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Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.

STUDY QUESTION Do sexual functioning, sexual esteem, genital self-image and psychological and relational functioning in women with Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome differ from a comparison group of women without the condition? SUMMARY ANSWER In comparison to controls, women with MRKH with a non-surgically or surgically created neovagina did not differ in psychological and relational functioning but reported lower sexual esteem and more negative genital self-image, intercourse-related pain, clinically relevant sexual distress and sexual dysfunction, with sexual esteem levels strongly associated with sexual distress and sexual dysfunction. WHAT IS KNOWN ALREADY Studies on sexual functioning measured with standardized questionnaires in women with MRKH syndrome compared with women without the condition have yielded contradictory results. Factors associated with sexual functioning in this patient population have rarely been investigated. STUDY DESIGN, SIZE, DURATION Between November 2015 and May 2017, 54 women with MRKH syndrome with a neovagina and 79 age-matched healthy women without the condition were enrolled in this case–control study. PARTICIPANTS/MATERIALS, SETTING, METHODS All participants had to be at least 18-years old and had to live in a steady heterosexual relationship. Women with MRKH syndrome were asked to participate by their (former) gynecologists at three university hospitals and by MRKH peer support group. Controls were recruited via advertisement in local newspapers and social media. Standardized questionnaires were administered to assess sexual functioning, sexual esteem, genital self-image and psychological and relational functioning. MAIN RESULTS AND THE ROLE OF CHANCE Women with MRKH syndrome with a surgically or non-surgically created neovagina reported significantly more pain during intercourse (P LIMITATIONS, REASONS FOR CAUTION Given the nature of the study focusing on sexual functioning, a potential selection bias cannot be excluded. It is possible that those women with the most severe sexual and/or psychological disturbances did or did not choose to participate in our study. WIDER IMPLICATIONS OF THE FINDINGS The study results add new data to the very limited knowledge about psychosexual functioning of women with MRKH syndrome and are of importance for more adequate counseling and treatment of these women. STUDY FUNDING/COMPETING INTEREST(S) The research was financially supported by the Dutch Scientific Society of Sexology (Nederlandse wetenschappelijke Vereniging Voor Seksuologie). The funding was unrestricted, and there was no involvement in the conduct of the research. There are no conflicts of interest to declare.

Investigations of positive body image among men and across various social identities are lacking, and could contribute to a more complete understanding of the construct, including how positive body image can be improved. This study addressed this gap by investigating correlates of body appreciation - a key facet of positive body image - in men, and testing whether levels of body appreciation vary across sexual orientation. Data from a British community sample of 439 men (M-age = 39.13) showed that body appreciation inversely correlated with conformity to masculine norms and upward appearance-based social comparisons, and positively correlated with physical activity. Body appreciation was lower among sexual minority compared to heterosexual men, and athletic appearance-ideal internalisation and upward appearance-based social comparisons mediated this relationship. Replicating prior research among men, body appreciation positively correlated with body satisfaction, and inversely correlated with perceived appearance pressures from media and eating pathology. These findings have implications for interventions addressing body image among men. (C) 2018 Elsevier Ltd. All rights reserved.

A growing body of evidence demonstrated that it is feasible to induce ownership over an artificial body to alter bodily experience. However, several uncharted aspects about full-body illusion applications need to be tackled before a complete exploitation of these methods in clinical practice. This work is devoted to explore possible individual age-related differences in shaping changes in body representations induced with a full-body illusion. A total of 40 women were divided into two different age groups according to the median of the variable age. Participants estimated the width of three different body parts (i.e., shoulders, abdomen, and hips) before the entire illusion was induced (baseline), and after the synchronous and the asynchronous conditions. Results revealed that 26-to-55-year-old participants were more resistant to changes induced by the bodily illusion, whereas 19-to-25-year-old participants underestimated their bodies after both conditions. The findings were discussed in terms of the literature exploring age differences in responses to bodily illusion, which could suggest a Bayesian mechanism underlying these individual differences.

Les troubles des conduites alimentaires (TCA) de type accès ­hyperphagiques sont associés à l'obésité et sont présents sous leurs formes complètes ou partielles chez près d'un quart des adolescents en excès de poids. Un dépistage systématique doit être effectué dans cette population lorsqu'elle consulte, afin de permettre une prise en charge optimale. Un outil de dépistage nommé ADO-BEDs a été spécifiquement développé pour ces ­adolescents. Utile pour guider la consultation, il permet au ­soignant d'aborder le trouble et d'adresser le patient pour une évaluation spécialisée en cas de suspicion de TCA. Viser une ­augmentation de l'insatisfaction corporelle ou faire des commentaires négatifs portant sur le physique de l'adolescent ne sont pas une aide à la motivation, mais augmentent le risque de TCA et devraient être évités en consultation.

