Changes in eating behaviour and food choices in families where the mother undergoes gastric bypass surgery for obesity

Changes in Parent and Child Skin Carotenoids, Weight, and Dietary Behaviors over Parental Weight Management

(1) The objective was to determine changes in parent-child (ages 7-18) dyad skin carotenoids spanning parental participation in a medical weight management program (WMP), and associations with parent BMI, child BMIz, fruit/vegetable intake, and family meals and patterns. (2) The study design was a longitudinal dyadic observational study with assessment at WMP initiation, mid-point (3-months), and conclusion (6-months). Twenty-three dyads initiated the study, 16 provided assessments at 3 months, and 11 at program conclusion. Associations between parent and child carotenoids (dependent variables) and parent BMI, child BMIz, increases in fruit/vegetable intake, and family meals and patterns were analyzed using Pearson's correlations and independent samples t-tests. Repeated measures ANOVA assessed changes in weight status and carotenoids. (3) Parents experienced significant declines in BMI and skin carotenoid levels over 6 months. Parent and child carotenoids were correlated at each assessment. At initiation, parent BMI and carotenoids were inversely correlated, child carotenoids were associated with increased family meals, and never consuming an evening fast food or restaurant meal were associated with increased parent and child carotenoids. (4) Results demonstrate skin carotenoids are strongly correlated within dyads and may be associated with lower parental BMI and positive family meal practices.

Change in emotional eating after bariatric surgery: systematic review and meta-analysis

BACKGROUND

The effect of bariatric surgery on 'emotional eating' (EE) in people with obesity is unclear. This systematic review and meta-analysis aimed to examine changes in self-reported emotional eating behaviour after bariatric surgery.

METHODS

Fifteen electronic databases were searched from inception to August 2019. Included studies encompassed patients undergoing primary bariatric surgery, quantitatively assessed EE, and reported EE scores before and after surgery in the same participants. Studies were excluded if they were not in English or available in full text. The systematic review and meta-analysis were conducted according to the PRISMA guidelines. Random-effects models were used for quantitative analysis. Study quality was assessed using the National Heart, Lung, and Blood Institute quality assessment tool for before-after (pre-post) studies with no control group.

RESULTS

Some 23 studies containing 6749 participants were included in the qualitative synthesis, with follow-up of from 2 weeks to 48 months. EE scores decreased to 12 months after surgery. Results were mixed beyond 12 months. Quantitative synthesis of 17 studies (2811 participants) found that EE scores decreased by a standardized mean difference of 1·09 (95 per cent c.i. 0·76 to 1·42) 4-18 months after surgery, indicating a large effect size.

CONCLUSION

Bariatric surgery may mitigate the tendency to eat in response to emotions in the short to medium term.

Change in Children's Self-Concept, Body-Esteem, and Eating Attitudes Before and 4 Years After Maternal RYGB

Introduction

The aim of the present study was to look at longitudinal changes in children’s self-concept, body-esteem, and eating attitudes before and 4 years after maternal RYGB surgery.

Methods

Sixty-nine women and 81 appurtenant children were recruited from RYGB waiting lists at 5 hospitals in Sweden. Families were visited at home pre-surgery, 9 months, and 4 years post-maternal RYGB to measure BMI. Furthermore, all participating family members completed questionnaires. Mothers’ questionnaires measured eating behavior, depression, anxiety, and sleep quality, and children’s questionnaires measured body-esteem, self-concept, and eating attitudes.

Results

Thirty-five/sixty-nine mothers and 43/81 children participated in all 3 measurements. Mothers reduced their BMI from pre-surgery (39.2) to 9 months (27.0) and 4 years post-surgery (27.4). Children’s prevalence of overweight/obesity was lower 9 months post-surgery (48.8%) but at the same levels again 4 years post-surgery (58.1%), compared to pre-surgery (58.1%). The same rebound pattern was seen among children’s eating attitudes, mothers’ symptoms of depression and anxiety, and sleep quality. We found no correlations between mothers’ BMI or eating behavior and children’s BMI or eating behavior.

Conclusion

Children’s prevalence of overweight/obesity and eating attitudes improves soon after their mothers’ RYGB, but then return to pre-surgery levels at 4 years post-surgery, as do mothers’ sleep quality and symptoms of depression and anxiety, even though their weight loss was maintained.

Electronic supplementary material

The online version of this article (10.1007/s11695-018-3348-z) contains supplementary material, which is available to authorized users.

Parental correlates of food parenting practices: socioeconomic status, weight, and dieting status

Little research has considered how parents' socioeconomic indicators, body mass index (BMI), and dieting status relate to their food parenting. The current study used self-report data from parents of young children to examine group differences on three types of food parenting practices (Structure, Coercive Control, and Autonomy Promotion). Few group differences were found for socioeconomic indicators. However, parent dieting status moderated effects of parent BMI on structure and autonomy promotion. Obese, non-dieting parents reported lower scores on both variables. More research is needed to better understand how parents' dieting status moderates the effects of parent's weight.

A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery: study protocol for a randomized controlled trial

Background

Roux-en-Y gastric bypass (RYGB) surgery is the most common bariatric procedure in Sweden and results in substantial weight loss. Approximately one year post-surgery weight regain for these patient are common, followed by a decrease in health related quality of life (HRQoL) and physical activity (PA). Our aim is to investigate the effects of a dissonance-based intervention on HRQoL, PA and other health-related behaviors in female RYGB patients 24 months after surgery. We are not aware of any previous RCT that has investigated the effects of a similar intervention targeting health behaviors after RYGB.

Methods

The ongoing RCT, the “WELL-GBP”-trial (wellbeing after gastric bypass), is a dissonance-based intervention for female RYGB patients conducted at five hospitals in Sweden. The participants are randomized to either control group receiving usual follow-up care, or to receive an intervention consisting of four group sessions three months post-surgery during which a modified version of the Stice dissonance-based intervention model is used. The sessions are held at the hospitals, and topics discussed are PA, eating behavior, social and intimate relationships. All participants are asked to complete questionnaires measuring HRQoL and other health-related behaviors and wear an accelerometer for seven days before surgery and at six months, one year and two years after surgery. The intention to treat and per protocol analysis will focus on differences between the intervention and control group from pre-surgery assessments to follow-up assessments at 24 months after RYGB. Patients’ baseline characteristics are presented in this protocol paper.

Discussion

A total of 259 RYGB female patients has been enrolled in the “WELL-GBP”-trial, of which 156 women have been randomized to receive the intervention and 103 women to control group. The trial is conducted within a Swedish health care setting where female RYGB patients from diverse geographical areas are represented. Our results may, therefore, be representative for female RYGB patients in the country as a whole. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.

Trial registration

The trial was registered on February 23th 2015 with registration number ISRCTN16417174.