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All in the Family: Child and Adolescent Weight Loss Surgery in the Context of Parental Weight Loss Surgery. CHILDREN 2021; 8:children8110990. [PMID: 34828703 PMCID: PMC8620201 DOI: 10.3390/children8110990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/24/2021] [Accepted: 10/25/2021] [Indexed: 12/05/2022]
Abstract
Background: Bariatric surgery is the most effective current treatment option for patients with severe obesity. More children and adolescents are having surgery, many whose parents have also had surgery. The current study examines whether parental surgery status moderates the association between perceived social support, emotional eating, food addiction and weight loss following surgery, with those whose parents have had surgery evidencing a stronger relationship between the psychosocial factors and weight loss as compared to their peers. Methods: Participants were 228 children and adolescents undergoing sleeve gastrectomy between 2014 and 2019 at one institution. Children and adolescents completed self-report measures of perceived family social support, emotional eating, and food addiction at their pre-surgical psychological evaluation. Change in body mass index (BMI) from pre-surgery to 3, 6, and 12 months post-surgery was assessed at follow-up clinic visits. Parents reported their surgical status as having had surgery or not. Results: There were no differences in perceived family support, emotional eating, or food addiction symptoms between those whose parents had bariatric surgery and those whose parents did not. There were some moderating effects of parent surgery status on the relationship between social support, emotional eating/food addiction, and weight loss following surgery. Specifically, at 3 months post-surgery, higher change in BMI was associated with lower perceived family support only in those whose parents had not had surgery. More pre-surgical food addiction symptoms were associated with greater weight loss at 3 months for those whose parents had not had surgery, whereas this finding was true only for those whose parents had surgery at 12 months post-surgery. Conclusions: Children and adolescents whose parents have had bariatric surgery may have unique associations of psychosocial factors and weight loss. More research is needed to determine mechanisms of these relationships.
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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] [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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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: 5] [Impact Index Per Article: 1.7] [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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Franklin EV, Klement J, Mulpuri N, Qureshi FG. Mental health factors associated with progression to adolescent metabolic and bariatric surgery. Surg Obes Relat Dis 2021; 17:1855-1863. [PMID: 34281804 DOI: 10.1016/j.soard.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/15/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND While bariatric surgery has demonstrated significant weight loss for adolescents with severe obesity, only a limited number of adolescents referred to surgery successfully complete the surgical program. Better identification of pre-surgical factors, especially mental health factors, associated with completing bariatric surgery may determine successful referrals to surgical programs versus alternative behavioral health interventions. OBJECTIVES The primary objective of this article was to investigate the relationship between presurgical mental health factors and whether or not a patient received bariatric surgery within the first six months of entering the program. SETTING Pediatric Children's Hospital, Bariatric Surgery Program within Pediatric Surgery Department. METHODS A retrospective medical record review of all patients referred from 2016 to 2019 to an adolescent surgical weight loss program was conducted. Patients were determined as completers if they received a laparoscopic sleeve gastrectomy within 6 months of entering the program. Demographic and preoperative mental health factors among completers (n = 30) were compared with surgery noncompleters (n = 44) using enter method logistic regression. RESULTS Regression analyses revealed that younger patients, White patients, patients with lower internalizing symptoms on a standardized measure, and patients with greater self-reported motivation for surgery at their initial surgery visit were more likely to obtain surgery within 6 months of starting the program. CONCLUSION The findings underscore the importance of assessing patients' motivation early in the bariatric surgery referral process. This study highlights potential treatment implications in how best to mitigate patient barriers, such as internalizing symptoms and low motivation, to pursue bariatric surgery and remain committed to weight loss goals through techniques such as motivational interviewing.
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Affiliation(s)
| | - Jessica Klement
- University of Texas Southwestern Medical School, Department of Pediatrics and Surgery, Dallas, Texas
| | - Neha Mulpuri
- University of Texas Southwestern Medical School, Department of Pediatrics and Surgery, Dallas, Texas
| | - Faisal G Qureshi
- University of Texas Southwestern Medical School, Department of Pediatrics and Surgery, Dallas, Texas
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5
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Social Support for People with Morbid Obesity in a Bariatric Surgery Programme: A Qualitative Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126530. [PMID: 34204427 PMCID: PMC8297395 DOI: 10.3390/ijerph18126530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022]
Abstract
Background—Morbid obesity (MO) is a chronic metabolic disease affecting physical, psychological and social wellbeing. Bariatric surgery is a reliable method for losing weight in the long term, improving the quality of life, body image and social life of people with MO. Current literature recognises the importance of social support in controlling weight and coping with MO. The objective of this study was to describe and understand experiences related to social support for patients with MO included in a bariatric surgery programme. Methods—A qualitative descriptive study, where data collection included thirty-one interviews with people diagnosed with MO involved in a bariatric surgery programme. Results—Three main themes emerged from the analysis: (1) accepting the problem in order to ask for help, (2) the need for close support and (3) professional support: opposing feelings. Conclusions—A partner, family and friends are the key pillars of social support for those with MO included in a bariatric surgery programme. Healthcare professionals gave formal support; the bariatric surgery team provided information, trust and assurance. Nurses provided healthcare 24 h a day, making them the main formal support for people in the bariatric surgery programme.
