Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study.

Background: Postoperative body shape expectations (BSE) of bariatric surgery candidates remain relatively unexplored, and may have important implications for weight loss outcomes, treatment satisfaction, and education.

Methods: The 'Silhouette Figure Rating Scale' was administered to 69 consecutive female candidates. Self-perceived current and goal body shape and postoperative BSE in four categories; "dream, "happy", "acceptable", and "disappointed" were examined.

Results: The mean age and BMI of the sample was 43.4 ± 8.9 years and 48.8 ± 7.0 kg/m(2). Self-ideal body shape discrepancy of 4.1 ± 1.3 silhouettes was reported, indicating body image dissatisfaction. 53% incorrectly identified the silhouette associated with their actual BMI. Goal body shape (4.3 ± 0.8 silhouettes) corresponded to a BMI figure 23.1 kg/m(2)- 26.2 kg/m(2). The postoperative "dream" (4.1 ± 1.0 silhouettes), "happy" (5.0 ± 0.8 silhouettes), "acceptable" (5.3 ± 1.0 silhouettes), and "disappointed" (6.9 ± 1.0 silhouettes) BSE corresponded to silhouettes that were thinner than the thinnest silhouette clinically expected based on a 56.1% excess weight loss 1-year after laparoscopic sleeve gastrectomy (LSG) or a 22.3% to 47.2% total body weight loss.

Conclusions: Women seeking bariatric surgery experience body image dissatisfaction and misperceive their actual body size. BSE do not correspond with evidence-based LSG weight loss outcomes.