariatric centre, a week prior to scheduled surgery. Results showed that BID was positively correlated with suicidality (r = 0.18, P < 0.05), depression (r = 0.39, P < 0.01) and anxiety (r = 0.20, P < 0.05). The relation between BID and depression was partially mediated by emotional eating, whereas the relation between BID and suicidality was fully mediated by emotional eating. Physicians and other health professionals who treat bariatric surgery patients should be encouraged to detect behaviours indicating emotional eating, as these could be an indicator of psychological distress resulting from poor body image.
Collapse
Affiliation(s)
- Shulamit Geller
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Sigal Levy
- Statistics Education Unit, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Anat Manor
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Shiran Dahan
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Eyal Rothschild
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Yelena Stukalin
- Statistics Education Unit, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel
| | - Subhi Abu-Abeid
- Bariatric Surgery Unit, General Surgery Division, The Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| |
Collapse
|
13
|
Lechmiannandan S, Panirselvam M, Muninathan P, Hussin N, Rajan R, Sidi H, Kosai NR, Vinayak CR. Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia. Obes Surg 2019; 29:1571-1575. [PMID: 30706310 DOI: 10.1007/s11695-019-03722-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery. MATERIAL AND METHODS This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared. RESULTS Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value < 0.001). The rate of FSD among the obese is 75.0% pre-surgery compared to 36.0% post-surgery. There was a significant improvement in mean FSFI score pre- and post-surgery: 18.73 and 25.93 respectively and in each of all 6 domains (p value < 0.001). There was a significant association between BMI reduction and improvement in FSFI score (p = 0.019). There was no difference in outcomes between types of surgery. CONCLUSION FSD is highly prevalent among the obese multiethnic Malaysian women. Bariatric surgery has proven benefit in resolving FSD across all sexual domains and should be considered as a management option in this group of women.
Collapse
Affiliation(s)
| | - Mayurran Panirselvam
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Prema Muninathan
- Clinical Research Centre, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| | - Narwani Hussin
- Clinical Research Centre, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| | - Reynu Rajan
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Nik Ritza Kosai
- Minimally Invasive, Upper Gastrointestinal and Bariatric Surgery Unit, Department of Surgery, Faculty of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Cheras, 56000, Kuala Lumpur, Malaysia
| | - C Rajkumar Vinayak
- Bariatric Surgery Unit, Department of Surgery, Hospital Taiping, Jalan Taming Sari, 34000, Taiping, Perak, Malaysia
| |
Collapse
|
14
|
Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surg Obes Relat Dis 2019; 15:636-642. [PMID: 30803880 DOI: 10.1016/j.soard.2019.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/19/2018] [Accepted: 01/21/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the motivating factors and people that lead patients to seek bariatric surgery. Bariatric surgery helps to improve body image, but little is known about patients' desired changes in the appearance of specific body parts. OBJECTIVES To identify key factors and people motivating patients' decision to seek bariatric surgery, and to assess body dissatisfaction and desire for surgery to change the appearance of specific body parts. SETTING U.S. university-based hospital clinic. METHODS Patients seeking bariatric surgery (N = 208, 78.4% women, 52.4% black, mean age = 42.0 ± 12.3 yr, mean body mass index = 46.7 ± 8.5 kg/m2) completed the Reasons for Bariatric Surgery questionnaire before their preoperative Psychosocial-behavioral evaluation. Participants rated (1-10) the importance of 15 potential reasons and 7 potential people motivating their decision to seek bariatric surgery. Participants also rated their dissatisfaction and desire for surgery to change the appearance of 11 body parts. RESULTS Mean scores of motivating factors were highest for Physical Health (9.9 ± .4), followed by Longevity (9.7 ± .9). Patients reported high body dissatisfaction and desire for surgery to change the appearance of several body parts, including stomach and thighs. "Myself" was the highest-rated motivating person, followed by healthcare providers, family, and someone who had undergone bariatric surgery. CONCLUSIONS Health is the primary reason reported by patients for seeking bariatric surgery. Patients also report a strong desire for surgery to change the appearance of their body. Patients are self-driven to pursue surgery but are also influenced by healthcare providers, family, and people who have undergone surgery. (Surg Obes Relat Dis 2019;X:XXX-XXX.) © 2019 American Society for Metabolic and Bariatric Surgery. All rights reserved.
Collapse
Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kaylah Walton
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jena Shaw Tronieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
15
|
|
16
|
Akan S, Uruc F, Aydin MT, Verit A. The effect of sleeve gastrectomy technique on women's sexual function: A prospective study. Rev Int Androl 2018; 16:167-173. [PMID: 30286871 DOI: 10.1016/j.androl.2017.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 11/03/2017] [Accepted: 12/30/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Obesity may lead to a serious deterioration in general quality of daily life and sexual functionality. Bariatric surgery is the most effective treatment method for obesity and related morbidities so far and it is better than some medical treatment modalities. In this study, we aimed to investigate the effects of bariatric surgery and especially sleeve gastrectomy, which has been currently performed in increasing numbers on female sexual functions and quality of life. MATERIALS AND METHODS A total of 53 patients were included to the current study. The participants were selected from eligible individuals who have undergone laparoscopic sleeve gastrectomy operation in our center between April 2014 and March 2015 dates. Age, body weights and body mass indexes (BMIs) of the patients were pre-operatively recorded. The patients have completed the Female Sexual Function Index (FSFI), Beck Depression Scale and SF-36 (Short form-36) forms before and after the surgery. Additionally, post-operative decrease in body weights and mean BMI were recorded. RESULTS Following bariatric surgery, sexual functions of the female patients improved and total FSFI scores increased. When FSFI scores were analyzed, it was observed that sexual desire, sexual arousal, lubrication, orgasm and sexual satisfaction increased, while the pain parameter has not changed. CONCLUSION Recent literature reveals that unfavorable effects of increasingly prevalent obesity on sexual functions cannot be denied. We think that sleeve gastrectomy can obtain considerable weight loss, improvement in self-esteem, decrease in anxiety, amelioration in sexual functions and general quality of life.
