When the body changes faster than the brain: a narrative and theoretical review of body schema updating after bariatric surgery.

As indicated by the guidelines of the National Institutes of Health (NIH) and the Italian Society of Obesity Surgery and Metabolic Diseases (SICOB), bariatric surgery is the treatment of choice for severe obesity due to its effectiveness in achieving long-term weight loss and improving associated comorbidities. Many individuals with obesity exhibit profound body dissatisfaction, which often represents a primary motivation for seeking bariatric surgery, sometimes outweighing health-related reasons. Following surgery, a significant reduction in body weight is typically observed; however, perceived body image does not always change in parallel with physical transformation. Some individuals experience difficulties adapting to bodily changes, with a persistent perception of themselves as people with obesity despite substantial weight loss. This phenomenon is typically interpreted in terms of body image disturbances; however, it may also indirectly point to difficulties in updating body representations, potentially involving body schema mechanisms, although this has not yet been directly investigated in bariatric populations. Given the limited number of studies on body schema in this context, this article provides a narrative and theory-driven review of body representation following bariatric surgery. Specifically, it integrates findings from body image research, obesity studies, and embodied cognition to explore whether body schema updating may contribute to the mismatch between physical and perceived body. This interpretation remains hypothetical and highlights a critical gap in the literature, namely the lack of direct empirical investigations of body schema in bariatric populations. Further research is needed to clarify its role in post-operative adaptation and its implications for psychological and behavioural outcomes.