The Effect of Obesity Management on Body Image in Patients Seeking Treatment at Medical Centers

Riccardo Dalle Grave,Giulio Marchesini,Simona Calugi,Massimo Cuzzolaro,Flavia Temperilli,Franco Tomasi

doi:10.1038/oby.2007.275

Riccardo Dalle Grave, Giulio Marchesini + Show 4 more

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https://doi.org/10.1038/oby.2007.275

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Abstract

Body image dissatisfaction is common in treatment-seeking patients with obesity. We aimed to investigate the effects of obesity management on body image in patients with obesity attending Italian medical centers for weight loss programs. A total of 473 obese patients seeking treatment in 13 Italian medical centers (80% females; age, 45.9 +/- standard deviation 11.0 years; BMI, 36.8 +/- 5.7 kg/m(2)) were evaluated at baseline and after a 6-month weight loss treatment. Body uneasiness, psychiatric distress, and binge eating were tested by Body Uneasiness Test (BUT, Part A), Symptom CheckList-90 (SCL-90), and Binge Eating Scale (BES), respectively. At 6-month follow-up, the percentage weight loss was significantly higher in men (9.0 +/- 6.3%) than in women (6.8 +/- 7.3%; p = 0.010). Both men and women had a significant improvement in BUT Global Severity Index and in all of the BUT subscales with the exception of the Compulsive Self-Monitoring subscale. Linear regression analysis selected baseline psychological and behavioral measures (global score of BUT and SCL-90) and improved psychiatric distress and binge eating as independent predictors of changes in basal body dissatisfaction in females, whereas in males, changes were associated only with baseline BUT-Global Severity Index score, binge eating, and its treatment-associated improvement. Pre-treatment BMI and BMI changes did not enter the regression. Obesity treatment, even with a modest degree of weight loss, is associated with a significant improvement of body image, in both females and males. This effect depends mainly on psychological factors, not on the amount of weight loss.

Highlights

Body image dissatisfaction is common in treatment-seeking patients with obesity, in association with a few relatively well-defined characteristics and experiences [1]
A post hoc analysis showed that the group available at follow-up differed from the total entry population in a few characteristics
This study confirms that individuals with obesity have a high prevalence of body dissatisfaction, which is improved at 6-month follow-up after treatment, independently of the amount of weight loss

Summary

Introduction

Body image dissatisfaction is common in treatment-seeking patients with obesity, in association with a few relatively well-defined characteristics and experiences [1]. Prepubertal onset of obesity and the experience of weight-related criticism and teasing are associated with body image dissatisfaction in adulthood [2,3]. Adults with binge eating disorder [4] or weight cycling [5] and those stigmatized for their excess weight [6,7], women with obesity [8], report greater body image dissatisfaction. Women with overweight and obesity report a poor perceived health status and lower-than-norm quality of life in several psychosocial areas, related to body image dissatisfaction [10]. In treatment-seeking obese women, a relationship has been observed among body image dissatisfaction, depressive symptoms, and low self-esteem [2,8,11]. While obese and non-obese women differ in body image dissatisfaction, they do not differ in self-reported depressive symptoms, self-esteem, and anxiety [6,12]

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