Aesthetic Plastic Surgery

, Volume 43, Issue 6, pp 1570–1574 | Cite as

The Impact of Massive Weight Loss on Psychological Comorbidities: A Large, Retrospective Database Review

  • Rachel A. Guest
  • Debra A. Bourne
  • Ian Chow
  • Jeffrey A. Gusenoff
  • J. Peter RubinEmail author
Original Article Body Contouring



The obese population has a higher incidence of mood disorders compared to individuals with normal body mass index (BMI). A better understanding of the unique psychosocial challenges faced by this patient population will allow physicians to better optimize patient psychosocial support systems perioperatively, as well as help the patient to maintain appropriate expectations.


A large, retrospective database of 1135 patients with greater than 50 pounds of weight loss was reviewed. Data were analyzed using a multinomial regression model to determine the influence of psychosocial factors on the incidence of depression and anxiety.


Prior to massive weight loss, patients reported an overall incidence of depression and anxiety of 42.5% and 26.3%, respectively. Following massive weight loss, the incidence of depression decreased to 32.3% and the incidence of anxiety decreased to 22.0%. Patients with spousal support and with positive self-image were more likely to experience resolution of depression. Patients with positive self-image were likely to experience resolution of anxiety. Resolution of medical comorbidities correlated with a decrease in the rate of depression.


Depression and anxiety are prevalent in the massive weight loss patient population undergoing body contouring surgery. Support systems are a vital resource for patients with psychological comorbidities undergoing massive weight loss. Patients who have a positive self-image of themselves are more likely to experience resolution of psychological comorbidities. Physicians should consider recommending support groups and/or counseling in patients who have poor support and negative self-image.

Level of Evidence IV

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


Massive weight loss Psychosocial Depression Anxiety Body contouring 



The authors thank the Clinical and Translational Science Institute (CTSI) for their assistance with data analysis.

Compliance with Ethical Standards

Conflict of interest

The authors deny commercial interest in the subject of study and deny financial or material support for this study. The authors declare that they have no conflict of interest.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  • Rachel A. Guest
    • 1
  • Debra A. Bourne
    • 2
  • Ian Chow
    • 2
  • Jeffrey A. Gusenoff
    • 2
  • J. Peter Rubin
    • 2
    Email author
  1. 1.University of Kansas Medical CenterKansas CityUSA
  2. 2.University of PittsburghPittsburghUSA

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