title: The impact of history of exposure to abuse on outcomes after bariatric surgery: data from the Ontario Bariatric Registry.
abstract: BACKGROUND
  Studies worldwide have reported an increased prevalence of abuse histories among bariatric surgery candidates. The impact of abuse history on weight loss after surgery has not been examined in Canada.
  
  
  OBJECTIVE
  Determine the prevalence of abuse and its impact on postoperative outcomes in Ontario, Canada.
  
  
  METHODS
  Data from the Ontario Bariatric Registry.
  
  
  METHODS
  A retrospective cohort study of laparoscopic gastric bypass and sleeve gastrectomy surgeries from 2010 to 2014, for which any follow-up data were available (N = 6016). Weight loss outcomes at 3 months (n = 5147), 6 months (n = 4749), and 1 year (n = 4024) were compared between those with and without a self-reported history of any of emotional, physical or sexual abuse and those with and without a history of sexual abuse specifically. Mixed repeated measures models were adjusted for age, sex, type of surgery, and baseline body mass index. One-year postoperative occurrence of revisions or repairs, hospitalization, and death were also examined.
  
  
  RESULTS
  The prevalence of documented abuse was 21.5%. Emotional abuse was most common (13.1%), followed by sexual abuse (10.6%), then physical abuse (8.9%). There was no significant association between presence of abuse history and weight loss at any time point in repeated measures analyses.
  
  
  CONCLUSIONS
  Abuse histories are common in bariatric surgery candidates in Ontario, but at a lower prevalence than what has been reported elsewhere. History of abuse does not appear to affect weight loss out to 1 year postoperatively and may alert providers to offer additional support perioperatively and postoperatively, particularly in the setting of psychiatric co-morbidity.
authors.affiliation: Department of Psychiatry, Women's College Hospital & University of Toronto, Toronto, Ontario, Canada. Electronic address: jennifer.hensel@wchospital.ca.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Hensel
authors.affiliation: Department of Psychiatry, Emek Medical Center, Afula, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Grosman Kaplan
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mehran
authors.initials: M
authors.lastname: Anvari
authors.affiliation: Department of Psychiatry, Women's College Hospital & University of Toronto, Toronto, Ontario, Canada.
authors.forename: Valerie H
authors.initials: VH
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000401:mortality / Q000706:statistics & numerical data*; D015992:Body Mass Index; D004644:Emotions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000401:mortality / Q000523:psychology / Q000601:surgery; D009864:Ontario / Q000453:epidemiology; D000066550:Physical Abuse / Q000706:statistics & numerical data*; D015995:Prevalence; D012042:Registries; D012742:Sex Offenses / Q000706:statistics & numerical data*; D015431:Weight Loss; D055815:Young Adult
keywords: Abuse; Bariatric surgery; Psychiatric; Suicide; Weight loss