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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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7
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Moore JM, Haemer MA, Fox CK. Lifestyle and pharmacologic management before and after bariatric surgery. Semin Pediatr Surg 2020; 29:150889. [PMID: 32238284 PMCID: PMC8456424 DOI: 10.1016/j.sempedsurg.2020.150889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
As metabolic and bariatric surgery (MBS) increasingly becomes a treatment of choice for adolescents with severe obesity, there is a need to understand how to deliver pre- and postoperative care in ways that maximize long-term safety and efficacy. This article describes major pre- and postoperative goals, lifestyle modification targets, and, when necessary, pharmacologic management strategies for adolescents undergoing MBS. Three categories of evidence were used-studies of pre- and postoperative interventions and factors influencing MBS outcomes in adolescents, studies of pre- and postoperative associations and interventions in adults, and studies of non-surgical weight management applicable to adolescents pursuing MBS. Finally, priority areas for future research within this topic are identified.
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Affiliation(s)
- Jaime M Moore
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States.
| | - Matthew A Haemer
- Department of Pediatrics, Section of Nutrition, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States
| | - Claudia K Fox
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, University of Minnesota Medical School, Minneapolis, MN 55455, United States
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8
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Lee K, Lee K. Relationship of Friend/Parent Exercise Participation Levels and Adolescents' Exercise Intention/Behavior as Moderated by Action Control. Percept Mot Skills 2020; 127:347-366. [PMID: 31959077 DOI: 10.1177/0031512519900058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigated the role of action control in the relationship between friend and parent exercise participation levels with adolescents’ exercise intention and behavior, based on the theory of planned behavior. Data were collected from 740 Korean adolescents through questionnaires that assessed the exercise participation level of these participants’ parents and friends, and the adolescent participants’ personal exercise intention, exercise behavior, action control, and exercise constraints. The results showed that the exercise participation level of friends, but not of parents, mediated the adolescents’ exercise behavior through their exercise intention. This relationship was magnified by higher levels of the adolescents’ action control.
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Affiliation(s)
- Keunchul Lee
- Department of Physical Education, Changwon National University, South Korea
| | - Kanghun Lee
- Department of Physical Education, Changwon National University, South Korea
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9
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Messiah SE, Sacher PM, Yudkin J, Qureshi FG, Hoelscher DM, Barlow SE. Partnering Support Interventions with Bariatric Surgery to Maximize Health Outcomes in Adolescents with Severe Obesity. Obesity (Silver Spring) 2019; 27:1784-1795. [PMID: 31562699 DOI: 10.1002/oby.22612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 06/19/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Rates of adolescents with severe obesity continue to rise worldwide, with concurrent increases in metabolic and bariatric surgery (MBS) uptake. The gap between support (lifestyle, pharmacotherapy) interventions and MBS as treatment options for adolescents has been understudied. This review, couched in a socio-ecological framework, investigates how support interventions for adolescents with severe obesity could be combined or sequenced with MBS to optimize health outcomes. METHODS A comprehensive search revealed 36 published articles between 1995 and 2019 that included the combination of support interventions and MBS among adolescents. RESULTS There were no studies that specifically reported outcomes or effect sizes for the combination of lifestyle intervention with MBS. Previous studies have reported individual results for either lifestyle intervention or MBS but not for their compound effect. CONCLUSIONS As rates of adolescents with severe obesity are on the rise globally, future research should focus on how partnering support interventions with MBS can amplify positive short- and long-term health outcomes and within a socio-ecological framework. Understanding the sequence of these approaches will be of particular importance. High-risk and vulnerable populations such as ethnic minorities who have suffered a disproportionate burden of the obesity epidemic must be included in rigorously tested future trials of combination interventions to maximize health outcomes worldwide.
