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Decker KM, Reiter‐Purtill J, Bejarano CM, Goldschmidt AB, Mitchell JE, Jenkins TM, Helmrath M, Inge TH, Michalsky MP, Zeller MH. Psychosocial predictors of problematic eating in young adults who underwent adolescent bariatric surgery. Obes Sci Pract 2022; 8:545-555. [PMID: 36238228 PMCID: PMC9535670 DOI: 10.1002/osp4.590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/23/2021] [Indexed: 11/08/2022] Open
Abstract
Introduction This study examined problematic eating and eating-related psychopathology among young adults who underwent adolescent bariatric surgery including concurrent and prospective associations with psychosocial factors and weight change. Methods VIEW point is a 6-year follow-up study within a prospective observational study series observing adolescents with severe obesity who had bariatric surgery (n = 139) or who presented to nonsurgical lifestyle modification programs (n = 83). Participants completed height/weight measurements, questionnaires, and diagnostic interviews. Regression analyses compared problematic eating across groups and examined Year 6 correlates (i.e., psychosocial factors and weight change) and baseline predictors (i.e., psychosocial factors) of eating-related psychopathology. Results Compared to the nonsurgical group, the surgical group reported lower eating-related psychopathology, objective binge eating, and grazing at Year 6. While chewing/spitting out and vomiting for weight/shape-related reasons were very infrequent for the surgical group, self-induced vomiting for other reasons (e.g., avoid plugging) was more common. For the surgical group, lower self-worth, greater internalizing symptoms, and higher weight-related teasing in adolescence predicted increased eating-related psychopathology in young adulthood. Year 6 eating-related psychopathology was concurrently associated with lower percent weight loss for the surgical group and greater percent weight gain for the nonsurgical group. Conclusion Undergoing adolescent bariatric surgery appears to afford benefit for problematic eating and eating-related psychopathology. Current findings suggest that the clinical intervention related to problematic eating and associated psychosocial concerns may be needed for young adults with obesity, regardless of surgical status.
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Affiliation(s)
- Kristina M. Decker
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Jennifer Reiter‐Purtill
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Carolina M. Bejarano
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human BehaviorWarren Alpert Medical SchoolBrown University and Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James E. Mitchell
- Department of Clinical NeuroscienceSchool of Medicine and Health SciencesUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - Todd M. Jenkins
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Michael Helmrath
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Thomas H. Inge
- Department of SurgeryUniversity of ColoradoAnschutz Medical Campusand Children's Hospital ColoradoAuroraColoradoUSA
| | | | - Meg H. Zeller
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
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Cheng TY, Akhiyat YM, Mehta N, Ahlich E, Verzijl CL, Chermak R, Weiss AL, Rancourt D. Eating Disorder Symptomatology Among Adolescents Presenting for Bariatric Surgery Candidacy: Examining Differences by Sex and Racial Minority Status. Obes Surg 2021; 31:5295-5302. [PMID: 34599727 DOI: 10.1007/s11695-021-05723-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research on adolescent bariatric surgery candidates is limited by insufficient inclusion of ethnic minorities and males, and lack of consideration of the full spectrum of disordered eating behaviors (i.e., restriction, compensatory behaviors [e.g., purging], overeating/binge eating behaviors). OBJECTIVES The current study investigated differences in the full range of disordered eating behaviors across sex and ethnicity among adolescents seeking bariatric surgery. SETTING Teaching hospital, United States. METHODS Data were collected using retrospective chart review of 79 adolescent bariatric surgery candidates (59% female, 46.8% Hispanic, MBMI = 50.2, SDBMI = 10.0, Mage = 17.3, SDage = 2.02) who had completed the self-reported Eating Disorder Diagnostic Scale for DSM-5 at intake. RESULTS Approximately 33% of study participants met self-reported criteria for an eating disorder, with 35% endorsing binge eating behaviors and 50% endorsing compensatory behaviors. Few differences in behavior frequencies were observed across sex or racial/ethnic status. CONCLUSIONS Findings underscore the importance of assessing the full spectrum of disordered eating behaviors among adolescent bariatric surgery candidates.
