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Low resilience in severe obesity: marker of adverse childhood experiences and current psychological disorders

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Abstract

Purpose

Psychological disorders, early-age psychological traumas and eating disorders may contribute to the development of severe obesity in vulnerable individuals. Resilience may serve a protective role against binge eating disorder or depression. The current study aimed to investigate the relationship between adverse childhood experiences (ACE), resilience, and current psychological disorders. It also examined whether resilience plays a protective role in this pathway in a cohort of patients seeking bariatric surgery.

Methods

Two hundred patients (153 women, 47 men) with severe obesity scheduled for bariatric surgery at the CHRU Nancy were included between September 2016 and April 2017. Participants completed the Resilience Scale for Adults (RSA) questionnaire and underwent a structured interview on ACE and current psychological disorders.

Results

Mean total RSA score was 5.16 ± 0.87. The most frequent ACE were emotional neglect (90.5%) and emotional abuse (61%); 96% reported at least one ACE; 67% presented at least one current psychological disorder, the most frequent being anxiety (36%) and BED (35%). The number of psychological disorders, cumulative ACE and age explained 19.5% of the variance in total RSA score (p < 0.0001; adjusted R2 = 0.19). The association of cumulative ACE and number of psychological disorders was mediated by resilience.

Conclusion

Our findings suggest that resilience is a relevant component of the psychosocial phenotype of severe obesity in bariatric surgery candidates. Resilience seems to play a partly mediation role in the relationship between ACE and psychological disorders. Low resilience becomes a marker that underscores the necessity to examine in greater depth ACE and psychological disorders.

Level of evidence

Level III, cohort analytic study.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Laboratoire INTERPSY, Campus LSH de Nancy - Université de Lorraine, 23 Boulevard Albert 1er, 54000, Nancy, France

    Joris Mathieu & Joëlle Lighezzolo-Alnot

  2. Centre Spécialisé de l’Obésité (CSO) et Service d’Endocrinologie, Diabétologie et Nutrition (EDN), CHRU-Nancy, Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France

    Joris Mathieu, Pierrette Witkowski & Olivier Ziegler

  3. Département de Chirurgie Viscérale, Métabolique et Cancérologique (CVMC), Unité Multidisciplinaire de Chirurgie de l’Obésité, CHRU-Nancy, Rue du Morvan, 54511, Vandoeuvre-lès-Nancy, France

    Joris Mathieu, Laurent Brunaud, Nicolas Reibel, Pierrette Witkowski, Didier Quilliot & Olivier Ziegler

  4. Département de Nutrition, Université de Lorraine, 54000, Nancy, France

    Dehbia Moukah, Didier Quilliot & Olivier Ziegler

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  1. Joris Mathieu
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  2. Laurent Brunaud
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  3. Nicolas Reibel
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  7. Didier Quilliot
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  8. Olivier Ziegler
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Mathieu, J., Brunaud, L., Reibel, N. et al. Low resilience in severe obesity: marker of adverse childhood experiences and current psychological disorders. Eat Weight Disord 27, 3507–3519 (2022). https://doi.org/10.1007/s40519-022-01488-2

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