Clinical Investigation Center (CIC) 1411, INSERM, CHU of Montpellier, University of Montpellier, Montpellier, France.
Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France.
Obes Facts. 2024;17(3):237-242. doi: 10.1159/000535067. Epub 2024 Apr 10.
Obesity is a chronic disease that increases cardiovascular and metabolic morbidity and mortality, decreases quality of life, and increases health care costs. While the role of lifestyle behavioral factors in the development of obesity is well established, the role of traumatic life events, including violence, is unclear. The purpose of this study was to describe situations of traumatic life events reported by patients undergoing a bariatric surgery program, with a particular focus on sexual violence and its clinical correlates.
In this cross-sectional study, patients with grade II or III obesity, admitted to our digestive surgery department for bariatric surgery from August 01, 2019, to December 31, 2020, underwent a structured interview by a trained psychologist to describe the history of traumatic life events self-reported by the patients. The primary endpoint was the presence of a history of sexual violence (SV). Multivariate logistic regressions were applied to identify independent risk factors for SV.
Of the 408 patients interviewed, 87.1% reported at least one traumatic life event and 33.1% reported having had an SV in the past. Female gender (aOR = 7.44, 95% confidence interval: 3.85-15.73; p < 0.001) and higher body mass index (1.05, 1.02-1.08; p = 0.002) were associated with an increased risk of SV. Male gender was associated with a higher risk of difficulties including sports cessation, depression, and work-related distress.
In the context of obesity, psychosocial trauma is characterized by a high frequency and several gender specificities that must be taken into account in the management of these patients.
肥胖是一种慢性疾病，会增加心血管和代谢疾病的发病率和死亡率，降低生活质量，并增加医疗保健成本。虽然生活方式行为因素在肥胖的发展中的作用已得到充分证实，但创伤性生活事件（包括暴力）的作用尚不清楚。本研究的目的是描述接受减重手术计划的患者报告的创伤性生活事件情况，特别关注性暴力及其临床相关性。
在这项横断面研究中，2019 年 8 月 1 日至 2020 年 12 月 31 日，我院消化外科收治的 II 级或 III 级肥胖患者，由经过培训的心理学家进行结构化访谈，以描述患者自我报告的创伤性生活事件史。主要终点是存在性暴力（SV）史。应用多变量逻辑回归来确定 SV 的独立危险因素。
在接受访谈的 408 名患者中，87.1%报告至少发生过一次创伤性生活事件，33.1%报告过去曾发生过 SV。女性（优势比[aOR] = 7.44，95%置信区间：3.85-15.73；p < 0.001）和更高的体重指数（1.05，1.02-1.08；p = 0.002）与 SV 的风险增加相关。男性与运动停止、抑郁和与工作相关的困扰等困难的风险增加相关。
在肥胖的背景下，心理社会创伤的特点是高频率和一些性别特异性，在这些患者的管理中必须考虑到这些特征。
