Evaluation of the relationship between body image perception, patient satisfaction and quality of life of those who have obesity surgery within the scope of medical tourism

Obesity is one of the most important health problems of developed and developing countries. Obesity can be defined as the accumulation of fat in the human body above normal values, at a level that will negatively affect the health of individuals. Obesity is a complex, multifactorial disease and its development depends on the interaction of genotype and environmental conditions. Obesity alone can cause various health problems or aggravate an existing health problem. In particular, hypertension is blamed for the development of coronary heart disease (CHD), diabetes mellitus (type 2) or an increase in the incidence of some malignancies. In addition, overweight or obesity is accepted as a condition that increases morbidity associated with health problems such as osteoarthritis, sleep apnea, respiratory problems, gallbladder diseases, hypertension, diabetes, CHD, stroke. Being overweight is also a condition that increases all-cause mortality. In recent years, those who have not been successful in the treatment of obesity, especially with medical nutrition therapy, behavioral therapy treatment, exercise therapy and pharmacology treatment, finally prefer surgical treatment. However, since the cost of surgical treatment is high, individuals travel to places with lower costs to get this service. Obesity, which is an important health problem that should be prevented because it causes many health problems, also negatively affects the quality of life and body image of individuals. The match of the research we planned for this reason is to evaluate the demographic characteristics, body image, patient satisfaction and quality of life relationship of obese individuals who prefer our country within the scope of medical tourism. The population of the research is those who had bariatric surgery (Slevee Gastrectomy, Gastric Band, Gastric Plication, Roux-en Y Gastric Bypass, Mini Gastric Bypass, Single Anastomotic Gastaric Bypass, Duodenal Switch) in private hospitals with health tourism authorization certificate in Samsun province between 2015-2022. It consists of 329 medical tourists who are over the age of 18, have mental competence and can speak Turkish or English. Research data were collected with 4 forms; personal information form, body image scale", quality of life scale and patient satisfaction scale. Data were collected between 01.09.2021 and 31.10.2022 by online, face-to-face and drop-collect method. Descriptive statistics and student t test, ANOVA test, correlation and multiple regression statistical analysis methods were used in the evaluation of the data. 37.4% of the participants were male, 62.6% were female, and 25.3% were between the ages of 41-50. Preoperative BMI of 40.39 and surgery 35.2% of the participants came from Germany. The mean body image perception of the participants was 129.93±24.592, the mean quality of life was 27.01±4.004, and the mean patient satisfaction was 66,813±8.872. According to the results obtained from the study, patient satisfaction is affected by age, education level, family type, monthly income, income status, exercise status, chronic disease status and body image perception (p<0.05). It was determined that quality of life was affected by body image perception, marital status, education status, employment status, family type, income status, alcohol use, exercise status (p<0.05). Another result obtained from the study is that there is a positive correlation between body image perception, patient satisfaction and quality of life in individuals who have undergone obesity surgery. Based on these results, it can be recommended to examine psychological factors with a larger participation of patients who have bariatric surgery. Keywords: Medical Tourism, Bariatric Surgery, Body Image Perception, Patient Satisfaction, Quality of Life