INFLUENCES OF MAJOR WEIGHT LOSS IN WOMEN TREATED WITH BARIATRIC SURGERY ON THEIR PARTNERS' AND CHILDREN'S WEIGHT AND PSYCHOSOCIAL FUNCTIONING

The overall aim of the current PhD thesis was to explore how families of female bariatric surgery patients are affected by the surgery. The focus of the thesis was on differences in weight status in siblings born before and after maternal bariatric surgery, and on changes in weight and psychosocial functioning in partners and children of women undergoing Roux-enY gastric bypass (RYGB). Study I explored differences in BMI and prevalence of overweight and obesity at the ages of four, six and 10 in children born before and after maternal bariatric surgery. Results showed that at no age did the children born after surgery have a lower prevalence of overweight or obesity, and that there was no association between differences in maternal BMI at week 10 of the two pregnancies and differences in siblings’ BMI at age four. Study II focused on changes in female RYGB patients’ partners in terms of BMI, waist circumference, sleep quality, body dissatisfaction and symptoms of anxiety and depression. The results showed significant reductions in BMI and waist circumference in the partners. However, psychosocial variables, as measured by questionnaires, remained unchanged in the men. In Study III, differences in weight status, body esteem and self-concept in children of female RYGB patients were explored. It was found that the children had a reduced relative risk of overweight after maternal RYGB. The results also showed that the boys improved their ageadjusted body esteem slightly, whilst the girls did not. Study IV investigated changes in eating behaviour and food choices in female RYGB patients and their families. The women were shown to increase their cognitive restraint, decrease their uncontrolled and emotional eating, and reduce their intake frequency of soft drinks and sweets after surgery. Their partners, however, reported no changes in their eating behaviour and food choices. The boys’ eating behaviour improved following maternal RYGB, but the same was not true for the girls in the sample. The children who were overweight or obese at baseline also improved their eating behaviour in comparison to the normal weight children. In conclusion, this thesis shows that women’s gastric bypass surgery may be associated with positive changes in her partners’ and children’s weight, especially if they are themselves overweight. Changes in psychosocial functioning are smaller and more complex in the current sample, and require further study. LIST OF SCIENTIFIC PAPERS I. Willmer M, Berglind D, Sørensen TIA, Näslund E, Tynelius P, Rasmussen F. Surgically induced interpregnancy weight loss and prevalence of overweight and obesity in offspring. Plos One. 2013; Dec 12;8(12):e82247. (Available from: http://www.plosone.org/article/info%3Adoi%2F10.1371%Fjournal.pone.0082247) II. Willmer M, Berglind D, Thorell A, Sundbom M, Uddén U, Raoof M, Hedberg J, Tynelius P, Ghaderi A, Näslund E, Rasmussen F. Changes in BMI and psychosocial functioning in partners of women who undergo gastric bypass surgery for obesity. Obes Surg. 2014 Aug 23. [Epub ahead of print] III. Willmer M, Berglind D, Tynelius P, Ghaderi A, Näslund E, Rasmussen F. Children’s weight status, body esteem and self-concept following maternal gastric bypass surgery. IV. Willmer M, Berglind D, Tynelius P, Ghaderi A, Näslund E, Rasmussen F. Changes in eating behaviour and food choices in families where the mother undergoes gastric bypass surgery.