BACKGROUND: The widespread adoption of glucagon-like peptide-1 (GLP-1) receptor agonists has generated a new cohort of weight loss patients seeking aesthetic surgery. Their psychosocial characteristics and aesthetic expectations, compared with traditional post-bariatric patients, remain poorly defined.
OBJECTIVES: To compare psychosocial well-being, body image, and satisfaction in female patients undergoing body contouring after GLP-1-induced versus bariatric weight loss.
METHODS: A single-center, prospective pilot comparative study including women only was conducted. Of 82 enrolled patients, 72 completed follow-up and were analyzed (GLP-1: n = 38; post-bariatric: n = 34). The prespecified primary endpoint was the change in BODY-Q Satisfaction with Body score from baseline (T0) to 6 months (T6). Secondary endpoints included other BODY-Q domains and, when applicable, FACE-Q and Wrinkle Severity Rating Scale (WSRS) measures. Validated patient-reported outcome measures (PROMs) were administered at T0 and T6.
RESULTS: Both cohorts demonstrated significant improvement in Satisfaction with Body from T0 to T6 (GLP-1: 43.1 ± 12.5 → 72.8 ± 13.9; Δ = 29.7; p < 0.001; post-bariatric: 39.6 ± 11.7 → 68.5 ± 14.7; Δ = 28.9; p < 0.001), with no between-group difference in improvement (p = 0.67). GLP-1 patients showed higher preoperative scores but greater emotional reactivity to residual contour irregularities. In the facial subgroup (n = 21), FACE-Q improved and WSRS decreased similarly across groups. Multivariable analysis revealed no independent effect of weight loss modality on BODY-Q change (β = 0.12; p = 0.58); lower baseline psychosocial scores predicted postoperative dissatisfaction (β = -0.34; p = 0.02).
CONCLUSIONS: Body contouring after GLP-1-induced weight loss yields psychosocial and aesthetic benefits comparable to those achieved after bariatric surgery, yet GLP-1 patients exhibit distinct preoperative expectations and heightened emotional sensitivity to imperfections. Despite the female-only, single-center pilot design, these findings underscore the importance of tailored counseling and highlight the need for larger multicenter studies to refine patient selection and expectation management.
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