title: Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes.
abstract: To comprehensively assess family characteristics of adolescents with severe obesity and whether family factors impact weight loss outcomes following weight loss surgery (WLS).
  
  
  
  Multisite prospective data from 138 adolescents undergoing WLS and primary caregivers (adolescent: Mage= 16.9; MBMI= 51.5 kg/m2; caregiver: Mage= 44.5; 93% female) and 83 nonsurgical comparators (NSComp: adolescent: Mage= 16.1; MBMI =46.9 kg/m2; caregiver: Mage= 43.9; 94% female) were collected using standardized measures at presurgery/baseline and at 1 and 2 years.
  
  
  
  The majority (77.3%) of caregivers had obesity, with rates of caregiver WLS significantly higher in the WLS (23.8%) versus NSComp group (3.7%, P < 0.001). Family dysfunction was prevalent (≈1 in every two to three families), with rates higher for NSComp than the WLS group. For the WLS group, preoperative family factors (i.e., caregiver BMI or WLS history, dysfunction, social support) were not significant predictors of adolescent weight loss at 1 and 2 years postoperatively, although change in family functioning over time emerged as a significant correlate of percent weight loss.
  
  
  
  Rates of severe obesity in caregivers as well as family dysfunction were clinically noteworthy, although not related to adolescent weight loss success following WLS. However, change in family communication and emotional climate over time emerged as potential targets to optimize weight loss outcomes.
authors.affiliation: Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Meg H
authors.initials: MH
authors.lastname: Zeller
authors.affiliation: Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Sanita
authors.initials: S
authors.lastname: Hunsaker
authors.affiliation: Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.|Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Carmen
authors.initials: C
authors.lastname: Mikhail
authors.affiliation: Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Reiter-Purtill
authors.affiliation: Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: McCullough
authors.affiliation: Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.|Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Garland
authors.affiliation: Center of Weight Management, Children's Hospital of Alabama, Birmingham, Alabama, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Austin
authors.affiliation: Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.|Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Gia
authors.initials: G
authors.lastname: Washington
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Baughcum
authors.affiliation: Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Dana
authors.initials: D
authors.lastname: Rofey
authors.affiliation: Department of Developmental and Behavioral Sciences, Children's Mercy Hospitals & Clinics, Kansas City, Missouri, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D050110:Bariatric Surgery; D017028:Caregivers; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D063766:Pediatric Obesity / Q000523:psychology* / Q000601:surgery*; D011184:Postoperative Period; D015995:Prevalence; D011446:Prospective Studies; D015431:Weight Loss