Perceived child weight status, family structure and functioning, and support for health behaviors in a sample of bariatric surgery patients

INTRODUCTION

The purpose of this study is to describe the associations between bariatric surgery patients' perspectives of their child's weight status, family support for eating and exercise behavior change, and family structure and functioning.

METHOD

A cross-sectional descriptive design with pre- and postsurgery (N = 224) patients was used. Demographics, perceptions of child weight status, family support for eating habits and exercise, and family functioning were assessed from patients at a University Bariatric Clinic.

RESULTS

Patients who perceived their child to be overweight/obese reported more impaired family functioning, less family exercise participation, and more discouragement for eating habit change in the family compared to patients who did not perceive their child to be overweight/obese. Single parents more often perceived their children to be overweight/obese, and had more impaired family functioning, and less support for changing eating habits and family exercise participation. Patients with impaired family functioning reported less support for changing eating habits and family exercise participation.

DISCUSSION

Bariatric patients who perceived their child to be overweight/obese and identified as single parents reported more impaired family functioning and less support for eating habits and family participation in exercise. Assessing pre- and postsurgery measures from parents and children will allow the further identification of relationship variables that can be targeted to promote positive family changes that benefit parents and children long-term. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Associations Between Romantic Relationship Factors and Body Mass Index Among Weight Loss Surgery Patients

The current study utilized a sample of 183 patients, in romantic relationships, who were either pre- or post-weight loss surgery (WLS), to assess (a) associations between romantic relationship factors and pre- and post-surgery body mass index (BMI), (b) the positive and negative influences of obesity in romantic relationships, and (c) the influence of romantic relationship factors on BMI and the reciprocal. Correlations, confirmatory factor analysis, and multiple linear regression were conducted. Patients endorsed greater negative influence of obesity in their romantic relationships compared to positive influences, and their romantic relationship quality was predicted by several variables, including BMI, in pre- and post-surgery patient groups.

Adult weight management patients' perceptions of family dynamics and weight status

Our overall objective was to describe the parent-child, romantic, and family dynamics of adult weight management program (WMP) patients, and associations with children's and partners' weight status. First, we determined if family functioning mediated the effect between parent-child feeding practices and perceived child weight status, and romantic relationship anxiety and avoidance and perceived partner weight status. Second, we assessed if perceived child and partner weight status moderated the associations between family functioning and parent-child feeding practices and romantic relationship anxiety and avoidance, respectively. Patients (N=203) who resided with a child and partner from two WMPs completed assessments of parent-child feeding practices (Child Feeding Questionnaire), romantic relationship anxiety and avoidance (Relationship Structures Questionnaire), family functioning (Family Assessment Device General Functioning Scale), and perceived child and partner weight status. Bivariate analyses determined differences in weight status and relationship dynamics and family functioning, and mediation and moderation analyses were conducted to answer the two research questions. Family functioning was not a mediator between romantic relationship dynamics and partner weight status or parent-child dynamics and child weight status. Lower family functioning was associated with higher parent-child restrictive feeding practices, only among children with overweight/obesity. Similarly, lower family functioning was associated with higher anxiety and avoidance in romantic relationships, only for partners with overweight/obesity. Patients with children and/or partners with overweight/obesity reported more impaired family dynamics and functioning, compared to patients with children and/or partners with a healthy weight status.

Postoperative outcomes based on patient participation in a presurgery education and weight management program

BACKGROUND

The benefits of presurgery weight management programs (WMPs) for bariatric patients are mixed; some show a positive impact on percent excess weight loss (%EWL) at 12 months postsurgery, while others show no effect.

OBJECTIVES

The purpose of this study was to compare pre- and postoperative 6- and 12-month outcomes between patients who attended a 12-week presurgery WMP and patients who did not participate.

SETTING

Ohio State Wexner Medical Center, University Hospital, United States.

METHODS

A retrospective medical record analysis was conducted to compare preoperative and 6- and 12-month postoperative outcomes for patients who attend the presurgery WMP (n = 56) and patients who did not (n = 441) within a 2-year time period (N = 497). Descriptive statistics and independent t tests were conducted to determine mean differences between groups, while controlling for surgery type, for weight status outcomes (%EWL, change in body mass index) preoperatively and 6 and 12 months postsurgery, and length of stay and readmission rate.

