減重手術對肥胖患者身體心像之影響

The Influence of Bariatric Surgery on Body Image in Obesity Patients

背景：肥胖是全球通病，影響患者身體健康及身體心像。減重手術能有效達成減重目標並改善身體心像，但台灣相關研究付之闕如。目的：探討減重手術對肥胖患者身體心像之影響。方法　採縱貫性研究設計，於北部及南部兩家醫院收案，完成率93.3%，共56名行減重手術的肥胖患者參與，以具信效度的身體心像問卷為測量工具，於術前及術後三個月進行測量，資料以SPSS 20.0進行統計分析。結果　減重手術前，肥胖患者的身體心像數值偏低，身體質量指數(body mass index, BMI)與外表評價呈負相關(r=-.36, p＜.01)。減重手術後，多餘流失體重百分比(excess weight loss, EWL)為42.08%，體重有效減輕，患者整體身體心像及外表評價、外表取向、身體部位滿意度顯著改善，僅肌肉張力滿意度未達顯著。術後BMI及EWL與身體心像變化無顯著相關。結論／實務應用　減重手術三個月後可改善肥胖患者的身體心像，提升外表評價及身體外觀的滿意度，但對肌肉張力滿意度仍未改善。建議醫護人員給予術後適切之期望並衛教病人配合肌肉緊實之運動，以利患者提升術後身體心像。此為減重手術與肥胖患者身體心像之研究，可提供臨床實證依據及未來研究參考。

Background: Obesity is a worldwide epidemic that threats the health and body image of those who suffer from this condition. While bariatric surgery has been shown to effectively assist patients to achieve weight loss goals and to improve body image, related research on this intervention is lacking in Taiwan. Purpose: The purpose of this research is to investigate the effect of bariatric surgery on body image in obese patients. Method: This study used a longitudinal design. Data was collected from 2 hospitals located in northern and southern Taiwan. A total of 56 obese patients who had undergone bariatric surgery enrolled as participants, and the completion rate was 93.3%. Participants responded to a validated body image questionnaire immediately prior to and 3 months after bariatric surgery, with data used to assess the effects of the surgery. SPSS 20.0 software for windows was used for data analysis. Result: Participant scores for body image were low on the questionnaire administered prior to surgery, with a significant negative correlation identified between body mass index (BMI) and the value of appearance (r=-.36, p＜.01). After bariatric surgery, the average EWL was 42.08%, which effectively achieved expected weight loss goals. Variables including overall body image, appearance evaluation, orientation, and body satisfaction of participants were significantly improved. Only the variable of muscle tension did not improve significantly. Postoperative body image did not correlate with either BMI or EWL. Conclusion: Three months after the bariatric surgery, the body image, appearance evaluation, and physical appearance satisfaction of participants had significantly improved. However, there was no improvement in muscle tension scores. In order to improve the post-surgery body image of patients, we recommend that healthcare workers provide patients with proper expectations of bariatric surgery and teach patients appropriate muscle-tension exercises. This paper reports the relation between bariatric surgery and body image. The results provide evidence for clinical and future research in this field.