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Affiliation(s)
- Tiffany Y Cheng
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Yasmine M Akhiyat
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Nitisha Mehta
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Erica Ahlich
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA
| | - Christina L Verzijl
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA
| | - Rebecca Chermak
- Tampa General Hospital and USF Health Bariatric Center, 5 Tampa General Cir, Tampa, FL, 33606, USA
| | - Amy L Weiss
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
- Tampa General Hospital and USF Health Bariatric Center, 5 Tampa General Cir, Tampa, FL, 33606, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA.
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3
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Moustafa AF, Quigley KM, Wadden TA, Berkowitz RI, Chao AM. A systematic review of binge eating, loss of control eating, and weight loss in children and adolescents. Obesity (Silver Spring) 2021; 29:1259-1271. [PMID: 34227229 PMCID: PMC8319063 DOI: 10.1002/oby.23185] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This review synthesizes literature on changes in binge eating (BE) and loss of control eating (LOC) following weight loss and the association between BE/LOC and weight loss in children and adolescents. METHODS A systematic literature search was conducted in PubMed, Scopus, and PsycInfo. Eligible studies included all peer-reviewed journal articles of primary research that assessed BE/LOC and weight change following a weight-loss intervention in individuals under 18 years of age. RESULTS The 29 articles included studies on behavioral therapy, pharmacotherapy, and surgical interventions. Of the 14 studies that assessed the relationship between weight loss and BE/LOC at baseline, 4 showed that higher baseline BE/LOC was associated with less weight loss, whereas 10 showed no significant association. BE/LOC behaviors significantly decreased following weight-loss interventions in 20 of 21 studies. A greater decrease in BE/LOC was associated with improved weight loss in 4 of 9 studies that assessed this change. CONCLUSIONS Weight-loss interventions are associated with improved BE/LOC in youth with obesity. The persistence of BE/LOC symptoms may be associated with less weight loss. These results can aid in guiding future treatment for youth with BE/LOC seeking weight-loss treatment.
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Affiliation(s)
| | - Kerry M. Quigley
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Thomas A. Wadden
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
| | - Robert I. Berkowitz
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- The Children’s Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Philadelphia, PA, USA
| | - Ariana M. Chao
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, US
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USA
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4
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Burton ET, Mackey ER, Reynolds K, Cadieux A, Gaffka BJ, Shaffer LA. Psychopathology and Adolescent Bariatric Surgery: A Topical Review to Support Psychologists in Assessment and Treatment Considerations. J Clin Psychol Med Settings 2021; 27:235-246. [PMID: 32333235 DOI: 10.1007/s10880-020-09717-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The rising rates of severe obesity among adolescents in the United States indicate a dire need for more intensive weight management strategies. While current evidence suggests that bariatric surgery is a safe and efficacious intervention for adolescents, the linkages with psychopathology before and after surgery are not well understood. Psychologists are an integral part of the interdisciplinary surgery team and play an important role in preparing youth for bariatric surgery as well as supporting adolescents post-surgery. The present manuscript reviews the literature on psychopathology in the context of adolescent bariatric surgery, discusses consideration of psychopathology as a contraindication for surgery, and provides recommendations on how psychologist members of the bariatric surgery team may balance attention to motivation and adherence to medical recommendations with assessment and treatment of psychopathology. Finally, the importance of continued research to confirm clinical consensus regarding decision-making and expansion of psychological resources within adolescent bariatric surgery programs are discussed.
