The Association Between Adverse Childhood Experiences (ACEs) and Postoperative Bariatric Surgery Weight Loss Outcomes
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ORIGINAL CONTRIBUTIONS
The Association Between Adverse Childhood Experiences (ACEs) and Postoperative Bariatric Surgery Weight Loss Outcomes Austin Shinagawa 1 & Andrew J. Ahrendt 2 & Emerson M. Epstein 2 & John-Henry Lambin 1 & Rachael Lambin 1 & Makayla Cox 1 & Jonathan Gevorkian 1 & Deacon Shoenberger 2 & Kent Sasse 1 Received: 31 March 2020 / Revised: 9 June 2020 / Accepted: 11 June 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Previous research demonstrates that exposure to adverse childhood experiences (ACEs) is associated with development of obesity. The same mechanisms mediating this relationship could theoretically affect attempts to lose weight in adulthood. However, it is unclear whether or not exposure to ACEs impacts the effectiveness of bariatric surgery. The present study aimed to examine the association of exposure to ACEs to postoperative weight loss outcomes. Materials and Methods One hundred ninety-eight patients undergoing bariatric surgery were evaluated for their exposure to ACEs, determined by a presurgical questionnaire and recorded as an ACEs score. Percent total weight loss (%TWL) was calculated to evaluate postoperative weight loss at 1-, 3-, and 6-month intervals postoperatively. One hundred forty-two participants were available for follow-up at the 6-month postoperative interval. Results The sample consisted of 167 women and 31 men with a mean age of 47.7. Twenty-five percent of participants experienced high exposure to ACEs, defined as experiencing ≥ 4 ACEs. The average %TWL at 6 months was 16.52%. Multilevel modeling found no significant relationship between ACEs score and %TWL at any of the postoperative time intervals, both before and after adjusting for age, sex, and race. Conclusion High exposure to ACEs was not associated with poorer weight loss outcomes, and participants with a large number of ACEs generally lost the anticipated amount of weight. Keywords Adverse childhood experiences . ACEs . Postoperative . Weight loss . Bariatric surgery . Childhood trauma
Introduction Despite the demonstrated benefits of bariatric surgery, not all patients experience the anticipated weight loss. Several factors have been associated with smaller than expected weight loss,
including higher presurgical body mass index (BMI), diabetes, and psychiatric conditions such as depression or anxiety [1–4]. Another such factor potentially correlating to reduced postoperative weight loss is a history of childhood trauma [5–8].
* Austin Shinagawa [email protected]
Jonathan Gevorkian [email protected]
Andrew J. Ahrendt [email protected]
Deacon Shoenberger [email protected]
Emerson M. Epstein [email protected]
Kent Sasse [email protected]
John-Henry Lambin [email protected] 1
School of Medicine, University of Nevada Reno, 1664 N. Virginia Street, Reno, NV 89557, USA
2
Clinical Psychology Doctoral Program, University of Nevada Reno, 1664 N. Virginia Street, Reno, NV 89557, USA
Rachael Lambin [email protected] Makayla Cox
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