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Affiliation(s)
- Sarah E Messiah
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
| | - Paul M Sacher
- Childhood Nutrition Research Centre, University College London, London, UK
| | - Joshua Yudkin
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
| | - Faisal G Qureshi
- Division of Pediatric Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Deanna M Hoelscher
- University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, Texas, USA
- Michael & Susan Dell Center for Healthy Living, School of Public Health, University of Texas Health Science Center at Houston, Austin, Texas, USA
| | - Sarah E Barlow
- Division of Pediatric Gastroenterology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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10
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Meyers PM, Leeds IL, Enumah ZO, Burkhart RA, He J, Haut ER, Efron JE, Johnston FM. Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery. Surgery 2019; 166:177-183. [DOI: 10.1016/j.surg.2019.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/08/2019] [Accepted: 04/20/2019] [Indexed: 01/03/2023]
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11
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Khoursheed M, Al-Bader I, Mouzannar A, Ashraf A, Al-Haddad A, Sayed A, Alsalim A, Fingerhut A. Laparoscopic Sleeve Gastrectomy for Morbid Obesity in Kuwaiti Adolescents. Bariatr Surg Pract Patient Care 2019. [DOI: 10.1089/bari.2018.0048] [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)
- Mousa Khoursheed
- Department of Surgery, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Ibtisam Al-Bader
- Department of Surgery, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Ali Mouzannar
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Aqeel Ashraf
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | | | - Ali Sayed
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Ahmad Alsalim
- Department of Surgery, Mubarak Hospital, Kuwait City, Kuwait
| | - Abe Fingerhut
- Department of Surgery, Surgical Research Unit Graz, Medical University of Graz, Graz, Austria
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12
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The Maturation of Research on Psychosocial Outcomes Among Adolescents Receiving Bariatric Surgery. J Adolesc Health 2018; 63:127-128. [PMID: 30149921 DOI: 10.1016/j.jadohealth.2018.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 11/23/2022]
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13
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Leeds IL, Efron DT, Lehmann LS. Surgical Gatekeeping - Modifiable Risk Factors and Ethical Decision Making. N Engl J Med 2018; 379:389-394. [PMID: 30044939 DOI: 10.1056/nejmms1802079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Ira L Leeds
- From the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (I.L.L., D.T.E.); the National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC (L.S.L.); and Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston (L.S.L.)
| | - David T Efron
- From the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (I.L.L., D.T.E.); the National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC (L.S.L.); and Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston (L.S.L.)
| | - Lisa S Lehmann
- From the Department of Surgery, Johns Hopkins University School of Medicine, Baltimore (I.L.L., D.T.E.); the National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC (L.S.L.); and Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston (L.S.L.)
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14
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Cottam S, Cottam D, Cottam A, Zaveri H, Surve A, Richards C. The Use of Predictive Markers for the Development of a Model to Predict Weight Loss Following Vertical Sleeve Gastrectomy. Obes Surg 2018; 28:3769-3774. [DOI: 10.1007/s11695-018-3417-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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15
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Mackey ER, Wang J, Harrington C, Nadler EP. Psychiatric Diagnoses and Weight Loss Among Adolescents Receiving Sleeve Gastrectomy. Pediatrics 2018; 142:peds.2017-3432. [PMID: 29858452 DOI: 10.1542/peds.2017-3432] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/17/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Severe obesity is associated with higher risk of psychiatric difficulties. Bariatric surgery is the most effective treatment of severe obesity. Few guidelines exist regarding the association of psychiatric diagnoses in adolescents and outcomes after surgery because of the lack of longitudinal research. Our objective is to evaluate the rates of psychiatric diagnoses in adolescents undergoing surgery compared with those not receiving surgery and the association of preoperative psychiatric diagnoses with postsurgical weight loss outcomes. METHODS Adolescents (N = 222) referred for psychological evaluation at one institution for bariatric surgery (2009-2017) completed semistructured clinical interviews to assess the presence and number of psychiatric diagnoses. Comparison analyses were conducted between those who did not end up receiving surgery (N = 53) and those who did (N = 169). Using longitudinal modeling, we assessed the association of preoperative diagnoses with weight loss outcomes between 3 and 12 months after surgery. RESULTS Seventy-one percent of adolescents qualified for a psychiatric disorder. There were no differences in rates of specific disorders or numbers of diagnoses between those receiving surgery and those not receiving surgery. The presence or absence or number of diagnoses before surgery was not associated with weight loss outcomes after surgery. CONCLUSIONS Psychiatric diagnoses are prevalent among adolescents with severe obesity. These diagnoses are not associated with weight loss outcomes. The presurgical psychological evaluation serves as an opportunity to identify adolescents experiencing psychiatric problems and provide them with care but should not necessarily be considered a contraindication to surgery.
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Affiliation(s)
- Eleanor R Mackey
- Center for Translational Science, Children's National Health System, Washington, District of Columbia; and .,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Jichuan Wang
- Center for Translational Science, Children's National Health System, Washington, District of Columbia; and.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Chloe Harrington
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Evan P Nadler
- Center for Translational Science, Children's National Health System, Washington, District of Columbia; and.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
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