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Introduction: Weight bias internalization (WBI) is associated with reduced psychological well-being in individuals with obesity. The aim of this study was to investigate the application of Cohen’s stress-buffering model of social support for WBI on well-being in patients presenting for bariatric surgery. Methods: In N = 804 adult prebariatric patients, WBI, social support, depression severity, health-related quality of life (HRQOL), and self-esteem were assessed by self-report questionnaires. Structural Equation Modeling was applied to test for direct associations between social support and well-being and for a buffering effect of social support on the relationship between WBI and well-being. Results: After controlling for age, sex, and body mass index, greater social support was directly associated with reduced depression severity and increased self-esteem, but not with increased HRQOL. Contrary to Cohen’s stress-buffering model, social support showed no moderating effects on the association between WBI and depression severity, HRQOL, and self-esteem. Conclusion: These cross-sectional results may indicate that greater social support is associated with improved well-being, supporting it as a potential coping resource in bariatric surgery. Given the absence of supporting evidence for the buffering effect in the present study, future prospective research may reevaluate the existence of a moderating effect of social support and investigate whether support-focused interventions improve psychological well-being.

Introduction: Almost 25% of German adults have obesity and numbers are rising, making it an important health issue. Bariatric-metabolic surgery reduces body weight and complications for persons with obesity, but therapeutic success requires long-term post-operative care. Since, no German standards for follow-up by family physicians exist, follow-up is provided by surgical obesity centers, but they are reaching their limits. The ACHT study, funded by the German Innovation Fund, is designed to establish and evaluate the follow-up program, with local physicians following patients supported remotely by obesity centers. Methods: ACHT is a multicenter, prospective, non-randomized control-group study. The 18-month ACHT follow-up program is a digitally supported, structured, cross-sectoral, and close-to-home program to improve success after bariatric-metabolic surgery. Four groups are compared: intervention group 1 starts the program immediately (3 weeks) after Roux-en-Y gastric-bypass or sleeve-gastrectomy (months 1-18 postoperatively), intervention group 2 begins the program 18-months after surgery (months 19-36 postoperatively). Intervention groups are compared to corresponding control groups that had surgery 18 respectively 36 months previously. In total, 250 patients, enrolled in the intervention groups, are compared with 360 patients in the control groups, who only receive standard care. Results: The primary endpoint to compare intervention and control groups is the adapted King’s Score, a composite tool evaluating physical, psychological, socio-economic and functional health status. Secondary endpoints include changes in care structures and care processes for the intervention groups. Multivariate regression analyses adjusting for confounders (including the type of surgery) are used to compare intervention and control groups and to evaluate determinants in longitudinal analyses. The effect of the intervention on healthcare costs will be evaluated based on health insurance billing data of patients who had bariatric-metabolic surgery in the three years prior to the start of the study and of patients who undergo bariatric-metabolic surgery during the study period. Conclusions: ACHT will be the one of the first evaluated structured, close-to-home follow-up programs for bariatric surgery in Germany. It will evaluate the effectiveness of the implemented program regarding improvements in health status, mental health, quality of life and the feasibility of such a program outside of specialized obesity centers.

Introduction The Weight Bias Internalization Scale and the Modified Weight Bias Internalization Scale are well-established self-report questionnaires for assessing weight bias internalization, which is widespread among bariatric patients. However, among this group, psychometric properties of the Weight Bias Internalization Scale have only been examined in small samples showing unsatisfactory model fit and have not been explored for the modified questionnaire. Methods This study psychometrically evaluated and compared the Weight Bias Internalization Scale and Modified Weight Bias Internalization Scale in a large sample of prebariatric patients (N=825, mean age=46.75 years, SD=11.55) regarding item characteristics, model fit to unidimensionality, reliability, construct validity, and measurement invariance. Results Item 4 of both questionnaires showed low corrected item-total correlations (

Objective: To determine whether rats reaching the same body mass, having been fed either a low-fat (LFD) or a high-fat diet (HFD), differ in white adipose tissue (WAT) deposition. Methods: In experiment 1, 22 Sprague-Dawley rats of the same age were divided into 11 rats with body mass below the batch median and fed a HFD, and 11 above the median and fed a LFD. In experiment 2, 20 Sprague-Dawley rats of the same age and starting body mass were randomised to either a HFD or LFD. When all groups reached similar final body mass, WAT was quantified using magnetic resonance imaging (MRI), dissection, and plasma leptin. Results: In experiment 1, both groups reached similar final body mass at the same age; in experiment 2 the HFD group reached similar final body mass earlier than the LFD group. There were no significant differences in WAT as assessed by MRI or leptin between the HFD and LFD groups in both experiments. Dissection revealed a trend for higher retroperitoneal and epididymal adiposity in the HFD groups in both experiments. Conclusions: We conclude that at similar body mass, adiposity is independent of the macronutrient composition of the feeding regimen used to achieve it.