World Journal of Laparoscopic Surgery

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  17 (2024)
Volume  16 (2023)
Volume  15 (2022)
Volume  14 (2021)
Volume  13 (2020)
Volume  12 (2019)
Volume  11 (2018)
Volume  10 (2017)
Volume  9 (2016)
Volume  8 (2015)
Volume  7 (2014)
Volume  6 (2013)
Volume  5 (2012)
Volume  4 (2011)
Volume  3 (2010)
Volume  2 (2009)
Volume  1 (2008)
Related articles

VOLUME 14 , ISSUE 2 ( May-August, 2021 ) > List of Articles

RESEARCH ARTICLE

Perioperative Antidepressant Use Improves Body Image to a Greater Extent Compared to Those Not Taking Antidepressants in Patients Who Undergo Bariatric Surgery

David Fipps, Sharon Holder, Dorothy Schmalz, John Scott

Keywords : Antidepressant, Bariatric surgery, Body image

Citation Information : Fipps D, Holder S, Schmalz D, Scott J. Perioperative Antidepressant Use Improves Body Image to a Greater Extent Compared to Those Not Taking Antidepressants in Patients Who Undergo Bariatric Surgery. World J Lap Surg 2021; 14 (2):126-130.

DOI: 10.5005/jp-journals-10033-1452

License: CC BY-NC 4.0

Published Online: 19-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Introduction: Body image often improves after bariatric surgery; however, those who are depressed are more vulnerable to continuing to have body image concerns. Body image dissatisfaction and depression are associated with poorer quality of life, less weight loss after surgery, and poorer overall physical/mental functioning. Our study aims to determine whether antidepressants influence the improvement seen in body image after bariatric surgery. Materials and methods: Body-Esteem Scale for Adolescents and Adults (BESAA), a validated tool for trending body image, was administered preoperatively and at 3, 6, and 12 months postoperative follow-ups. Scores were compared for improvement, and linear regression models were used to determine the influence of medications and demographic factors on score improvement. Results: The study sample was consisted of 47 men and 57 women (22–72 years of age). Preoperative BMI was in the range of 35.87–75.66 (mean: 49.26). Sixty-nine percent (69%) were taking psychiatric medications and 57% of those medications were antidepressants (12 different antidepressants represented). Improvement in BMI was in the range of 1.44–30.77 points (mean: 15.08). The majority (98.07%) showed improved BESAA scores; two factors revealed statistical significance for influence on score magnitude. For every 1 point of BMI improvement, our sample increased BESAA scores by 0.68 points (p = 0.021). Those taking antidepressants scored an average of 8.55 points higher than those not taking antidepressants (p = 0.032). There were no significant differences found for age, gender, race, type of surgery, use of anxiolytics/hypnotics, or stimulants. Conclusion: Perioperative antidepressant usage is associated with a greater improvement in body image after bariatric surgery compared to those who are not taking antidepressants. Given the high comorbidity of depression in bariatric surgery patients, this highlights potential for improved outcomes with treatment of psychiatric comorbidities in this population.

