Psychological variables: determinants of the body image adjustment of obese subject to gastric bypass

Mariela González


Morbid obesity as an entity that is associated to numerous clinical complications, an increased mortality and a deterioration of the quality of life, the World Health Organization (WHO) recommends surgical treatments as an alternative. In this sense, the physical and psychological benefits associated with bariatric surgery are well documented. However, the surgery can generate negative effects. The structural changes in the digestive system, coupled with the disruption of the body image especially patients who undergo bypass gastric, reinforce the idea that everything is not positive. Given this reality, this theoretical review is to emphasize the importance of studying the role that psychological variables in adapting to the new body image in these patients.



Palabras clave

Obesity, Gastric bypass, body image, psychological variables.

Texto completo:



Kleifinger S, Robles J, Vásquez J, Murillo A, Silva J, Esparza R, et al. Asoc Mex Cir Endoscópica. 2009; 10(1): 23-26.

Makarem-Kanso Z, Miquilarena R, Navas H, Fermín D, Jiménez R. Manga Gástrica Laparoscópica. Técnica para el tratamiento quirúrgico de la obesidad mórbida: experiencia en 70 casos. Rev Venez Cirugía. 2008; 61(3): 125-130.

World Health Organization. World Health Statistics 2015. [Internet]. USA. Organización Mundial de la Salud. [acceso Agosto 2015]. Disponible en:

Banco Mundial [Internet]. Data Banco Mundial [acceso Agosto 2015]. Disponible en: ty+latinamerica&title=&filetype=

Organización Mundial de la Salud. Obesidad y sobrepeso. 2010.

[Internet]. Organización Mundial de la Salud. [acceso Agosto 2015]. Disponible en: fs311/es/index.html.

Comuzzie AG, Willimas JT, Blangero MJ. Searching for genes underlying normal variation in human adiposity. J Mol Med. 2001;79:57-70.

Visscher PM, Hill WG, Wray NR. Heritability in the genomics era-concepts and misconceptions. Nat Rev Genet. 2008;9:255- 66.

Campos G, Ryder E, Diez M, Rivero F, Fernández V, Raleigh X, et al. Prevalencia de Obesidad e Hiperinsulinemia en una Población Aparentemente Sana de Venezuela y su Relación con las Concentraciones de Lípidos y Lipoproteínas del Suero. Revista de Investigación Clínica. 2003; 44(1): 5-2.

Campbell I, Mill J, Uher R, Schmidt U. Eating Disorders, Gene-Environment Interactions and Epigenetics. Neuroscience & Biobehavioral Reviews. 2011; 35(3): 784-793. doi:

1016/j.neubiorev.2010.09.012 10. Rosengren A, Lissner L. The sociology of obesity. Obesity and Metabolism. 2008; 36: 260-270.

Pinheiro A, Freitas S, Corso A. Uma abordagem epidemiológica da obesidade. Revista de Nutrição. 2004; 17(4): 523-533.

McLaren L. Socioeconomic status and obesity. Epidemiology Review. 2007; 29: 29-48.

Shrewbury V, Wardle J. Socioeconomic status and adiposity in childhood: a systematic review of cross-sectional studies 1990- 2005. Obesity. 2008; 16(2): 275-284.

Dave D, Tennant J, Colman G. Isolating the Effect of Major Depression on Obesity: Role of Selection Bias. Journal of Mental Health Policy and Economics. 2011; 14(4): 165-186. doi:10.338 6/w17068

Schneider K, Appelhans B, Whited M, Oleski J, Pagoto S. Trait anxiety, but not trait anger, predisposes obese individuals to emotional eating. Appetite. 2010; 55(3): 701-706. 10.1016/j.ap pet.2010.10.006

Hayden MJ, Dixon ME, Dixon JB, Playfair J, O’Brien PE. Perceived discrimination and stigmatization against severely obese women: age and weight loss make a difference. Obes Fact. 2010; 3(1): 7-14.

Ríos B, Rangel G, Álvarez R, Castillo F, Ramírez G, Pantoja J, et al. Ansiedad, depresión y calidad de vida en el paciente obeso. Acta Med Gpo Ang. 2008; 6, 147-153.

