Ecological Momentary Assessment of Behavioral and Psychosocial Predictors of Weight Loss Following Bariatric Surgery
Condition: Obesity
MeSH terms: Weight Loss
Study type: Observational

Summary: 
      Bariatric surgery is a powerful tool for producing significant and durable weight loss. Yet,
      not all patients achieve initial weight loss success and many patients have weight regain as
      early as 1-2 years post-surgery. Suboptimal weight loss patterns not fully explained by
      surgical, demographic, and medical factors has led to greater emphasis on patient behaviors
      evidenced by clinical guidelines that focus on appropriate eating and physical activity.
      However, research to inform such guidelines typically has relied on imprecise measures or not
      been specific to bariatric surgery. There is also little understanding of mechanisms by which
      psychosocial factors influence outcomes. Thus, there is a need to: (a) measure behaviors and
      psychosocial factors thought to be related to surgical outcomes (particularly those
      emphasized in guidelines) using innovative strategies to maximize data quality, (b) determine
      which behaviors and psychosocial factors are related to outcomes, and (c) explore how
      psychosocial factors influence weight both directly and via influences on behavior. Our
      research team was the first to employ innovative mobile health (mHealth) technology within an
      Ecological Momentary Assessment (EMA) framework to measure adherence to recommended behaviors
      at 6 months post-surgery. The investigators propose to build on this work by using EMA to
      measure behavioral, psychosocial, and environmental factors over a longer period to
      understand how they predict success and risk after surgery. An NIH-funded multi-sensor PiLR
      HEALTH platform will integrate objective sensor data measuring behaviors and the environments
      in which they are performed with self-report information collected via smartphone in
      real-time and in patients' natural environment. Participants (N=100) recruited from 2
      ASMBS-designated centers of excellence will complete a 10-day EMA protocol pre-surgery and at
      3, 6, and 12 months post-surgery to assess recommended behaviors [e.g., meal frequency, PA],
      psychosocial indicators with the most prior evidence of an association with surgical outcomes
      (e.g., mood/depression), and key environmental factors (e.g., type/quality of the food
      environment). Participants will also be weighed at the above time points. Along with
      describing patterns in behaviors and their relation to weight loss, the investigators will
      test causal models to understand how complex systems of behavioral, psychosocial, and
      environmental factors affect weight loss, and to identify optimal targets for intervention.
      This project has the potential to build a much more sophisticated and valid understanding of
      who is and is not successful after bariatric surgery and why. This new understanding will
      directly contribute to improved (i.e., specific, consistent, and validated) guidelines for
      recommended pre and postoperative behaviors, which could lead to improved surgical outcomes.
      The enhanced understanding will also inform behavioral, psychosocial, and environmental
      targets for intervention that are mostly likely to improve surgical outcomes.
    


Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Individuals diagnosed with obesity who plan to have bariatric surgery within 8 weeks.