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PurposeThe Bariatric Experience Long Term (BELONG) prospective study cohort was created to address limitations in the literature regarding the relationship between surgical weight loss and psychosocial, health, behaviour and environmental factors. The BELONG cohort is unique because it contains 70% gastric sleeve and 64% patients with non-white race/ethnicity and was developed with strong stakeholder engagement including patients and providers.ParticipantsThe BELONG cohort study included 1975 patients preparing to have bariatric surgery who completed a baseline survey in a large integrated health system in Southern California. Patients were primarily women (84%), either black or Hispanic (59%), with a body mass index (BMI) of 45.1±7.4 kg/m2, age 43.3±11.5 years old, and 32% had at least one comorbidity.Findings to dateA total of 5552 patients were approached before surgery between February 2016 and May 2017, and 1975 (42%) completed a baseline survey. A total of 1203 (73%) patients completed the year 1 and 1033 (74%) patients completed the year 3 postoperative survey. Of these survey respondents, 1341 at baseline, 999 at year 1, and 951 at year 3 were included in the analyses of all survey and weight outcome data. A total of 803 (60% of eligible patients) had survey data for all time points. Data collected were self-reported constructs to support the proposed theoretical model. Height, weight and BMI were abstracted from the electronic medical record to obtain the main outcomes of the study: weight loss and regain.Future plansWe will collect self-reported constructs and obtain height, weight and BMI from the electronic medical record 5 years after bariatric surgery between April 2022 and January 2023. We will also collect patient experiences using focus groups of 8–12 patients each throughout 2022.

Gay bear refers to a burly gay man with a hirsute body and face. Chinese gay bear men are highly homogeneous and strictly emphasize a uniform bear appearance; however, obesity is an obvious health issue in this population. This study aims to explore the Chinese gay bear men's inner conflicts between bear identity and health concerns. Eleven Chinese gay bear men including four Taiwanese, two mainland Chinese, two Hong Kong, two Malaysian, and one Singaporean were interviewed. The study used a thematic analysis approach and found three coping strategies including (a) Eat healthy but maintain a minimal bear standard; (b) Eat like a bear but go to gym and take physical exam; (c) Reframe the meaning of being a bear or reduce the need of being a bear. This study expects to increase health professionals' knowledge about Chinese gay bear men's inner conflicts between identity and health and to suggest coping strategies for health professionals when addressing this population's health issues.

The purpose of this study was to explore African American men’s perceptions of what they learned from their fathers regarding mental health and relationships, as well as how these teachings have impacted their experiences as adults. Using a qualitative description methodology, researchers conducted 90-min virtual interviews with 20 African American men. Three themes emerged from the participants’ responses, which included (a) Emotional Avoidance, (b) Shifting Attitudes Towards Mental and Relational Health, and (c) Integrity, Love, and Protection. Findings for this study suggest that despite cultural stigma toward therapy, African American men are willing to participate in therapy. Furthermore, these findings confirmed the already existing literature surrounding dating and mating trends within the African American community and further illuminated the development of parenting dynamics over time. Researchers discuss the clinical implications of these findings and make recommendations for clinicians to assess and address constraints within the mental health and relational landscape for this demographic.

The purpose of this study was to explore the perspectives of pastoral leaders regarding obesity and health within faith-based organizations (FBOs). In this study, the authors focused on gaining additional insight regarding how pastoral leaders conceptualize and make sense of their roles in terms of health promotion within FBOs. Utilizing a qualitative research methodological approach, specifically Qualitative Description, authors administered a qualitative survey to 12 participants which yielded three emerging themes: (1) perceived scope, (2) understanding and use of resources, and (3) defining obesity through pastoral leaders’ perspectives. In the study, investigators discuss clinical implications and provide recommendations.

PurposeWeight loss surgery is an effective, long-term treatment for severe obesity but individual response to surgery varies widely. The purpose of this study was to test a comprehensive theoretical model of factors that may be correlated with the greatest surgical weight loss at 1–3 years following surgery. Such a model would help determine what predictive factors to measure when patients are preparing for surgery that may ensure the best weight outcomes.Materials and MethodsThe Bariatric Experience Long Term (BELONG) study collected self-reported and medical record-based baseline information as correlates of 1- and 3-year % total weight loss (TWL) in n = 1341 patients. Multiple linear regression was used to determine the associations between 120 baseline variables and %TWL.ResultsParticipants were 43.4 ± 11.3 years old, Hispanic or Black (52%; n = 699), women (86%; n = 1149), and partnered (72%; n = 965) and had annual incomes of ≥ $51,000 (60%; n = 803). A total of 1006 (75%) had 3-year follow-up weight. Regression models accounted for 10.1% of the variance in %TWL at 1-year and 13.6% at 3 years. Only bariatric operation accounted for a clinically meaningful difference (~ 5%) in %TWL at 1-year. At 3 years after surgery, only bariatric operation, Black race, and BMI ≥ 50 kg/m2 were associated with clinically meaningful differences in %TWL.ConclusionsOur findings combined with many others support a move away from extensive screening and selection of patients at the time of surgery to a focus on improving access to this treatment.

