Endocrine Abstracts

Introduction: Bariatric surgery is one of the most important treatment modalities for obesity. Studies suggested that obese subjects have distorted body image perception. Dissatisfaction with body shape is one of the leading reasons for treatment referral.

Aim: To prospectively study body image perception and its relationship with body composition in patients treated with bariatric surgery.

Methods: Nineteen patients were evaluated before and after sleeve gastrectomy using the Stunkard Figure Rating Scale (SFRS) and bioimpedance. Image dissatisfaction and distortion, body mass index (BMI), body fat percentage, muscle mass, and visceral fat were studied.

Results: Fifteen women and four men (mean age = 41.63 ± 10.17 years) were investigated. After surgery (3.7 ± 1.4 months), BMI decreased from 42.53 ± 6.53 to 33.88 ± 5.55 kg/m² (P = 0.0001), body fat from 49.21 ± 4.33 to 43.21 ± 4.76% (P = 0.003), visceral fat index from 23.3 ± 2.6 to 17.6 ± 4.9 (P < 0.0001), and muscle mass from 32.13 ± 6.29 to 28.75 ± 6.67 kg (P = 0.0002). According to the SFRS, all subjects presented image dissatisfaction both at baseline and after surgery. However, dissatisfaction scores were higher at baseline (4.2 ± 1.4) than postoperatively (2.9 ± 1.3, P = 0.0008). Dissatisfaction was correlated with BMI (r = 0.4632, P = 0.0034), body fat percentage (r = 0.5284, P = 0.0006), and visceral fat index (r = 0.4457, P = 0.0050). In the multiple regression model, after the adjustment for the influence of other variables, body fat percentage was identified as the main influence on the dissatisfaction scores. When self-image distortion was present (pre- and postoperative prevalence of 45.8 and 54.2%, respectively), it consisted of underestimation of body shape and scores did not change significantly after surgery (0.68 ± 0.67 vs 0.89 ± 0.74, P ± 0.2590). Women had a higher relative risk of image distortion than men (RR = 1.522, P = 0.0391).

Conclusion: All patients presented image dissatisfaction both preoperatively and after a short postoperative period. Dissatisfaction improved significantly after sleeve gastrectomy as a result of a decrease in body fat percentage. Nevertheless, there was no significant change in image distortion, a common feature in this cohort and reportedly involved in the very pathogenesis of obesity.