One of the first studies to define and examine the perceptions ‘bariatric families’ towards obesity has reported that there are significant differences between the perceptions of those parents and children – in a ‘bariatric family’ - toward themselves, their health and the preferred mode of obesity treatment, compared to non-bariatric families, according to researchers from Dana Dwek Children’s Hospital and Tel Aviv University, Tel Aviv, Israel.
The authors of the paper, ‘”Bariatric families”- a new phenomenon with unique characteristics’, published in BMC Pediatrics, noted that larger studies are warranted in order to better understand the uniqueness and address the special needs of these families.
The study was designed to explore the perceptions and attitudes towards child obesity of parents in bariatric families, defined as at least one parent who had undergone bariatric surgery, compared with non-bariatric families. Specifically, they examined how parents who underwent bariatric surgery for obesity perceived their child’s obesity vs. the perceptions of parents with obesity who did not undergo bariatric surgery.
In total, 18 children were recruited to the bariatric group and 18 children who were matched for age and sex were recruited to the control group. The median age of the children in both groups was 10.6 years and 61% were females. The median BMI values of the children were 32.3 for the bariatric group and 28.6 for the control group. There were no group differences in mean birth weight, high-risk pregnancies, developmental delays or previous hospitalisations, as well as in parental characteristics. However, the children in the bariatric group reported significantly more attempts to lose weight in the past (72% vs. 44% for the controls, p<0.02).
The children with obesity were asked about their perception of their health and social status, which were documented during their first encounter at the clinic on a scale of 1 (worst) to 10 (best), the data were retrieved from their medical records. There were no group differences in the child’s ranking of academic and social skills.
The children’s reported motivation to lose weight was similar in both groups, as was their estimated body image. There was, however, a significant difference in the children’s willingness to undergo a bariatric procedure: five (28%) of the children in the bariatric group were interested in bariatric surgery instead of a conservative approach to losing weight, compared to none of the children in the control group (p<0.02).
The parents in the bariatric group were more likely to think that the number of friends their child had was related to their child’s weight (p<0.03). In addition, those parents were more likely to consider that their child’s weight played an important role in the child’s self- image (p<0.03). The parents in the bariatric group were also more likely to think that their child will not attain a normal weight without an intervention (p<0.02).
The parents in the bariatric group were more likely to see their child’s weight as a health problem (p<0.04). They were also more likely to fear that obesity is putting their child’s health at risk, but this difference did not reach statistical significance. The parents in both groups feared that their children will be overweight in the future, however, none of the parents’ responses indicated that they were worried about an obesity-related comorbidity.
Most of the participants agreed that overweight is not a deterministic factor: 72% of the parents in the bariatric group and 77% of the parents in the control group disagreed that weight is determined by fate. There was unanimous agreement about the parameter of lifestyle: they all responded that healthy nutrition and frequent physical activity are needed in order to lose weight.
The parental responses to the items on future intervention revealed that the parents in the bariatric group were four times more likely to think that their children will need a bariatric procedure in the future (44% vs. 11% for the controls, p<0.07). Importantly, most of the parents who underwent bariatric surgery (83%) were satisfied with the surgery, considered it successful (72%) and would have done it again (83%).
“Those families (bariatric families) are becoming more common in the paediatric nutrition clinics, and healthcare professionals should be aware of the differences between them and non-bariatric families and take those differences into account while planning treatment options,” the authors wrote. “Since a parent’s perception has an important impact on the child’s success in losing weight, it is important to identify the children who are likely to fail to lose weight by standard dietary and lifestyle methods in order to avoid sense of failure and the metabolic effects of weight regain.”
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