Three-Dimensional Model Improves Body Image Perception After Bariatric Surgery

Abstract

Background: Despite losing weight, the majority of subjects retained an obese view of themselves. The aim of the study was to evaluate the usefulness of a 3D modeling tool in improving the body image of patients who have undergone bariatric surgery. Methods: Morbidly obese subjects involved in a medico-surgical obesity management program and having undergone a Roux en Y Gastric Bypass (RYGB) or a sleeve gastrectomy (SG) were prospectively included during their usual postoperative medical follow-up. The figure rating scale (FRS), body image questionnaire, and Hospital Anxiety Depression Scale test were performed. The FRS was assessed before and after visualizing their body image using a 3D modeling tool. Distributions between the groups for gender (female vs. male) and type of surgery (gastric bypass vs. sleeve gastrectomy) were tested with a Pearson's chi² independence test. The significance threshold was p < 0.05. Results: We included 140 adults with sleeve gastrectomy (72.9%; n = 102) or gastric bypass (27.1%; n = 38). The mean time from surgery was 308.3 ± 111.4 days (63-511). Participants were mostly female (77.9%; n = 109). Nearly half of the subjects who had undergone bariatric surgery almost one year before modified their body perception after visualizing their avatar thanks to a 3D modeling tool. One third reduced their FRS score ("perceived body") after visualizing their avatar. FRS score and body mass index (BMI) following surgery ("real body") were significantly correlated before and after visualizing the 3D avatar, with a stronger correlation after visualizing the 3D avatar. Conclusions: A 3D modeling tool may improve body perception after weight loss in subjects with bariatric surgery. Being simple, non-invasive, not expansive, and easy to use during a consultation and to understand for the patient, a regular use of this tool may be largely implemented in clinical practice. Its usefulness in improving body image, mood disorders, and eating disorders and the further success of the surgery should be further evaluated.

Keywords: bariatric surgery; body satisfaction; three-dimensional imaging.

Figure 1

BMI-FUP: outpatient follow-up body mass index; BMI-surg: body mass index before bariatric surgery; pBMI: percentage of BMI loss; Tx-BMI: percentage of BMI loss per week; QIC: body image questionnaire; HAD: Hospital Anxiety and Depression Scale; FRS-pre: Stunkard figure rating scale before 3D avatar visualization; FRS-post: Stunkard figure rating scale after 3D avatar visualization.

Figure 2

Example of a computerized 3D modeling of the body silhouette of a patient participating in the study.

Figure 3

Stunkard scale scores recorded before (FRS-pre) and after (FRS-post) 3D avatar visualization for patient groups A, B, and C (Mean ± SE). ***: significantly different from group B (p < 0.001); $$$: significantly different from group A (p < 0.001). Group A: FRS-pre = FRS-post. Group B: FRS-pre > FRS-post. Group C: FRS-pre < FRS-post.

Figure 4

Linear regressions established for all subjects between the FRS score (i.e., “perceived body”) and BMI-FUP (i.e., “actual body”) before 3D avatar visualization ((A); FRS-pre) and after 3D avatar visualization ((B); FRS-post).