Excessive skin and sexual function: relationship with psychological variables and weight regain in women after bariatric surgery

After bariatric surgery, the majority of patients develop a problem with excessive hanging skin. This can negatively influence the psychological benefits associated with bariatric surgery. The present study aims to explore the relationship between overall impairment related to the presence of excessive skin, body image, depressive symptomatology, sexual functioning, and weight regain in a sample of women after bariatric surgery.Sixty-one women (body mass index (BMI) = 30.45 +/- 5.35 kg/m(2)) with excessive skin who had undergone bariatric surgery 19.02 +/- 9.98 months before were evaluated as part of a cross-sectional study using a semi-structured clinical interview and completed a set of self-report measures. A path analysis, an extension of multiple regression analysis, using IBMA (R) SPSSA (R) Amos (TM) was conducted to explore simultaneously the associations between the variables under study.The model tested with path analysis showed a good fit to the data (chi (2) = 1.241, df = 4, p = 0.871; Comparative Fit Index (CFI) = 1.000, Tucker-Lewis Index (TLI) = 1.138, Incremental Fit Index (IFI) = 1.049, Root-Mean-Square of Approximation (RMSEA) = 0.000) and suggests that sexual functioning and overall impairment caused by excessive skin were associated with concerns regarding body image and depressive symptomatology, which in turn relate to a greater percentage of total weight regain.These data stress the importance of considering sexual intimacy and body image in order to optimize psychological and weight outcomes after bariatric surgery.This research was partially supported by a Fundacao para a Ciencia e a Tecnologia/Foundation for Science and Technology, Portugal grant (PTDC/MHC-PCL/4974/2012), postdoctoral grant (SFRH/BPD/78896/2011) to Eva Conceicao, postdoctoral grant (SFRH/BPD/94490/2013) to Ana Rita Vaz and doctoral grant (SFRH/BD/80468 / 2011) to Catia Silva. FCT had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or in the decision to submit the paper for publication.