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Investigation of Body Awareness and Affecting Factors in Patients with Bariatric Surgery

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Abstract

Background

Major weight loss after bariatric surgery (BS) makes the body sensitive to the environment. The factors associated with body awareness are unknown in patients with BS. In this study, we aimed to investigate the body awareness and the affecting factors in patients with BS.

Graphical abstract

Methods

Our study included 81 patients who had BS at least 6 months ago and 40 people of the same age and gender who had not. Participants’ body awareness was evaluated with the Body Awareness Questionnaire, body compositions with bioelectric impedance device, joint position sensation (JPS) with photography method, physical activity level with International Physical Activity Questionnaire, quality of life with the Short Form-36, depression status with the Beck Depression Inventory, and cognition with the Montreal Cognitive Assessment Scale. Mann–Whitney U and Chi-square tests were used for the comparison of the groups, and Spearman correlation analysis was used for in-group correlation analysis.

Results

Body awareness was found to be higher in patients with BS compared to the control group (p = 0.002). Body awareness had a positive correlation with cognition (r = 0.277, p = 0.012), quality of life sub-scales (r = 0.245–0.374, p < 0.05), the amount of change in total body weight (r = 0.241, p = 0.027), and body mass index (BMI) (r = 0.269, p = 0.032); negative correlation with depression (r =  − 0.409, p = 0.016) and deviation in the JPS (r =  − 0.223, p = 0.046).

Conclusion

Body awareness of patients with BS was found to be high after surgery. Body awareness in patients with BS is associated with the amount of weight loss and BMI, depression, cognition, JPS, and health-related quality of life.

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References

  1. Biorserud C, Shams K, Elander A, Fagevik OM. Self-image after bariatric surgery and its relationship to gender, excess skin and health-related quality of life. J Plast Surg Hand Surg. 2018;52(5):288–93. https://doi.org/10.1080/2000656x.2018.1481860.

    Article  PubMed  Google Scholar 

  2. The International Federation for the Surgery of Obesity and Metabolic Disorders. 5th IFSO Global Registry Report 2019. IFSO 2019. https://www.ifso.com/pdf/5th-ifso-global-registryreport-september-2019.pdf. . Accessed 4 Sep 2021.

  3. Sabuncu T, Kıyıcı S, Eren MA, Sancak S, Sönmez A, Güldiken S, et al. Summary of bariatric surgery guideline of the society of endocrinology and metabolism of Turkey. Turk J Endocrinol Metab. 2017;21(4).

  4. Skjaerven LH, Mattsson M, Catalan-Matamoros D, Parker A, Gard G, Gyllensten AL. Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy. Physiother Theory Pract. 2019;35(1):80–93. https://doi.org/10.1080/09593985.2018.1434578.

    Article  CAS  PubMed  Google Scholar 

  5. del CQ-BL, González-Ramírez MT, Cebolla A, Soler J, Garcia-Campayo J. Body awareness and mindfulness: validation of the Spanish version of the Scale of Body Connection. Actas Esp Psiquiatr. 2014;42(2):57–67.

  6. Gyllensten AL, Hui-Chan CW, Tsang WW. Stability limits, single-leg jump, and body awareness in older Tai Chi practitioners. Arch Phys Med Rehabil. 2010;91(2):215–20. https://doi.org/10.1016/j.apmr.2009.10.009.

    Article  PubMed  Google Scholar 

  7. Ginzburg K, Tsur N, Barak-Nahum A, Defrin R. Body awareness: differentiating between sensitivity to and monitoring of bodily signals. J Behav Med. 2014;37(3):564–75.

    Article  Google Scholar 

  8. Gyllensten AL, Hansson L, Ekdahl C. Outcome of basic body awareness therapy. A randomized controlled study of patients in psychiatric outpatient care. Adv Physiother. 2003;5(4):179–90.

  9. Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord. 2019;246:886–94.

    Article  Google Scholar 

  10. Natvik E, Groven KS, Raheim M, Gjengedal E, Gallagher S. Space perception, movement, and insight: attuning to the space of everyday life after major weight loss. Physiother Theory Pract. 2019;35(2):101–8. https://doi.org/10.1080/09593985.2018.1441934.

    Article  PubMed  Google Scholar 

  11. Guardia D, Metral M, Pigeyre M, Bauwens I, Cottencin O, Luyat M. Body distortions after massive weight loss: lack of updating of the body schema hypothesis. Eat Weight Disord. 2013;18(3):333–6. https://doi.org/10.1007/s40519-013-0032-0.