RESULTS

Patients who attended the preoperative WMP had significantly higher %EWL at 12 months postsurgery compared with patients who did not attend the WMP. Additional findings indicated a positive, but nonsignificant effect, from the WMP on presurgery body mass index, and postsurgery %EWL at 6 months and body mass index change at 6 and 12 months postsurgery.

CONCLUSIONS

Patients attending the WMP had better 12-month %EWL and outcomes compared with those who did not attend the WMP, though this was not true for 6-month outcomes and differed based on surgery type.

Bariatric Surgery Candidates' Peer and Romantic Relationships and Associations with Health Behaviors

BACKGROUND

The aim was to assess the romantic and peer relationships of bariatric surgery candidates and associations with health behaviors.

METHOD

Adults seeking bariatric surgery (N = 120) completed surveys addressing health behaviors and social relationships at information sessions. Analysis was done to compare male/female differences in peer and romantic relationships and associations with health behaviors. Previously published reference (REF) data on the Relationship Structures questionnaire was used for comparison, and to split our sample into those ≤ or > REF mean for relationship anxiety and avoidance.

RESULTS

Our sample reported higher avoidance and lower anxiety in their close friendships and romantic relationships compared to the REF sample. Men in our sample had higher peer and romantic relationships avoidance compared to the REF sample and had significantly higher close friendship avoidance than women in our sample. Participants with lower anxiety in their romantic relationships (≤ REF) had higher uncontrolled eating and physical activity; those with more anxiety in their romantic relationships (> REF) had a higher BMI.

CONCLUSIONS

Our findings highlight the potential influence that social relationships may have on health behaviors within the bariatric surgery population. Further investigation is warranted to explore male bariatric surgery candidates' relationships to inform understanding and intervention development.

The Family System and Depressive Symptoms during the College Years: Triangulation, Parental Differential Treatment, and Sibling Warmth as Predictors

Guided by Bowen theory, we investigated the relationships between parent-child triangulation, parental differential treatment (PDT), sibling warmth, and individual depressive symptoms in a sample of 77 sibling dyads, aged 18-25 years, recruited through undergraduate classes at a U.S. public University. Results of the actor-partner interdependence models suggested that being triangulated into parental conflict was positively related to both siblings' perception of PDT; however, as one sibling felt triangulated, the other perceived reduced levels of PDT. For both siblings, the perception of higher levels of PDT was related to decreased sibling warmth and higher sibling warmth was associated with fewer depressive symptoms. The implications of these findings for research and the treatment of depression in the college-aged population are discussed.

Marriage and Family Therapy Trainees' Reports of Explicit Weight Bias

Discrimination based on an individual's weight has been observed in health care, education, retail, and other public sectors (Puhl & Huer, Obesity, 17, 941, 2007). Such inequity, known as "weight bias," generates negative short-term and long-term consequences for the individuals that experience it (Puhl & Brownell, Weight bias in health care settings, 2007). Past research has shown that healthcare trainees exhibit weight bias (Phelan et al., Obesity, 22, 1201, 2014; Wigton & McGaghie, Journal of General Internal Medicine, 16, 262, 2001), yet little focus is given to weight bias in marriage and family therapy (MFT) education. The purpose of this study was to survey MFT students (N = 162) to explore weight bias and how contextual factors associate with weight bias. Participants in MFT programs reported explicit weight bias, with specific contextual factors associating with more bias. Female participants reported more fear of gaining weight, and individuals who identified as overweight had higher rates of explicit weight bias. Contextual differences and implications for training programs are discussed.

Dimensions of attachment and commitment across the transition to parenthood

We used structural equation modeling and actor-partner interdependence models to test dyadic associations between adult attachment and changes in relationship commitment at the transition to parenthood in a sample of 182 dual-earner couples. Overall, more avoidant individuals experienced significant changes in commitment at the transition to parenthood; specifically, higher avoidance was associated with decreases in personal confidence and dedication. More anxious fathers experienced increases in personal felt constraint while anxious mothers' commitment remained stable. Partners of more anxious individuals experienced changes in commitment at the transition to parenthood. Higher anxiety was associated with decreases in partners' confidence and dedication and increases in partners' felt constraint. These results suggest that interventions focused on couple relationships at the transition to parenthood should address commitment as well as relationship skills and explore how adult attachment may influence the parents' reactions to stress during this disruptive transition. Future research should examine whether commitment levels recover once the initial stress of the transition to parenthood decreases and family roles and routines renegotiated.