Background

History of childhood trauma (CT), which is over-represented among bariatric surgery candidates, is associated with increased risk of mental disorders, eating pathology and obesity.

Methods

A literature review was conducted to evaluate CT in relation to pre-surgery status and outcomes of bariatric surgery.

Results

Four studies (sample size range: 230-567) have reported significant associations between CT and lifetime history of psychiatric disorders/conditions and treatment (including mood, anxiety, binge eating and substance use disorders, emotional difficulties, depressive symptoms, suicidal ideation and antidepressant use) among pre-surgery patients. When evaluated by sex and by CT type (i.e., emotional, physical and sexual abuse, and emotional and physical neglect), associations differed. Severity of childhood emotional and physical abuse/neglect also differentiated outcomes; this was not true for sexual abuse. Six studies (sample size range: 96-424, follow-up ≤2 years in 4 of 6) have reported lack of significant associations between measures of CT (most often sexual abuse) and either post-surgery weight/BMI, weight loss and/or weight regain. Three of these studies, however, found significant associations with post-surgery depression or less improvement in depressive symptoms. Finally one study found no association with post-surgery eating disorders but another study reported significant associations with less improvement in eating pathology.

Conclusions

It does not appear that CT, childhood sexual abuse in particular, is related to surgery-induced weight outcomes. However, CT may result in less improvement in depressive symptomology and eating pathology. Research with larger samples is needed to clarify differences in associations for males vs. females and by type/severity of CT.