Journal of Education and Health Promotion

The comparison of morbid obesity quality of life and body image between surgery and other treatments: A case–control study

Document Type : Original Article

Authors

. Negar Yazdani 1
. Nasrin Elahi 2
. Farkhondeh Sharif 3
. Seyed Vahid Hosseini 4
. Abbas Ebadi 5

1 Departments of Community Health Nursing, Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz

2 Department of Nursing, Nursing Care Research Center In Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz

3 Department of Psychiatric Nursing, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences

4 Department of Surgery, Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz

5 Department of Nursing, Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract
BACKGROUND: Morbid obesity is rising around the world. Surgery is a selective treatment
intervention for it. Since most of the surgeons use weight loss for evaluating of the morbid obesity
surgical outcomes and paying attention to the the quality of life (QOL) and body image evaluation
are rare, this study aimed to assess the QOL and body image in pre‑ and postsurgery with other
interventions.
MATERIALS AND METHODS: This case–control study was done on 200 morbidly obese
patients (n = 100 in each group) who referred to the obesity clinic in Shiraz. The data were collected
by Body Image Concern Inventory and 12‑item Short Form Survey. The data were analyzed by
t‑test, Pearson correlation coefficient test, analysis of variance, and regression analysis. P = 0.05
was considered as significant.
RESULTS: The paired t‑test showed a significant difference in mean scores of body image (P < 0.001)
and all dimensions of the QOL (P < 0.001) in the case and control groups. In the case group, there
was a significant difference between the mean scores of the QOL and the different categories of
body mass index (BMI) in postsurgery (P < 0.05) and the different mean scores of body image and
the different categories of BMI in pre- and postsurgery wasn’t significant (P > 0.05). Age was a
predictor variable for the QOL of morbidly obese persons after surgery (P < 0.001). After surgery,
men showed better QOL than women (P < 0.001).
CONCLUSION: Final results indicated that body image and QOL defects caused by obesity could be
more improvement after surgery. This study can promote health‑care team’s knowledge about holistic
supporting of all dimensions’ QOL of obese individuals. It is suggested that supporting interventions
should be done as effective methods of maintenance for effects of weight loss methods such as surgery.

Keywords

Body image
morbid obesity
quality of life
surgery
  1. Smith KB, Smith MS. Obesity statistics. Prim Care 2016;43:121‑35,
    ix.
    2. Hruby A, Hu FB. The epidemiology of obesity: A big picture.
    Pharmacoeconomics 2015;33:673‑89.
    3. Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, Finucane MM,
    et al. National, regional, and global trends in adult overweight
    and obesity prevalences. Popul Health Metr 2012;10:22.
    4. Sarrafzadegan N, Kelishadi R, Siadat ZD, Esmaillzadeh A,
    Solhpour A, Shirani S, et al. Obesity and cardiometabolic risk
    factors in a representative population of Iranian adolescents and
    adults in comparison to a western population: The Isfahan healthy
    heart programme. Public Health Nutr 2010;13:314‑23.
    5. SkyrudRV, Aaseth J, Birketvedt GS. Outpatient, multidisciplinary
    treatment of morbidly obese patients: A two‑year retrospective
    study. Open Behav Sci J 2011;5:28‑32. Available on Jan 2019
    from: https://www.benthamopen.com/DOWNLOAD‑PDF/
    TOBSJ‑5‑28/.
    6. Jepsen R, Aadland E, Robertson L, Kolotkin RL, Andersen JR,
    Natvig GK, et al. Physical activity and quality of life in severely
    obese adults during a two‑year lifestyle intervention programme.
    J Obes 2015;2015:314194.
    7. Verhagen M. Body Image of Patients with Morbid Obesity
    before and After Bariatric Surgery. Clinical and Health
    Psychology (Master thesis); June, 2016. P. 5‑16.
  2. 8. Abolhassani S, Irani MD, Sarrafzadegan N, Rabiei K, Shahrokhi S,
    Pourmoghaddas Z, et al. Barriers and facilitators of weight
    management in overweight and obese people: Qualitative
    findings of TABASSOM project. Iran J Nurs Midwifery Res
    2012;17:205‑10.
    9. Charalampakis V, Seretis C, Daskalakis M, Fokoloros C, Karim A,
    Melissas J, et al. The effect of laparoscopic sleeve gastrectomy on
    quality of life: A prospective cohort study with 5‑years follow‑up.
    Surg Obes Relat Dis 2018;14:1652‑8.
    10. Douglas IJ, Bhaskaran K, Batterham RL, Smeeth L. Bariatric
    surgery in The United Kingdom: A Cohort study of weight
    loss and clinical outcomes in routine clinical care. PLoS Med
    2015;12:e1001925.
    11. Vine M, Hargreaves MB, Briefel RR, Orfield C. Expanding
    the role of primary care in the prevention and treatment of
    childhood obesity: A review of clinic‑ and community‑based
    recommendations and interventions. J Obes 2013;2013:172035.
    12. Laxy M, Holle R, Döring A, Peters A, Hunger M. The longitudinal
    association between weight change and health‑related quality
    of life: The KORA S4/F4 cohort study. Int J Public Health
    2014;59:279‑88.
    13. Döring N, de Munter J, Rasmussen F. The associations between
    overweight, weight change and health related quality of life:
    Longitudinal data from the stockholm public health cohort
    2002‑2010. Prev Med 2015;75:12‑7.
    14. Cox TL, Ard JD, Beasley TM, Fernandez JR, Howard VJ, Affuso O,
    et al. Body image as a mediator of the relationship between body
    mass index and weight‑related quality of life in black women.
    J Womens Health (Larchmt) 2011;20:1573‑8.
    15. Hayward J, Millar L, Petersen S, Swinburn B, Lewis AJ. When
    ignorance is bliss: Weight perception, body mass index and
    quality of life in adolescents. Int J Obes (Lond) 2014;38:1328‑34.
    16. Schigt A, Gerdes VE, Cense HA, Berends FJ, van Dielen FM,
    Janssen I, et al. Bariatric surgery is an effective treatment for
    morbid obesity. Neth J Med 2013;71:4‑9.
    17. Colwell AS. Current concepts in post‑bariatric body contouring.
    Obes Surg 2010;20:1178‑82.
    18. de Zwaan M, Georgiadou E, Stroh CE, Teufel M, Köhler H,
    Tengler M, 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.
    19. Moraes JM, Caregnato RC, Schneider DS. Quality of life before
    and after bariatric surgery. Acta Paul Enferm 2014;27:157‑64.
    20. Streur WJ, Hurlburt WB, Birch S. Measuring Height/Weight and
    Calculating BMI Guidelines for School. State of Alaska: Alaska
    Department of Health and Social Services/Division of Public
    Health; 2011.
    21. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM.
    Prevalence of high body mass index in US children and
    adolescents, 2007‑2008. JAMA 2010;303:242‑9.
    22. Littleton HL, Axsom D, Pury CL. Development of the body image
    concern inventory. Behav Res Ther 2005;43:229‑41.
    23. Basaknejad S, Ghafari M. The relationship between body
    image concern and psychological disorders in students. JBS
    2008;1:179‑87.
    24. Esmaeil Riahi M. Gender Differences in the Level of Body Image
    Satisfaction. 2012; 9 (3): 5‑33 (In press).
    25. Ware J Jr., Kosinski M, Keller SD. A 12‑item short‑form health
    survey: Construction of scales and preliminary tests of reliability
    and validity. Med Care 1996;34:220‑33.
    26. Montazeri A, Vahdaninia M, Mousavi SJ, Omidvari S. The Iranian
    version of 12‑item short form health survey (SF‑12): Factor
    structure, internal consistency and construct validity. BMC Public
    Health 2009;9:341.
    27. Polit DF, Beck CT. Nursing Research: Generating and Assessing
    Evidence for Nursing Practice. 9th ed. Philadelphia: Wolters
    Kluwer Health/Lippincott Williams and Wilkins; 2012.
    28. Pétré B, Scheen AJ, Ziegler O, Donneau AF, Dardenne N,
    Husson E, et al. Body image discrepancy and subjective norm
    as mediators and moderators of the relationship between
    body mass index and quality of life. Patient Prefer Adherence
    2016;10:2261‑70.
    29. Melo IT, São‑Pedro M. Musculoskeletal pain in lower limbs in
    obese patients before and after bariatric surgery. Arq Bras Cir Dig
    2012;25:29‑32. Available on Jan 2019 from:http://www.scielo.br/
    pdf/abcd/v25n1/07.pdf.
    30. Grans R, Warth CF, Farah JF, Bassitt DP. Quality of life and
    prevalence of osteoarticular pain in patients submitted to bariatric
    surgery. Einstein 2012;10:415‑21.
    31. Wijhoven H, De Vet H, Picavet S. Explaining sex differences
    in chronic musculoskeletal pain in general population. Pain
    2006;124:158‑66.
    32. Serrano AQ, Vasconcelos MG, Silva GA, Cerqueira MM,
    PontesCM.Obese adolescents’ perceptions about the repercussions
    of obesity on their health. Rev Esc Enferm USP 2010;44:25‑31.
    33. Klassen AF, Cano SJ, Scott A, Johnson J, Pusic AL. Satisfaction
    and quality‑of‑life issues in body contouring surgery patients:
    A qualitative study. Obest Surg 2012;22:1527‑34.
    34. Ghai A, Milosevic I, Laliberte M, Taylor VH, McCabe RE. Body
    image concerns in obese women seeking bariatric surgery. Ethn
    Inequal Health Soc Care 2014;7:96‑107.
    35. Watkins JA, Christie C, Chally P. Relationship between body
    image and body mass index in college men. J Am Coll Health
    2008;57:95‑100.
    36. Cox TL. Zunker C. Wingo B. Thomas DM. Ard JD. Body image
    and quality of life in a group of African American women. Soc
    Indicator Res 2010;99:531‑40.
    37. Sabeti F, Gorjian Z. The Relationship between the satisfaction of
    body image and self‑esteem among obese Adolescents in Abadan,
    Iran. IJDO 2013;5:126‑31.
    38. van den Berg PA, Mond J, Eisenberg M, Ackard D,
    Neumark‑Sztainer D. The link between body dissatisfaction and
    self‑esteem in adolescents: Similarities across gender, age, weight
    status, race/ethnicity, and socioeconomic status. J Adolesc Health
    2010;47:290‑6.
    39. Befort CA, Rickard KM. Gender similarities in response to
    figure‑size feedback in a selected non‑clinical population. Sex
    Roles 2003;49:71‑80.
    40. van der Beek ES, Geenen R, de Heer FA, van der Molen AB,
    van Ramshorst B. Quality of life long‑term after body contouring
    surgery following bariatric surgery: Sustained improvement after
    7 years. Plast Reconstr Surg 2012;130:1133‑9.
Journal of Education and Health Promotion
Volume 10, Issue 1
January 2020
Pages 1-7

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