The Association Between Traumatic Experiences and Weight Loss Outcomes in Obesity

Obesity and lifetime exposure to violence are preventable public health issues. The relationship between exposure to violence and obesity treatment outcomes has not been extensively investigated. The aim of this study was to examine the effect of childhood trauma and violence during adulthood on short -term weight loss success among individuals with obesity.

The study included 89 female patients diagnosed with obesity who had no active psychiatric disorders. Participants were assessed using the Structured Clinical Interview for DSM-5, Clinical Version (SCID-5-CV). Childhood trauma was measured with the Childhood Trauma Questionnaire (CTQ-28). Exposure to physical, emotional, sexual, and economic violence during adulthood was evaluated using a researcher-developed questionnaire. After a three-month follow-up period, participants who achieved at least 5% weight loss, a short-term treatment target recommended for reducing morbidity were compared with those who did not.

A substantial proportion of participants (85.4%) reported experiencing at least one type of childhood trauma, and more than half (51.7%) had been exposed to at least one type of violence in adulthood. Participants who failed to achieve ≥5% weight loss had significantly higher CTQ subscale scores for physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect (p <0.05). A significant association was also observed between childhood trauma and subsequent exposure to violence in adulthood (p <0.01). Effective weight loss was less common among individuals exposed to physical, emotional, economic, or sexual violence during adulthood; however, multivariate analyses revealed that only economic violence was a significant risk factor for unsuccessful weight loss (aOR=5.65[2.05-15.55]).

This study highlights the high prevalence of exposure to different types of lifetime violence among women with obesity and demonstrates a significant association between trauma history and diminished weight loss outcomes. Integrating trauma-focused approaches into obesity treatment may contribute to improving both treatment and prevention processes.