Psychological Well-being After Body Contouring Surgery: Hormonal and Surgical Predictors

Background: Body image reflects how individuals perceive, evaluate, and emotionally respond to their physical appearance. Massive weight loss often leads patients to seek body contouring procedures to relieve both physical discomfort and psychological distress from excess skin. While primarily esthetic, such surgeries have shown psychological benefits. This study assessed the association between body contouring and changes in psychometric scores and identified predictors of improved outcomes. Methods: Patients undergoing body contouring at Hamad General Hospital between January 2021 and December 2023 were evaluated using the Appearance Anxiety Inventory (AAI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7). Scores were categorized into a low-risk group (LRG; ≤ 2) and higher-risk group. Hormone concentrations of active ghrelin (AG), glucagon-like peptide-1 (GLP-1), leptin, spexin, and peptide YY were measured. Logistic regression, adjusted for repeated measures, examined predictors of LRG status. Results: Forty patients completed baseline assessments, with 19 completing Visit 3 (6–10 weeks postoperatively). Postoperative status was statistically divergently associated with LRG membership for PHQ-9 (a nearly fourfold increase in odds 6–10 weeks after surgery), and AAI (a nearly fivefold increase in odds 6–10 weeks after surgery). AG levels demonstrated the strongest and most statistically divergent positive association with LRG membership for GAD-7. Conclusion: Body contouring surgery is associated with short-term psychological improvements, reflected in higher odds of being in a LRG for PHQ-9, GAD-7, and AAI 6–10 weeks after surgery. The strong postoperative association with LRG status underscores the mental health benefits of surgical reshaping, suggesting that such procedures may positively influence psychological well-being although such well-being is also modulated by nutrient-stimulated hormones. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.