HTML PDF Share
  1. Cash TF. The body image workbook: an eight-step program for learning to like your looks. 2nd ed. Oakland: New Harbinger; 2008.
  2. Varns J, Fish A, Eagon JC. Conceptualization of body image in the bariatric surgery patient. Appl Nurs Res 2018;41:52–58. DOI: 10.1016/j.apnr.2018.03.008.
  3. Cash TF. Cognitive behavioral perspectives on body image. In: Cash TF, Smolak L, editors. Body image: a handbook of science, practice, and prevention. 2nd ed. New York: The Guilford Press; 2011. p. 39–47.
  4. Bianciardi E, Lorenzo G, Niolu C, et al. Body Image dissatisfaction in individuals with obesity seeking bariatric surgery: exploring the burden of new mediating factors. Riv Psichiatr 2019;54(1):8–17. DOI: 10.1708/3104.30935.
  5. Levy AS, Heaton AW. Weight control practices of US adults trying to lose weight, Ann Intern Med 1993;119(7 Pt 2):661–666. DOI: 10.7326/0003-4819-119-7_part_2-199310011-00007.
  6. Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obesity Surg 2004;14(3):392–398. DOI: 10.1381/096089204322917936.
  7. Ivezaj V, Grilo C. The complexity of body image following bariatric surgery: a systematic review of the literature. Obes Rev 2018;19(8):1116–1140. DOI: 10.1111/obr.12685.
  8. Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res 2005;13(4):639–648. DOI: 10.1038/oby.2005.71.
  9. Neven K, Dymek M, leGrange D, et al. The effects of Roux-en-Y gastric bypass surgery on body image. Obes Surg 2002;12(2):265–269. DOI: 10.1381/096089202762552755.
  10. Pona AA, Heinberg LJ, Lavery M, et al. Psychological predictors of body image concerns 3 months after bariatric surgery. Surg Obes Relat Dis 2016;12(1):188–193. DOI: 10.1016/j.soard.2015.05.008.
  11. Van Eck K, Morse M, Flory K. The role of body image in the link between ADHD and depression symptoms among college students. J Atten Disord 2015;22(5). DOI: 10.1177/1087054715580845.
  12. Jackson KL, Janssen I, Appelhans BM, et al. Body image satisfaction and depression in midlife women: the study of women's health across the nation (SWAN). Arch Women's Ment Health 2014;17(3):177–187. DOI: 10.1007/s00737-014-0416-9.
  13. de Zwaan M, Georgiadou E, Stroh CE, et al. Body image and quality of life in patients with and without body contouring surgery following bariatric surgery: a comparison of pre- and post-surgery groups. Front Psychol 2014;5:1310. DOI: 10.3389/fpsyg.2014.01310.
  14. Sarwer DB, Cohn NI, Gibbons LM, et al. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obes Surg 2004;14(9):1148–1156. DOI: 10.1381/0960892042386922.
  15. Sarwer DB, Thompson JK, Cash TF. Body image and obesity in adulthood. Psychiat Clin N Am 2005;28(1):69–87. DOI: 10.1016/j.psc.2004.09.002.
  16. Rand CS, Kuldau JM. Morbid obesity: a comparison between a general population and obesity surgery patients. Int J Obes Relat Metab Disord 1993;17(11):657–661. PMID: 8281224.
  17. Williams G, Hudson D, Whisenhunt B, et al. Short-term changes in affective, behavioral, and cognitive components of body image after bariatric surgery. Surg Obes Relat Dis 2018;14(4):521–526. DOI: 10.1016/j.soard.2017.12.026.
  18. Levenson JL. The APA textbook of psychosomatic medicine and consultation Liaison psychiatry. 3rd ed. Washington DC: American Psychiatric Association Publishing; 2019.
  19. Yu M, Zhang X, Lu F, et al. Depression and risk for diabetes: a meta-analysis. Can J Diab 2015;39(4):266–272. DOI: 10.1016/j.jcjd.2014.11.006.
  20. Van der Kooy K, van Hout H, Marwijk H, et al. Depression and the risk for cardiovascular diseases: systematic review and meta-analysis. Int J Geriatr Psychiatry 2007;22(7):613–626. DOI: 10.1002/gps.1723.
  21. Ramasubbu R, Patten S. Effect of depression on stroke morbidity and mortality. Can J Psychiatry 2003;48(4):250–257. DOI: 10.1177/070674370304800409.
  22. Schwartz MB, Brownell KD. Obesity and body image. Body Image 2004;1(1):43–56. DOI: 10.1016/S1740-1445(03)00007-X.
  23. Monpellier VM, Antoniou E, Mulkens S, et al. Body image dissatisfaction and depression in postbariatric patients is associated with less weight loss and a desire for body contouring surgery. Surg Obes Relate Dis 2018;14(10):1507–1515. DOI: 10.1016/j.soard.2018.04.016.
  24. McCabe MP, Ricciardelli LA. Body image dissatisfaction among males across the lifespan: a review of past literature. J Psychosom Res 2004;56(6):675–685. DOI: 10.1016/S0022-3999(03)00129-6.
  25. Lacerda RM, Castanha CR, Castanha AR, et al. Perception of body image by patients undergoing bariatric surgery. Rev Col Bras Cir 2018;45(2):e1793. DOI: 10.1590/0100-6991e-20181793.
  26. Yusufov M, Dalrymple K, Berstein M, et al. Body mass index, depression, and suicidality: the role of self-esteem in bariatric surgery candidates. J Affective Disord 2017;208:328–347. DOI: 10.1016/j.jad.2016.10.005.
  27. Mendelson B, White D. Body-esteem scale for adolescents and adults. J Person Assess 2001;76(1):90–106. DOI: 10.1207/S15327752JPA7601_6.
  28. Madan AK, Beech BM, Tichansky DS. Body esteem improves after bariatric surgery. Surg Innov 2008;15(1):32–37. DOI: 10.1177/1553350608316135.
