It is known that childhood maltreatment and problematic eating behaviors are higher in bariatric surgery patients compared to over- and normal-weight persons. The aim of the study is to investigate the relationship between childhood maltreatment and problematic eating behaviors such as restraint, eating concern, weight concern, shape concern, and emotional eating in bariatric surgery patients.
Materials and methods
112 consecutive obese individuals seeking bariatric surgery at a University Hospital were administered asset of scales, including Childhood Trauma Questionnaire (CTQ), Dutch Eating Behavior Questionnaire-Emotional Eating subscale (DEBQ-E), and Eating Disorder Examination-Questionnaire (EDE-Q) and sociodemographic form, cross-sectionally. After descriptive statistics, a regression analysis was conducted to understand the relationships of CTQ scores with EDE-Q total, and subscale scores and DEBQ-E.
In the Pearson correlation analysis, a statistically significant positive correlation was found between CTQ total score with EDE-Q total score and all subscales scores. In linear regression analyses, it was found that emotional abuse (β = 0.39, p = 0.02) and physical abuse (β = 0.36, p = 0.01) predicted increased DEBQ-E scores. In addition, sexual abuse was found to significantly predict weight concern (β = 0.26, p = 0.04) and shape concern (β = 0.31, p = 0.01).
Our findings showed that the dynamics of problematic eating behaviors may differ depending on the type of childhood trauma. Psychiatric evaluation of bariatric surgery patients is important in understanding the relationship between childhood maltreatment and problematic eating behaviors.
Level of evidence
Level V, cross-sectional descriptive study.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Mutlu H (2015) Assesment of the relationships between childhood traumas and adult obesity. Baskent University, Ankara
Green JG, McLaughlin KA, Berglund PA, Gruber MJ, Sampson NA, Zaslavsky AM, Kessler RC (2010) Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Arch Gen Psychiatry 67(2):113–123. https://doi.org/10.1001/archgenpsychiatry.2009.186
Amianto F, Spalatro AV, Rainis M, Andriulli C, Lavagnino L, Abbate-Daga G, Fassino S (2018) Childhood emotional abuse and neglect in obese patients with and without binge eating disorder: personality and psychopathology correlates in adulthood. Psychiatry Res 269:692–699. https://doi.org/10.1016/j.psychres.2018.08.089
Hemmingsson E, Johansson K, Reynisdottir S (2014) Effects of childhood abuse on adult obesity: a systematic review and meta-analysis. Obes Rev 15(11):882–893. https://doi.org/10.1111/obr.12216
Trottier K, MacDonald DE (2017) Update on psychological trauma, other severe adverse experiences and eating disorders: State of the research and future research directions. Curr Psychiatry Rep 19(8):45. https://doi.org/10.1007/s11920-017-0806-6
Caslini M, Bartoli F, Crocamo C, Dakanalis A, Clerici M, Carrà G (2016) Disentangling the association between child abuse and eating disorders: a systematic review and meta-analysis. Psychosom Med 78(1):79–90. https://doi.org/10.1097/PSY.0000000000000233
Madowitz J, Matheson BE, Liang J (2015) The relationship between eating disorders and sexual trauma. Eat Weight Disord 20(3):281–293. https://doi.org/10.1007/s40519-015-0195-y
Evers C, Marijn Stok F, de Ridder DT (2010) Feeding your feelings: emotion regulation strategies and emotional eating. Pers Soc Psychol Bull 36(6):792–804. https://doi.org/10.1177/0146167210371383
Michopoulos V, Powers A, Moore C, Villarreal S, Ressler KJ, Bradley B (2015) The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating. Appetite 91:129–136. https://doi.org/10.1016/j.appet.2015.03.036
Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, Shekelle PG (2016) Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA 315(2):150–163. https://doi.org/10.1001/jama.2015.18118
Danese A, Tan M (2014) Childhood maltreatment and obesity: systematic review and meta-analysis. Mol Psychiatry 19(5):544. https://doi.org/10.1038/mp.2013.54
