Abstract
Background: The present study aimed to examine the relations between body image dissatisfaction (BID) and psychological distress variables among bariatric surgery candidates from two distinct cultures in Israel and in the United States. Methods: A sample of consecutive pre-surgical bariatric candidates was recruited from a Bariatric Center in Israel (N = 114) and a Bariatric Center in the Unites States (N = 81). Body image dissatisfaction (BID-BSQ8), suicidal ideation (SBQ-R), depressive symptoms (PHQ-9), anxious symptoms (PHQ-7), and emotional eating behaviors (EES), were measured. Mediation models were assessed using path analysis. Results: BID was positively correlated with suicidality, depression, and anxiety in both samples. The relations between BID depression and anxiety were mediated by emotional eating in both cultures. However, the relation between BID and suicidality that was mediated by emotional eating in the Israeli sample, was reflected in a direct link between BID and suicidality in the US sample. Conclusion: Our findings confirm the adverse effect of BID on psychological distress among surgery candidates in both cultures, emphasizing the intercultural similarities related to emotional eating behavior. Physicians and other health professionals are encouraged to be more attentive to this specific behavior.
Highlights
Obesity has become increasingly prevalent throughout the world [1]
With regards to main study variables, we found significant differences between the samples in body image and emotional eating scores, such that the US sample presented with higher body image dissatisfaction (BID) scores, and the Israeli sample had higher emotional eating scores
Our findings further supported the hypothesis that BID is a source of psychological distress in bariatric surgery candidates [7,12,15]
Summary
Obesity has become increasingly prevalent throughout the world [1]. Approximately one in every seven people is obese, totaling over half a billion people worldwide [2], and obesity has, become a leading public health challenge.Bariatric surgery is a treatment proven to induce weight loss and to reduce the adverse effect of obesity-related physical comorbidity [3]. Patients who opt for bariatric surgery suffer a wider variety of challenges related to psychological distress, such as attempting suicide during the past year, as well as suicide ideation, in stark contrast to the general population [4] or other (non-bariatric) surgery candidates [5]. They suffer an increased risk of anxiety, depression, and suicidality Conclusion: Our findings confirm the adverse effect of BID on psychological distress among surgery candidates in both cultures, emphasizing the intercultural similarities related to emotional eating behavior. Physicians and other health professionals are encouraged to be more attentive to this specific behavior
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