RP is the most common manifestation of SSc and a major cause of disease-related morbidity. This review provides a detailed appraisal of the patient experience of SSc-RP and potential implications for disease classification, patient-reported outcome instrument development and SSc-RP clinical trial design. The review explores the clinical features of SSc-RP, the severity and burden of SSc-RP symptoms and the impact of SSc-RP on function, work and social participation, body image dissatisfaction and health-related quality of life in SSc. Where management of SSc-RP is concerned, the review focuses on the 'patient experience' of interventions for SSc-RP, examining geographic variation in clinical practice and potential barriers to the adoption of treatment recommendations concerning best-practice management of SSc-RP. Knowledge gaps are highlighted that could form the focus of future research. A more thorough understanding of the patient experience could support the development of novel reported outcome instruments for assessing SSc-RP.

Body dissatisfaction has been regularly associated with negative consequences on health of young women, but less is known regarding middle-aged or older women. However, body dissatisfaction in women has been seen for long as a “normative discontent” (i.e. widespread and chronic dissatisfaction) because of its high prevalence among all age categories. The goal of this study was to explore the relationships between the desire to lose weight, energy intake and psychological health in community-dwelling women issued from the second wave (cross-sectional data) of the cohort study CoLaus (2009–2012, Switzerland), taking age categories (40–59 and 60–80) and body mass index (BMI, normal and overweight/obese) into account. Results showed that the desire to lose weight was common even in women with normal BMI and whatever the age category. Women with normal BMI who wished to lose weight reported lower energy and protein intake per kg of body weight, more signs of depression and less satisfaction with their quality of life than those who did not wish to lose weight in both age groups. The desire to lose weight was similarly associated with psychological health in women with overweight/obesity, in both age categories as well. These results indicate that the desire to lose weight may be associated with an impaired psychological health also in middle-aged and older women, even in those with normal BMI. This should not be considered as normal by health care professionals but as a possible indicator of psychological health and of the capacity to comply with dietary recommendations.

Measures of sexual wellbeing and positive aspects of sexuality in the World Health Organization definition for sexual health are rarely studied and remain poorly understood, especially among adolescents in Sub-Saharan Africa. The objective of this study was to assess sexual wellbeing in its broad sense—i.e., body image, self-esteem, and gender equitable norms—and associated factors in young adolescents in Uganda. A cross-sectional survey of adolescents ages 10–14 years in schools was carried out between June and July 2016. Among 1096 adolescents analyzed, the median age was 12 (Inter-Quartile Range (IQR): 11, 13) and 58% were female. Self-esteem and body image scores were high with median 24 (IQR: 22, 26, possible range: 7–28) and median 22 (IQR: 19, 24, possible range: 5–25) respectively. Gender equitable norms mean score was 28.1 (SD 5.2: possible range 11–44). We noted high scores for self-esteem and body image but moderate scores on gender equitable norms. Girls had higher scores compared to boys for all outcomes. A higher age and being sexually active were associated with lower scores on gender equitable norms. Gender equitable norms scores decreased with increasing age of adolescents. Comprehensive and timely sexuality education programs focusing on gender differences and norms are recommended.

Women with a more negative body evaluation perceive that their body is associated with more negative social feedback. This covariation bias could reinforce negative body evaluation. We investigated whether covariation bias could be diminished and explored the potential roles of outcome aversiveness and interpretation of negative social feedback associated with one's body. Ninety-seven undergraduate women completed a computer task wherein photos of their body, a control woman's body, and a neutral object were followed by negative social feedback or nothing. When the relation between each category and the negative feedback was random, women with a more negative body evaluation perceived more negative feedback following their body. They also experienced negative feedback following their body and the control woman's body as more aversive. After a manipulation block, women with a more negative body evaluation no longer perceived more negative feedback for their body. These effects coincided with improvements in state body evaluation.

In recent years, the study of body image shifted from focusing on the negative aspects to a more extensive view of body image. The present study seeks to validate a measure of positive body image, the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) in Denmark, Portugal, and Sweden. Participants (N = 1012) were adolescents and young adults aged from 12 to 19. Confirmatory factor analyses confirmed the one-dimensional factor structure of the scale. Multi-group confirmatory factor analyses indicated that the scale was invariant across sex and country. Further results showed that BAS-2 was positively correlated with self-esteem, psychological well-being, and intuitive eating. It was negatively correlated with BMI among boys and girls in Portugal but not in Denmark and Sweden. Additionally, boys had higher body appreciation than girls. Results indicated that the BAS-2 has good psychometric properties in the three languages.

