The Impact of Adverse Childhood Experiences on Obesity and Unhealthy Weight Control Behaviors Among Adolescents

Background: Childhood abuse and other early-life stressors associate with being overweight or obese later in life. In addition to being overweight, unhealthy weight control behaviors (e.g., vomiting, using diet pills, fasting, and skipping meals) have been shown to be common among adolescents. To our knowledge, the association between these behaviors and adverse childhood experiences (ACEs) remains unexamined.

Methods: We examined the association of ACEs to body mass index (BMI) and unhealthy weight control behaviors among 449 Finnish adolescents aged 12 to 17years admitted to an acute psychiatric hospital unit between April 2001 and March 2006. We used the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) to obtain information about ACEs, psychiatric diagnoses and weight control behaviors. BMI was calculated using the weight and height measured for each adolescent upon admission.

Results: Girls who experienced sexual abuse were more likely to be obese (OR: 2.6; 95% CI: 1.1-6.4) and demonstrate extreme weight loss behaviors (EWLB) (OR: 2.2; 95% CI: 1.0-4.7). Among girls, parental unemployment is associated with an increased likelihood of obesity (OR: 3.5; 95% CI: 1.2-9.6) and of being underweight (OR: 3.6; 95% CI: 1.1-11.6). A proneness for excessively exercising was found among girls who had witnessed domestic violence (OR: 3.5; 95% CI: 1.4-9.2) and whose parent(s) had died (OR: 5.4; 95% CI: 1.1-27.7).

Conclusion: This study showed that female adolescents with a history of traumatic experiences or difficult family circumstances exhibited an elevated likelihood of being obese and engaging in unhealthy weight control behaviors.