Impact of dietary and behavioural factors on obesity and response to treatment

Worldwide obesity prevalence has never been so great. Deceleration of this disturbing trend is critical from a public health and economic perspective and for the individual, for whom the physiological and psychological consequences of obesity can be debilitating. The pathogenesis of obesity is multifactorial. Our genetic makeup has predisposed susceptible humans to weight gain when exposed to the modern "obesogenic" environment. Currently available medical and behavioural obesity treatments most often fail to produce sustained weight loss. Inability to maintain behaviours conducive to weight loss management is a commonly cited cause. For clinically severe obesity bariatric surgery is considered the most reliable and durable intervention. Despite its growing popularity, the impact of pre- and post-operative behavioural patterns on surgical outcomes is unclear, and empirical evidence to support important aspects of dietary and behavioural management is lacking. This thesis aimed to provide an evidence base to direct key features of pre-and post-surgical care of the bariatric surgery recipient.