Objective:To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR).Methods:Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display.Results:Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position.Conclusions:The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols.

Introduction Inflammatory bowel disease (IBD) is likely to have an impact on sexual function because of its symptoms, like diarrhea, fatigue, and abdominal pain. Depression is commonly reported in IBD and is also related to impaired sexual function. This study aimed to evaluate sexual function and its association with depression among patients with IBD compared with controls. Methods IBD patients registered at two hospitals participated. The control group consisted of a general practitioner practice population. The web-based questionnaire included the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. Other variables evaluated were depression, disease activity, IBD-related quality of life, body image, and fatigue. Results In total, 168 female and 119 male patients were available for analysis (response rate 24%). Overall, patients with IBD did not significantly differ in prevalence of sexual dysfunctions from controls: female patients 52%, female controls 44%, male patients and male controls both 25%. However, men and women with an active disease scored significantly lower than patients in remission and controls, indicating impaired sexual functioning during disease activity. Significant associations were found between active disease, fatigue, depressive mood, quality of life, and sexual function for both male and female patients. The association between disease activity and sexual function was totally mediated by depression. Conclusion Male and female IBD patients with an active disease show impaired sexual function relative to patients in remission and controls. Depression is the most important determinant for impaired sexual function in IBD.

BACKGROUND: Eating disorder behaviours begin in adolescence. Few longitudinal studies have investigated childhood risk and protective FACTORS. AIMS: To investigate the prevalence of eating disorder behaviours and cognitions and associated childhood psychological, physical and parental risk factors among a cohort of 14-year-old children. METHOD: Data were collected from 6140 boys and girls aged 14 years. Gender-stratified models were used to estimate prospective associations between childhood body dissatisfaction, body mass index (BMI), self-esteem, maternal eating disorder and family economic disadvantage on adolescent eating disorder behaviours and cognitions. RESULTS: Childhood body dissatisfaction strongly predicted eating disorder cognitions in girls, but only in interaction with BMI in boys. Higher self-esteem had a protective effect, particularly in boys. Maternal eating disorder predicted body dissatisfaction and weight/shape concern in adolescent girls and dieting in boys. CONCLUSIONS: Risk factors for eating disorder behaviours and cognitions vary according to gender. Prevention strategies should be gender-specific and target modifiable predictors in childhood and early adolescence.

Introduction Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited. Aims This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis. Methods We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed. Results At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful. Conclusion We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always offering a multidisciplinary care, including sexual therapy before and after the surgery.

Introducción: Los modelos de belleza actuales representan una extremada delgadez en las mujeres y un cuerpo musculoso en los hombres. La propia percepción de imagen corporal va a condicionar la búsqueda del ideal de belleza, a través de diferentes conductas y comportamientos, que en último término pueden transformarse en trastornos de conducta alimentaria. Los jóvenes universitarios sometidos a los cambios propios de la juventud y de la transición universitaria, son un grupo de población especialmente vulnerable. Objetivo: El objetivo del estudio consistió en describir la percepción de la imagen corporal (PIC) de estudiantes universitarios en Navarra. Método: Se incluyeron 1.162 participantes de entre 17 y 35 años, que respondieron a un cuestionario de autocumplimentación anónimo y firmaron un consentimiento informado para someterse a mediciones antropométricas que permitieron calcular el índice de masa corporal. Para conocer la percepción de imagen corporal, los sujetos eligieron de entre 9 siluetas de hombres y mujeres, aquella con la que mejor se identificaban. Resultados: El 55,6% de los estudiantes tuvo una percepción de imagen corporal que no se correspondía con la realidad. Sobreestimando su índice de masa corporal el 9,7% de los hombres y el 58,1% de las mujeres. Discusión: Un alto porcentaje de universitarios tenían una percepción de imagen corporal que no se correspondía con la realidad, mostrando la preocupación de este grupo de población por su imagen corporal. Se identificaron más casos de alteración de la percepción de imagen corporal en mujeres, que en general sobreestimaban su índice de masa corporal. En los hombres, la tendencia era a subestimarlo. Coincidiendo con otras investigaciones, el sobrepeso/obesidad influye en la PIC. Los estudiantes más corpulentos, de ambos sexos, tendían a subestimar su índice de masa corporal. Introduction: Current models of beauty represent an extreme thinness in the women and a muscular body in the men. The body image perception will condition the search of ideal beauty through different behaviors and can be transform in eating disorders. The university students, with the changes typical of youth and university transition, are a vulnerable group. Objective: The purpose of this study was to evaluate the body image perception of university students in Navarra. Methods: The study included 1162 subjects of which 64.2% were female. Students asked for a self-managed questionnaire and they were weighted and heighted to calculate the body mass index (BMI). Their body image perception were obtained asking the students to select a picture, according to their perception which corresponded to their current body image from nine different silhouettes for men and women. Their BMI were calculated and compared with their perceived BMI. Results: 43.03% of students, overestimated their body image (10.65% in males and 59.69% in females) and 10.20% of students underestimated it. 46.75% of students had concordance between BMI and body image perception. Discussion: There were more cases the alterations in the body image perception in women. In general, women saw themselves as being fatter than really were while men saw themselves as being thinner than they really were. The results shown that the women were more worried about their weight and body image than the men.