Collapse
Affiliation(s)
- Serkan Akan
- University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Department of Urology, Istanbul, Turkey.
| | - Fatih Uruc
- Fatih Sultan Mehmet Research & Training Hospital, Department of Urology, Istanbul, Turkey
| | - M Timucin Aydin
- Fatih Sultan Mehmet Research & Training Hospital, Department of General Surgery, Istanbul, Turkey
| | - Ayhan Verit
- Fatih Sultan Mehmet Research & Training Hospital, Department of Urology, Istanbul, Turkey
| |
Collapse
|
17
|
Patient satisfaction, body image, and quality of life after lower body lift: a prospective pre- and postoperative long-term survey. Surg Obes Relat Dis 2017; 13:882-887. [DOI: 10.1016/j.soard.2017.01.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 12/17/2016] [Accepted: 01/04/2017] [Indexed: 12/16/2022]
|
18
|
Alzahrani K, Kattan A, Ezzat L, Alsaleh S, Murad K, Alghamdi B. A Psychosocial Analysis of the Effect of Body-Contouring Surgery on Patients After Weight Loss. EPLASTY 2017; 17:e12. [PMID: 28405262 PMCID: PMC5372753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives (Background): Patients are often bothered by excess skin laxity and redundancy after weight loss. Body-contouring surgery offers a solution. This study assessed the psychosocial impact of body-contouring surgery on patients after weight loss. Methods (Settings, Design): In this cross-sectional study, a specifically designed questionnaire developed in collaboration with psychiatric department for our research was used for 43 patients who underwent body-contouring surgery. Data were collected during single visit to the plastic surgery clinic. All the patients had lost 20 kg or less before the surgery and were interviewed at least 6 months after the surgery. The questionnaire was used to compare the psychosocial status of the patients before and after surgery. Data were analyzed appropriately using Statistical Package for the Social Sciences. Results: The participants' mean age was 34 ± 10 years; the sample included 24 (55.8%) women and 19 (44.2%) men (total N = 43). The patients' quality of life improved significantly in the areas of social life (P < .001), job performance (P < .002), and sexual activity (P < .001). Moreover, while 17 (39.5%) patients suffered symptoms of depression before surgery, only 1 (2.3%) patient suffered symptoms of depression after surgery. The overall satisfaction was found to be 62.8%, with mammoplasty being the procedure with the highest satisfaction (66.6%). Conclusion: Body-contouring surgery after weight loss has shown to improve both psychological and social aspects of the patients' lives. Recall bias is the main limitation in our study.
Collapse
Affiliation(s)
- Khalid J. Alzahrani
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Abdullah E. Kattan
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Loui A. Ezzat
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia.,Correspondence:
| | - Saud A. Alsaleh
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Khalid A. Murad
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Bader A. Alghamdi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia; and Plastic Surgery Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
19
|
Abstract
INTRODUCTION Bariatric surgery has emerged as an effective method of combating the morbid obesity epidemic. However, the massive weight loss that follows may result in contour changes that can affect body image and quality of life. Our study examines the effects and consequences of bariatric surgery and subsequent body contouring on body image and quality of life. METHODS Patients were prospectively followed up through their experience with bariatric surgery and subsequent body contouring surgery. Using 2 validated survey instruments, the Multidimensional Body-Self Relations Questionnaire and the Short Form 36 (SF-36), patients completed questionnaires preoperatively and at 6, 12, and 24 months postoperatively. Mean scores were determined by repeated measures analyses of variance F tests. RESULTS One hundred seventy-five patients were surveyed before bariatric surgery, with noted declines in survey completion at 6, 12, and 24 months. Appearance Evaluation scores improved significantly at all intervals (P = 0.0033), as did Body Area Satisfaction Scale and Appearance Orientation scores (P = 0.0079 and P = 0.044, respectively). While Overweight Preoccupation and Self-Classified Weight scores decreased over time, only the latter was significant (P < 0.0001). The composite SF-36 score for patients awaiting bariatric surgery (54.1%) with postoperative scores at 6 (67.6%,), 12 (at 74.0%), and 24 (76.7%) months being significantly higher (P < 0.0001). The body contouring group consisted of 41 patients who primarily had lower body procedures, with 31 patients surveyed at 6 months and 27 patients at 12 months. For this cohort, Appearance Evaluation and Body Area Satisfaction Scale scores both improved significantly (P = 0.0001 and P = 0.0005, respectively) whereas Appearance Orientation scores declined significantly (P = 0.0055). Both Overweight Preoccupation and Self-Classified Weight scores decreased with only the latter being statistically significant (P = 0.0286). Postoperative SF-36 scores at 6 (72.9%) and 12 (64.5%) months were no different than patients awaiting body contouring (71.3%). CONCLUSIONS Using 2 validated survey instruments, we show that patients undergoing bariatric surgery have improvements in body image and quality of life. Subsequent postbariatric body contouring surgery results in further improvements in body image. Our findings provide measurable evidence for the value of body contouring after significant weight loss, which may favor greater insurance coverage for this patient population.
