The Importance of Assessing for Childhood Abuse and Lifetime PTSD in Bariatric Surgery Candidates

For bariatric surgery candidates, history of child abuse and PTSD may be under-recognized or under-reported at pre-surgical evaluation. On a range of clinically relevant factors, we studied 3045 candidates for bariatric surgery: (1) those with a history of childhood abuse compared to those without such history; and (2) among candidates with a history of abuse, those with a lifetime diagnosis of PTSD compared to those without that diagnosis. We compared them on current and lifetime eating disorders, physical health problems, health behaviors, physical functioning, psychosocial functioning, psychiatric disorders, emotional wellness, body satisfaction, and self-esteem. We hypothesized that patients with a history of childhood abuse, and within that group, those with a lifetime PTSD diagnosis, would display greater overall impairment. Patients were interviewed with semi-structured interviews and completed self-report questionnaires. Results showed that (1) patients with a history of childhood abuse exhibited significantly greater impairment than those without abuse; and (2) among candidates with a history of abuse, those with a lifetime history of PTSD displayed significantly greater impairment than those without a PTSD diagnosis. The findings suggest that a history of both childhood abuse and lifetime PTSD should be thoroughly assessed for at pre-surgical evaluation, and that greater attention be paid to the experience of PTSD symptoms in abuse survivors presenting for bariatric surgery.