O objetivo desse estudo foi compreender a percepção sobre a imagem corporal e a sexualidade de mulheres jovens submetidas à mastectomia. Foi realizado um estudo transversal com uma abordagem qualitativa. Para a análise da sexualidade e da imagem corporal foi realizada uma entrevista semi-estruturada. Participaram do estudo quatro mulheres que tiveram diagnóstico de câncer de mama antes dos 35 anos de idade. Na análise das entrevistas, emergiram duas categorias: Percepção e significação da mama: da dor da perda até a satisfação e valorização da vida; Repercussões sobre a feminilidade e sexualidade: o enfrentamento da alteração da libido, das mudanças conjugais até a aceitação e o amadurecimento emocional. Concluiu-se com o estudo que a mastectomia interfere negativamente na imagem corporal e na sexualidade da mulher jovem, uma vez que a mama possui um simbolismo de feminilidade e saúde durante todas as etapas da vida da mulher. Também foram identificados pontos positivos, como a superação do câncer e a ressignificação da imagem corporal e da sexualidade, fazendo com que essas mulheres desenvolvam uma nova visão da sua vida, do seu corpo e das suas necessidades sexuais. The aim of this study was to understand the perception about body image and sexuality of young women submitted to mastectomy. A cross - sectional study was carried out with a qualitative approach. A semi-structured interview was performed for the analysis of sexuality and body image. Four women who had a diagnosis of breast cancer before the age of 35 participated in the study. In the analysis of the interviews, two categories emerged: Perception and signification of the breast: from pain of loss to satisfaction and appreciation of life; Repercussions on femininity and sexuality: coping with changing libido, from marital changes to acceptance and emotional maturation. It was concluded that mastectomy negatively interferes with the body image and sexuality of young women, since the breast has a symbolism of femininity and health and during all stages of the woman’s life. Positive points have also been identified, such as overcoming cancer and re-signification of body image and sexuality, making these women develop a new vision of their life, body and sexual needs.

Introduction: This cross-sectional study examined variables associated with body image concern (BIC) and\ud whether these associations differed between female and male students in Egypt. During the period 2009-2010,\ud 3271 undergraduate students (1663 females, 1504 males) at Assuit University in Egypt completed a\ud self-administered questionnaire that assessed BIC and other socio-demographic and health related variables.\ud Methods: Based on Cooper et al.’s Body Shape Questionnaire the authors categorized BIC into ‘no BIC’; ‘mild\ud BIC’; and ‘moderate/marked BIC’. Multifactorial linear regression analysis examined the association between\ud BIC and BMI, body image perception, lifestyle (physical activity, nutrition, smoking) and mental well-being\ud variables (quality of life, finances-related stress, perceived stress, perceived health, depressive symptoms).\ud Results: About 40% of the female students and 25.6% of male students reported having mild to marked BIC.\ud The correlates of BIC did not exhibit striking differences between male and female students. For both genders,\ud BIC was positively associated with BMI, body image perception as being too fat and with depressive symptoms.\ud Self-rated health was inversely associated with BIC.\ud Conclusion: These findings suggest that health promoting strategies should address the co-occurrence of\ud depressive symptoms and BIC, and should furthermore pay due attention to higher prevalence of BIC among female students.

