Prevalence and Predictors of Self-Reported Sexual Abuse in a Population-Based Bariatric Program

Abstract

Past sexual abuse is associated with poorer weight loss outcomes following bariatric treatment. Identifying predictors of past sexual abuse would enable focused screening to be performed, which may increase weight management success. We analyzed data from 500 consecutively recruited morbidly obese subjects enrolled in a population-based, regional bariatric program. The prevalence of past or current self-reported sexual abuse was ascertained using a single interview question. Health status was measured from 0-100 using a visual analogue scale (VAS). Multivariable logistic regression was performed to identify socio-demographic, psychological, and clinical predictors of sexual abuse. The mean age of the 500 subjects was 43.7 years (SD 9.6), 441 (88%) were female, 458 (92%) were white, and the mean body mass index (BMI), 47.9 kg/m2 (SD 8.1). The prevalence of sexual abuse was 22% (95%CI 18-26%). Abuse was significantly more common in females (23.6 vs. 8.5%, p=0.007) and subjects with past abuse reported lower VAS scores [53.1 (SD 21.2) vs. 58.0 (SD 20.1), p=0.03]. BMI was not significantly associated with sexual abuse. Age, sex, BMI, and covariate-adjusted independent predictors of abuse included: self-reported alcohol addiction (adjusted OR 15.8; 95%CI 4.0-62.8), post-traumatic stress disorder (4.9; 2.5-9.5) borderline personality (3.7; 1.0-13.8), lower household income (3.3; 1.6-7.0), and depression (2.4; 1.3-4.3). One in five patients in a publically funded bariatric program reported past sexual abuse. Abused subjects reported lower health status than those without abuse. Alcohol addiction, psychiatric comorbidity, and low-income status were highly associated with past sexual abuse.