Body weight and obesity in adults and self-reported abuse in childhood

• Published in: International Journal of Obesity Vol. 26; no. 8; pp. 1075 - 1082
• Main Authors: Williamson, D.F, Thompson, T.J, Anda, R.F, Dietz, W.H, Felitti, V
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01-08-2002; Nature Publishing
• Subjects: Adult; Adults; Adverse childhood experiences; Aged; Aged, 80 and over; Biological and medical sciences; Body Mass Index; Body weight; California - epidemiology; Child; child abuse; Child abuse & neglect; Child Abuse - statistics & numerical data; childhood; children; Children & youth; clinical examination; cohort studies; confidence interval; Emotional abuse; fearfulness; Female; Health maintenance organizations; HMOs; Humans; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity - epidemiology; Obesity - etiology; Obesity - prevention & control; patients; Preventive medicine; Questionnaires; relative risk; Risk Factors; Self Concept; Self report; Sex crimes; Sexual abuse; Sexual intercourse; surveys; Surveys and Questionnaires; Young adults; California; Southern California; Atlanta Georgia; United States > US; Human; Obesity; Prevalence; Questionnaire; Abuse; Body weight; Nutrition disorder; Victimology; Attribution; Prevention; Association; Cohort study; Risk factor; Child; Nutritional status
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802038

BACKGROUND: Little is known about childhood factors and adult obesity. A previous study found a strong association between childhood neglect and obesity in young adults. OBJECTIVE: To estimate associations between self-reported abuse in childhood (sexual, verbal, fear of physical abuse and physical) adult body weight, and risk of obesity. DESIGN: Retrospective cohort study with surveys during 1995-1997. PATIENTS: A total of 13 177 members of California health maintenance organization aged 19-92 y. MEASUREMENTS: Body weight measured during clinical examination, followed by mailed survey to recall experiences during first 18 y of life. Estimates adjusted for adult demographic factors and health practices, and characteristics of the childhood household. RESULTS: Some 66% of participants reported one or more type of abuse. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. Compared with no physical abuse (55%), being 'often hit and injured' (2.5%) had a 4.0 kg (95% confidence interval: 2.4-5.6 kg) higher weight and a 1.4 (1.2-1.6) relative risk (RR) of body mass index (BMI)30. Compared with no verbal abuse (53%), being 'often verbally abused' (9.5%) had an RR of 1.9 (1.3-2.7) for BMI40. The abuse associations were not mutually independent, however, because the abuse types strongly co-occurred. Obesity risk increased with number and severity of each type of abuse. The population attributable fraction for 'any mention' of abuse (67%) was 8% (3.4-12.3%) for BMI30 and 17.3% (-1.0-32.4%) for BMI40. CONCLUSIONS: Abuse in childhood is associated with adult obesity. If causal, preventing child abuse may modestly decrease adult obesity. Treatment of obese adults abused as children may benefit from identification of mechanisms that lead to maintenance of adult obesity.