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Affiliation(s)
- E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, 50 N. Dunlap Street, Room 452R, Memphis, TN, 38103, USA. .,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA.
| | - Eleanor R Mackey
- Center for Translational Research, Children's National Health System, Washington, DC, USA.,Department of Psychiatry and Behavioral Science, The George Washington University School of Medicine, Washington, DC, USA
| | - Kimberly Reynolds
- Institute on Development and Disability, Oregon Health & Science University, Portland, OR, USA
| | - Adelle Cadieux
- Helen DeVos Children's Hospital, Grand Rapids, MI, USA.,Michigan State University, East Lansing, MI, USA
| | - Bethany J Gaffka
- Department of Pediatrics, C.S. Mott Children's Hospital, Michigan Medicine, Ann Arbor, MI, USA
| | - Laura A Shaffer
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA
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Is it possible to improve long-term results of laparoscopic adjustable gastric banding with appropriate patient selection? Wideochir Inne Tech Maloinwazyjne 2020; 15:166-170. [PMID: 32117500 PMCID: PMC7020718 DOI: 10.5114/wiitm.2019.86773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/02/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction The gastric band is still offered as a good bariatric option for highly motivated and carefully selected patients. The question is whether this faith is justified or not. Aim To assess long-term clinical outcomes of patients who underwent laparoscopic adjustable gastric banding (LAGB) at a single bariatric center and to examine variables associated with patients’ adherence to scheduled postoperative appointments. Material and methods A retrospective review of patients who underwent LAGB between 2004 and 2009 was performed. The initial cohort included 167 patients. Data regarding sex, age, preoperative weight, hometown population and distance from the bariatric center, and gastric band volume were collected. Compliance was measured as the number of postoperative appointments. Clinical outcome was defined as percent excess weight loss (%EWL) at the end of the observation period or at band removal. Results The LAGB was performed in 167 patients between 2004 and 2009. The mean follow-up time was 90 ±24 months. Five (3%) patients were lost to follow-up; 37 (22.2%) had their band removed. The remaining 125 (74.8%) patients retained their bands and were included in the analysis. The mean %EWL was 33.0 ±26.6%. Thirty-one (18.6%) patients achieved %EWL > 50%. Conclusions This study found that LAGB was not an effective bariatric procedure in long-term observation. Only 25% of 125 patients who maintained a functioning band achieved %EWL > 50%. Compliance was the only independent prognostic factor for weight loss. Other factors had no influence on outcome.
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Preoperative exercise as a predictor of weight loss in adolescents and young adults following sleeve gastrectomy: a cohort study. Surg Obes Relat Dis 2019; 15:1051-1057. [PMID: 31130404 DOI: 10.1016/j.soard.2019.03.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/12/2019] [Accepted: 03/17/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Preoperative exercise is associated with weight loss following bariatric surgery in adults, but this relationship in adolescents and young adults (AYA) is not well studied. OBJECTIVES The present study examined AYA-reported preoperative exercise and demographic factors and their prediction of percent excess body mass index (BMI) loss at 6 and 12 months following sleeve gastrectomy. SETTING The setting for recruitment and surgeries was in a children's hospital in the United States. METHODS Participants were 173 AYA aged 12-21 years (mean age, 16.5 [SD, 2.0] yr; mean preoperative BMI, 50 [SD, 8.5] kg/m2). Demographic characteristics including age, sex, ethnicity, and preoperative BMI were extracted from the medical record. Preoperatively, adolescents self-reported on exercise using 5 items from the Center for Disease Control's Youth Risk Behavior Surveillance Survey. The study evaluated the association of self-reported preoperative exercise in total and obtained a threshold of higher exercise to weight loss at 6 and 12 months after surgery. RESULTS More preoperative exercise was associated with greater weight loss at 12 months. Grouping participants by those who reported exercising at high levels (≥5 hr/wk) compared with those who reported <5 hr/wk, high levels of exercise predicted greater weight loss at 6 and marginally at 12 months postoperatively. Lower preoperative BMI was a significant predictor of weight loss in all analyses. CONCLUSIONS Preoperative exercise may predict and contribute to weight loss in AYA and could be a target for pre- and postoperative intervention to improve outcomes. The importance of lower preoperative BMI for maximizing postoperative weight loss was also supported.
