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

Abstract

Background: History of childhood trauma is associated with increased risk of mental disorders, eating pathology, and obesity.

Objective: To examine associations between childhood trauma and changes in depressive symptoms, eating pathology, and weight after Roux-en-Y Gastric Bypass (RYGB).

Setting: Three U.S. academic medical centers.

Method: Adults undergoing bariatric surgery (2007-2011) were enrolled in a cohort study. Participants (96 of 114; 86%) completed the Beck Depression Inventory-1 (BDI-1) to assess depressive symptomology, the interviewer-administered Eating Disorder Examination (EDE) to assess subthreshold eating pathology, weight assessment before and 6 months and annually after RYGB for ≥7 years, and the Childhood Trauma Questionnaire (CTQ) once post-RYGB.

Results: Presurgery, median age was 46 years, and median body mass index was 47 kg/m²; 79% were female. Data completeness across 7-year follow-up was 78% to 90%, 66% to 91%, and 93% to 100% for the BDI-1, EDE, and weight, respectively. Using mixed models, presence/severity of childhood emotional abuse, emotional neglect, and physical neglect, but not sexual abuse or physical abuse, were significantly associated (P < .05) with change (i.e., less improvement/worsening) in the BDI-1 and EDE global scores, as were higher total CTQ score and more types of moderate-intensity trauma. All CTQ measures were associated (P < .05) with less improvement or worsening in the EDE eating concern and shape concern scores. CTQ measures were not significantly related to weight loss or regain.

Conclusions: Although childhood trauma did not affect weight outcomes after RYGB, those who experienced childhood trauma had less improvement in depressive symptomology and eating pathology and therefore might benefit from clinical intervention.

Keywords: Childhood trauma; Roux-en-Y gastric bypass; bariatric surgery; childhood maltreatment; depression; depressive symptoms; eating pathology; mental disorders; weight.