Collapse
|
20
|
Long-Term Results after Bariatric Surgery: A Patient-Centered Analysis. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
21
|
Outcomes of Breast Reconstruction After Mastectomy Using Deep Inferior Epigastric Perforator Flap After Massive Weight Loss. Ann Plast Surg 2016; 76 Suppl 4:S286-9. [DOI: 10.1097/sap.0000000000000677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Patient Expectations of Bariatric and Body Contouring Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e694. [PMID: 27200256 PMCID: PMC4859253 DOI: 10.1097/gox.0000000000000677] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/23/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Patient expectations are important in bariatric and body contouring surgery because the goals include improvements in health-related quality of life, appearance, and body image. The aim of this study was to identify patient expectations along the weight loss journey and/or body contouring surgery. METHODS This qualitative study took an interpretive description approach. Between September 2009 and February 2012, 49 patients were interviewed postbody contouring surgery. Data were analyzed using a line-by-line approach whereby expectations were identified and labeled as expected, unexpected, or neutral. Constant comparison was used to ensure coding was done consistently. Interviews continued until no new themes emerged. RESULTS Participants described expectations according to appearance, health-related quality of life, and patient experience of care. Two areas stood out in terms of unmet expectations and included appearance and physical health, ie, recovery from body contouring surgery. Most participants, who underwent bariatric surgery, expected neither the extent of excess skin after weight loss nor how the excess skin would make them look and feel. For recovery, participants did not expect that it would be as long or as hard as it was in reality. CONCLUSIONS A full understanding of outcomes and expectations for this patient population is needed to enhance patient education and improve shared medical decision making. Education materials should be informed by the collection of evidence-based patient-reported outcome information using measures such as the BODY-Q. A patient-reported outcome scale measuring patient expectations is needed for obese and bariatric patients.
Collapse
|
23
|
Sisti A, Cuomo R, Zerini I, Tassinari J, Brandi C, Grimaldi L, D'Aniello C, Nisi G. Complications Associated With Medial Thigh Lift: A Comprehensive Literature Review. J Cutan Aesthet Surg 2016; 8:191-7. [PMID: 26865783 PMCID: PMC4728900 DOI: 10.4103/0974-2077.172189] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Medial contouring of the thigh is frequently requested to improve appearance and function of medial thigh deformities, following massive weight loss or aging process. This surgical procedure can be associated with a significant rate of complications. Our aim was to consider the complications and outcomes according to the performed technique, through a wide and comprehensive review of the literature. A search on PubMed/Medline was performed using “medial thighplasty”, “medial thigh lifting” and “technique” as key words. As inclusion criteria, we selected the clinical studies describing techniques of medial thighplasty. We excluded the papers in which complications related to medial thighplasty were not specified. We also excluded literature-review articles. We found 16 studies from 1988 to 2015. Overall, 447 patients were treated. Different techniques were applied. Complications were observed in 191/447 patients (42.72%). The most frequent complications were wound dehiscence(18.34%) and seroma (8.05%). No major complications, such as thromboembolism and sepsis, were observed. Minor complications occurred in a high percent of patients, regardless of the performed surgical procedure. Patients should be informed about the possible occurrence of wound dehiscence and seroma, as common complications associated with this surgical procedure.
Collapse
Affiliation(s)
- Andrea Sisti
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Roberto Cuomo
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Irene Zerini
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Juri Tassinari
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Cesare Brandi
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Luca Grimaldi
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Carlo D'Aniello
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| | - Giuseppe Nisi
- Plastic Surgery Division, Department of General and Specialist Surgery, University of Siena, Siena, Italy
| |
Collapse
|
24
|
Marek RJ, Ben-Porath YS, Heinberg LJ. Understanding the role of psychopathology in bariatric surgery outcomes. Obes Rev 2016; 17:126-41. [PMID: 26783067 DOI: 10.1111/obr.12356] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 09/28/2015] [Accepted: 10/16/2015] [Indexed: 12/01/2022]
Abstract
Bariatric surgery is the most effective treatment for morbid obesity; however, a subset of patients who undergo this procedure regain weight or achieve suboptimal weight loss results. A large number of studies have examined whether psychological variables play a role in weight loss surgery outcome. Although presurgical psychopathology has been found to be associated with suboptimal results in some studies, this literature is equivocal. These inconsistent findings are reviewed and considered in the context of contemporary models of psychopathology. More specifically, the review focuses on the limitations of atheoretical, descriptive diagnostic systems and examines whether comorbidity within the mood/anxiety disorders, impulse control/substance use disorders and thought disorders can account for the inconsistent findings reported to date. Contemporary models of psychopathology are highlighted and linked to the Research Domain Criteria, which have been advanced by the National Institute of Health. Means for assessing psychological constructs congruent with these models are reviewed. Recommendations are made for standardizing approaches to investigating how psychopathology contributes to suboptimal bariatric surgery outcomes.
