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Psychological Considerations of the Bariatric Surgery Patient Undergoing Body Contouring Surgery

Sarwer, David B. Ph.D.; Thompson, J Kevin Ph.D.; Mitchell, James E. M.D.; Rubin, J Peter M.D.

Plastic and Reconstructive Surgery: June 2008 - Volume 121 - Issue 6 - p 423e-434e
doi: 10.1097/PRS.0b013e3181772aa8

Learning Objectives: After studying this article, the participant should be able to: 1. Understand the relevant psychosocial issues of persons with extreme obesity who undergo bariatric surgery. 2. Describe the relationship of body image to both obesity and plastic surgery. 3. Assess the psychosocial functioning of post–bariatric surgery patients who present for body contouring surgery.

Background: Body contouring following the massive weight loss associated with bariatric surgery has grown in popularity. Little is known, however, about the psychosocial aspects of these procedures. This article discusses the psychological considerations of the postoperative bariatric surgery patient who undergoes body contouring surgery.

Methods: A review of the psychosocial and physical characteristics of individuals with extreme obesity who undergo bariatric surgery, and the changes in these traits that typically occur postoperatively, is provided. The relationship of body image dissatisfaction to both bariatric and plastic surgery is discussed. The breast reduction literature is reviewed and used to provide a framework with which to understand the psychosocial issues of body contouring patients.

Results: These related literatures are used as a guide to provide suggestions for future research investigating the physical and psychosocial outcomes following body contouring surgery. Preliminary recommendations for the psychosocial assessment of body contouring patients are provided.

Conclusions: Given the current popularity of both bariatric and plastic surgery, the number of individuals who present for body contouring following massive weight loss is likely to increase. Appropriate psychosocial assessment and management of these patients is believed to play an important role in successful postoperative outcomes.

Philadelphia and Pittsburgh, Pa.; Tampa, Fla.; Grand Forks, N.D.

From the Department of Psychiatry, (Center for Weight and Eating Disorders), the Department of Surgery (Division of Plastic Surgery), and the Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania School of Medicine; Department of Psychology, University of South Florida; Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences; Department of Surgery, Division of Plastic Surgery, University of Pittsburgh School of Medicine.

Received for publication August 4, 2006; accepted December 10, 2006.

Disclosures: David B. Sarwer, Ph.D., is a consultant with Allergan and Ethicon Endo-Surgery. He also has grants from the American Society of Plastic Surgeons, the American Society of Metabolic and Bariatric Surgery, and the National Institutes of Health. J. Kevin Thompson, Ph.D., has no financial ties or disclosures to make for any organization or entity. James E. Mitchell, M.D., has grants from the National Institutes of Health, the Bremer Foundation, Pfizer, and Eli Lilly. J. Peter Rubin, M.D., receives educational support from Covidien and research funding from Pfizer and the National Institutes of Health.

David B. Sarwer, Ph.D., University of Pennsylvania School of Medicine, Edwin and Fannie Gray Hall Center for Human Appearance, 10 Penn Tower, 3400 Spruce Street, Philadelphia, Pa. 19104,

©2008American Society of Plastic Surgeons