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


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 BMI≥40. 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 BMI≥30 and 17.3% (−1.0–32.4%) for BMI≥40.

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.

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  1. Comuzzie AG, Allison DB . The search for obesity genes Science 1998 280: 1374–1377.

    Article  CAS  Google Scholar 

  2. Hill JO, Peters JC . Environmental contributions to the obesity epidemic Science 1998 280: 1371–1374.

    Article  CAS  Google Scholar 

  3. Stamler J . Epidemic obesity in the United States Arch Intern Med 1993 153: 1040–1044.

    Article  CAS  Google Scholar 

  4. Dietz WH . Prevention of childhood obesity Pediatr Clin N Am 1986 33: 823–833.

    Article  Google Scholar 

  5. Felitti VJ, Williams SA . Long-term follow-up and analysis of more than 100 patients who each lost more than 100 pounds Permanente J 1998 2: 17–21.

    Google Scholar 

  6. Maddi SR, Khoshaba DM, Persico M, Bleecker F, VanArsdall G . Psychosocial correlates of psychopathology in a national sample of the morbidly obese Obes Surg 1997 7: 397–404.

    Article  CAS  Google Scholar 

  7. Lissau I, Sørensen TIA . Parental neglect during childhood and increased risk of obesity in young adulthood Lancet 1994 343: 324–327.

    Article  CAS  Google Scholar 

  8. Stunkard AJ, Sørensen TIA, Hanis C, Teasdale TW, Chakraborty R, Schull WJ, Schulsinger F . An adoption study of human obesity New Engl J Med 1986 314: 193–198.

    Article  CAS  Google Scholar 

  9. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS . Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults Am J Prev Med 1998 14: 245–258.

    Article  CAS  Google Scholar 

  10. Dietz PM, Spitz AM, Anda RF, Williamson DF, McMahon PM, Santelli JS, Nordenberg D, Felitti VJ, Kendrick JS . Unintended pregnancy among adult women exposed to abuse or household dysfunction during their childhood JAMA 1999 282: 1359–1364.

    Article  CAS  Google Scholar 

  11. Anda RF, Croft JB, Felitti VJ, Nordenberg D, Giles WH, Williamson DF, Giovino GA . Adverse childhood experiences and smoking during adolescence and adulthood JAMA 1999 282: 1652–1658.

    Article  CAS  Google Scholar 

  12. Wyatt GE . The sexual abuse of Afro-American and White-American women in childhood Child Abuse Negl 1985 9: 507–519.

    Article  CAS  Google Scholar 

  13. Straus M, Gelles RJ . Physical violence in American families: risk factors and adaptations to violence in 8,145 families Transaction Press: New Brunswick, NJ 1990.

    Google Scholar 

  14. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994 Int J Obes Relat Metab Disord 1998 22: 39–47.

    Article  CAS  Google Scholar 

  15. Schoenborn CA . Exposure to alcoholism in the family: United States, 1988 Advance Data From Vital and Health Statistics, no. 205. US Department of Health and Human Services publication (PHS) 95-1880 National Center for Health Statistics: Hyattsville, MD 1995.

    Google Scholar 

  16. Graubard BI, Korn EL . Predictive margins with survey data Biometrics 1999 55: 652–659.

    Article  CAS  Google Scholar 

  17. Efron B, Tibshirani RJ . An introduction to the bootstrap Chapman and Hall: New York 1993.

    Book  Google Scholar 

  18. Rockhill B, Newman B, Weinberg C . Use and misuse of population attributable fractions Am J Pub Health 1998 88: 15–19.

    Article  CAS  Google Scholar 

  19. Greenland S, Drescher K . Maximum likelihood estimation of the attributable fraction from logistic models Biometrics 1993 40: 865–872.

    Article  Google Scholar 

  20. SAS Institute. SAS version 8.00 for Windows SAS Institute: Cary, NC 2000.

  21. Aptech Systems. GAUSS Mathematical and statistical system Aptech Systems Inc.: Maple Valley, WA 1996.

  22. Wonderlich SA, Wilsnack RW, Wilsnack SC, Harris TR . Childhood sexual abuse and bulimic behavior in a nationally representative sample Am J Public Health 1996 86: 1082–1086.

    Article  CAS  Google Scholar 

  23. Lutzker JR, Boyle CL . Preventing physical and sexual abuse In Innovative strategies for preventing psychological problems Glenwick D, Jason L (Eds) Springer: New York 2002.

    Google Scholar 

  24. Felitti VJ . Childhood sexual abuse, depression, and family dysfunction in adult obese patients: a case control study South Med J 1993 86: 732–736.

    Article  CAS  Google Scholar 

  25. King TK, Clark MM, Pera V . History of sexual abuse and obesity treatment outcome Addict Behav 1996 21: 283–290.

    Article  CAS  Google Scholar 

  26. Serdula MK, Ivery D, Coates RJ, Freedman DS, Williamson DF, Byers T . Do obese children become obese adults? A review of the literature Prev Med 1993 22: 167–177.

    Article  CAS  Google Scholar 

  27. Wadden TA, Stunkard AJ . Social and psychological consequences of obesity Ann Intern Med 1985 103 (6 pt 2): 1062–1067.

    Article  CAS  Google Scholar 

  28. Widom CS, Weiler BL, Cottler LB . Childhood victimization and drug abuse: a comparison of prospective and retrospective findings J Consult Clin Psychol 1999 67: 867–880.

    Article  CAS  Google Scholar 

  29. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL . Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960 to 1991 JAMA 1994 272: 205–211.

    Article  CAS  Google Scholar 

  30. Finkelhor D, Hotaling G, Lewis IA, Smith C . Sexual abuse in a national survey of adult men and women Child Abuse Negl 1990 14: 19–28.

    Article  CAS  Google Scholar 

  31. MacMillan HL, Fleming JE, Trocme N, Boyle MH, Wong M, Racine YA, Beardslee WR, Offord DR . Prevalence of child physical and sexual abuse in the community: results from the Ontario Health Supplement JAMA 1997 278: 131–135.

    Article  CAS  Google Scholar 

  32. Ney PG, Fung T, Wickett AR . The worst combinations of child abuse and neglect Child Abuse Neglect 1994 18: 705–714.

    Article  CAS  Google Scholar 

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Williamson, D., Thompson, T., Anda, R. et al. Body weight and obesity in adults and self-reported abuse in childhood. Int J Obes 26, 1075–1082 (2002).

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  • adult obesity
  • attributable fraction
  • body mass index
  • child abuse
  • relative risk

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