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Obesity and Health Practices · Journal article
Obesity Surgery · August 18, 2026
Encouraging direction, but not yet definitive.
This retrospective observational study of 141 treatment-seeking patients with severe obesity found that 91.5% reported at least one adverse childhood experience, with family maladjustment showing the strongest association with current and lifetime psychiatric disorders (bipolar disorder, substance use disorders, anxiety disorders). The number of ACEs was significantly associated with current psychiatric disorders, with each additional ACE increasing odds by 7%.
Retrospective observational study. Treatment-seeking patients with severe obesity undergoing metabolic bariatric surgery. Sample composition: 83.0% women; mean age 52 years; mean BMI 34.2 kg/m².. Intervention: Assessment of adverse childhood experiences and psychiatric diagnoses (observational; no intervention applied). n = 141. A specialized bariatric centre (specific location not stated in abstract).
91.5% of patients reported at least one ACE; maltreatment was the most frequent category at 81.6% Family maladjustment associated with bipolar disorder (current OR = 2.9; lifetime OR = 3.5) Family maladjustment associated with any substance use disorder (current OR = 4.3; lifetime OR = 5.3)
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This study reinforces the high prevalence of ACEs in severe obesity and identifies family maladjustment as a particularly strong predictor of multiple psychiatric disorders. Clinicians evaluating bariatric surgery candidates may use this to guide mental health screening, though the observational design does not establish causation or optimal intervention strategies.
Retrospective observational study in a single specialized centre with modest sample size (n=141) showing associations between ACE categories and psychiatric outcomes in severe obesity; clear methodology and specific effect sizes reported, but limited by observational design and lack of comparator group.
As stated by the source record.
Quoted from the source exactly as published.
This study reinforces the high prevalence of ACEs in severe obesity and identifies family maladjustment as a particularly strong predictor of multiple psychiatric disorders. Clinicians evaluating bariatric surgery candidates may use this to guide mental health screening, though the observational design does not establish causation or optimal intervention strategies.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Abstract Introduction Adverse childhood experiences (ACEs) are well-established risk factors for obesity and psychiatric disorders in adulthood. Despite growing evidence, the association of specific ACE categories with the mental health of patients with severe obesity remains poorly understood. This study aimed to evaluate the frequency of ACEs and the association of ACEs with mental conditions among patients who underwent metabolic bariatric surgery. Methods A total of 141 were recruited from a specialized bariatric center. ACEs were assessed using the Childhood Experiences section of the Composite International Diagnostic Interview 3.0. Psychiatric disorders (current and lifetime) were evaluated using the Structured Clinical Interview for DSM-5. Results The sample (83.0% women; mean age 52 years; mean BMI 34.2 kg/m²) showed that 91.5% of patients reported at least one ACE, with maltreatment being the most frequent (81.6%). Among the ACE categories, family maladjustment was associated with the highest number of psychiatric disorders, both in current and lifetime assessments. Specifically, it was significantly associated with bipolar disorder (current: OR = 2.9; lifetime: OR = 3.5), any substance use disorder (current: OR = 4.3; lifetime: OR = 5.3), and any anxiety disorder (current: OR = 2.9; lifetime: OR = 2.3). The number of ACEs was associated with current psychiatric disorders ( p = 0.04), where each additional ACE increased the odds of current psychiatric disorders by 7% (OR = 1.1, 95% CI: 1.0–1.1). Conclusions Patients with severe obesity presented a high frequency of ACEs, which was associated with a later risk of developing psychiatric disorders.
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