This study compared the perceptions of the child’s obesity among families in which one or both parents underwent bariatric surgery to those of matched families without parental bariatric surgeries who served as controls. The perceptions of the obese children of both parental groups that were documented during their first encounter at the clinic were also compared. The bariatric parents were more inclined to think that their child’s obesity negatively affects his/her self-image and social status. They also tended to think that their child’s obesity is a current and future health problem, and that he/she will eventually need to undergo a bariatric procedure. The children in the bariatric group were more willing to undergo bariatric surgery themselves compared to the children in the control group.
Parental overweight is frequently cited as a predictor for childhood obesity.14,15 The familial effect on childhood obesity is multifactorial and has both genetic and environmental components.16 The genetic component of obesity includes both differnces in metabolic rate but more importanly the genetic of eating behavior which have an influence on meal timing, quantity of food intake, and food preference.15,17 Moreover, there is also an undeniable environmental component that comprised of food availability within the home, family meal structure, cultural preference, and poor engagement in exercise, maintains adolescent obesity.9,18 Several studies have illustrated the interdependence of home food availability and the intake of both unhealthy and healthy foods,19,20 while other studies focused on the role of an obesogenic environment that promotes physical inactivity and access to energy-dense foods.21,22 As all the bariatric group parents faced morbid obesity, their households may have genetic and enviromental influences their children’s weight and eating behaviors. Beyond the influence of the family on the tendency to become obese, it also has an effect on the attitude towards obesity. The bariatric parents are highly aware of the difficulties involved in the conventional methods of losing weight, especially considering their own failures to do so. This may cause them to be sceptical about their children’s chances to succeed. Van Geelen et al. assessed attitudes and normative beliefs about pediatric bariatric surgery among morbidly obese adolescents and parents.11 Those authors showed that parents and adolescents who viewed obesity as something that they could influence themselves were more in favor of non-surgical treatment and vice versa. Given the bariatric parents’ life experiences and the fact they consider their own surgery as having been successful, it is understandable that they might want the same option for their children.
Thompson et al. have shown that different variables can influence the preferences of methods to lose weight, such as the number of attempts to lose weight, gender, age, BMI, and medical condition.22 The present study extends these results and demonstrates that a history of bariatric surgery in the family can also have an impact of the perception and treatment preference of childhood obesity among the parents and their children.
This study is limitated by the small sample size due to the uniqueness of the study group. Nevertheless, this is the first study to assess the phenomenon of “bariatric families”. Those families are becoming more common in the pediatric 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. 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.