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Majority of female bariatric patients retain an obese identity 18-30 months after surgery.

Authors
  • Perdue, Tamara O1
  • Schreier, Ann2
  • Swanson, Melvin2
  • Neil, Janice2
  • Carels, Robert3
  • 1 Brody School of Medicine, Metabolic Surgery Research Group, East Carolina University, 600 Moye Blvd, Greenville, NC, 27834, USA. [email protected]
  • 2 College of Nursing, East Carolina University, Greenville, USA.
  • 3 Department of Psychology, East Carolina University, Greenville, USA.
Type
Published Article
Journal
Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity
Publisher
Springer-Verlag
Publication Date
Apr 01, 2020
Volume
25
Issue
2
Pages
357–364
Identifiers
DOI: 10.1007/s40519-018-0601-3
PMID: 30382542
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

When bariatric surgery is performed, a successful outcome is usually described as % total weight lost (EWL) or a change in BMI. These definitions fail to address the importance of post-operative psychosocial adjustment. Previous research has alluded to a 'mind-body lag' where the patient's experienced body feels larger than their physically smaller post-operative body, perhaps as a result of amygdalae conditioning. The purpose of this study is to further investigate this psychological issue and assess its relationship to health locus of control, alexithymia, health quality of life and weight regain in bariatric surgery patients. Forty female bariatric surgery patients between 18 and 30 months post-op completed demographic data, survey instruments and anthropometric testing. Their evolving self-view, health locus of control, tendency toward alexithymic thought, and health quality of life were measured to identify significant relationships. Hermans' Dialogical Self Theory was used to understand the conflicted self-view of the participants. The majority of participants retained an obese view of self despite weight loss. Those who retained an 'I-obese' viewpoint were significantly more likely to see external situations and powerful others as controlling their weight, have difficulty identifying their feelings and score significantly lower in vitality, social functioning and mental health. Despite losing weight, the majority of participants retained an obese view of self that was significantly associated with a lessened health quality of life. Use of the Evolving Self-View (ESV) exploratory tool may allow early identification of post-operative patients with a prolonged 'I-obese' self-view and provide an opportunity for intervention. Level III, cross-sectional case-control study.

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