    Article  CAS  PubMed  Google Scholar 

  12. Annis NM, Cash TF, Hrabosky JI. Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences. Body Image. 2004;1(2):155–67. https://doi.org/10.1016/j.bodyim.2003.12.001.

    Article  PubMed  Google Scholar 

  13. Warholm C, Marie Oien A, Raheim M. The ambivalence of losing weight after bariatric surgery. Int J Qual Stud Health Well-being. 2014;9:22876. https://doi.org/10.3402/qhw.v9.22876.

    Article  PubMed  Google Scholar 

  14. Ambolt A, Gard G, Hammarlund CS. Therapeutically efficient components of Basic Body Awareness Therapy as perceived by experienced therapists - a qualitative study. J Bodyw Mov Ther. 2017;21(3):503–8. https://doi.org/10.1016/j.jbmt.2016.07.006.

    Article  PubMed  Google Scholar 

  15. Tihanyi BT, Sági A, Csala B, Tolnai N, Köteles F. Body awareness, mindfulness and affect: does the kind of physical activity make a difference? J Ment Health. 2016;11(1–2):97.

    Google Scholar 

  16. Gyllensten AL, Skar L, Miller M, Gard G. Embodied identity–a deeper understanding of body awareness. Physiother Theory Pract. 2010;26(7):439–46. https://doi.org/10.3109/09593980903422956.

    Article  PubMed  Google Scholar 

  17. Bond DS, Jakicic JM, Vithiananthan S, Thomas JG, Leahey TM, Sax HC, et al. Objective quantification of physical activity in bariatric surgery candidates and normal-weight controls. Surg Obes Relat Dis. 2010;6(1):72–8. https://doi.org/10.1016/j.soard.2009.08.012.

    Article  PubMed  Google Scholar 

  18. Sergi G, De Rui M, Stubbs B, Veronese N, Manzato E. Measurement of lean body mass using bioelectrical impedance analysis: a consideration of the pros and cons. Aging Clin Exp Res. 2017;29(4):591–7. https://doi.org/10.1007/s40520-016-0622-6.

    Article  PubMed  Google Scholar 

  19. Shields SA, Mallory ME, Simon A. The Body Awareness Questionnaire: reliability and validity. J Pers Assess. 1989;53(4):802–15. https://doi.org/10.1207/s15327752jpa5304_16.

    Article  Google Scholar 

  20. Mir SM, Hadian MR, Talebian S, Nasseri N. Functional assessment of knee joint position sense following anterior cruciate ligament reconstruction. Br J Sports Med. 2008;42(4):300–3. https://doi.org/10.1136/bjsm.2007.044875.

    Article  CAS  PubMed  Google Scholar 

  21. Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111(1):278–84. https://doi.org/10.2466/06.08.Pms.111.4.278-284.

    Article  PubMed  Google Scholar 

  22. Kocyigit H. Kisa Form-36 (KF-36)’nm Turkce versiyonunun guvenilirligi ve gecerliligi. Ilaç ve Tedavi Dergisi. 1999;12:102–6.

    Google Scholar 

  23. Hisli N. Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi. (A reliability and validity study of Beck Depression Inventory in a university student sample). J Psychol. 1989;7:3–13.

    Google Scholar 

  24. Ozdilek B, Kenangil G. Validation of the Turkish Version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson’s disease. Clin Neuropsychol. 2014;28(2):333–43.

    Article  Google Scholar 

  25. Alpar C. Spor Sağlık Ve Eğitim Bilimlerinden Örneklerle Uygulamalı İstatistik Ve Geçerlik Güvenirlik. 2016.

  26. Mehling WE, Gopisetty V, Daubenmier J, Price CJ, Hecht FM, Stewart A. Body awareness: construct and self-report measures. PLoS ONE. 2009;4(5):e5614. https://doi.org/10.1371/journal.pone.0005614.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Spaniolas K, Kasten KR, Celio A, Burruss MB, Pories WJ. Postoperative follow-up after bariatric surgery: effect on weight loss. Obes Surg. 2016;26(4):900–3. https://doi.org/10.1007/s11695-016-2059-6.