Braguinsky, J. Obesidad: saberes y conflictos. Un tratado de obesidad. Buenos Aires: Acindes; 2007.

Chevallier JM. From bariatric to metabolic surgery: 15 years experience in a French university hospital. Bull Acad Natl Med. 2010; 194: 25-36.

Karmali S, Schauer P,Birch D, Sharma AM, Sherman V. Laparoscopic sleeve gastrectomy: an innovative new tool in the battle against the obesity epidemic in Canada. Can J Surg 2010; 53: 126-132.

González M, Lugli Z. Control Personal de la Conducta y la Manga Gástrica Laparoscópica. Revista de la Facultad de Medicina UCV. 2012; 35(1):21-28.

Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Obesity (Silver Spring). 2009;17(1):S1-S70.

Khwaja H, Bonanomi G. Bariatric surgery: Techniques, outcomes and complications. Current Anaesthesia and Critical Care. 2010; 21(1): 31-38. doi: 2009.10.0 05

Fobi M. El Presente y Futuro de la Cirugía Bariátrica, Rev. Chilena de Cirugía. 2010; 62(1): 79-82.

Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, et al. (2010) Behavioral predictors of weight regain after bariatric surgery. Obes Surg 20: 349-356.

Widhalm K, Dietrich S, Prager G, Silberhummer G, Orth D, Kispal Z. Bariatric surgery in morbidly obese adolescents: a 4-year follow-up of ten patients. Int J Pediatr Obes. 2008; 3(1): 78-82.

Chacón H, Salas J, Benitez G, García V, Arias D. Gastrectomía en manga laparoscópica para el tratamiento de la obesidad mórbida. Revista de la Facultad de Medicina UCV. 2009; 32(2):158-165.

Ruiz I, Santiago M, Bolaños P, Lobera I. Obesidad y rasgos de personalidad. Trastornos de la conducta alimentaria. 2010; 12: 1330-1348.

Castellini G, Lapi, F, Ravaldi C, Vannacci A, Rotella C, Faravelli C, et al. Eating disorder psychopathology does not predict the overweight severity in subjects seeking weight loss treatment. Compr Psychiatry. 2008; 49(4): 359-363.

Wadden TA, Sarwer, DB. Behavioral Assessment of Candidates for Bariatric Surgery: A Patient-Oriented Approach. Obesity. 2006; 14:53S-62S.

Rosenberger PH, Henderson KE, Grilo, CM. Correlates of body image dissatisfaction in extremely obese female bariatric surgery candidates. Obes Surg. 2006; 16(10): 1331-1336.

Baccouche M, Arous I, Trabelsi K, Masmoudi L, Elloumi A. Effect of physical training on anxiety and self-esteem of obese adolescents. Journal Of Humanities And Social Science. 2013; 8(6): 67-73.

Nowicka P, Högñund P, Birgerstam P, Lissau I., Pietrobelli A, Flodmark CE. Self-esteem in a clinical sample of morbidly obese children and adolescent. Acta Paediatr. 2009; 98, (1): 153-158.

Lykouras L. Psychological profile of obese patients. Dig Dis. 2008; 26(1): 36-39.

Roehrig M, Masheb RM, White MA, Rothschild BS., BurkeMartindale CH, Grilo CM. Chronic dieting among extremely obese bariatric surgery candidates. Obes Surg. 2009; 19(8): 1116-1123.

Pecori L, Serra C, Cervetti GG, Marinari GM, Migliori F, Adami, GF. Attitudes of morbidly obese patients to weight loss and body image following bariatric surgery and body contouring. Obes Surg. 2007; 17(1): 68-73.

Fabricatore A, Wadden T, Sarwer D, Crerand C, Kuehnel R, Lipschutz P, et al. Self-reported Eating Behaviors of Extremely Obese Persons Seeking Bariatric Surgery: A Factor Analytic Approach. Obesity. 2006; 14: 83S-89S. doi: 10.1038/oby. 2006.287

Allison KC, Wadden TA, Sarwer DB, Fabricatore AN. Crerand CE, Gibbons LM, et al. Night Eating Syndrome and Binge Eating Disorder among Persons Seeking Bariatric Surgery: Prevalence and Related Features. Obesity. 2006; 14: 77S-82S.

