Meg H Zeller1, Sanita Hunsaker1, Carmen Mikhail2,3, Jennifer Reiter-Purtill1, Mary Beth McCullough1, Beth Garland2,3, Heather Austin4, Gia Washington2,3, Amy Baughcum5, Dana Rofey6, Kevin Smith7. 1. Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. 2. Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA. 3. Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA. 4. Center of Weight Management, Children's Hospital of Alabama, Birmingham, Alabama, USA. 5. Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA. 6. Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 7. Department of Developmental and Behavioral Sciences, Children's Mercy Hospitals & Clinics, Kansas City, Missouri, USA.
Abstract
OBJECTIVE: To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS). METHODS: Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage = 16.9; MBMI = 51.5 kg/m2 ; caregiver: Mage = 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage = 16.1; MBMI = 46.9 kg/m2 ; caregiver: Mage = 43.9; 94% female) were collected using standardized measures at presurgery/baseline and at 1 and 2 years. RESULTS: The majority (77.3%) of caregivers had obesity, with rates of caregiver WLS significantly higher in the WLS (23.8%) versus NSComp group (3.7%, P < 0.001). Family dysfunction was prevalent (≈1 in every two to three families), with rates higher for NSComp than the WLS group. For the WLS group, preoperative family factors (i.e., caregiver BMI or WLS history, dysfunction, social support) were not significant predictors of adolescent weight loss at 1 and 2 years postoperatively, although change in family functioning over time emerged as a significant correlate of percent weight loss. CONCLUSIONS: Rates of severe obesity in caregivers as well as family dysfunction were clinically noteworthy, although not related to adolescent weight loss success following WLS. However, change in family communication and emotional climate over time emerged as potential targets to optimize weight loss outcomes.
OBJECTIVE: To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS). METHODS: Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage = 16.9; MBMI = 51.5 kg/m2 ; caregiver: Mage = 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage = 16.1; MBMI = 46.9 kg/m2 ; caregiver: Mage = 43.9; 94% female) were collected using standardized measures at presurgery/baseline and at 1 and 2 years. RESULTS: The majority (77.3%) of caregivers had obesity, with rates of caregiver WLS significantly higher in the WLS (23.8%) versus NSComp group (3.7%, P < 0.001). Family dysfunction was prevalent (≈1 in every two to three families), with rates higher for NSComp than the WLS group. For the WLS group, preoperative family factors (i.e., caregiver BMI or WLS history, dysfunction, social support) were not significant predictors of adolescent weight loss at 1 and 2 years postoperatively, although change in family functioning over time emerged as a significant correlate of percent weight loss. CONCLUSIONS: Rates of severe obesity in caregivers as well as family dysfunction were clinically noteworthy, although not related to adolescent weight loss success following WLS. However, change in family communication and emotional climate over time emerged as potential targets to optimize weight loss outcomes.
Authors: Anita P Courcoulas; Nicholas J Christian; Robert W O'Rourke; Greg Dakin; E Patchen Dellinger; David R Flum; Ph D Melissa Kalarchian; James E Mitchell; Emma Patterson; Alfons Pomp; Walter J Pories; Konstantinos Spaniolas; Kristine Steffen; Bruce M Wolfe; Steven H Belle Journal: Surg Obes Relat Dis Date: 2015-01-23 Impact factor: 4.734
Authors: Meg H Zeller; Jennie G Noll; David B Sarwer; Jennifer Reiter-Purtill; Dana L Rofey; Amy E Baughcum; James Peugh; Anita P Courcoulas; Marc P Michalsky; Todd M Jenkins; Jennifer N Becnel Journal: J Pediatr Psychol Date: 2015-03-15
Authors: Thomas H Inge; Anita P Courcoulas; Todd M Jenkins; Marc P Michalsky; Michael A Helmrath; Mary L Brandt; Carroll M Harmon; Meg H Zeller; Mike K Chen; Stavra A Xanthakos; Mary Horlick; C Ralph Buncher Journal: N Engl J Med Date: 2015-11-06 Impact factor: 91.245
Authors: Sarah B Cairo; Indrajit Majumdar; Aurora Pryor; Alan Posner; Carroll M Harmon; David H Rothstein Journal: Obes Surg Date: 2018-04 Impact factor: 4.129
Authors: Meg H Zeller; Jennifer L Brown; Jennifer Reiter-Purtill; David B Sarwer; Lora Black; Todd M Jenkins; Katherine A McCracken; Anita P Courcoulas; Thomas H Inge; Jennie G Noll Journal: Surg Obes Relat Dis Date: 2019-03-20 Impact factor: 4.734
Authors: Sanita L Hunsaker; Beth H Garland; Dana Rofey; Jennifer Reiter-Purtill; James Mitchell; Anita Courcoulas; Todd M Jenkins; Meg H Zeller Journal: J Adolesc Health Date: 2018-04-30 Impact factor: 5.012
Authors: Janey S A Pratt; Allen Browne; Nancy T Browne; Matias Bruzoni; Megan Cohen; Ashish Desai; Thomas Inge; Bradley C Linden; Samer G Mattar; Marc Michalsky; David Podkameni; Kirk W Reichard; Fatima Cody Stanford; Meg H Zeller; Jeffrey Zitsman Journal: Surg Obes Relat Dis Date: 2018-03-23 Impact factor: 4.734
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Authors: Kristina M Decker; Jennifer Reiter-Purtill; Carolina M Bejarano; Andrea B Goldschmidt; James E Mitchell; Todd M Jenkins; Michael Helmrath; Thomas H Inge; Marc P Michalsky; Meg H Zeller Journal: Obes Sci Pract Date: 2022-01-22