Background

Many patients with obesity are unsuccessful in achieving long term weight loss.Additional research is needed to assist health care providers in delivering patient-centered care and elucidating causes of obesity treatment failure.

Methods

A multisite survey was developed by the PCORI LHSNet obesity cohort workgroup composed of 49 questions with two questions focusing on being the victim of childhood physical and sexual abuse.

Results

Total of 2,211 surveys were included in analysis (631 [28.5%] overweight cohort, 600 [27.1%] class I obesity, 467 [21.1%] class II obesity, and 513 [23.2%] class III obesity).The percentage of respondents reporting being the victim of abuse increased significantly with obesity (23.6%, 26.0%, 29.1%, and 36.8% for overweight, Class I, Class II and Class III obesity respectively; p<0.001). Those who reported being the victim of childhood abuse noted that weight issues began at an earlier age and were more likely to have weight related co-morbidities (arthritis, diabetes, hyperlipidemia, obstructive sleep apnea, and asthma) after controlling for BMI.Patients who were a victim of abuse also reported lower self-esteem, were more likely to feel judged by health-care providers, and less likely to feel they were treated with respect.

Conclusions

Overall, being a victim of childhood abuse was significantly associated with obesity and was associated with lower self-esteem and negative experiences interacting with healthcare providers.Healthcare providers should receive training to ensure open and non-judgmental visits with patients and consider the role of trauma survivorship issues in patients’ development of obesity and care experiences.