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Appetite. 2019 Jul 10;142:104366. doi: 10.1016/j.appet.2019.104366. [Epub ahead of print]

Halo or horn? A qualitative study of mothers' experiences with feeding children during the first year following bariatric surgery.

Author information

1
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States. Electronic address: meg.zeller@cchmc.org.
2
Department of Behavioral Health and Nutrition, University of Delaware, 100 Discovery Boulevard, Newark, DE, United States. Electronic address: robson@udel.edu.
3
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States. Electronic address: jennifer.reiter-purtill@cchmc.org.
4
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States. Electronic address: katherine.kidwell@cchmc.org.
5
Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States. Electronic address: roohi.kharofa@cchmc.org.
6
Department of Psychology, Suffolk University, 73 Tremont Street Boston, Masschusetts, United States. Electronic address: mmcullough@suffolk.edu.
7
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States. Electronic address: lori.crosby@cchmc.org.
8
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States. Electronic address: taylor.howarth@cchmc.org.
9
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States. Electronic address: s.comstock.emu@gmail.com.
10
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue Cincinnati, Ohio, United States; Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States. Electronic address: sanita.ley@cchmc.org.
11
Division of Minimally Invasive Bariatric & General Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street Pittsburgh, Pennsylvania, United States. Electronic address: courcoulasap@upmc.edu.
12
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States; Department of Surgery, University of Cincinnati College of Medicine, 3230 Eden Avenue Cincinnati, Ohio, United States. Electronic address: lisa.west-smith@uchealth.com.

Abstract

BACKGROUND:

Obesity is a chronic condition that has an intergenerational effect. The aims of the study were to better understand the impact of maternal bariatric surgery on obesogenic risks to child offspring in the home via documenting mothers' thoughts, behaviors, and experiences around child feeding, family meals, and the home food environment during her first year postsurgery.

METHOD:

Utilizing a mixed-method cross-sectional design, 20 mothers (Mage = 39.6 ± 5.7 years, 75% White, MBMI = 33.6 ± 4.3 kg/m2, Mtime = 7.7 ± 3.1 months post-surgery) of children ages 6-12 years completed validated self-report measures and participated in a focus group. Mother and child heights/weights were measured.

RESULTS:

The majority of children (N = 20; Mage = 9.2 ± 2.3 years, 65% White, 60% female) were overweight (N = 12; BMI≥85th percentile) and were not meeting the American Academy of Pediatrics healthy eating and activity recommendations to treat/reduce obesity risk. As child zBMI increased, mothers expressed significantly more weight concern (r = 0.59, p = 0.01) and lower obesity-specific quality of life (r = -0.56, p = 0.01), yet assumed less responsibility for child eating choices (r = -0.47, p = 0.04). Qualitative data demonstrated disconnects between mothers' changes to achieve her own healthier weight and applying this knowledge to feeding her child/family.

CONCLUSIONS:

While bariatric surgery and requisite lifestyle change are effective tools for weight loss at the individual level, there is a great need for innovative family-based solutions. Pediatric obesity is preventable or risk-diminished if addressed early. Maternal bariatric surgery may be a unique (yet missed) opportunity to intervene.

KEYWORDS:

Bariatric surgery; Family; Mothers; Pediatric obesity

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