Collapse
Affiliation(s)
- R J Marek
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Y S Ben-Porath
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - L J Heinberg
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| |
Collapse
|
25
|
Sioka E, Tzovaras G, Katsogridaki G, Bakalis V, Bampalitsa S, Zachari E, Zacharoulis D. Desire for Body Contouring Surgery After Laparoscopic Sleeve Gastrectomy. Aesthetic Plast Surg 2015; 39:978-84. [PMID: 26395092 DOI: 10.1007/s00266-015-0561-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 08/28/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Laparoscopic sleeve gastrectomy (LSG) is an effective approach for the treatment of morbid obesity. Surgically induced massive weight loss provokes skin deformities that can be addressed with plastic surgery. However, there is a paucity of data regarding the esthetic outcome of patients after LSG. The aim of the study was to assess the postoperative appearance and the request for body contouring surgery after LSG. METHODS All the patients who underwent LSG between August 2006 and September 2014 with a minimum follow-up of 1 year were interviewed using the Post-Bariatric Surgery Appearance Questionnaire. Postoperative satisfaction with their appearance, and the desire and frequency for body contouring surgery were assessed. RESULTS A total of 175 patients were interviewed. Overall, 75% of the patients rated that they felt attractive with their appearance. More specifically, 84% of men and 72% of women were satisfied with their appearance. Females were most dissatisfied with waist/abdomen, chest/breasts, and upper arms, in descending order. Males were dissatisfied with chest/breasts, upper arms, and waist/abdomen, respectively. The most desired procedures were abdominoplasty, chest/breast lift, and upper arm lift in females and abdominoplasty, thigh lift and upper arm lift in males. Only 3.6% of patients underwent body contouring surgery postoperatively. CONCLUSION LSG patients rated their overall appearance from slightly to moderately attractive. There was a strong desire for abdominoplasty; breast lift and upper arm lift in females, although only a small proportion of patients proceeded to plastic surgery. LEVEL OF EVIDENCE II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.
Collapse
|
26
|
Hayden MJ, Murphy KD, Brown WA, O'Brien PE. Axis I disorders in adjustable gastric band patients: the relationship between psychopathology and weight loss. Obes Surg 2015; 24:1469-75. [PMID: 24570091 DOI: 10.1007/s11695-014-1207-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Bariatric surgery candidates have higher rates of co-morbid psychological illnesses than those in the general population. The effect of weight loss on these illnesses is unclear. METHODS This prospective observational study explored psychiatric co-morbidities and weight loss outcomes in 204 gastric banding surgery candidates. Psychiatric co-morbidities were assessed prior to surgery and 2 years post-surgery. One hundred and fifty patients (74%) completed assessments at both time points. RESULTS At baseline, 39.7% of the patients met the criteria for a current axis I disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Mood disorders were the most frequent (26.5%), followed by anxiety disorders (15.2%) and binge eating disorder (13.2%). Preoperative psychopathology predicted clinical psychopathology at 2 years. No preoperative or post-operative axis I disorder was significantly related to weight loss at 2 years. The frequency of current axis I disorders decreased significantly from 39.7% preoperatively to 20% 2 years post-surgery. CONCLUSIONS The point prevalence of psychopathology in this sample of Australian bariatric candidates is high. Psychopathology, preoperatively and at 2 years of follow-up, was not associated with weight loss at 2 years.
Collapse
Affiliation(s)
- M J Hayden
- Centre for Obesity Research and Education, Monash University, Melbourne, Australia,
| | | | | | | |
Collapse
|
27
|
Herman CK, Hoschander AS, Wong A. Post-Bariatric Body Contouring. Aesthet Surg J 2015; 35:672-87. [PMID: 25902949 DOI: 10.1093/asj/sjv008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The "epidemic" of obesity has recently been accompanied by a new "epidemic" of massive weight loss. The demand for post-bariatric contouring is rising and, as such, it is extremely important for plastic surgeons to be well versed in the treatment of these patients. Unfortunately, the problem is not solely surgical. OBJECTIVES The aim of this article is to understand the nutritional and psychological complications that can occur in patients following massive weight loss, to understand the anatomic deformities in massive weight loss as a means to correct those deformities surgically, and to understand the complications from post-bariatric contouring procedures in an effort to avoid them. METHODS This article discusses the nutritional and psychological considerations in the massive weight loss patient, anatomical considerations in this patient group, and the surgical techniques designed to address these anatomic concerns. Important pertinent studies are reviewed and discussed. RESULTS Anatomical changes are encountered in each region of the body: there are surgical options available to correct them, although potential complications are associated with these surgical procedures. These surgical options are reviewed as well as the risk and benefits associated with them. CONCLUSIONS There are many problems that need to be addressed in the massive weight loss patient prior to embarking on surgical treatment. Additionally, surgery on massive weight loss patients has unique considerations that distinguish these operations from those performed on the non-bariatric population.