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Versteegden DPA, Van Himbeeck MJJ, Nienhuijs SW. Assessing the value of eHealth for bariatric surgery (BePatient trial): study protocol for a randomized controlled trial. Trials 2018; 19:625. [PMID: 30428902 PMCID: PMC6237032 DOI: 10.1186/s13063-018-3020-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 10/25/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The expansion of digital devices and widespread access to the Internet has opened up opportunities to provide patients with more personal information. It can be hypothesized that eHealth in addition to standard care could enhance clinical outcomes such as increased weight loss, co-morbidity reduction, and commitment to the program. The beneficial value of incorporating eHealth applications as standard postoperative care is yet to be established. In this trial, the value of different levels of eHealth are assessed. METHODS/DESIGN Two hundred adult patients with a body mass index (BMI) ≥ 40 kg/m2, or ≥ 35 kg/m2 with obesity-related co-morbidity, undergoing sleeve gastrectomy or gastric bypass will be enrolled in this randomized controlled trial. Patients will be randomly assigned to one of the groups: receiving standard care (control group, n = 100); have access to an online eHealth platform in addition to the previous group (online group, n = 50); or receive wireless monitoring devices in addition to previous groups (device group, n = 50). The total follow-up period is two years postoperatively. Primary outcome is weight loss in terms of BMI. Secondary outcomes include: quality of life; return-to-work time; co-morbidity reduction; additional contacts; and ease of use of devices. DISCUSSION In this trial, the value of different levels of eHealth will be assessed. This addresses an important aspect of a changing healthcare environment. TRIAL REGISTRATION Trialregister.nl, NTR6827. Retrospectively registered on 19 November 2017. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6827 .
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Affiliation(s)
- Dirk P A Versteegden
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands.
| | - Magaly J J Van Himbeeck
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands
| | - Simon W Nienhuijs
- Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, the Netherlands
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8
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Perceived Social Support for Exercise and Weight Loss in Adolescents Undergoing Sleeve Gastrectomy. Obes Surg 2018; 28:421-426. [PMID: 28770423 DOI: 10.1007/s11695-017-2853-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery. METHOD Participants were 101 adolescents ages 12-21 (M age = 16.6, SD = 1.8). Pre-operative body mass index (BMI) ranged from 35 to 87 (M = 50.3, SD = 8.6). Structural equation modeling (SEM) was used to evaluate a model of the association of adolescent report of perceived social support for exercise with less binge eating (items from the Eating Disorder Diagnostic Scale) and more self-reported exercise (items from the Youth Risk Behavior Surveillance System). The model was used to predict EBMI loss at 3, 6, 9, and 12 months post-surgery. RESULTS Social support significantly predicted exercise and demonstrated a trend for predicting binge eating, such that more social support was associated with more exercise and a trend for less binge eating. Binge eating was associated with less EBMI loss. However, there was no association of exercise with EBMI loss. CONCLUSIONS Pre-operative binge eating should be a target for identification and treatment prior to sleeve gastrectomy in adolescents. Although not directly or indirectly associated with EBMI loss, perceived social support around exercise was associated with increased exercise, which may make it a consideration for a target for intervention as well.
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9
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Christon LM, Weber A, Lesher A, Crowley N, Jones M, Byrne TK, Wedin S. Transition Readiness in Adolescents with Severe Obesity Presenting for Bariatric and Metabolic Surgery. Bariatr Surg Pract Patient Care 2018. [DOI: 10.1089/bari.2018.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lillian M. Christon
- Division of Bio-Behavioral Medicine, Department of Psychiatry and Behavioral Sciences, Institute of Psychiatry, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Aimee Weber
- Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Aaron Lesher
- Department of Surgery and Pediatrics, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Nina Crowley
- Department of Surgery, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Molly Jones
- Department of Surgery, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Thomas Karl Byrne
- Department of Surgery, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
| | - Sharlene Wedin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, College of Medicine, Charleston, South Carolina