Moral de la rubia J. Los Trastornos de la Conducta Alimentaria, un complejo fenómeno biopsicosocial. Revista de Salud Pública y Nutrición. 2002; 3(3).

Rusch MD, Andris D. Maladaptive eating patterns after weightloss surgery. Nutr Clin Pract 2007; 22(1): 41-49.

Amigo I, Fernández C, Pérez M. La adhesión a los tratamientos terapéuticos. Madrid: Ediciones Pirámide; 1998.

Cormillot A, Fuchs A. Obesidad y dismorfofilia: otro punto de vista sobre una enfermedad crónica. Revista Actualidad Psicológica. 2002; XI (300):1-12.

Mauri M, Rucci P, Calderone A, Santini, F, Oppo A, Romano A, et al. Axis I and II disorders and quality of life in bariatric surgery candidates. J Clin Psychiatry. 2008; 69(2): 295-301.

Wegener I, De Beer K, Schilling G, Conrad R, Imbierowicz K, Geiser F, et al. Patients with obesity show reduced memory for others’ body shape. Appetite. 2008; 50 (2-3): 359-366.

Geiser F, Imbierowicz K, Conrad R, Wermter F, et al. Impact of an additional behavioral anxiety intervention on therapy outcome in a psychodynamic inpatient setting. Zeitschrift fur Psychosomatische Medizin und Psychotherapie. 2004; 50(1):53-69.

Belanger SB, Wechsler FS, Nademin ME, Virden TB. Predicting outcome of gastric bypass surgery utilizing personality scale evaluations, psychosocial factors, and diagnostic group membership. Obes Surg.

Sansone RA, Wiederman MW, Schumacher DF, RoutsongWeichers L. The prevalence of self-harm behaviors among a sample of gastric surgery candidates.J Psychosom Res. 2008; 65(5): 441-444.

Bancheri L, Patrizi B, Kotzalidis GD, Mosticoni S, Gargano T, Angrisani P, et al. Treatment choice and psychometric characteristics: differences between patients who choose bariatric surgical treatment and those who do not. Obes Surg. 2006;16(12): 1630-1637.

Wadden TA, Butryn M.L, Sarwer DB, Fabricatore AN, Crerand CE, Lipschutz PE, et al. Comparison of Psychosocial Status in Treatment-seeking Women with Class III vs. Class I-II Obesity. Obesity. 2006; 14: 90S- 98S.

Mitchell JE, Crosby RD, Ertelt TW, Marino JM, Sarwer DB, Thompson JK, et al. The desire for body contouring surgery after bariatric surgery. Obes Surg. 2008; 18(10): 1308-1312.

Kinzl JF, Schrattenecker M, Traweger C, Aigner F, Fiala M, Biebl W: Quality of life in morbidly obese patients after surgical weight loss. Obes Surg. 2007; 17: 229-235. doi: 10.1007/s11695- 007-9030-5

Shiri S, Gurevich T, Feintuch U, Beglaibter N. Positive psychological impact of bariatric surgery. Obes Surg. 2007; 17(5):663-668.

Burgmer R, Petersen I, Burmer M, de Zwaan M, Wolf AM, Herpertz S. Psychological outcome two years after restrictive bariatric surgery. Obes Surg. 2007; 17(6): 785-791.

Pedersen JO, Zimmermann E, Stallknecht BM, Bruun JM, Kroustrup JP, Larsen JF, et al. Lifestyle intervention in the treatment of severe obesity. Ugeskr Laeger. 2006; 168(2), 167-172.

Leiva MJ, Fuentealba C, Boggiano C, Gattás V, Barrera G, Leiva L et al. Calidad de vida en pacientes operadas de bypass gástrico hace más de un año: Influencia del nivel socioeconómico. Revista médica de Chile. 2009; 137(5): 625-633.

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