title: Adolescent bariatric surgery: caregiver and family functioning across the first postoperative year.
abstract: BACKGROUND
  The present study examined the psychological distress, parenting stress, and family functioning in female caregivers of adolescents undergoing bariatric surgery compared to that of caregivers of adolescents with extreme obesity not undergoing surgery across the first postoperative year.
  
  
  METHODS
  The female caregivers of 16 adolescents undergoing Roux-en-Y gastric bypass (mean age 16.6 years, mean body mass index 66.2 kg/m(2); 94% recruitment) and those of 28 comparison adolescents who had sought behavioral weight management (mean age 16.2 years, mean body mass index 46.3 kg/m(2); 90% recruitment) were included in the study. The caregivers completed measures of psychological distress (Symptom Checklist-90-Revised), parenting stress (Stress Index for Parents of Adolescents), and family functioning (Family Assessment Device) at baseline (before surgery) and at 6 and 12 months after surgery. Caregiver and adolescent anthropometric data were also obtained.
  
  
  RESULTS
  At baseline, clinical cutoffs were exceeded by 29.5% of the caregivers for psychological distress, 31.8% for family dysfunction, and 13.2% for parenting stress. Linear mixed modeling indicated that bariatric adolescents had a significantly greater body mass index at baseline than the comparison adolescents (t = -7.79, P <.001), with a substantial reduction by 12 months relative to the near-flat trajectory of the comparison group (t = 20.32, P <.001). No significant group differences at baseline or group trajectory differences were identified for any caregiver or family variable.
  
  
  CONCLUSIONS
  Our initial findings suggest that caregivers of adolescents with extreme obesity present with limited dysfunction and that bariatric surgery has no effect on caregiver distress, parenting stress, or family functioning across the first postoperative year. Larger samples and longer term follow-up will allow examination of what role caregiver/family factors play in the adolescent postoperative outcomes.
authors.affiliation: Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. meg.zeller@cchmc.org
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.forename: Shanna M
authors.initials: SM
authors.lastname: Guilfoyle
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reiter-Purtill
authors.forename: Megan B
authors.initials: MB
authors.lastname: Ratcliff
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Long
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D050110:Bariatric Surgery / Q000534:rehabilitation*; D015992:Body Mass Index; D017028:Caregivers / Q000523:psychology*; D005195:Family Relations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology / Q000601:surgery*; D010290:Parents / Q000523:psychology*; D011184:Postoperative Period; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology* / Q000534:rehabilitation; D013997:Time Factors