PurposeBariatric surgery is the most effective treatment for severe obesity, but currently, only 1–2% of all eligible patients undergo surgery each year. This study examined which factors were associated with a patient receiving bariatric surgery after referral in a real-world healthcare setting.Materials and MethodsThe current study used the baseline survey and electronic medical record (EMR) data from the Bariatric Experience Long Term (BELONG) study (n = 1975). Predictors of who did (n = 1680) and who did not (n = 295) have surgery were analyzed using multivariate logistic regression.ResultsParticipants (n = 1975; 42.4% response rate) were primarily women (84%) and either non-Hispanic Black or Hispanic (60%). In the fully adjusted multivariate model, the strongest predictors of having surgery were being a woman (OR = 3.17; 95% CI = 2.15, 4.68; p < .001) and losing at least 5% of their body weight in the year before surgery (OR = 3.16; 95% CI = 2.28, 4.38; p < .001). The strongest predictors of not having surgery were a ≥ BMI 50 kg/m2 (OR = .39; 95% CI = .27, .56; p < .001) and having a higher physical comorbidity burden (OR = .84; 95% CI = .75, .94; p = .004).ConclusionsPractices such as 5–10% total weight loss before surgery and selection of patients with safer operative risk profiles (younger with lower comorbidity burden) may inadvertently contribute to under-utilization of bariatric surgery among some demographic subpopulations who could most benefit from this intervention.

The purpose of this study was to explore Marriage and Family Therapy students’ perspectives regarding food addiction and associated eating disorders, as a clinical treatment issue. In a standard addictions course housed in a Marriage and Family Therapy program approved by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), 20 students completed a qualitative survey where they reflected on the topic of food addiction, Binge Eating Disorder, and Bulimia Nervosa, within the context of individual, couple, and family relationships. In the study four major themes emerged, which included (1) Defining Food Addiction, (2) Perceptions of Eating Disorders, (3) Conceptualizing Systemic Treatment, and (4) Experiences in clinical training. Clinical implications, recommendations for MFT education, clinical practice, and future research are discussed. Findings suggest that while MFT students in the study were well versed in conceptualized systemic treatment, it was of a general treatment and understanding using MFT theory, and not in relation to or specifically concerning food addictions and their connection or distinction from Binge Eating Disorder and/or other eating disorders found in the Diagnostic and Statistical Manual, potentially impacting the level of skillfully and appropriately working with clients.

African American marriage rates have declined over the years. This qualitative study examines the ways in which African American young adult women describe their desires in potential long-term (possibly marriage) partners. The following research questions guided the study: (a) What are young adult African American women’s perceptions as it relates to long-term relationships and marriage? and (b) What qualities do African American young adult women desire in a long-term partner? A total of 35 African American young adults participated in the study. Findings for the study indicated that childhood observations of family members’ relationships, personality traits, and values had great influence in the type of partner desired. The study offers several recommendations for future research and strategies for marriage and family practices in the African American community.

The major question being answered in the study is, “What is the experience of being an insider/outsider in a study regarding men and significant weight loss?” The purpose of the paper is to explore the experience of being both an insider and an outsider, and specifically to discuss how researcher status and self-disclosure emerged and impacted the research process. The methodology used in the research study is narrative inquiry, specifically self-narrative. In the study, membership role status was found to be difficult to define, inherently complex, and arbitrary at times. Additional research on the topic of membership role status is needed and the level of importance should be further explored for the specific population.

For this study, authors engaged in 9 semi-structured interviews with romantic partners of contestants who were involved with a weight loss intervention (The Biggest Loser), to gain insight into the phenomenon of weight loss within the context of couple relationships and reality television. Utilizing Basic Qualitative Description influenced by aspects of phenomenology, the authors explored the role of weight loss and the role that the specific intervention utilized, has played within the couple relationship. Building upon previous research (Moore, Cooper, Williams, & Zwierstra, 2017a) authors added the voice of the non-contestant partners to the discussion and explored experiences of weight loss and perceptions regarding the utilization of Marriage and Family Therapists during the weight loss process. The major themes that emerged were (1) Behind the Scenes: The sacrifices we make, (2) After the Show Wraps: Re-entry and the Transition Home, and (3) Perceptions of MFT: Addressing couple relationships. Implications for Marriage and Family Therapists as well as other professionals involved in working with couples during weight loss are discussed as well as future directions in research.