The impact of childhood trauma on change in depressive symptoms, eating pathology, and weight after Roux-en-Y gastric bypass

King, Wendy C.; Hinerman, Amanda; Kalarchian, Melissa A.; Devlin, Michael J.; Marcus, Marsha D.; Mitchell, James E.

doi:10.1016/j.soard.2019.04.012

Cited by 20 publications

(14 citation statements)

References 38 publications

(61 reference statements)

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“…Although some investigators have postulated that being a victim of childhood sexual abuse may impact the weight loss outcome of bariatric surgery, because weight may be protective for survivors of childhood sexual abuse, results of studies have been mixed . A recent LABS‐3 cohort study that included 96 patients undergoing bariatric surgery with ≥ 7 years of follow‐up found that history of childhood sexual abuse was not significantly related to weight loss or regain following RYGB . History of childhood sexual abuse may be associated with increased risk of psychiatric hospitalization after bariatric surgery .…”

Section: Bariatric Population Mental Health Risksmentioning

confidence: 99%

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes

Morledge

Pories

2020

Obesity

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Severe obesity has many psychiatric consequences that can be influenced by bariatric surgery. The goal of this article is to review these challenges, including the mental health status of patients with severe obesity, the evaluation of surgical candidates, and the early and late effects of the operations, and to offer some recommendations to manage these challenges. The failure of the insurance‐mandated preoperative psychosocial evaluation is also discussed.

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Section: Bariatric Population Mental Health Risksmentioning

confidence: 99%

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes

Morledge

Pories

2020

Obesity

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“…34 Patients with unresolved trauma are more likely to present after bariatric surgery with difficulties, for example, increased alcohol use; unhealthy eating behaviors; poor weight-loss; and increased suicide risk. [36][37][38][39] The use of food as an emotional regulatory strategy, and as a method of self-soothing has been postulated as an explanatory mechanism. 32 Although there are improvements in cognitive function postbariatric surgery for those with pre-surgical severe and complex obesity, there is a correlation between elevated levels of disinhibition and lower levels of restraint with poor compliance with post-surgical dietary recommendations and suboptimal weight loss 2 years after surgical intervention.…”

Section: What Are the Increased Risks For Those Who Have Had Bariatri...mentioning

confidence: 99%

“…Further, childhood sexual abuse is cited as having the greatest impact on living with childhood obesity in comparison to other Adverse Childhood Experiences (ACEs), with multiple ACEs predicting increased risk 34 . Patients with unresolved trauma are more likely to present after bariatric surgery with difficulties, for example, increased alcohol use; unhealthy eating behaviors; poor weight‐loss; and increased suicide risk 36–39 . The use of food as an emotional regulatory strategy, and as a method of self‐soothing has been postulated as an explanatory mechanism 32 …”

Section: Introductionmentioning

confidence: 99%

The forgotten patient: A psychological perspective on the implementation of bariatric surgery guidelines

Johnston

Jackson

Hilton

et al. 2023

Obesity Science & Practice

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There is strong evidence demonstrating the impact of bariatric surgery on weight‐loss and comorbidity improvement. In the UK, there is specific guidance to facilitate the assessment of a person's suitability for bariatric surgery. This paper highlights the clinical reality of routinely implementing this guidance, supported by literature and the perspectives of practicing psychologists. The consequences of the implementation of clinical guidelines within the context of the typical biopsychosocial profile of those referred for bariatric surgery are discussed. The ramifications of a screening approach rather than a clinical formulation‐based approach to assessment, impact of a possible unconscious bias in commissioning and an overemphasis on a biomedical model approach to treatment are also presented. These contextual factors are argued to contribute to a population of “forgotten patients” that is, patients who have been assessed as not suitable for bariatric surgery, and thus “stuck” in their journey toward better health. For these individuals the only option left are energy balance only approaches, which are the very same approaches to weight‐loss and comorbidity improvement that have been attempted, often for many years. Not only have these approaches not resulted in weight‐loss and health improvement, they also fail to address the underlying psychological causes of obesity. Consequently, this lack of support means that patients continue to suffer from poor quality of life, with no clear pathway to improved health and wellbeing. This paper illuminates the clear gaps in weight management service provision, the implementation of guidelines in practice, and offers practical suggestions to reduce the unintended consequences of clinical guidelines for bariatric surgery.

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“…Most research examining the relationship between childhood abuse and obesity treatment has focused on bariatric surgery. Despite some evidence indicating that exposure to adverse childhood experiences, including abuse, is associated with less weight loss following bariatric surgery (10), these findings have been mixed, with additional research showing no relationship between adverse childhood experiences and postoperative weight loss or regain (11).…”

Section: Introductionmentioning

confidence: 99%

“…childhood experiences, including abuse, is associated with less weight loss following bariatric surgery (10), these findings have been mixed, with additional research showing no relationship between adverse childhood experiences and postoperative weight loss or regain (11).…”

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confidence: 99%

Association of childhood abuse with behavioral weight‐loss outcomes: Examining the mediating effect of binge eating severity

Emery

Mason

Levy

et al. 2021

Obesity

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Objective The study aims were to (1) document the relationship between a history of childhood abuse and weight change during behavioral obesity treatment and (2) estimate the indirect effect of childhood abuse on weight change through binge eating severity. Methods Participants (n = 431) were enrolled in a behavioral weight‐loss intervention. Childhood physical and emotional abuse history and current binge eating severity were self‐reported. Percent weight loss at 6 months was calculated using measured weight. Adjusted mediation models examined whether there was an indirect effect of childhood physical and emotional abuse on 6‐month percent weight loss that operated through binge eating severity. Results After covariate adjustment, childhood physical abuse, but not emotional abuse, predicted a lower percent weight loss (B = −1.78%; 95% CI: −3.10% to −0.47%). Although childhood physical and emotional abuse were positively related to baseline binge eating severity, binge eating severity did not mediate the associations between either childhood abuse type and percent weight loss. Conclusions Individuals with a childhood physical abuse history had a lower percent weight loss than those without such histories during behavioral obesity treatment. This effect was not explained by binge eating severity. Individuals with a history of childhood abuse may benefit from trauma‐informed obesity care.

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The impact of childhood trauma on change in depressive symptoms, eating pathology, and weight after Roux-en-Y gastric bypass

Cited by 20 publications

References 38 publications

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes

The forgotten patient: A psychological perspective on the implementation of bariatric surgery guidelines

Association of childhood abuse with behavioral weight‐loss outcomes: Examining the mediating effect of binge eating severity

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