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Keywords:

  • Childhood maltreatment;
  • severe obesity;
  • United States;
  • young adult

Summary

What is already known about this subject

  • Severe obesity prevalence in adults has close to doubled from the 1990s to 2010 and is expected to double again by 2030.
  • Over 3 million reports of child maltreatment were received by child protective services in 2008.
  • While clinic and population-based studies have found high rates of adult psychological distress among severely obese individuals, little is known about how the experience of abuse during childhood relates to the risk of severe obesity later in life.

What this study adds

  • Using data from a nationally representative, longitudinal study, we found that incidence rates and 13-year risk of developing severe obesity in adulthood varied by abuse type.
  • We found significantly higher risk of incident severe obesity in non-minority females and males who experienced the combined occurrence of sexual and physical abuse during childhood, relative to individuals with no history of abuse.
  • In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life.

Background

Severe obesity has increased, yet childhood antecedents of adult severe obesity are not well understood.

Objective

Estimate adult-onset severe obesity risk in individuals with history of childhood physical and/or sexual abuse compared with those who did not report abuse.

Methods

Longitudinal analysis of participants from the US National Longitudinal Study of Adolescent Health (n = 10 774) wave II (1996; aged 12–22 years) followed through wave IV (2008–2009; aged 24–34 years). New cases of adult-onset severe obesity (body mass index [BMI] ≥ 40 kg/m2 using measured height and weight) in individuals followed over 13 years who were not severely obese during adolescence (BMI <120% of 95th percentile Centers for Disease Control and Prevention National Center for Health Statistics growth curves).

Results

The combined occurrence of self-reported sexual and physical abuse during childhood was associated with an increased risk of incident severe obesity in adulthood in non-minority females (hazard ratio [HR; 95% Confidence Interval] = 2.5; 1.3, 4.8) and males (HR = 3.6; 1.5, 8.5) compared with individuals with no history of abuse.

Conclusion

In addition to other social and emotional risks, exposure to sexual and physical abuse during childhood may increase risk of severe obesity later in life. Consideration of the confluence of childhood abuse might be considered as part of preventive and therapeutic approaches to address severe obesity.