title: Halo effect for bariatric surgery: collateral weight loss in patients' family members.
abstract: BACKGROUND
  Bariatric surgery is an effective treatment for morbid obesity, which is increasingly recognized as a familial disease. Healthy behavior transmission may be enhanced by family relationships.
  
  
  OBJECTIVE
  To determine changes in weight and healthy behavior in patients who underwent Roux-en-Y gastric bypass surgery and their family members.
  
  
  METHODS
  Prospective, longitudinal, and multidimensional health assessment before and 1 year after index Roux-en-Y gastric bypass surgery.
  
  
  METHODS
  An academic bariatric center of excellence, from January 1, 2007, through December 31, 2009.
  
  
  METHODS
  Eighty-five participants (35 patients, 35 adult family members, and 15 children <18 years old).
  
  
  METHODS
  Roux-en-Y gastric bypass surgery and associated dietary and lifestyle counseling.
  
  
  METHODS
  Weight and expected body mass index (calculated as weight in kilograms divided by height in meters squared). Secondary outcomes were waist circumference, quality of life (36-Item Short Form or Pediatric Quality of Life Inventory), healthy behaviors, eating behaviors, and activity levels.
  
  
  RESULTS
  Participants were grouped by relationship to patient for analysis with paired 2-sample t tests. Before the operation, 60% of adult family members and 73% of children of patients undergoing Roux-en-Y gastric bypass surgery were obese. At 12 months after the operation, significant weight loss was observed in obese adult family members (from 234 to 226 lb; P = .01). There was a trend for obese children to have a lower body mass index than expected for their growth curve (31.2 expected vs 29.6 observed; P = .07). Family members increased their daily activity levels (adults, from 8 to 17 metabolic equivalent task-hours, P = .005; and children, from 13 to 22, P = .04). Adult family members also had improved eating habits with less uncontrollable eating (from 35 to 28; P = .01), emotional eating (from 36 to 28; P = .04), and alcohol consumption (from 11 drinks per month to 1 drink per month; P = .009).
  
  
  CONCLUSIONS
  Gastric bypass surgery may render an additional benefit of weight loss and improved healthy behavior for bariatric patients' family members.
authors: Section of Minimally Invasive and Bariatric Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
authors: Gavitt A
authors: GA
authors: Woodard
authors: Betsy
authors: B
authors: Encarnacion
authors: Joe
authors: J
authors: Peraza
authors: Tina
authors: T
authors: Hernandez-Boussard
authors: John
authors: J
authors: Morton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005190:Family / Q000523:psychology; D005192:Family Health; D005260:Female; D015390:Gastric Bypass; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D015431:Weight Loss