Body image dissatisfaction and quality of life: The role of self-esteem and depression in individuals seeking cosmetic surgeries

Background Research suggests high incidence rates of body image dissatisfaction in adult populations. Poor body image has been linked to mental health outcomes including symptoms of depression and low self-esteem. As research into the negative impact of body image dissatisfaction has expanded evidence suggests a link between body image concerns and quality of life. Limited research has focused on the relationship between body image dissatisfaction and quality life, and explored the potential mechanisms that may explain this relationship (self-esteem, depression) in those seeking cosmetic procedures. Research suggests cosmetic procedures lead to improvements in psychosocial functioning. However not all studies report improvements. Criteria for individuals undergoing cosmetic procedures in public healthcare settings and private health providers differ. It is not known if such differences impact on these outcomes. Aims The study aimed to conduct a systematic review to explore quality of life, body image, general mental health and self-esteem outcomes for those undergoing surgery in the public healthcare sector and compare these to the private healthcare sector. The purpose of the second part of the study was to investigate self-esteem and depression as mediators in the relationship between body image dissatisfaction and quality of life. Method Studies were identified by searching 11 databases for research which explored psychosocial variables before and after cosmetic surgery procedures. Methodological quality of included studies was assessed. A cross-sectional, quantitative design was used in the empirical study. Data was collected with self-report forms from 404 participants seeking cosmetic surgery through two NHS Health Boards. Results Systematic review results indicated a greater number of improvements were reported in the public sector in comparison to private sector studies. However the quality of included studies was generally higher in the public sector and significant differences in study design and methodology was found across studies. Empirical results suggested that self-esteem and depression mediate the relationship between psychological, social relations and environment quality of life. Depression was found to mediate the relationship between body image dissatisfaction and physical health quality of life. Self-esteem did not mediate this relationship. Conclusions The results suggest there is a relationship between body image dissatisfaction and poor quality of life and self-esteem and depression mediate this relationship. Self esteem and depression interventions, therefore, may be suitable areas to target for those seeking cosmetic surgery procedures particularly those who may be contraindicated for surgery. Findings also suggest patients undergoing cosmetic procedures in the public sector experience greater improvements in psychosocial functioning compared to private medical settings