Imperatori C, Innamorati M, Lamis DA, Farina B, Pompili M, Contardi A, Fabbricatore M (2016) Childhood trauma in obese and overweight women with food addiction and clinical-level of binge eating. Child Abuse Negl 58:180–190. https://doi.org/10.1016/j.chiabu.2016.06.023
Peterhänsel C, Nagl M, Wagner B, Dietrich A, Kersting A (2019) Childhood maltreatment in bariatric patients and its association with postoperative weight, depressive, and eating disorder symptoms. Eat Weight Disord 1:12. https://doi.org/10.1016/10.1007/s40519-019-00720-w
Grilo CM, Masheb RM, Brody M, Toth C, Burke-Martindale CH, Rothschild BS (2005) Childhood maltreatment in extremely obese male and female bariatric surgery candidates. Obes Res 13(1):123–130. https://doi.org/10.1038/oby.2005.16
Sarwer DB, Allison KC, Wadden TA, Ashare R, Spitzer JC, McCuen-Wurst C, LaGrotte C, Williams NN, Edwards M, Tewksbury C (2019) Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surg Obes Relat Dis 15(4):650–655. https://doi.org/10.1016/j.soard.2019.01.029
Belli H, Ural C, Akbudak M, Sagaltıcı E (2019) Levels of childhood traumatic experiences and dissociative symptoms in extremely obese patients with and without binge eating disorder. Nord J Psychiatry 73(8):527–531. https://doi.org/10.1080/08039488.2019.1662085
Bernstein DP, Fink L, Handelsman L, Foote J, Lovejoy M, Wenzel K, Sapareto E, Ruggiero J (1994) Initial reliability and validity of a new retrospective measure of child abuse and neglect. Am J Psychiatry 151(8):1132–1136. https://doi.org/10.1176/ajp.151.8.1132
Sar V, Ozturk E, Ikikardes E (2012) Validity and reliability of the Turkish version of childhood trauma questionnaire. Turkiye Klinikleri J Med Sci 32(4):1054–1063. https://doi.org/10.5336/medsci.2011-26947
Van Strien T, Frijters JE, Bergers GP, Defares PB (1986) The dutch eating behavior questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. Int J Eat Disord 5(2):295–315. https://doi.org/10.1002/1098-108X(198602)5:2<295:AID-EAT2260050209>3.0.CO;2-T
Bozan N (2009) To determine of the DEBQ’s reliability and validity on Turkish University Students. Baskent University, Ankara
Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16(4):363–370. https://doi.org/10.1002/1098-108X(199412)16:4<363:AID-EAT2260160405>3.0.CO;2-#
Yucel B, Polat A, Ikiz T, Dusgor BP, Elif Yavuz A, Sertel Berk O (2011) The Turkish version of the eating disorder examination questionnaire: reliability and validity in adolescents. Eur Eat Disord Rev 19(6):509–511. https://doi.org/10.1002/erv.1104
Bakalar JL, Barmine M, Druskin L, Olsen CH, Quinlan J, Sbrocco T, Tanofsky-Kraff M (2018) Childhood adverse life events, disordered eating, and body mass index in US Military service members. Int J Eat Disord 51(5):465–469. https://doi.org/10.1002/eat.22851
Hymowitz G, Salwen J, Salis KL (2017) A mediational model of obesity related disordered eating: the roles of childhood emotional abuse and self-perception. Eat Behav 26:27–33. https://doi.org/10.1016/j.eatbeh.2016.12.010
Orcutt M, King WC, Kalarchian MA, Devlin MJ, Marcus MD, García L, Steffen KJ, Mitchell JE (2019) The relationship between childhood maltreatment and psychopathology in adults undergoing bariatric surgery. Surg Obes Relat Dis 15(2):295–303. https://doi.org/10.1016/j.soard.2018.11.009
Availability of data and material
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Conflict of interest
The authors have no conflict of interest to declare.
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Non-Invasive Ethical Committee of Bezmialem Vakıf University, Faculty of Medicine (22.06.2017/11376).
Informed consent was obtained from all individual participants included in the study.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The article is part of the Topical Collection on Obesity Surgery and Eating and Weight Disorders.
About this article
Cite this article
Akduman, I., Sevincer, G.M., Bozkurt, S. et al. The relationship between childhood maltreatment and problematic eating behaviors in bariatric surgery candidates. Eat Weight Disord (2020). https://doi.org/10.1007/s40519-020-00943-2
- Adverse life events
- Bariatric surgery
- Childhood maltreatment
- Emotional eating
- Problematic eating behaviors