    Article  PubMed  Google Scholar 

  28. Albertsen MN, Natvik E, Råheim M. Patients’ experiences from basic body awareness therapy in the treatment of binge eating disorder-movement toward health: a phenomenological study. J Eat Disord. 2019;7(1):36. https://doi.org/10.1186/s40337-019-0264-0.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014(8):Cd003641. https://doi.org/10.1002/14651858.CD003641.pub4.

  30. Bout-Tabaku S, Gupta R, Jenkins TM, Ryder JR, Baughcum AE, Jackson RD, et al. Musculoskeletal Pain, Physical function, and quality of life after bariatric surgery. Pediatrics. 2019;144(6). https://doi.org/10.1542/peds.2019-1399.

  31. Jacobi D, Ciangura C, Couet C, Oppert JM. Physical activity and weight loss following bariatric surgery. Obes Rev. 2011;12(5):366–77.

    Article  CAS  Google Scholar 

  32. King WC, Chen JY, Belle SH, Courcoulas AP, Dakin GF, Elder KA, et al. Change in pain and physical function following bariatric surgery for severe obesity. JAMA. 2016;315(13):1362–71. https://doi.org/10.1001/jama.2016.3010.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Horváth Á, Ferentzi E, Köteles F. Proprioceptive accuracy is not associated with self-reported body awareness, body competence, and affect. Physiol Int. 2019;106(4):347–54.

    Article  Google Scholar 

  34. Grabauskaitė A, Baranauskas M, Griškova-Bulanova I. Interoception and gender: what aspects should we pay attention to? Conscious Cogn. 2017;48:129–37.

    Article  Google Scholar 

  35. Craig AD. How do you feel? Interoception: the sense of the physiological condition of the body. Nat Rev Neurosci. 2002;3(8):655–66.

    Article  CAS  Google Scholar 

  36. Bariyatrik Cerrahi Kılavuzu. Ankara: Türkiye Endokrinoloji ve Metabolizma Derneği; 2018.

  37. Faria GFR, Santos JMN, Simonson DC. Quality of life after gastric sleeve and gastric bypass for morbid obesity. Porto Biomedical Journal. 2017;2(2):40–6.

    Article  Google Scholar 

  38. Driscoll S, Gregory DM, Fardy JM, Twells LK. Long-term health-related quality of life in bariatric surgery patients: a systematic review and meta-analysis. Obesity. 2016;24(1):60–70.

    Article  Google Scholar 

  39. Helmiö M, Salminen P, Sintonen H, Ovaska J, Victorzon M. A 5-year prospective quality of life analysis following laparoscopic adjustable gastric banding for morbid obesity. Obes Surg. 2011;21(10):1585–91.

    Article  Google Scholar 

  40. Strain G, Kolotkin R, Dakin G, Gagner M, Inabnet W, Christos P, et al. The effects of weight loss after bariatric surgery on health-related quality of life and depression. Nutr Diabetes. 2014;4(9):e132-e.

  41. Erden A, Altuğ F, Cavlak U. Sağlıklı kişilerde vücut farkındalık durumu ile ağrı, emosyonel durum ve yaşam kalitesi arasındaki ilişkinin incelenmesi. J Kartar TR. 2013;24(3):145–50.

    Article  Google Scholar 

  42. Günel MK, Yağlı NV, Akel S, Şener G. Değişik kas iskelet sistemine bağlı problemlerde vücut farkındalığı tedavisinin etkinliği: bir pilot çalışma. Fizyoterapi Rehabilitasyon. 2008;19(1):37–42.

    Google Scholar 

  43. Gunstad J, Paul RH, Cohen RA, Tate DF, Spitznagel MB, Gordon E. Elevated body mass index is associated with executive dysfunction in otherwise healthy adults. Compr Psychiatry. 2007;48(1):57–61. https://doi.org/10.1016/j.comppsych.2006.05.001.

    Article  PubMed  Google Scholar 

  44. Handley JD, Williams DM, Caplin S, Stephens JW, Barry J. Changes in cognitive function following bariatric surgery: a systematic review. Obes Surg. 2016;26(10):2530–7. https://doi.org/10.1007/s11695-016-2312-z.

    Article  PubMed  Google Scholar 

  45. Galioto R, King WC, Bond DS, Spitznagel MB, Strain G, Devlin M, et al. Physical activity and cognitive function in bariatric surgery candidates. Int J Neurosci. 2014;124(12):912–8. https://doi.org/10.3109/00207454.2014.895344.

