Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study

Abstract

Background: Postoperative body shape expectations (BSE) of bariatric surgery candidates remain relatively unexplored, and may have important implications for weight loss outcomes, treatment satisfaction, and education.

Methods: The 'Silhouette Figure Rating Scale' was administered to 69 consecutive female candidates. Self-perceived current and goal body shape and postoperative BSE in four categories; "dream, "happy", "acceptable", and "disappointed" were examined.

Results: The mean age and BMI of the sample was 43.4 ± 8.9 years and 48.8 ± 7.0 kg/m(2). Self-ideal body shape discrepancy of 4.1 ± 1.3 silhouettes was reported, indicating body image dissatisfaction. 53% incorrectly identified the silhouette associated with their actual BMI. Goal body shape (4.3 ± 0.8 silhouettes) corresponded to a BMI figure 23.1 kg/m(2)- 26.2 kg/m(2). The postoperative "dream" (4.1 ± 1.0 silhouettes), "happy" (5.0 ± 0.8 silhouettes), "acceptable" (5.3 ± 1.0 silhouettes), and "disappointed" (6.9 ± 1.0 silhouettes) BSE corresponded to silhouettes that were thinner than the thinnest silhouette clinically expected based on a 56.1% excess weight loss 1-year after laparoscopic sleeve gastrectomy (LSG) or a 22.3% to 47.2% total body weight loss.

Conclusions: Women seeking bariatric surgery experience body image dissatisfaction and misperceive their actual body size. BSE do not correspond with evidence-based LSG weight loss outcomes.

Keywords: Bariatric surgery; Body shape expectations; Laparoscopic sleeve gastrectomy; Silhouette.

Figure 1

Body shape expectations of women seeking laparoscopic sleeve gastrectomy compared to average clinically expected %EWL 1-year post surgery. A. depicts the silhouettes associated with women’s “dream”, “happy”, “acceptable”, and “disappointed” postoperative body shape expectations. B. depicts the goal, current perceived, and actual self-reported silhouettes of women seeking LSG compared to the range of clinically expected body shapes 1-year post bariatric surgery. Dotted area indicates the range of silhouettes clinically expected 1-year after LSG based on a 56.1%EWL in this sample of women [6]. BMI values assigned according to population normative data [57]. Obesity classes arranged according to Canadian Clinical Practice Guidelines [4]. n = 69, less than 10% missing data. Reprinted with permission from Stunkard AJ, Sorenson T, Schulsinger F: Use of the Danish Adoption Register for the study of obesity and thinness. In The Genetics of Neurological and Psychiatric Disorders. Edited by Kety SS, Rowland LP, Sidman RL, Matthysse SW. New York: Raven Press; 1983: 115–120.