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8.26.2014

Review Finds Gap in Family-Based Approaches for Improved Bariatric Surgery Outcomes

An article published August 18 in the journal Surgery for Obesity and Related Diseases identifies a research gap in family-based approaches to improve post-operative outcomes in bariatric surgery patients.

Led by Denise C. Vidot, M.A., a Ph.D. candidate in epidemiology, the “Review of Family-Based Approaches to Improve Post-Operative Outcomes among Bariatric Surgery Patients” shows that although there is evidence such approaches are successful, little documentation exists about the necessary lifestyle modifications after bariatric surgery and how these may affect the patient and other family members living in the same household.

“Since obesity has a strong intergenerational effect, it is important to formally investigate how lifestyle modifications, such as eating healthy and exercising, may render an additional benefit of improved healthy behaviors and weight loss for this patient population and their family members,” Vidot said.

Under the direction of faculty mentors Guillermo “Willy” Prado, Ph.D., Miller Professor of Public Health Sciences and Director of the Division of Prevention Science and Community Health, and Sarah Messiah, Ph.D., M.P.H., research associate professor of pediatrics and senior author, Vidot and her team searched the bibliographic database MEDLINE for publications demonstrating the impact of bariatric surgery on families.

Though initial searches yielded 650 publications, only two met the criteria for a family-based approach to improve metabolic outcomes in bariatric patients. An additional seven were identified that discussed an impact on obesity prevalence in children with parents who underwent bariatric surgery, eating behavior patterns of the family and weight changes in the spouses of patients.

Most publications, the review found, discussed post-surgery group therapy sessions or attending peer support groups as sources of improved outcomes, but none specifically identified family-based approaches. Similarly, the two family-based studies identified included improved outcomes but involved multiple family members who underwent bariatric surgery around the same time and nothing was reported in the literature regarding systematically planned family-based approaches.

These findings, the researchers say, mark the need for studies of family-based interventions that can improve outcomes among patients who do not have family members or peers who have received the same surgery.

“Improved body mass index, excess weight loss and decreased prevalence of co-morbidities were found in the two studies we reviewed,” Vidot said. “But our review shows that further evaluation of family-based approaches for improved bariatric surgery outcomes is needed.”

Other Miller School co-authors of the study are Nestor de la Cruz-Muñoz, M.D., Chief of the Division of Laparoendoscopic and Bariatric Surgery, Melissa Cuesta, L.P.N., Bariatric Program Coordinator, and Christine Spadola, M.S., senior research associate.

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