The impact of history of exposure to abuse on outcomes after bariatric surgery: data from the Ontario Bariatric Registry
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BACKGROUND: Studies worldwide have reported an increased prevalence of abuse histories among bariatric surgery candidates. The impact of abuse history on weight loss after surgery has not been examined in Canada. OBJECTIVES: Determine the prevalence of abuse and its impact on postoperative outcomes in Ontario, Canada. SETTING: Data from the Ontario Bariatric Registry. METHODS: A retrospective cohort study of laparoscopic gastric bypass and sleeve gastrectomy surgeries from 2010 to 2014, for which any follow-up data were available (N = 6016). Weight loss outcomes at 3 months (n = 5147), 6 months (n = 4749), and 1 year (n = 4024) were compared between those with and without a self-reported history of any of emotional, physical or sexual abuse and those with and without a history of sexual abuse specifically. Mixed repeated measures models were adjusted for age, sex, type of surgery, and baseline body mass index. One-year postoperative occurrence of revisions or repairs, hospitalization, and death were also examined. RESULTS: The prevalence of documented abuse was 21.5%. Emotional abuse was most common (13.1%), followed by sexual abuse (10.6%), then physical abuse (8.9%). There was no significant association between presence of abuse history and weight loss at any time point in repeated measures analyses. CONCLUSION: Abuse histories are common in bariatric surgery candidates in Ontario, but at a lower prevalence than what has been reported elsewhere. History of abuse does not appear to affect weight loss out to 1 year postoperatively and may alert providers to offer additional support perioperatively and postoperatively, particularly in the setting of psychiatric co-morbidity.
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