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High Prevalence of Sexual Abuse Victims in Bariatric Program



weight scale helpRegular readers will be well aware of the fact that emotional, physical and sexual abuse can often lead to overeating and significant weight gain.

In a paper, just published in the Journal of Obesity, we looked at the prevalence of self-reported sexual abuse in 500 consecutively recruited patients attending our bariatric clinic.

As is typical for bariatric programs, the vast majority of patients were female (88%) with a mean BMI of 48.

The self-reported prevalence of past abuse was 22%, whereby abused responders had a significantly worse health status, greater incidence of alcohol addiction, post-traumatic stress disorder, borderline personality disorders and depression. Abused patients also tended to have lower household incomes than their peers.

Despite this rather high prevalence of sexual abuse, there was no direct correlation between self-reported abuse and BMI levels (clearly implying that there are many other reasons why someone may gain weight).

This study should remind clinicians to take careful abuse histories in their obese patients, especially if they present with a past history of alcohol problems or depression.

@DrSharma
Kananaskis, AB

ResearchBlogging.orgGabert DL, Majumdar SR, Sharma AM, Rueda-Clausen CF, Klarenbach SW, Birch DW, Karmali S, McCargar L, Fassbender K, & Padwal RS (2013). Prevalence and predictors of self-reported sexual abuse in severely obese patients in a population-based bariatric program. Journal of obesity, 2013 PMID: 23864941

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6 Comments

  1. Hi,

    can you give us the rate of self-reported sexual abuse among women in the rest of the population?

    I am trying to figure out how big 22% is for the population you are studying. For all I know, maybe your patients are pretty much average in that regard. Or maybe they are much worse.

    Thank you,

    Valerie

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  2. The headline implies that a history of sexual abuse is somehow higher among the people in this study, but I can’t find any data to justify the claim.

    This study used a single question, “Do you have a history of sexual abuse, in the past or currently?” of 500 people signing up for weight loss “treatment” in the Edmonton area. Is there a representative sample survey of Canadians on the prevalence of sexual violence history? In the US, the statistics for the population as a whole are here:

    http://www.cdc.gov/ViolencePrevention/pdf/SV-DataSheet-a.pdf

    The prevalence of abuse reported in the study is not different from the ranges reported of the US population in general. Yes, it is high – any person suffering this experience is one too many – but it is misleading to tie it to this population in particular.

    Health care provider should be asking all patients about this history since it is the experience of somewhere between 1 in 5 and 1 in 3 women, and a smaller but significant number of men.

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  3. While I understand the points being made here, I’m glad that you clarify direct correlation has not been identified.

    I would continue to make the point that it still depends on the individual’s nature to determine the response to trauma and distress. I’m sick and tired of the assumption that if you’re obese, there’s “something wrong with you” and that has “caused” a weight problem for a person who is assumed to be out of control, weak-willed, and emotionally broken.

    A victim of sexual abuse may respond by becoming withdrawn and depressed, by becoming anorexic, by drinking or doing drugs, by becoming sexually promiscuous, by cutting or other forms of self-injury—the response could take so many forms. It stands to reason that there will be a percentage of us who will connect eating to anything that happens in our lives, good or bad. Some of us are going to be larger and crave food more no matter what path our lives take.

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  4. I take great offense at Dagny Kight’s post. As a female who was sexually molested around the age of 7 and being from a emotionally cold family, I immediately turned to food to comfort and nurture myself (subconsciously) to replace what I wasn’t getting.

    I also recognize that through the years, when I felt unsafe in a relationship, the weight protected me…..I no longer wanted to be “chosen.”

    If one has never experienced this as a child, he/she are not in a position to give an opinion, much less, a judgmental one. The first sentence of the last paragraph is so hilarious…..the writer acknowledges that sexual abuse causes every maladjustment mentioned, even anorexia which is an eating disorder also, except for obesity. Yet, in treatment centers, both are considered as being alike in nature.

    Sadly, it sounds more like a misinformed prejudice versus being based on sound, psychological research.

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    • Please don’t take offence. The thing to remember is that how one person reacts, is not how another person might react. Yes, many people (including myself) react to abuse by developing eating disorders. Many people do not – they find a different way to cope. It’s important to remember that eating disorders – whether they are the kind that makes you obese or the kind that makes you emaciated, or (most commonly) the kind that doesn’t outwardly affect your weight that noticeably – are not *caused* by abuse. They can be *triggered*. Eating disorders are the result of a powerful combination of factors, including genetic predisposition, environmental factors, behavioural and personal factors, events, and so on.

      22% of bariatric patients reporting abuse is actually not much different to the proportion of the entire population – the majority who do not have eating disorders – who report abuse. So abuse is a trigger, among other triggers, but it’s not a cause, just because it triggered your disorder, doesn’t mean it’s THE cause of eating disorders for you or anyone. It’s a trigger.

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