Surgery for Obesity and Related Diseases ] (2014) 00–00 Original article Review of family-based approaches to improve postoperative outcomes among bariatric surgery patients Denise C. Vidot, M.A. a,b, * , Guillermo Prado, Ph.D. c , Nestor De La Cruz-Munoz, M.D. d , Melissa Cuesta, L.P.N. d , Christine Spadola, M.S. e , Sarah E. Messiah, Ph.D., M.P.H. a,b a Division of Epidemiology, Department of Public Health Sciences b Division of Pediatric Clinical Research, Department of Pediatrics c Division of Prevention Science, Department of Public Health Sciences d Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida e Florida International University, Robert Stempel College of Public Health and Social Work, Miami, Florida Received April 3, 2014; accepted August 4, 2014 Abstract Background: Bariatric surgery must be partnered with postoperative lifestyle modifications for enduring weight loss and related health effects to be fully appreciated. Little is known about how these lifestyle modifications may be affected by the involvement of other family members living in the household; therefore, this review describes current family-based approaches to improving postoperative outcomes in bariatric surgery patients and their families. Methods: A MEDLINE search of publications from 1999 to 2014 was conducted in January 2014. Retrieved titles and abstracts were assessed by 2 authors to determine relevance to the topic sur- rounding family-based approaches to improve postbariatric surgery outcomes. All study designs except case studies were considered if they included some aspect of family as a predictor in relation to improved health outcomes after surgery. Results: Initial searches yielded 650 publications (bariatric surgery þ family, n ¼ 193; bariatric surgery þ child, n ¼ 338; bariatric surgery þ spouse, n ¼ 4; bariatric surgery þ social support, n ¼ 115). Two studies met criteria for a family-based approach to improving metabolic outcomes in bariatric patients. Seven studies discussed the impact of bariatric surgery on families. All other studies were excluded for not discussing family-based approaches. Conclusion: Despite limited documentation of family-based approaches on improving health out- comes in patients who underwent bariatric surgery, evidence suggests that such an approach may be advantageous if planned a priori to occur before, during, and after bariatric surgery. Future studies could test the combination of bariatric surgery and a family-based approach for improved metabolic outcomes in both the patient and involved family member(s). (Surg Obes Relat Dis 2014;]:00–00.) r 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved. Keywords: Family; Bariatric surgery; Severe obesity; Obesity The high prevalence of obesity and obesity-related co- morbidities such as cardiovascular disease, diabetes, hyper- tension, hyperlipidemia, cancer, and osteoarthritis continues to pose major public health and clinical challenges [1–9]. Moreover, recent obesity-related medical cost calculations now account for 21% of United States healthcare costs [10,11]. As severe obesity prevalence estimates continue to http://dx.doi.org/10.1016/j.soard.2014.08.004 1550-7289/ r 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved. All work originated from the University of Miami, Miller School of Medicine, Department of Pediatrics, Division of Pediatric Clinical Research, and the Department of Public Health Sciences, Divisions of Epidemiology, Prevention Science, and Biostatistics. This research was supported by NIH/ NIDA grant K01 DA 026993 and the Micah Batchelor Foundation. * Correspondence: Denise C. Vidot, M.A., University of Miami, Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Suite 1264, Miami, Florida 33136. E-mail: dvidot@med.miami.edu