Collapse
Affiliation(s)
- Charles K Herman
- Dr Herman is the Chief Medical Executive, Chairman of the Department of Surgery and Chief of the Division of Plastic and Reconstructive Surgery, Pocono Health Systems, East Stroudsburg, PA; Clinical Professor of Surgery, The Commonwealth Medical College, Scranton, PA; and Assistant Clinical Professor of Surgery, Albert Einstein College of Medicine, New York, NY. Dr. Hoschander is the Chief Resident and Dr. Wong is a Resident in the Division of Plastic Surgery, University of Miami, Miller School of Medicine, Miami, FL
| | - Ari S Hoschander
- Dr Herman is the Chief Medical Executive, Chairman of the Department of Surgery and Chief of the Division of Plastic and Reconstructive Surgery, Pocono Health Systems, East Stroudsburg, PA; Clinical Professor of Surgery, The Commonwealth Medical College, Scranton, PA; and Assistant Clinical Professor of Surgery, Albert Einstein College of Medicine, New York, NY. Dr. Hoschander is the Chief Resident and Dr. Wong is a Resident in the Division of Plastic Surgery, University of Miami, Miller School of Medicine, Miami, FL
| | - Anselm Wong
- Dr Herman is the Chief Medical Executive, Chairman of the Department of Surgery and Chief of the Division of Plastic and Reconstructive Surgery, Pocono Health Systems, East Stroudsburg, PA; Clinical Professor of Surgery, The Commonwealth Medical College, Scranton, PA; and Assistant Clinical Professor of Surgery, Albert Einstein College of Medicine, New York, NY. Dr. Hoschander is the Chief Resident and Dr. Wong is a Resident in the Division of Plastic Surgery, University of Miami, Miller School of Medicine, Miami, FL
| |
Collapse
|
28
|
Alizai PH, Akkerman MK, Kaemmer D, Ulmer F, Klink CD, Ernst S, Mathiak K, Neumann UP, Perlitz V. Presurgical assessment of bariatric patients with the Patient Health Questionnaire (PHQ)--a screening of the prevalence of psychosocial comorbidity. Health Qual Life Outcomes 2015; 13:80. [PMID: 26059334 PMCID: PMC4460674 DOI: 10.1186/s12955-015-0278-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 05/28/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Bariatric surgery has gained increasing relevance due to the dramatic rise in morbid obesity prevalence. A sound body of scientific literature demonstrates positive long-term outcome of bariatric surgery in decreasing mental and physical health morbidity. Still, there is a need for a manageable presurgical screening to assess major mental disorders. The aim of this study was to assess the frequency of common psychiatric syndromes in bariatric surgery candidates using a computerized version of the Patient Health Questionnaire (PHQ). METHODS In a prospective cohort study from August 2009 to July 2011 morbidly obese individuals seeking bariatric treatment were evaluated for mental health disorders using the PHQ (computerized German version). RESULTS A total of 159 patients were included in this study. The median age of participants was 42 years, the median BMI was 49 kg/m(2). The PHQ revealed a prevalence of 84 % for mental health disorders, 50 % of the participants had three or more mental health disorders. A high somatic symptom burden (46 %), depressive syndromes (62 %) and anxiety disorders (29 %) were the most frequent psychiatric syndromes. The median number of psychiatric syndromes was 3 for women and 1 for men (p = 0.007). No correlation between BMI and a single syndrome or the sum of syndromes was observed. CONCLUSION 84 % of the patients seeking bariatric treatment were screened positive for at least one mental health disorder. The computerized PHQ with automated reporting appears to be a useful instrument for presurgical assessment of bariatric patients in routine medical settings.
Collapse
Affiliation(s)
- Patrick H Alizai
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Maren K Akkerman
- Department of Medicine, Luisenhospital Aachen, Academic teaching hospital of the RWTH Aachen University, Boxgraben 99, 52064, Aachen, Germany.
| | - Daniel Kaemmer
- Department of Surgery, St. Elisabeth Hospital Geilenkirchen, Martin-Heyden-Str. 32, 52511, Geilenkirchen, Germany.
| | - Florian Ulmer
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Christian D Klink
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Sabine Ernst
- Institute of Medical Statistics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Ulf P Neumann
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Volker Perlitz
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| |
Collapse
|
29
|
Naghshineh N, Rubin JP. Preoperative evaluation of the body contouring patient: the cornerstone of patient safety. Clin Plast Surg 2015; 41:637-43. [PMID: 25283451 DOI: 10.1016/j.cps.2014.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The obesity pandemic has resulted in increasing cases of bariatric surgery and subsequent issues related to excess skin and laxity for patients. This patient population requires unique insight and consideration as part of the preoperative evaluation. Nutritional derangements are common, psychosocial issues are prevalent, and the sequelae of past and present medical conditions can all affect surgical planning and outcomes. This article familiarizes the plastic surgeon with the issues of the body contouring candidate and provides tools that may assist in surgical planning.
Collapse
Affiliation(s)
- Nima Naghshineh
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 6B Scaife Hall, Suite 690, 3550 Terrace Street, Pittsburgh, PA 15261, USA
| | - J Peter Rubin
- Department of Plastic Surgery, University of Pittsburgh Medical Center, 6B Scaife Hall, Suite 690, 3550 Terrace Street, Pittsburgh, PA 15261, USA.
