Weight Loss Surgery Benefits Entire Family

Having gastric bypass surgery has a ripple effect that causes family members to lose weight, eat better and exercise more, a new study shows.

The research found that spouses, relatives and even the children of patients who underwent the procedure dropped significant amounts of weight, doubled their activity levels and had other improvements that were still evident a year after the surgery. The findings suggest that doctors who perform gastric bypass operations may want to look at the procedure as a way to bring about change in entire families in need of help with their weight and exercise habits, said Dr. John Morton, the director of bariatric surgery at the Stanford School of Medicine and an author of the study, which appeared in The Archives of Surgery.

"If you have a committed and involved family," he said, "you're going to have better outcomes for the patient, and also by the same token, the family members can have a collateral benefit."

Every year, about 200,000 people undergo the most common gastric bypass operation, known as Roux-en-Y. Patients typically see significant weight loss and improvements in overall health, but researchers hadn't really looked at whether the changes could affect other members of a patient's household. Dr. Morton got the idea for the new study when he noticed that his bypass patients would often come in for follow-up visits alongside family members who showed improvements of their own.

"Patients would come in with their spouses, and in the course of them telling me how great everything was, the spouse would say, 'I've lost weight too, and we're eating healthier,'" he said.

Social support can be a powerful motivator in breaking bad habits. Studies have shown, for example, that people tend to lose more weight - and keep it off longer - when they take part in weight loss groups or start a diet with a husband or wife . Smokers, too, are nearly 70 percent more likely to give up cigarettes if a spouse quits smoking.

To find out whether gastric bypass could have a similar effect, Dr. Morton and several researchers, including Dr. Gavitt Woodard, recruited 35 people preparing to undergo the procedure and followed them and their families for a year. Only family members who lived with the patients, including their children, were included in the study. Family members were asked to accompany the patients to all of their counseling sessions: three that occurred before the surgery, and five that took place in the year after. At the sessions, the subjects learned about portion control and were encouraged to eat meals high in protein and fiber and low in fat and sugar. They were also encouraged to exercise and cut back on alcohol and television.

A year after the surgery, the patients, who had all been morbidly obese at the start, had lost an average of 100 pounds and went from body mass indexes of 48.7 to 33.3. Their adult spouses and family members who were overweight, meanwhile, had lost an average of about 10 pounds and saw their B.M.I.'s drop from 38 to 36.3, which is on par with controlled medical weight loss trials. The obese children in the study saw their waist sizes drop several inches, though their B.M.I.'s did not change very much because they were growing and getting taller.

"The kids were on a steeper trajectory for higher B.M.I. before the parent's surgery," Dr. Morton said. "At the end of one year, that slope was less."

The researchers also saw other beneficial changes in the young and adult family members. They watched less television, exercised more and reported fewer instances of uncontrollable and emotional eating. The adults drank significantly less alcohol, going from an average of 11 drinks a month down to just one. Dr. Morton said it was clear bariatric surgery could be an opportunity for intervention for many people beyond the patient.

"Obesity is a family disease," he said, "and we do need to treat everyone involved and start thinking about bariatric surgery as a platform for change."