Abstract
Background
This study evaluated the social environment of bariatric surgery patients in the preoperative period.
Methods
Forty bariatric surgery patients (mean = 46.2 ± 11.2 years), 35 adult cohabitating family members (mean = 45.2 ± 12.7 years), and 15 cohabitating children (mean = 11.5 ± 3.6 years) were recruited from a large rural medical center. Adult participants (patients and family members) completed height, weight, body composition, blood draws, and physical activity assessments (accelerometry), as well as eating behavior and social support inventories before the patient underwent bariatric surgery. Child participants completed demographic, height, and weight assessment only.
Results
Over 90 % of adult family members were overweight or obese (body mass index (BMI) ≥ 25 kg/m2, as were 50 % of children (BMI percentile ≥ 85 %). More than one third (37.1 %) of family members met the criteria for moderate to severe insulin resistance. Physical activity measured by accelerometry was moderately correlated between the patient and adult family members (r = 0.46, p = 0.023). Bariatric surgery patients reported high levels of social support from their family members on multiple social support measures.
Conclusions
Many family members of bariatric surgery patients also lived with obesity and related comorbidities, and demonstrate high sedentary behavior. However, patients reported high levels of support from family members, including support in following a healthy diet and engaging in physical activity. Engaging families in behavior change may help bariatric surgery patients and their families to become healthier.
Similar content being viewed by others
References
Reilly JJ et al. Early life risk factors for obesity in childhood: cohort study. BMJ. 2005;330(7504):1357.
Adams TD et al. Familial aggregation of morbid obesity. Obes Res. 1993;1(4):261–70.
Reed DR, Bradley EC, Price RA. Obesity in families of extremely obese women. Obes Res. 1993;1(3):167–72.
Lee JH, Reed DR, Price RA. Familial risk ratios for extreme obesity: implications for mapping human obesity genes. Int J Obes Relat Metab Disord. 1997;21(10):935–40.
Katzmarzyk PT, Hebebrand J, Bouchard C. Spousal resemblance in the Canadian population: implications for the obesity epidemic. Int J Obes Relat Metab Disord. 2002;26(2):241–6.
Jeffery RW, Rick AM. Cross-sectional and longitudinal associations between body mass index and marriage-related factors. Obes Res. 2002;10(8):809–15.
Gorin AA et al. Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes (Lond). 2008;32(11):1678–84.
Woodard GA et al. Halo effect for bariatric surgery: collateral weight loss in patients’ family members. Arch Surg. 2011;146(10):1185–90.
Willmer M et al. Changes in BMI and psychosocial functioning in partners of women who undergo gastric bypass surgery for obesity. Obes Surg. 2015;25(2):319–24.
Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357(4):370–9.
Hruschka DJ et al. Shared norms and their explanation for the social clustering of obesity. Am J Public Health. 2011;101 Suppl 1:S295–300.
Cohen-Cole E, Fletcher JM. Is obesity contagious? Social networks vs. environmental factors in the obesity epidemic. J Health Econ. 2008;27(5):1382–7.
Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.
Mechanick JI et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient©—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–91.
Herpertz S et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12(10):1554–69.
Vallis MT, Ross MA. The role of psychological factors in bariatric surgery for morbid obesity: identification of psychological predictors of success. Obes Surg. 1993;3(4):346–59.
Delin CR, Watts JM, Bassett DL. An exploration of the outcomes of gastric bypass surgery for morbid obesity: patient characteristics and indices of success. Obes Surg. 1995;5(2):159–70.
Shiri S et al. Positive psychological impact of bariatric surgery. Obes Surg. 2007;17(5):663–8.
Larsen JK et al. Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg. 2003;13(4):629–36.
Lanyon RI, Maxwell BM. Predictors of outcome after gastric bypass surgery. Obes Surg. 2007;17(3):321–8.
Valley V, Grace DM. Psychosocial risk factors in gastric surgery for obesity: identifying guidelines for screening. Int J Obes. 1987;11(2):105–13.
Canetti L, Berry EM, Elizur Y. Psychosocial predictors of weight loss and psychological adjustment following bariatric surgery and a weight-loss program: the mediating role of emotional eating. Int J Eat Disord. 2009;42(2):109–17.
Ray EC et al. Predicting success after gastric bypass: the role of psychosocial and behavioral factors. Surgery. 2003;134(4):555–63. discussion 563–4.
Livhits M et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. Obes Rev. 2011;12(2):142–8.
Hirsch, A.G., et al., Collateral weight loss in children living with adult bariatric surgery patients: a case control study. Obesity (Silver Spring). 2014.
Walters-Bugbee SE et al. Maternal child feeding practices and eating behaviors of women with extreme obesity and those who have undergone bariatric surgery. Surg Obes Relat Dis. 2012;8(6):784–91.
Lopes VP et al. Actigraph calibration in obese/overweight and type 2 diabetes mellitus middle-aged to old adult patients. J Phys Act Health. 2009;6 Suppl 1:S133–40.
Choi L et al. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357–64.
Lee IM, Shiroma EJ. Using accelerometers to measure physical activity in large-scale epidemiological studies: issues and challenges. Br J Sports Med. 2014;48(3):197–201.
Troiano RP et al. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.
Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985;29(1):71–83.
Sallis JF et al. The development of scales to measure social support for diet and exercise behaviors. Prev Med. 1987;16(6):825–36.
Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med. 1991;32(6):705–14.
Matthews DR et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.
Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27(12):1692–7.
Ginde SR et al. Air displacement plethysmography: validation in overweight and obese subjects. Obes Res. 2005;13(7):1232–7.
CDC. BMI percentile calculator for child and teen English version. [cited 2015 August 4].
Swain DP, American College of Sports Medicine. ACSM’s resource manual for Guidelines for exercise testing and prescription. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. 862 p.
Berglind D et al. Women undergoing Roux-en-Y gastric bypass surgery: family resemblance in pre- to postsurgery physical activity and sedentary behavior in children and spouses. Surg Obes Relat Dis. 2015;11(3):690–6.
Madan AK, Turman KA, Tichansky DS. Weight changes in spouses of gastric bypass patients. Obes Surg. 2005;15(2):191–4.
Kiernan M et al. Social support for healthy behaviors: scale psychometrics and prediction of weight loss among women in a behavioral program. Obesity (Silver Spring). 2012;20(4):756–64.
Kitzman-Ulrich H et al. The integration of a family systems approach for understanding youth obesity, physical activity, and dietary programs. Clin Child Fam Psychol Rev. 2010;13(3):231–53.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
Support for this project was provided by internal grants at Geisinger and NIH grants 1F32DK096756 and t P30 DK072488. These funding sources did not play any role in the study design, collection, analysis, interpretation of data, writing the manuscript, or the decision to submit the manuscript for publication.
Conflicts of Interest
The authors declare that they have no conflicts of interest.
Ethical Statements
This study was approved by the Medical Center’s Institutional Review Board (IRB) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Lent, M.R., Bailey-Davis, L., Irving, B.A. et al. Bariatric Surgery Patients and Their Families: Health, Physical Activity, and Social Support. OBES SURG 26, 2981–2988 (2016). https://doi.org/10.1007/s11695-016-2228-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-016-2228-7