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.
Department of Behavioral Health and Nutrition, University of Delaware, 100 Discovery Boulevard, Newark, DE, United States.
Appetite. 2019 Nov 1;142:104366. doi: 10.1016/j.appet.2019.104366. Epub 2019 Jul 10.
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.
Utilizing a mixed-method cross-sectional design, 20 mothers (M = 39.6 ± 5.7 years, 75% White, M = 33.6 ± 4.3 kg/m, M = 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.
The majority of children (N = 20; M = 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.
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.
肥胖是一种具有代际影响的慢性疾病。本研究旨在通过记录母亲在手术后第一年与儿童喂养、家庭用餐和家庭食物环境相关的想法、行为和经验，更好地了解母亲接受减重手术对子女肥胖相关风险的影响。
采用混合方法的横断面设计，20 名母亲（M=39.6±5.7 岁，75%为白人，M=33.6±4.3kg/m，M=7.7±3.1 个月术后）的子女年龄为 6-12 岁，完成了经过验证的自我报告量表，并参加了焦点小组。测量了母亲和孩子的身高/体重。
大多数孩子（N=20；M=9.2±2.3 岁，65%为白人，60%为女性）超重（N=12；BMI≥85 百分位），且未达到美国儿科学会关于健康饮食和活动的建议来治疗/降低肥胖风险。随着儿童 zBMI 的增加，母亲表达了更多的体重担忧（r=0.59，p=0.01）和较低的肥胖特异性生活质量（r=-0.56，p=0.01），但对儿童饮食选择的责任感降低（r=-0.47，p=0.04）。定性数据表明，母亲为实现自身更健康体重而做出的改变与将这些知识应用于喂养孩子/家庭之间存在脱节。
虽然减重手术和必要的生活方式改变是个体减肥的有效工具，但非常需要创新的以家庭为基础的解决方案。如果及早解决，儿童肥胖是可以预防或降低风险的。母亲接受减重手术可能是一个独特（但被忽视）的干预机会。
