History of Trauma Exposure and Post-Traumatic Stress Spectrum Symptoms in a Sample of Bariatric Surgery Candidates: Clinical Correlates and Association with Maladaptive Eating Behaviours

TL;DR

This study finds that many bariatric surgery candidates have trauma-related stress symptoms linked to unhealthy eating behaviors.

Contribution

The study identifies a novel association between trauma exposure and maladaptive eating in bariatric surgery candidates.

Findings

36.5% of participants had high post-traumatic stress spectrum symptoms.

High PTSS scores correlated with increased emotional and maladaptive eating behaviors.

Emotional eating was significantly associated with a higher likelihood of trauma-related symptoms.

Abstract

Obesity is a growing health concern in Western countries and the link between obesity and mental disorders has been extensively studied, although less attention has been paid to post-traumatic stress spectrum symptoms (PTSS). This observational study aimed at exploring the correlations between lifetime trauma exposure and its related PTSS and maladaptive eating behaviours in obese patients who are candidates for bariatric surgery. A total of 189 obese candidates for bariatric surgery were recruited at the Azienda Ospedaliero-Universitaria Pisana (AOUP) and assessed by the Trauma and Loss Spectrum—Self-Report (TALS-SR Lifetime Version), Emotional Eating Scale (EES), Night Eating Questionnaire—Italian Version (I-NEQ), Grazing Questionnaire (GQ), and Eating Disorder Examination (EDE-Q), Eating Disorder Inventory (EDI). Based on the TALS-SR (Lifetime Version) scores, patients were dichotomised as either with low PTSS scores or high PTSS scores. Results showed high PTSS scores in more than a third of the sample (36.5%), with these individuals showing statistically significant higher total and EES domain scores, total and controllability GQ domain scores, I-NEQ mood/sleep domain scores, and EDE-Q shape concern domain score. A logistic regression showed an association between higher burden of emotional eating and greater probability of lifetime PTSS. PTSS appear to be frequent among bariatric surgery candidates and are related with maladaptive eating behaviours, suggesting accurate evaluation to optimise surgical outcomes.

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