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Pratt JSA, Browne A, Browne NT, Bruzoni M, Cohen M, Desai A, Inge T, Linden BC, Mattar SG, Michalsky M, Podkameni D, Reichard KW, Stanford FC, Zeller MH, Zitsman J. ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surg Obes Relat Dis 2018; 14:882-901. [PMID: 30077361 PMCID: PMC6097871 DOI: 10.1016/j.soard.2018.03.019] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 12/11/2022]
Abstract
The American Society for Metabolic and Bariatric Surgery Pediatric Committee updated their evidence-based guidelines published in 2012, performing a comprehensive literature search (2009-2017) with 1387 articles and other supporting evidence through February 2018. The significant increase in data supporting the use of metabolic and bariatric surgery (MBS) in adolescents since 2012 strengthens these guidelines from prior reports. Obesity is recognized as a disease; treatment of severe obesity requires a life-long multidisciplinary approach with combinations of lifestyle changes, nutrition, medications, and MBS. We recommend using modern definitions of severe obesity in children with the Centers for Disease Control and Prevention age- and sex-matched growth charts defining class II obesity as 120% of the 95th percentile and class III obesity as 140% of the 95th percentile. Adolescents with class II obesity and a co-morbidity (listed in the guidelines), or with class III obesity should be considered for MBS. Adolescents with cognitive disabilities, a history of mental illness or eating disorders that are treated, immature bone growth, or low Tanner stage should not be denied treatment. MBS is safe and effective in adolescents; given the higher risk of adult obesity that develops in childhood, MBS should not be withheld from adolescents when severe co-morbidities, such as depressed health-related quality of life score, type 2 diabetes, obstructive sleep apnea, and nonalcoholic steatohepatitis exist. Early intervention can reduce the risk of persistent obesity as well as end organ damage from long standing co-morbidities.
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Affiliation(s)
- Janey S A Pratt
- Lucille Packard Children's Hospital and Stanford University School of Medicine Stanford, California.
| | - Allen Browne
- Diplomate American Board of Obesity Medicine Falmouth, Maine
| | - Nancy T Browne
- WOW Pediatric Weight Management Clinic, EMMC, Orono, Maine
| | - Matias Bruzoni
- Lucille Packard Children's Hospital and Stanford University School of Medicine Stanford, California
| | - Megan Cohen
- Nemours/Alfred I. DuPont Hospital for Children Wilmington, Delaware
| | | | - Thomas Inge
- University of Colorado, Denver and Children's Hospital of Colorado Aurora, Colorado
| | - Bradley C Linden
- Pediatric Surgical Associates and Allina Health Minneapolis, Minnesota
| | - Samer G Mattar
- Swedish Weight Loss Services Swedish Medical Center Seattle, Washington
| | - Marc Michalsky
- Nationwide Children's Hospital and The Ohio State University Columbus, Ohio
| | - David Podkameni
- Banner Gateway Medical Center and University of Arizona Phoenix, Arizona
| | - Kirk W Reichard
- Nemours/Alfred I. DuPont Hospital for Children Wilmington, Delaware
| | - Fatima Cody Stanford
- Diplomate American Board of Obesity Medicine Massachusetts General Hospital and Harvard Medical School Boston, Massachusetts
| | - Meg H Zeller
- Cincinnati Children's Hospital Medical Center Cincinnati, Ohio
| | - Jeffrey Zitsman
- Morgan Stanley Children's Hospital of NY Presbyterian and Columbia University Medical Center New York, New York
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Hood MM, Kelly MC, Feig EH, Webb V, Bradley LE, Corsica J. Measurement of adherence in bariatric surgery: a systematic review. Surg Obes Relat Dis 2018; 14:1192-1201. [PMID: 29853195 DOI: 10.1016/j.soard.2018.04.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
After bariatric surgery, rates of adherence to behavioral recommendations, including attending regular appointments and following specific dietary, physical activity, and vitamin use recommendations, tend to be highly variable across studies. Lack of consistency in measurement of adherence is a likely contributor to this variability, making it challenging to determine the prevalence and impact of nonadherence in this population. PubMed was searched for articles measuring behavioral adherence or compliance in patients after bariatric surgery, resulting in 85 articles. Articles were reviewed for the definition and measurement of adherence in each area (appointment attendance, as well as dietary, physical activity, and vitamin use adherence), and on the use and reporting of recommended adherence measurement strategies. Over half of the articles measured adherence to appointment attendance. Significant variability was found across adherence definitions and measurement methods, and use of recommended adherence measurement strategies was poor. Adherence was mostly commonly measured via self-report (either verbal or written) using cutoffs for adherent versus nonadherent behavior. Over half of studies assessed adherence up to ≥2 years postsurgery. Recommendations for ways to improve adherence measurement in patients who have had bariatric surgery are outlined.
