title: Excessive Skin and Sexual Function: Relationship with Psychological Variables and Weight Regain in Women After Bariatric Surgery.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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 IBM® SPSS® Amos™ was conducted to explore simultaneously the associations between the variables under study.
  
  
  RESULTS
  The model tested with path analysis showed a good fit to the data (χ (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.
  
  
  CONCLUSIONS
  These data stress the importance of considering sexual intimacy and body image in order to optimize psychological and weight outcomes after bariatric surgery.
authors.affiliation: Psychotherapy and Psychopathology Research Unit - CIPsi, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ramalho
authors.forename: Ana Pinto
authors.initials: AP
authors.lastname: Bastos
authors.forename: Cátia
authors.initials: C
authors.lastname: Silva
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Vaz
authors.forename: Isabel
authors.initials: I
authors.lastname: Brandão
authors.forename: Paulo P P
authors.initials: PP
authors.lastname: Machado
authors.forename: Eva
authors.initials: E
authors.lastname: Conceição
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods / Q000523:psychology; D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology; D012867:Skin / Q000473:pathology*; D015430:Weight Gain