The Role of Body Appreciation in the Decision to Complete Metabolic and Bariatric Surgery Among Ethnically Diverse Patients

Abstract

Abstract Purpose. Metabolic and bariatric surgery (MBS) is an evidence-based safe, effective treatment for obesity. However, only half of referred or eligible persons complete the procedure for unknown reasons. The proposed study examined the association between the degree of body appreciation and the decision to complete MBS by ethnicity. Methods. This prospective cohort study included 409 participants who had been referred to a bariatric surgeon or an obesity medicine program between August 2019 to May 2022. Participants completed a survey about health behaviors and psychosocial characteristics, including body appreciation by MBS completion status (Y/N). Crude and adjusted odd ratios of predictors of MBS completion were compared by ethnicity using logistic regression. Results. The sample mean age was 47.18 years (SD 11.63), 86% were female. 40% identified as non-Hispanic White (NHW), 37.81% as non-Hispanic Black (NHB), and 18.08% as Hispanic. Over a third of the sample (31.2%, n=127) completed MBS. Overall, body appreciation did not differ between MBS completers and non-completers (p-value=0.70). Hispanic and NHB participants had greater body appreciation compared to NHWs (OR: 1.33, 95% CI: 1.16-1.51, p-value <.001; OR: 1.53, 95% CI: 1.27-1.86, p-value <.001, respectively). Multivariable logistic regression models revealed no significant association between body appreciation and MBS completion. Conclusion. Although NHB and Hispanic MBS candidates had greater body appreciation than NHWs, body appreciation did not correlate with MBS completion. Level of evidence Level III: Evidence obtained from cohort or case-control analytic studies.