| |
Collapse
|
30
|
Zhou C, Azin A, Al-Ozairi E, Okrainec A, Hawa R, Sockalingam S. Examining the Barriers to Accessing Body Contouring Surgery: A Qualitative Study. Bariatr Surg Pract Patient Care 2015. [DOI: 10.1089/bari.2014.0037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carrol Zhou
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Arash Azin
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ebba Al-Ozairi
- Faculty of Medicine, University of Kuwait School of Medicine, Kuwait
| | - Allan Okrainec
- Division of General Surgery, University Health Network, Toronto General Hospital, Toronto, Canada
- Department of Surgery, University of Toronto, Toronto, Canada
| | - Raed Hawa
- Medical Psychiatry Program, University Health Network, Toronto General Hospital, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Bariatric Surgery Psychosocial Program, Toronto Western Hospital, Toronto, Canada
| | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Bariatric Surgery Psychosocial Program, Toronto Western Hospital, Toronto, Canada
| |
Collapse
|
31
|
Park J, Cozza M. Research Trends in Measurement of Quality of Life Following Bariatric Surgery: Emerging Interest in Appearance. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Juyeon Park
- Department of Design and Merchandising, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado State University
| | - Melissa Cozza
- Department of Design and Merchandising, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado State University
| |
Collapse
|
32
|
Plastic surgery improves long-term weight control after bariatric surgery. Plast Reconstr Surg 2014; 133:599e-600e. [PMID: 24675217 DOI: 10.1097/prs.0000000000000026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
33
|
Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of mental health and health-related quality of life after bariatric surgery: a review of the recent research. Obes Res Clin Pract 2013; 8:e314-24. [PMID: 25091352 DOI: 10.1016/j.orcp.2013.11.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/27/2013] [Accepted: 11/07/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Improvement of mental health and health-related quality of life (HRQOL) is an important success criterion for bariatric surgery. In general, mental health and HRQOL improve after surgery, but some patients experience negative psychological reactions postoperatively and the influence of pre-surgical psychological factors on mental wellbeing after surgery is unclear. The aim of the current article therefore is to review recent research investigating psychological predictors of mental health and HRQOL outcome. METHODS We searched PubMed, PsycInfo and Web of Science for studies investigating psychological predictors of either mental health or HRQOL after bariatric surgery. Original prospective studies published between 2003 and 2012 with a sample size >30 and a minimum of 1 year follow-up were included. RESULTS Only 10 eligible studies were identified. The findings suggest that preoperative psychological factors including psychiatric symptoms, body image and self-esteem may be important for mental health postoperatively. Predictors of postoperative HRQOL seem to include personality, severe psychiatric disorder at baseline and improvement of depressive symptoms. In addition, psychiatric symptoms that persist after surgery and inappropriate eating behaviour postoperatively are likely to contribute to poor health-related quality of life outcome. CONCLUSION Certain psychological factors appear to be important for mental health and HRQOL after bariatric surgery. However, the literature is extremely sparse and further research is highly needed.
Collapse
Affiliation(s)
- Cathrine L Wimmelmann
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Flemming Dela
- Systems Biology Research Section, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Erik L Mortensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
34
|
|
35
|
|
36
|
Body distortions after massive weight loss: lack of updating of the body schema hypothesis. Eat Weight Disord 2013; 18:333-6. [PMID: 23760908 DOI: 10.1007/s40519-013-0032-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 11/22/2012] [Indexed: 10/26/2022] Open
Abstract
Behavioural therapy and bariatric surgery often produce rapid, massive body weight loss that may impact a patient's ability to gauge his/her new body shape. Although the patient is aware of the weight loss, he/she continues to feel obese, as if there was a conflict between the previous body schema and the new one. Here, we report the case of a 40-year-old woman who developed major body distortions after massive weight loss. Psychometric and behavioural assessments revealed strong disturbances in several tasks involving body representation. In particular, we observed abnormal behaviour in a body-scaled action task. Our findings suggest that the rapidity of our patient's weight loss prevented her central nervous system from correctly updating the body schema.
Collapse
|
37
|
Jabir S. Assessing Improvement in Quality of Life and Patient Satisfaction following Body Contouring Surgery in Patients with Massive Weight Loss: A Critical Review of Outcome Measures Employed. PLASTIC SURGERY INTERNATIONAL 2013; 2013:515737. [PMID: 23936646 PMCID: PMC3712248 DOI: 10.1155/2013/515737] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 06/04/2013] [Indexed: 11/30/2022]
Abstract
Body contouring following massive weight loss is a rapidly expanding field in plastic surgery. However, healthcare payers are reluctant to fund such procedures, viewing them as purely cosmetic. This has resulted in a flurry of studies assessing quality of life (QoL) and patient satisfaction following body contouring surgery in this cohort of patients to establish an evidence base to support the idea that body contouring is as much (or even more) a functional procedure as it is cosmetic. However, the methods employed in these studies are seldom ideal, and hence the conclusions are unreliable. The gold standard to assess QoL and patient satisfaction is to use patient specific psychometrically validated patient reported outcome (PRO) measures. Developing such measures consists of a three-step process which includes a review of the current literature, qualitative patient interviews to determine what patients consider the most important, and expert opinion. This study aims to appraise the currently available literature on assessment of QoL and patient satisfaction in body contouring surgery patients. This will hopefully provide an understanding of methodological weaknesses in current studies and inform future investigators of the design of ideal instruments for assessing QoL and patient satisfaction in body contouring patients.
Collapse
Affiliation(s)
- Shehab Jabir
- St. Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK
| |
Collapse
|
38
|
|
39
|
Klassen AF, Cano SJ, Scott A, Johnson J, Pusic AL. Satisfaction and quality-of-life issues in body contouring surgery patients: a qualitative study. Obes Surg 2013; 22:1527-34. [PMID: 22467000 DOI: 10.1007/s11695-012-0640-1] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Body contouring, which encompasses a range of surgical procedures on different areas of the body, is one of the most rapidly growing areas of plastic surgery. Little is known about outcomes from the perspective of post-weight loss body contouring patients. The aim of our qualitative study was to identify the health and aesthetic concerns of such patients through in-depth patient interviews. METHODS Forty-three bariatric surgery post-weight loss body contouring patients were recruited between September 2009 and January 2011 from the offices of five plastic surgeons located in the USA and Canada. Interviews were used to explore the impact that obesity, weight loss, and body contouring surgery had on all aspects of the patient's life. Interviews were transcribed and data analysis involved coding and the use of the constant comparison method to develop categories and themes. Interviewing continued until no new themes emerged. RESULTS Patients described a range of important health and aesthetic concerns related to body contouring surgery following massive weight loss, including the following: appearance-related concerns, physical health concerns, sexual health concerns, psychological health concerns, and social health concerns. Body contouring surgery played an instrumental role in the completion of the entire weight loss process for patients. CONCLUSIONS The removal of excess skin leads to improvements in a patient's appearance and enhanced physical, psychological, and social health and well-being. In order to appropriately measure the impact of body contouring procedures from the patient's perspective, a well-developed psychometrically sound patient-reported outcome instrument is needed.
