Associations of lifetime trauma exposure and bariatric surgery outcomes in adults with obesity

Abstract

Objective: This study aimed to examine the associations of lifetime traumatic experience with pre- and post-surgery eating pathology and postoperative weight-loss in a sample of bariatric surgery patients using electronic medical record (EMR) data. Methods: Pre-surgery lifetime exposure to traumatic event, pre- and post-surgery dysfunctional eating patterns, and post-operative total and excess weight losses were extracted from EMR of 200 consecutively admitted bariatric surgery patients in 2013 and 2014. Logistic regression analyses were conducted to determine whether the presence of lifetime traumatic experience was associated with post-surgery lower weight-loss and dysfunctional eating patterns at pre- and post-surgery. Findings: Up to 60.5% of the patients (81.5% women; age=44.4±11.5 years; BMIpre=44.9±5.5 kg/m2) reported that they were exposed to a traumatic event during their lifetime. Before surgery, trauma exposure was associated with impulsive, compulsive or restrictive eating patterns (OR=2.40; 95%CI=1.45–4.13), overeating or disturbed eating (OR=1.55; 95%CI=1.16–2.09), and grazing or night eating behaviors (OR=1.72; 95%CI=1.15–2.62). After surgery, trauma exposure was associated with lower weight loss at 6 months (OR=2.06; 95%CI=1.15–3.84) and 24 months (OR=2.06; 95%CI=1.15–3.84), and to overeating or disturbed eating (OR=1.53; 95%CI=1.03–2.29) 12 months after surgery. Discussion: Despite limitations of a retrospective study design, the results of this study suggest that bariatric surgery candidates with a history of trauma exposure could benefit from closer medical, dietetic, and/or psychological follow-up care to avoid insufficient postoperative weight-loss as well as reappearance of dysfunctional eating patterns after surgery.