A multisite view of psychosocial risks in patients presenting for bariatric surgery

Objective The psychosocial health of adolescents with severe obesity (BMI ≥ 120% for age and gender) has only recently been the focus of empirical work. Methods This multisite study—an ancillary to a prospective longitudinal observational study documenting health in adolescents having weight loss surgery (WLS)—presents preoperative/baseline data from 141 WLS adolescents and 83 nonsurgical comparisons (NSComps). Self‐report data from adolescent and caregiver dyads characterize adolescent psychopathology and potential correlates. Results One in three adolescents reported internalizing symptoms, and one in five endorsed externalizing symptoms in the clinical range. Generalized linear model analysis demonstrated that increased risk of psychopathology for adolescents with severe obesity was associated with family dysfunction, eating pathology, family composition, and seeking behavioral intervention (versus WLS), whereas better quality of life (QOL) was associated with lower psychopathology. Conclusions While psychopathology rates are comparable to national samples, there is a subgroup of youth who present for behavioral weight loss services and are at greater risk for psychopathology relative to national adolescent base rates. Adolescents who achieve candidacy for WLS may be a highly selective population of youth with severe obesity and may have lower base rates of psychopathology compared to NSComps.