Collapse
Affiliation(s)
- Anne F Klassen
- McMaster University, HSC-3N27, 1280 Main Street West, Hamilton, ON, Canada, L8S 4K1.
| | | | | | | | | |
Collapse
|
40
|
Al-Hadithy N, Mennie J, Magos T, Stewart K. Desire for post bariatric body contouring in South East Scotland. J Plast Reconstr Aesthet Surg 2013; 66:87-94. [DOI: 10.1016/j.bjps.2012.08.041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 08/27/2012] [Indexed: 10/27/2022]
|
41
|
|
42
|
Singh D, Zahiri HR, Janes LE, Sabino J, Matthews JA, Bell RL, Thomson JG. Mental and physical impact of body contouring procedures on post-bariatric surgery patients. EPLASTY 2012; 12:e47. [PMID: 22993645 PMCID: PMC3443403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The rapid rate of weight loss following bariatric surgery leads to areas of excessive skin that can cause physical ailments and distortion of body image. Dissatisfaction with the excessive skin can lead patients to seek plastic surgery. This study aims to assess the changes in mental and physical quality of life after body contouring procedures in the post-bariatric surgery population. METHODS In this cross-sectional study, the 36-Item Short Form Health Survey was given to 104 patients divided into 4 groups consisting of a control group, obese patients, post-bariatric surgery patients, and post-bariatric and -body contouring surgery patients. Scores from each survey question were individually averaged, scaled, and converted to the corresponding 8 scales that make up the 36-Item Short Form Health Survey. Scale comparisons were accomplished by analysis of variance and t test. RESULTS Compared with the obese group, both post-bariatric surgery patients and post-body contouring surgery patients had improved quality of life. When comparing the post-body contouring and post-bariatric surgery patients, the post-body contouring group did not show significant quality of life improvement and actually scored significantly lower in 2 measures, Role Emotional and Social Functioning, indicating a decreased mental component of quality of life. When compared with the control group, the post-body contouring surgery group had statistically significant lower scores in 6 of the 8 scales. CONCLUSIONS The functional impairment caused by excessive skin following massive weight loss interferes with quality of life. Patients electing to have body contouring after bariatric surgery show decreased quality of life even after plastic surgery compared to those patients who do not.
Collapse
Affiliation(s)
- Devinder Singh
- aDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Md,Correspondence:
| | - Hamid R Zahiri
- aDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Md
| | - Lindsay E Janes
- aDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Md
| | - Jennifer Sabino
- aDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Md
| | - Jamil A Matthews
- aDivision of Plastic Surgery, Department of Surgery, University of Maryland Medical Center, Baltimore, Md
| | - Robert L Bell
- bYale University School of Medicine, Division of Bariatric Surgery, New Haven, Conn
| | - J. Grant Thomson
- cYale University School of Medicine, Section of Plastic Surgery, New Haven, Conn
| |
Collapse
|
43
|
Modarressi A, Balagué N, Huber O, Chilcott M, Pittet-Cuénod B. Plastic Surgery After Gastric Bypass Improves Long-Term Quality of Life. Obes Surg 2012; 23:24-30. [DOI: 10.1007/s11695-012-0735-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
44
|
Kitzinger HB, Abayev S, Pittermann A, Karle B, Bohdjalian A, Langer FB, Prager G, Frey M. After massive weight loss: patients' expectations of body contouring surgery. Obes Surg 2012; 22:544-8. [PMID: 22101887 DOI: 10.1007/s11695-011-0551-6] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Massive weight loss following bariatric surgery leads to excess skin with functional and aesthetic impairments. Surplus skin can then contribute to problems with additional weight loss or gain. The aims of the current study were to evaluate the frequency of massive soft tissue development in gastric bypass patients, to determine whether males and females experience similar post-bypass body changes, and to learn about the expectations and impairments related to body contouring surgery. METHODS A questionnaire addressing information on the satisfaction of body image, quality of life, and expectation of body contouring surgery following massive weight loss was mailed to 425 patients who had undergone gastric bypass surgery between 2003 and 2009. Of these 425 individuals, 252 (59%) patients completed the survey. RESULTS Ninety percent of women and 88% of men surveyed rated their appearance following massive weight loss as satisfactory, good, or very good. However, 96% of all patients developed surplus skin, which caused intertriginous dermatitis and itching. In addition, patients reported problems with physical activity (playing sports) and finding clothing that fit appropriately. Moreover, 75% of female and 68% of male patients reported desiring body contouring surgery. The most important expectation of body contouring surgery was improved appearance, followed by improved self-confidence and quality of life. CONCLUSIONS Surplus skin resulting from gastric bypass surgery is a common issue that causes functional and aesthetic impairments in patients. Consequently, this increases the desire for body contouring surgery with high expectations for the aesthetic outcome as well as improved life satisfaction.
