Psychosocial functioning and quality of life in patients with loose redundant skin 4 to 5 years after bariatric surgery

Ryan J. Marek, Kristine J. Steffen, David R. Flum, Alfons Pomp, Walter J. Pories, J. Peter Rubin, Bruce M. Wolfe, James E. Mitchell

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Background: Bariatric surgery usually results in substantial weight loss and a reduction in medical comorbidities. Many patients, as a consequence of the weight loss, subsequently evidence loose, redundant skin. Objectives: This investigation seeks to examine the prevalence of body contouring surgery (BCS) by patients approximately 4 to 5 years after Roux-en-Y gastric bypass surgery. Demographics, change in BMI, and psychosocial variables were also used to predict body dissatisfaction, desire for BCS, and patients who reported obtaining BCS. Setting: The clinical sites involved in the Longitudinal Assessment of Bariatric Surgery project, which included 10 hospitals across the United States. Methods: The sample comprised 1159 patients who underwent Roux-en-Y gastric bypass and were enrolled in the Longitudinal Assessment of Bariatric Surgery-2 study. Participants were surveyed using the Excessive Skin Survey and other psychosocial measures at their 4- or 5-year postoperative outcome. The participants were predominately women (80.5%), Caucasian (88.3%), and middle-aged (mean = 46.1 yr, standard deviation = 11.11 yr). Results: Participants reported modest degrees of being bothered by excessive skin, primarily in their waist/abdomen, thighs, and chest/breasts body areas. Only 11.2% of the sample had undergone any BCS procedure, and a majority of those participants paid “out of pocket” for BCS. Desire for BCS and body dissatisfaction 4 to 5 years postsurgery was associated with higher depression scores and poorer quality of life scores. Conclusions: Excessive skin is associated with poorer psychosocial functioning. Despite reporting modest levels of being bothered by excessive skin and body dissatisfaction, only a small fraction of participants underwent BCS. Cost of BCS was reported to be a primary barrier for not obtaining BCS. All rights reserved.

Original languageEnglish (US)
Pages (from-to)1740-1747
Number of pages8
JournalSurgery for Obesity and Related Diseases
Issue number11
StatePublished - Nov 2018


  • Bariatric surgery
  • Body contouring surgery
  • Excess skin
  • Plastic surgery
  • Psychosocial

ASJC Scopus subject areas

  • Surgery


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