Psychological predictors of body image concerns 3 months after bariatric surgery

Background: Although studies have associated postoperative weight loss with improvement in body image dissatisfaction, some individuals continue to report body image concerns after bariatric surgery. These concerns are linked to increased depressive symptoms and decreased self-esteem in bariatric populations. Objective: This study sought to explore preoperative factors that may predict early body image concerns 3 months after bariatric surgery. Setting: Academic medical center. Method: Data were analyzed from 229 patients evaluated for bariatric surgery who completed a 3-month postoperative psychology appointment and the Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form (MMPI-2-RF). Scales measuring depression, persecution, self-doubt, and inadequacy were examined. Medical records were reviewed for demographic characteristics, psychotropic medication usage, history of psychological treatment, and current or lifetime depression diagnosis. Results: Patients who preoperatively scored higher on demoralization (F [1, 227] = 35.40, P < .001), low positive emotions (F [1, 227] = 4.18, P < .05), ideas of persecution (F [1, 227] = 15.24, P < .001), self-doubt (F [1, 227] = 27.47, P < .001), and inefficacy (F [1, 227] = 21.34, P < .001) were significantly more likely to report body image concerns 3 months after bariatric surgery. Similarly, body image concerns were more common in patients with a preoperative depression diagnosis (χ² = 8.76, P < .01), current psychotropic medication usage (χ² = 7.13, P < .01), and history of outpatient therapy (χ² = 8.34, P < .01) and psychotropic medication (χ² = 9.66, P < .001). Conclusion: Bariatric surgery candidates with psychopathology and other psychological risk factors are more likely to report body image concerns early after bariatric surgery. Future research is warranted to determine whether this association remains further out from surgery.