The Role of Body Appreciation in the Decision to Complete Metabolic and Bariatric Surgery Among Ethnically Diverse Patients

Olivia Kapera, Luyu Xie, Elisa M. Marroquín, Sophia Ngenge, M. Sunil Mathew, Jaime P. Almandoz, Jeffrey Schellinger, Sachin S. Kukreja, Benjamin Edward Schneider, Carrie McAdams, Sarah E. Messiah

Research output: Contribution to journalArticlepeer-review


Purpose: Metabolic and bariatric surgery (MBS) is an evidence-based safe, effective treatment for obesity. However, only half of referred or eligible persons complete the procedure for unknown reasons. The proposed study examined the association between the degree of body appreciation and the decision to complete MBS by ethnicity. Methods: This prospective cohort study included 409 participants who had been referred to a bariatric surgeon or an obesity medicine program between August 2019 and May 2022. Participants completed a survey about health behaviors and psychosocial characteristics, including body appreciation by MBS completion status (Y/N). Multivariate logistic regression models generated adjusted odd ratios (aOR) and 95% confidence intervals (CIs) of body appreciation among MBS completers vs. non-completers. Results: The sample mean age was 47.18 years (SD 11.63), 87% were female. 39.6% identified as non-Hispanic White (NHW), 38.5% as non-Hispanic Black (NHB), and 17.6% as Hispanic. Over a third of the sample (31.05%, n = 127) completed MBS. “Often” experiencing body appreciation was the most significant predictor of MBS completion (aOR: 28.19, 95% CI: 6.37–124.67, p-value < 0.001), followed by “Sometimes” (aOR: 20.47, 95% CI: 4.82–86.99, p-value < 0.001) and “Always” (aOR: 13.54, 95% CI: 2.55–71.87, p-value < 0.01) after controlling for sex, age, and race/ethnicity. There was not a significant interaction between body appreciation and race/ethnicity (p-value = 0.96). Conclusion: Results showed a significant association between body appreciation and MBS completion, controlling for sex, age, and race/ethnicity. MBS clinical settings may want to assess body appreciation as a pre-operative screener among ethnically diverse patients. Graphical Abstract: [Figure not available: see fulltext.].

Original languageEnglish (US)
JournalObesity Surgery
StateAccepted/In press - 2023


  • Bariatric surgery
  • Body appreciation
  • Ethnic disparities
  • MBS completion

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


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