77. Implications of Early Onset Obesity on Psychiatric Wellbeing in Patients Who Undergo Body Contouring Procedures

Abstract

PURPOSE: Childhood obesity is a stigmatizing condition, and its incidence is increasing exponentially. In 1978 only 3% of children aged 3-17 were obese; now, 19.7% of children are obese, and the onset of obesity occurs in younger cohorts each year. Patients who develop obesity early in life suffer unique psychosocial consequences that continue into adulthood. Obesity and history of obesity are extremely prevalent in patients who undergo body contouring procedures. This study aims to assess the relationship between age at onset of obesity, psychological welfare, and self-image in body-contouring patients. METHODS: A retrospective review was performed of patients who presented to a single institution for body contouring procedures between 2002 and 2018. Variables studied included demographic information, medical and psychiatric history, smoking and drinking history, self- image, social support, procedure history, outcomes and follow up. Univariate analysis, two-sample t-tests, and multinomial logistic regressions were performed using R statistical software (Version 1.3.1093). RESULTS: A total of 1,187 patients underwent at least one body contouring procedure at our institution during the study timeframe. The mean age of patients at presentation was 50.08 ± 0.78 years. The majority of our patient cohort was female (90.1 percent) and Caucasian (93 percent). Mean BMI at presentation was 31.21 ± 10.49 BMI units. Among these patients, 58% were obese before the age of 18 and 42.8% of patients were obese before the age of 11. Notably, patients who were obese before age 11 were 1.7 times more likely to suffer from at least one psychiatric comorbidity. Specifically, these patients were 1.5 times more likely to suffer from Generalized Anxiety Disorder (p<0.05), which was the most common psychiatric comorbidity seen in body-contouring patients overall. Childhood onset of obesity was also associated with more negative self-reported body image prior to undergoing body-contouring procedures. Notably, patients who were obese before the age of 18 were 77% less likely to report positive pre-operative body image than patients who developed obesity in adulthood. CONCLUSION: Obesity is increasingly prevalent in the pediatric population and has important implications on psychiatric well-being and body image in patients who undergo body-contouring procedures. Body contouring patients with childhood-onset obesity have a higher incidence of psychiatric comorbidities and worse self-rated body-image than patients who develop obesity later in life. These findings have implications on screening, provision of comprehensive interdisciplinary care, and post-operative management of this patient cohort.