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Affiliation(s)
- Megan M Hood
- Rush University Medical Center, Chicago, Illinois.
| | | | - Emily H Feig
- Rush University Medical Center, Chicago, Illinois
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12
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Hood MM, Corsica J, Bradley L, Wilson R, Chirinos DA, Vivo A. Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. J Behav Med 2016; 39:1092-1103. [PMID: 27444752 DOI: 10.1007/s10865-016-9772-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/12/2016] [Indexed: 01/11/2023]
Abstract
Severe obesity (body mass index ≥40 kg/m2) is a chronic disease that is associated with significantly increased risk of serious and chronic health problems as well as impaired quality of life. For those with severe obesity, bariatric surgery is the most effective treatment for significant and long-term weight loss and resolution of comorbid medical conditions, particularly diabetes. Long-term success is thought to depend to some degree on the patient's ability to adhere to a complex set of behaviors, including regular attendance at follow up appointments and following stringent dietary, exercise, and vitamin recommendations. Here, we summarize the current research on behavioral adherence in patients with severe obesity presenting for bariatric surgery and we highlight challenges and make recommendations for improved self-management before and after surgery.
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Affiliation(s)
- Megan M Hood
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA.
| | - Joyce Corsica
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Lauren Bradley
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Rebecca Wilson
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Diana A Chirinos
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Amanda Vivo
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
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13
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Hopkins JCA, Blazeby JM, Rogers CA, Welbourn R. The use of adjustable gastric bands for management of severe and complex obesity. Br Med Bull 2016; 118:64-72. [PMID: 27034443 PMCID: PMC5127420 DOI: 10.1093/bmb/ldw012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obesity levels in the UK have reached a sustained high and ∼4% of the population would be candidates for bariatric surgery based upon current UK NICE guidelines, which has important implications for Clinical Commissioning Groups. SOURCES OF DATA Summary data from Cochrane systematic reviews, randomized controlled trials (RCTs) and cohort studies. AREAS OF AGREEMENT Currently, the only treatment that offers significant and durable weight loss for those with severe and complex obesity is surgery. Three operations account for 95% of all bariatric surgery in the UK, but the NHS offers surgery to only a small fraction of those who could benefit. Laparoscopic adjustable gastric banding (gastric banding) has potentially the lowest risk and up-front costs of the three procedures. AREAS OF CONTROVERSY Reliable Level 1 evidence of the relative effectiveness of the operations is lacking. GROWING POINTS As a point intervention, weight loss surgery together with the chronic disease management strategy for obesity can prevent significant future disease and mortality, and the NHS should embrace both. AREAS TIMELY FOR DEVELOPING RESEARCH Better RCT evidence is needed including clinical effectiveness and economic analysis to answer the important question 'which is the best of the three operations most frequently performed?' This review considers the current evidence for gastric banding for the treatment of severe and complex obesity.
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Affiliation(s)
- James C A Hopkins
- Department of Upper Gastrointestinal Surgery and Bariatric Surgery, Musgrove Park Hospital, Taunton TA1 5DA, UK
| | - Jane M Blazeby
- Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Chris A Rogers
- Clinical Trials and Evaluation Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Richard Welbourn
- Department of Upper Gastrointestinal Surgery and Bariatric Surgery, Musgrove Park Hospital, Taunton TA1 5DA, UK
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Khen-Dunlop N, Dabbas M, De Filippo G, Jais JP, Hervieux E, Télion C, Chevallier JM, Michel JL, Aigrain Y, Bougnères P, Goulet O, Révillon Y. Primordial Influence of Post-operative Compliance on Weight Loss After Adolescent Laparoscopic Adjustable Gastric Banding. Obes Surg 2015; 26:98-104. [PMID: 26058753 DOI: 10.1007/s11695-015-1725-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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