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Association of Adverse Childhood Experiences and Food Addiction to Bariatric Surgery Completion and Weight Loss Outcome

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Abstract

Introduction/Purpose

Adverse childhood experiences (ACEs) are known risk factors for obesity and poor outcomes following weight loss interventions. ACEs are also associated with addictive behaviors and, potentially, food addiction (FA). This study examined the relationship between ACEs and FA, and their association to undergoing bariatric surgery and post-surgical weight loss outcomes.

Materials and Methods

Between June 2013 and January 2016, 1586 bariatric-surgery-seeking patients completed a psychological evaluation. During their evaluation, the patients were administered measures including the ACE questionnaire and the Yale Food Addiction Scale.

Results

19.2% of those seeking bariatric surgery reported being the victim of childhood sexual abuse, and 22.1% reported being the victim of childhood physical abuse. An elevated ACE score corresponded to increased likelihood of screening positive for FA and more severe FA. When the type of ACE was analyzed separately, ACE was not associated with bariatric surgery completion or percent total weight loss (%TWL). Screening positive for FA corresponded to less %TWL 1 year post-surgery as the total number of ACEs increased, yet there was no association with %TWL 2 years post-surgery. The participants were classified into two groups, those positive for an ACE or FA versus those negative for both. Those who screened positive were significantly less likely to undergo bariatric surgery.

Conclusion

Screening positive for experiencing ACEs was related to severity of FA, and screening positive for being the victim of either childhood abuse or FA reduced the likelihood of completing bariatric surgery. More research is needed to determine how these psychosocial factors might influence bariatric surgery outcomes.

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Abbreviations

ACE:

adverse childhood experience

FA:

food addiction

PA:

physical abuse

SA:

sexual abuse

%TWL:

percent total weight loss

YFAS:

Yale Food Addiction Scale

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Author information

Authors and Affiliations

  1. Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA

    Allison A. Holgerson, Matthew M. Clark, Karen M. Graszer, Sarah A. Kalsy & Karen Grothe

  2. Division of Endocrinology & Metabolism, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Matthew M. Clark & Maria L. Collazo-Clavell

  3. Department of Psychiatry & Psychology, Mayo Clinic Florida, Jacksonville, FL, USA

    Gretchen E. Ames

  4. Division of Breast, Endocrine, Metabolic & GI Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Todd A. Kellogg

Authors
  1. Allison A. Holgerson
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  2. Matthew M. Clark
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  3. Gretchen E. Ames
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  4. Maria L. Collazo-Clavell
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Correspondence to Matthew M. Clark.

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The authors declare that they have no conflicts of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Holgerson, A.A., Clark, M.M., Ames, G.E. et al. Association of Adverse Childhood Experiences and Food Addiction to Bariatric Surgery Completion and Weight Loss Outcome. OBES SURG 28, 3386–3392 (2018). https://doi.org/10.1007/s11695-018-3370-1

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  • DOI: https://doi.org/10.1007/s11695-018-3370-1

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