Psychological Correlates of Body Image Dissatisfaction before and after Bariatric Surgery

Purpose: Identify psychological factors associated with body image dissatisfaction (BID) before, 3 months, and 6+ months after bariatric surgery. Methods: Bariatric patients (n = 444) completed a preoperative interview, 3 month and/or 6+ month postoperative psychology appointment, and Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Scales measuring generalized distress, depression, anxiety, and low self-esteem were examined. Medical records were reviewed for demographics and current psychiatric diagnoses. Results: Preoperative BID was associated with higher scores on MMPI-2-RF scales of Emotional/Internalizing Dysfunction, Demoralization, Low Positive Emotions, Dysfunctional Negative Emotions, Self-Doubt, Inefficacy, Anxiety, and Negative Emotionality/Neuroticism, in addition to a diagnosis of depression and eating disorder not otherwise specified. Patients who reported BID at 3 months scored higher on MMPI-2-RF scales of Emotional/Internalizing Dysfunction, Demoralization, Ideas of Persecution, Dysfunctional Negative Emotions, Self-Doubt, Inefficacy, and Negative Emotionality/Neuroticism, and were more likely to have a depression or anxiety diagnosis. No psychiatric diagnoses or MMPI-2-RF scales were predictive of BID 6+ months after bariatric surgery. Conclusions: Bariatric candidates experiencing symptoms of depression, anxiety, low self-esteem, and disturbed eating at preoperative evaluation are more likely to report BID before and after bariatric surgery. Future research should consider the limitations of long-term follow-up in this study to advance the field forward.