Factors associated with excess skin after bariatric surgery: A mixed method study
Bibliographic record
Abstract
Abstract Introduction After metabolic and bariatric surgery (MBS), many patients have excess skin (ES), which can cause inconveniences. Identifying factors related to ES quantity and inconveniences is crucial to inform interventions. The aim of this study was to identify sociodemographic, physical, psychosocial, and behavioral factors associated with ES quantity and inconveniences. Methods A mixed-method study with a sequential explanatory design was conducted with 124 adults (92% women, M age 46.5±9.9 years, M time post-MBS 34.2±27.6 months). During Phase I, ES quantity (arms, abdomen, thighs) and inconveniences, sociodemographic, anthropometric, clinical and behavioral outcomes were assessed. In Phase II, 7 focus groups were performed with 37 participants from Phase I. A triangulation protocol was completed to identify convergences, complementarities, and dissonances from quantitative and qualitative data. Results Quantitative data indicate only ES quantity on arms was associated with ES inconveniences on arms (r=.36, p<.01). Total ES quantity was associated with maximal body mass index (BMI) reached pre-MBS (r=.48, p<.05) and current BMI (r=.35, p<.05). Greater ES inconveniences was associated with higher social physique anxiety and age (R 2 =.50, p<.01). Qualitative data were summarized into 4 themes: psychosocial experiences living with ES, physical ailments due to ES, essential support and unmet needs, and beliefs of ES quantity causes. Conclusions Measured ES quantity is related to higher BMI, but not reported inconveniences. Greater self-reported ES quantity and inconveniences were associated with body image concerns.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".