    Article  PubMed  PubMed Central  Google Scholar 

  46. de Jong M, Lazar SW, Hug K, Mehling WE, Hölzel BK, Sack AT, et al. Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression. Front Psychol. 2016;7(967). https://doi.org/10.3389/fpsyg.2016.00967.

  47. Karaca S, Bayar B. Turkish version of Body Awareness Questionnaire: validity and reliability study. Türk Fizyoterapi ve Rehabilitasyon Dergisi. 2021;32(1):44–50. https://doi.org/10.21653/tjpr.660186.

  48. Mundi MS, Lorentz PA, Swain J, Grothe K, Collazo-Clavell M. Moderate physical activity as predictor of weight loss after bariatric surgery. Obes Surg. 2013;23(10):1645–9.

    Article  Google Scholar 

  49. Romagna EC, Lopes KG, Mattos DMF, Farinatti P, Kraemer-Aguiar LG. Physical activity level, sedentary time, and weight regain after bariatric surgery in patients without regular medical follow-up: a cross-sectional study. Obes Surg. 2021;31(4):1705–13.

    Article  Google Scholar 

  50. Bond DS, Phelan S, Wolfe LG, Evans RK, Meador JG, Kellum JM, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity. 2009;17(1):78–83.

    Article  Google Scholar 

  51. Alabi F, Guilbert L, Villalobos G, Mendoza K, Hinojosa R, Melgarejo JC, et al. Depression before and after bariatric surgery in low-income patients: the utility of the beck depression inventory. Obes Surg. 2018;28(11):3492–8.

    Article  Google Scholar 

  52. Hayden MJ, Brown WA, Brennan L, O’Brien PE. Validity of the Beck Depression Inventory as a screening tool for a clinical mood disorder in bariatric surgery candidates. Obes Surg. 2012;22(11):1666–75.

    Article  Google Scholar 

  53. Mohun SH, Spitznagel MB, Gunstad J, Rochette A, Heinberg LJ. Performance on the Montreal Cognitive Assessment (MoCA) in older adults presenting for bariatric surgery. Obes Surg. 2018;28(9):2700–4. https://doi.org/10.1007/s11695-018-3206-z.

    Article  PubMed  Google Scholar 

  54. Hecht L, Cain S, Clark-Sienkiewicz SM, Martens K, Hamann A, Carlin AM, et al. Health literacy, health numeracy, and cognitive functioning among bariatric surgery candidates. Obes Surg. 2019;29(12):4138–41. https://doi.org/10.1007/s11695-019-04149-z.

    Article  PubMed  Google Scholar 

  55. Janik MR, Rogula T, Bielecka I, Kwiatkowski A, Paśnik K. Quality of life and bariatric surgery: cross-sectional study and analysis of factors influencing outcome. Obes Surg. 2016;26(12):2849–55.

    Article  Google Scholar 

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Author notes

  1. Ümit Varlı and İlknur Naz have contributed equally to this work.

Authors and Affiliations

  1. Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, İzmir Katip Çelebi University, 35620, Çiğli İzmir, Turkey

    Ümit Varlı

  2. Physiotherapy and Rehabilitation Clinic, EMOT Hospital, İzmir, Turkey

    Ümit Varlı

  3. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, İzmir Katip Çelebi University, İzmir, Turkey

    İlknur Naz

  4. Department of Endocrinology and Metabolic Diseases, Private Can Hospital, İzmir, Turkey

    Hüsnü Yılmaz

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  1. Ümit Varlı
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Correspondence to Ümit Varlı.

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Ethics Approval

The study was approved by the Izmir Katip Celebi University Non-Interventional Clinical Research Ethics Committee with decision number 103, dated 20.02.2019. 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. All scales used in the study have Turkish validity and reliability, and permission was obtained from their authors. The study was registered at ClinicalTrials.gov (NCT03905070; URL: www.clinicaltrials.gov).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Key points

• Body awareness of patients who have undergone bariatric surgery is high.

• Body awareness is related to the amount of change in BMI in patients with bariatric surgery.

• Body awareness is related to depression in patients with bariatric surgery.

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Varlı, Ü., Naz, İ. & Yılmaz, H. Investigation of Body Awareness and Affecting Factors in Patients with Bariatric Surgery. OBES SURG 32, 829–836 (2022). https://doi.org/10.1007/s11695-021-05864-2

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