Bariatric surgery in obese patients with a history of childhood sexual abuse: a systematic review

This systematic review examines the relationship between Childhood Sexual Abuse (CSA), obesity, and Bariatric Surgery (BS), exploring their impact on surgical outcomes and mental health. A search was conducted in databases including PubMed, Scopus, Google Scholar, Science.gov, and Redalyc until February 2025. Studies published between 2000 and 2025 that addressed the three variables CSA, obesity, and BS were included. Predefined inclusion and exclusion criteria were applied, and risk of bias in the selected studies was assessed. Data were qualitatively synthesized. Of 201,693 studies identified, 34 met the inclusion criteria. Findings indicate that CSA is associated with a higher prevalence of obesity, dysfunctional eating behaviors, and poorer postoperative adherence in patients undergoing BS. A relationship between CSA and psychiatric symptomatology, such as depression, anxiety, and binge eating disorders, was also observed. The methodological heterogeneity of the studies and the possible bias in self-reporting of patients represent challenges in the interpretation of the results. It is concluded that the history of ASI influences the evolution of obesity and the post-surgical results of BC, highlighting the need for multidisciplinary approaches and psychological support before and after surgery.