Importance Relatively little is known about the prevalence of concerns with physique and eating disorders among males and their relation to subsequent adverse outcomes. A broader range of eating disorders needs to be defined to diagnose these illnesses appropriately in males. Objective To investigate whether males with psychiatric symptoms related to disordered eating and concern about physique are more likely to become obese, to start using drugs, to consume alcohol frequently (binge drinking), or to develop high levels of depressive symptoms. Design, Setting, and Participants The data come from questionnaires sent every 12 to 36 months from 1999 through 2010 to youth in a prospective cohort study, the Growing Up Today Study. The analysis included 5527 males aged 12 to 18 years in 1999 from across the United States who responded to the Growing Up Today Study questionnaires. Main Outcomes and Measures Development of obesity and high levels of depressive symptoms and initiation of drug use and binge drinking at least monthly. Results From 1999 through 2011 in at least 1 study year, 9.2% of respondents reported high concerns with muscularity but no bulimic behaviors; 2.4%, high concerns with muscularity and use of supplements, growth hormone derivatives, or anabolic steroids to achieve their desired physique; 2.5%, high concerns with thinness but no bulimic behaviors; and 6.3%, high concerns with thinness and muscularity. For eating disorders, 0.8% had partial- or full-criteria bulimia nervosa or purging disorder and 2.9% had partial or full-criteria binge eating disorder but no association with the outcomes of interest. Infrequent binge eating or purging or overeating without a loss of control were reported by 31.0%. However, independent of age and body mass index, males with high concerns about thinness but not muscularity were more likely to develop high depressive symptoms (odds ratio, 2.72; 95% CI, 1.36-5.44). Males with high concerns about muscularity and thinness were more likely than their peers to use drugs (odds ratio, 2.13; 95% CI, 1.31-3.46), and males with high concerns about muscularity who used supplements and other products to enhance physique were more likely to start binge drinking frequently (2.06; 1.58-2.69) and using drugs (2.16; 1.49-3.11). Conclusions and Relevance High concerns with muscularity are relatively common among adolescent boys and young men. Males with these concerns who use potentially unhealthy products to improve their physique are at increased risk of adverse outcomes but may not be recognized by their health care providers as having a weight-related disorder because of the sex-specific presentation.

Objectives: Physical activity has a positive effect on people's mental health and well-being. The aim of this study was to compare the effects of hatha yoga and resistance exercises on mental health and well-being in sedentary adults. Design: Randomized controlled study. Methods: Fifty-one participants aged mean (SD) 25.6 (5.7) years were randomly divided into three groups: Hatha Yoga Group, Resistance Exercise Group and Control Group. The Hatha Yoga Group and Resistance Exercise Group participated in sessions three days per week for 7 weeks and the Control Group did not participate in any sessions. All the subjects were evaluated through the Rosenberg Self-Esteem Scale, Beck Depression Inventory, Body Cathexis Scale, Nottingham Health Profile and Visual Analog Scale for fatigue pre-and post-session. Results: Significant improvements were found in terms of all outcome measures in the Hatha Yoga Group and the resistance exercise group. No improvements were found in the Control Group. Hatha yoga more improved the dimensions fatigue, self-esteem, and quality of life, whilst resistance exercise training more improved body image. Hatha yoga and resistance exercise decreased depression symptoms at a similar level. Conclusion: The results indicated that hatha yoga and resistance exercise had positive effects on mental health and well-being in sedentary adults. Hatha yoga and resistance exercise may affect different aspects of mental health and well-being. © 2014 Elsevier Ltd., 2010SBE001, This study was supported by the Pamukkale University, Unit of Scientific Research Projects Coordination , grant and project number 2010SBE001 , approved on February 5, 2010. We also thank Professor Dr. Uğur Cavlak for his valuable contributions and the yoga instructor, Monica Münzinger, for her guidance in the creation of a yoga program for this study.

Background: Excess skin after massive weight loss impairs patient's health-related quality of life (HRQoL). Therefore, body-contouring surgeries can be proposed. However, few data exist concerning the effect of body contouring after bariatric surgery on HRQoL, including control group with a long-term follow-up. Methods: In a prospective study, 98 consecutive patients who had body contouring after gastric bypass for obesity (BMI > 40) were included (group A). A matched control-group containing 102 patients who had only gastric bypass was selected (group B). HRQoL was measured by Moorehead-Ardelt questionnaire before (group A1) and after (A2) body contouring, and at different time points for group B until 8years post-gastric bypass. To evaluate the effect of body contouring by two parallel methods, HRQoL was compared between groups A1 and A2, and between A2 and B. Results: We found that body contouring procedures improved significantly patients' HRQoL, in comparison to those who had only gastric bypass. Of the patients who had body contouring (group A2), 57% evaluated their HRQoL "much better” in comparison to only 22% of patients before body contouring (group A1) or those who never had body contouring (group B) (p