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. 2023 Apr 24;15(9):2046.
doi: 10.3390/nu15092046.

Childhood Maltreatment in Patients Undergoing Bariatric Surgery: Implications for Weight Loss, Depression and Eating Behavior

Tair Ben-Porat  1   2 , Simon L Bacon  1   2 , Robbie Woods  1   3 , Annabelle Fortin  1   4 , Kim L Lavoie  1   4 ; REBORN Study Team
Affiliations

Childhood Maltreatment in Patients Undergoing Bariatric Surgery: Implications for Weight Loss, Depression and Eating Behavior

Tair Ben-Porat et al. Nutrients. .

Abstract

We aimed to explore the relationships between childhood maltreatment and changes in weight, depressive symptoms and eating behavior post-bariatric surgery (BS). Participants (n = 111, 85% females) were evaluated pre-surgery, and at 6 months (6 M) and 12 months (12 M) post-BS. History of maltreatment was assessed at baseline (Childhood Trauma Questionnaire), and depressive symptoms (Beck Depression Inventory-II) and eating behavior (Dutch Eating Behavior Questionnaire) were assessed at all time points. Participants' mean age and median BMI were 45.1 ± 11.7 years and 46.7 (IQR 42.4-51.9) kg/m2, respectively. Histories of emotional (EA), physical (PA) and sexual abuse (SA) and emotional (EN) and physical (PN) neglect were reported by 47.7%, 25.2%, 39.6%, 51.4% and 40.5%, respectively, with 78.4% reporting at least one form of maltreatment. Changes in weight and depressive symptoms were not different between patients with vs. without a history of maltreatment. However, those with vs. without SA demonstrated limited changes in emotional eating (EE) at 12 M, while those without showed improvements. Conversely, patients with vs. without EN showed greater improvements in external eating (ExE) at 6 M, but differences were no longer observed by 12 M. Results indicate that histories of SA and EN are associated with changes in eating behaviors post-BS and have implications for assessment, monitoring and potential intervention development.

Keywords: bariatric surgery; childhood maltreatment; depressive symptoms; eating behavior; obesity.

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Conflict of interest statement

S.L.B. has served on the advisory board for Lucilab, Respiplus, Sanofi and Bayer; received an investigator-initiated educational grant from Moderna; and received consultancy and speaker fees from Respiplus, none of which are related to the current article. K.L.L. has served on the advisory board for Schering-Plough, Takeda, AbbVie, Almirall, Janssen, GSK, Astellas, Novartis, Boehringer Ingelheim (BI) and Sojecci Inc. and received sponsorship for investigator-generated research grants from GSK and AbbVie, speaker fees from GSK, AstraZeneca, Astellas, Novartis, BI, Takeda, Janssen, AbbVie, Merck, Bayer, Pfizer and Air Liquide and support for educational materials from Merck, none of which are related to the current article. All other authors have no conflict of interest to report.

Figures

Figure 1
Figure 1
Prevalence of childhood maltreatment history (emotional abuse (A), physical abuse (B), emotional neglect (C), physical neglect (D) and sexual abuse (E) and number of maltreatments of any type of any severity (F)) in the sample (n = 111).
Figure 2
Figure 2
Course of depressive symptoms based on the BDI-II total scores (A–D) and eating behaviors based on the DEBQ and its sub-scale scores (E,F) according to the status of maltreatment type. Abbreviations: Beck Depression Inventory-II (BDI-II), Dutch Eating Behavior Questionnaire (DEBQ), 6 and 12 months post-operation (6 M, 12 M), emotional abuse (EA), emotional neglect (EN), physical neglect (PA), sexual abuse (SA). Data were available for 111, 101 and 73 participants at baseline, 6 M and 12 M, accordingly.
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