  29. Franzoi SL, Herzog ME. The body esteem scale: a convergent and discriminant validity study. J Personality Assess 1986;50(1):24–31. DOI: 10.1207/s15327752jpa5001_4.
  30. Adami GF, Meneghelli A, Bressani A, Scopinaro body image in obese patients before and after stable weight reduction following bariatric surgery. J Psychosom Res 1999;46(3):275–281. DOI: 10.1016/s0022-3999(98)00094-4.
  31. Camps MA, Zervos E, Goode S, et al. Impact of bariatric surgery on body image and their partners. Obes Surg 1996;6(4):356–360. DOI: 10.1381/096089296765556700.
  32. Dixon JB, Dixon ME, O'Brien PE. Body image: appearance orientation and evaluation in the severely obese. Changes with weight loss. Obes Surg 2002;12(1):65–71. DOI: 10.1381/096089202321144612.
  33. Hrabosky JI, Masheb RM, White MA, et al. A prospective study of body dissatisfaction and concerns in extremely obese gastric bypass patients: 6- and 12-month postoperative outcomes. Obes Surg 2006;16(12):1615–1621. DOI: 10.1381/096089206779319527.
  34. Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health 2006;21(2):273–293. DOI: 10.1080/14768320500129064.
  35. Teufel M, Rieber N, Meile T, et al. Body Image after sleeve gastrectomy: reduced dissatisfaction and increased dynamics. Obes Surg 2012;22(8):1232–1237. DOI: 10.1007/s11695-012-0690-4.
  36. Sarwer DB, Wadden TA, Moore RH, et al. Williams. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis 2010;6(6):608–614. DOI: 10.1016/j.soard.2010.07.015.
  37. Cash TF, Counts B, Huffine CE. Current and vestigial effects of overweight among women: fear of fat, attitudinal body image, and eating behaviors. J Psychopathol Behav Assess 1990;12(2):157–167. DOI: 10.1007/BF00960765.
  38. Jiang W, Krishnan R, Kuchibhatla M, et al. SADHART-CHF Investigators: characteristics of depression remission and its relation with cardiovascular outcome among patients with chronic heart failure (from the SADHART-CHF Study). Am J Cardiol 2011;107(4):545–551. DOI: 10.1016/j.amjcard.2010.10.013.
  39. Navari R, Brenner M, Wilson M. Treatment of depressive symptoms in patients with early stage breast cancer undergoing adjuvant therapy. Breast Cancer Res Treat 2008;112(1):197–201. DOI: 10.1007/s10549-007-9841-z.
  40. Bacon L, Keim NL, Van Loan, MD, et al. Evaluating a “non-diet” wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors. Int J Obes Relat Metab Disord 2002;26(6): 854–865. DOI: 10.1038/sj.ijo.0802012.
  41. Rosen JC, Orosan P, Reiter J. Cognitive behavioral therapy for negative body image in obese women. Behav Ther 1995;26(1):25–42. DOI: 10.1016/S0005-7894(05)80081-4.
  42. Roughan P, Seddon E, Vernon-Roberts J. Long-term effects of a psychologically based group programme for women preoccupied with body weight and eating behavior. Int J Obes 1990;14(2):135–147. PMID: 2341222.
  43. Weineland S, Arvidsson D, Kakoulidis TP, et al. Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT. Obes Res Clin Pract 2012;6(1):e1–e90. DOI: 10.1016/j.orcp.2011.04.004.
  44. Weineland S, Hayes SC, Dahl J. Psychological flexibility and the gains of acceptance-based treatment for post-bariatric surgery: six-month follow-up and a test of the underlying model. Clin Obes 2012;2 (1-2):15–24. DOI: 10.1111/j.1758-8111.2012.00041.x.
  45. Friedman KE, Reichmann SK, Costanzo PR, et al. Weight stigmatization and ideological beliefs: relation to psychological functioning in obese adults. Obes Res 2005;13(5):907–916. DOI: 10.1038/oby.2005.105.
  46. Bucchianeri MM, Neumark-Sztainer D. Body dissatisfaction: an overlooked public health concern. J Public Ment Health 2014;13(2):64–69. DOI: 10.1108/JPMH-11-2013-0071.
  47. Hrabosky JI, White MA, Masheb RM, et al. Psychometric evaluation of the eating disorder examination-questionnaire for bariatric surgery candidates. Obesity (Silver Spring) 2008;16(4):763–769. DOI: 10.1038/oby.2008.3.
  48. Perdue T, Schreier A, Neil J, et al. A concept analysis of disturbed body image in bariatric surgery patients. Int J Nurs Knowl 2020;31(1):74–81. DOI: 10.1111/2047-3095.12220.
  49. Katon WJ. Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biol Psychiatry 2003;54(3):216–226. DOI: 10.1016/s0006-3223(03)00273-7.
  50. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;160(14):2101–2107. DOI: 10.1001/archinte.160.14.2101.
  51. Schulz R, Beach SR, Ives DG, et al. Association between depression and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med 2000;160(12):1761–1768. DOI: 10.1001/archinte.160.12.1761.
  52. Katon W, Lin E, Kroenke K. The association of depression and anxiety with medical symptom burden in patients with chronic medical illness. Gen Hosp Psychiatry 2007;29(2):147–155. DOI: 10.1016/j.genhosppsych.2006.11.005.
  53. Malone M, Alger-Mayer S, Polimeni J. Antidepressant drug therapy does not affect weight loss on year after gastric bypass surgery. Obes Surg 2011;21:1721–1723. DOI: 10.1007/s11695-010-0351-4.
  54. Pujols Y, Seal BN, Meston CM. The association between sexual satisfaction and body image in women. J Sex Med 2010(2 Pt2): 905–916. DOI: 10.1111/j.1743-6109.2009.01604.x.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.