Collapse
Affiliation(s)
- Hugo B Kitzinger
- Divison of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, General Hospital Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
45
|
Reavey PL, Klassen AF, Cano SJ, McCarthy C, Scott A, Rubin JP, Shermak M, Pusic AL. Measuring quality of life and patient satisfaction after body contouring: a systematic review of patient-reported outcome measures. Aesthet Surg J 2011; 31:807-13. [PMID: 21908812 DOI: 10.1177/1090820x11417426] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
UNLABELLED EVIDENCE-BASED BACKGROUND: In both cosmetic and postbariatric body contouring populations, the primary determinants of success are patient satisfaction and quality of life (QOL). These patient-reported outcomes (PRO) are ideally measured with specially-designed, procedure- or condition-specific questionnaires. OBJECTIVE The authors identify and appraise all patient-reported outcome (PRO) measures (questionnaires) developed for patients undergoing body contouring surgery. METHODS MEDLINE, EMBASE, PsychINFO, Ebase, CINAHL, HAPI, Science Citation Index/Social Sciences Citation Index, Ovid Evidence Based Medicine databases were searched from the inception of each database through August 2010. Articles included in the study described the development and/or psychometric evaluation of a PRO measure developed for body contouring patients. Each measure was then appraised for adherence to internationally-recommended guidelines for item generation, item reduction, and psychometric evaluation. RESULTS The following five PRO questionnaires were identified by our search: one liposuction (the Freiburg Questionnaire on Aesthetic Dermatology and Cosmetic Surgery, FQAD), one general plastic surgery (Derriford Appearance Scale, DAS-59/24), and three breast reduction measures (the Breast Reduction Assessed Severity Scale Questionnaire, BRASSQ; Breast Related Symptoms questionnaire, BRS; and the BREAST-Q reduction module. Detailed examination of these measures revealed that the FQAD, DAS-59, and BRS are limited by both their content range and psychometric properties. The BRASSQ and BREAST-Q both have strong psychometric properties, and the BREAST-Q is unique in its inclusion of items covering specific postoperative issues such as scarring. CONCLUSIONS While instruments are available for measuring outcomes in breast reduction patients, reliable, valid, and responsive PRO measures are lacking for the majority of body contouring procedures. To demonstrate the unique outcomes of body contouring surgery, future research to rigorously develop and validate new PRO measures in this population is necessary.
Collapse
Affiliation(s)
- Patrick L Reavey
- Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, New York, USA
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Bond DS, Wing RR, Vithiananthan S, Sax HC, Roye GD, Ryder BA, Pohl D, Giovanni J. Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis 2010; 7:1-7. [PMID: 20678969 DOI: 10.1016/j.soard.2010.05.015] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 05/19/2010] [Accepted: 05/23/2010] [Indexed: 01/23/2023]
Abstract
BACKGROUND We have previously reported that most women seeking bariatric surgery have had female sexual dysfunction (FSD) as defined by the validated Female Sexual Function Index (FSFI). The present study examined whether FSD resolves after bariatric surgery. METHODS A total of 54 reportedly sexually active women (43.3 ± 9.5 years) completed the FSFI preoperatively and 6 months postoperatively after a mean percentage of excess weight loss of 42.3% (laparoscopic adjustable gastric banding [n = 38], percentage of excess weight loss, 34.6% ± 15.7%; Roux-en-Y gastric bypass [n = 16], percentage of excess weight loss 60.0% ± 21.2%). The FSFI assesses sexual function across 6 domains, with higher scores indicating better sexual function. The summing of these scores yields a FSFI total score (range 2-36, with a score of ≤ 26.55 indicating FSD). RESULTS Before surgery, 34 women (63%) had scores indicative of FSD. By 6 months postoperatively, the FSD had resolved in 23 (68%) of these 34 women, and only 1 woman had developed FSD postoperatively. In the entire sample, significant (P < .05) improvements occurred from before to after surgery on all FSFI domains. The FSFI total scores improved after laparoscopic adjustable gastric banding (from 24.2 ± 5.9 to 29.1 ± 4.1, P < .001) and Roux-en-Y gastric bypass (from 23.7 ± 7.7 to 30.0 ± 4.7, P < .001). In regression analyses, being married, younger age, and worse preoperative sexual function were related to greater sexual function improvements. Postoperatively, the participants' FSFI total scores were indistinguishable from those of published normative controls (29.4 ± 4.3 versus 30.5 ± 5.3, P = .18). CONCLUSION FSD resolved in a large percentage of women after bariatric surgery. Sexual functioning in the entire sample improved to levels consistent with those of normative controls. This improvement in sexual function did not depend on surgery type or weight loss amount and appears to be an additional benefit for women undergoing bariatric surgery.
Collapse
Affiliation(s)
- Dale S Bond
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, The Miriam Hospital Weight Control and Diabetes Research Center, Providence, Rhode Island 02903, USA.
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Terre L. Maintaining Weight Loss Momentum After Bariatric Surgery. Am J Lifestyle Med 2010. [DOI: 10.1177/1559827609355383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Bariatric surgery holds considerable promise for initiating weight loss in extreme obesity. Yet, potential long-term benefits may not be fully realized without sustained lifestyle amelioration. This review discusses some key contributing dynamics as well as future research considerations for optimizing outcomes following weight loss surgery.
Collapse
Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City,
| |
Collapse
|
48
|
|