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Health Qual Life Outcomes. 2017 Nov 25;15(1):227. doi: 10.1186/s12955-017-0802-x.

Further psychometric validation of the BODY-Q: ability to detect change following bariatric surgery weight gain and loss.

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McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
Modus Outcomes, Letchworth Garden City, Letchworth, UK.
School of Rehabilitation Sciences, Institute of Applied Health Sciences, Room 308, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada.
McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.



Recent systematic reviews have identified that current patient-reported outcome instruments have content limitations when used to measure change following bariatric surgery. The aim of this study was to measure change after bariatric surgery using the BODY-Q, a PRO instrument designed for weight loss and body contouring.


The BODY-Q is composed of 18 independently functioning scales and an obesity-specific symptom checklist that measure appearance, health-related quality of life (HR-QOL) and experience of health-care. The sample for this study included patients who were exploring or seeking bariatric surgery in Hamilton (Canada) at the time of the BODY-Q field-test study and who agreed to further contact from the research team. These patients were invited to complete 12 BODY-Q scales and the symptom checklist between 7 June 2016 and 29 November 2016. Data were collected online (REDCap) and via postal surveys. Clinical change was measured using paired t-tests with effect sizes and standardized response means.


The survey was completed by 58 of 89 (65%) pre-bariatric participants from the original BODY-Q field-test sample. The non-participants did not differ from participants in terms of age, gender, ethnicity, BMI or initial BODY-Q scale scores. Participants who had undergone bariatric surgery had a mean BMI of 49 (SD = 7) at time 1 and 35 (SD = 7) at time 2. Time since bariatric surgery was on average 2 years (SD = 0.5) (range 0.4 to 3 years). Percentage total weight loss ranged from 12 to 51 (mean 31, SD = 9). The difference in the proportion of patients to report an obesity-specific symptom on the BODY-Q checklist was significantly lower at follow-up for 5 of 10 symptoms. Participants improved on BODY-Q scales measuring appearance (of abdomen, back, body, buttocks, hips/outer thighs, inner thigh), body image and physical function (p < 0.001 on paired t-tests) and social function (p = 0.002 on paired t-test). These changes were associated with moderate to large effect sizes (0.60 to 2.29) and standardized response means (0.47 to 1.35).


The BODY-Q provides a set of independently functioning scales that measure issues important to patients who undergo weight loss. BODY-Q scales were responsive to measuring clinical change associated with weight loss 2 years after bariatric surgery.


Appearance; Bariatric surgery; Body-Q; Clinical change; Obesity; Patient-reported outcomes; Quality of life; Responsiveness; Satisfaction

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