Background

Weight bias internalization (WBI), or the internationalization of “anti-fat” attitudes, is associated with greater eating-disorder psychopathology, body image issues, and mental health concerns in non-clinical and clinical samples, including in patients following bariatric surgery. There is currently no research examining WBI in patients seeking body contouring surgery (BCS) after bariatric surgery. This study prospectively examined the relationship between WBI, eating-disorder psychopathology, and depressive symptoms in patients seeking BCS after bariatric surgery.

Methods

Participants were 57 adults seeking consultation for BCS after bariatric surgery. Participants completed well-established measures assessing WBI, eating-disorder psychopathology, and depressive symptoms. Measures were completed at baseline following the BCS consultation, then repeated at one-month and three-month follow-ups.

Results

WBI was significantly associated with eating-disorder psychopathology and depressive symptoms at baseline (r=.457, p<.001; r=.420, p=.001), one-month (r=.357, p=.009; r=.364, p=.008), and three-month (r=.455 p<.001; r=.575, p=.001) follow-ups. The groups with and without BCS did not differ significantly in WBI at baseline (p=.323). By the 1-month and 3-month follow-ups, however, the non-BCS group had significantly higher WBI scores than the BCS group (p=.022, p=.021, respectively). Groups did not differ on BMI at any timepoint.

Conclusions

WBI is associated with greater eating-disorder psychopathology and depressive symptoms over time in patients seeking BCS after bariatric surgery. Group differences in WBI at one-month and three-month follow-ups suggest that BCS may help reduce WBI independent of BMI. Bariatric teams should be aware that internalized weight bias may persist for patients unable to obtain BCS. Reducing weight stigma after bariatric surgery is warranted.