Relation of childhood sexual abuse and other forms of maltreatment to 12-month postoperative outcomes in extremely obese gastric bypass patients.
BACKGROUND
The prognostic significance of sexual abuse for extremely obese patients who undergo bariatric surgery is uncertain. This study examined self-reported childhood sexual abuse and other forms of childhood maltreatment in relation to preoperative presentation and to 12-month postoperative outcomes in gastric bypass patients.


METHODS
137 extremely obese patients undergoing gastric bypass surgery completed a questionnaire battery before surgery and again 12 months after surgery. Weight loss was determined with measured weight and height, childhood maltreatment was assessed with the Childhood Trauma Questionnaire, and associated eating disorder and psychological functioning were assessed with established measures.


RESULTS
32% of patients self-reported childhood sexual abuse, 37% reported some form of non-sexual childhood abuse or neglect, and 31% reported no form of childhood maltreatment. Significant and clinically robust improvements in weight and in all measures of eating and psychological functioning were observed at 12 months after surgery. Patients who reported histories of childhood sexual abuse and other forms of childhood maltreatment differed little from patients who reported no childhood maltreatment in body mass index, eating disorder features, and psychological functioning both pre- and postoperatively at 12-month follow-up. Patients who reported childhood sexual abuse had statistically significantly higher levels of depression at 12 months after surgery, although the depression levels represented significant reductions from pre-surgery and fell within the non-depressed range.


CONCLUSIONS
Extremely obese patients who seek gastric bypass surgery report higher rates of childhood maltreatment than normative community samples. A history of childhood maltreatment, including reports of sexual abuse, does not appear to be a negative prognostic indicator for gastric bypass surgery.
Grilo
Carlos M
CM
Department of Psychiatry, Yale University School of Medicine, PO Box 208098, 301 Cedar Street, New Haven, CT 06520, USA. carlos.grilo@yale.edu
White
Marney A
MA
Masheb
Robin M
RM
Rothschild
Bruce S
BS
Burke-Martindale
Carolyn H
CH
D000328:Adult; D001828:Body Image; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D001068:Feeding and Eating Disorders; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D011379:Prognosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome