Interpersonal Violence in Childhood as a Risk Factor for ObesitiesFriday, March 18, 2011
Given the importance of mood, anxiety, anger, body image, self-esteem and disordered eating as common drivers of excessive weight gain (in many but certainly not all individuals with excess weight), eliciting a past or ongoing history of mental, physical and/or sexual abuse should be standard practice in any assessment for obesity.
This not only applies to the assessment of adult obesity but is increasingly recognised as a key factor in the assessment and management of weight gain in childhood and adolescence.
Thus, a review by Aimee Mide and Karen Matthews from the University of Pittsburgh, PA, USA, just published in Obesity Reviews, provides compelling evidence for a link between exposure to interpersonal violence in childhood and the risk for excess weight gain.
In a comprehensive search of the literature that revealed 36 separate studies, the authors found that 81% of these studies reported a significant positive association between some type of childhood interpersonal violence and obesity
Associations were consistent for caregiver physical and sexual abuse and peer bullying, with inconsistent evidence for exposure to community violence.
Three main pathways were reviewed as potential mechanisms linking interpersonal violence to obesity: negative affect, disordered eating, and physical inactivity.
Negative affect ranged from anger, perceived stress, and depressive symptoms to sadness, and loneliness.
There was also a relationship between the risk for disordered eating or binge eating and the risk of obesity in individuals with a history of childhood interpersonal violence.
The impact on physical activity was less clear.
As the authors note:
“Interpersonal violence in childhood (specifically physical and sexual abuse) has long been recognized as a risk factor for mental health, but only recently has interpersonal violence been considered as a precursor to physical health problems, such as obesity and overweight.”
It is important to note that children and adolescents are the most likely to be victimized compared to adults of any age, and they are also the least likely to report exposure to violence.
Fortunately, there is increasing evidence that the impact of interpersonal violence can be mitigated in intervention and treatment programs but this of course requires that such cases are identified early, or even better, prevented altogether.
Certainly many of my readers will have seen cases of interpersonal violence leading to excess weight and gain and I would certainly like to hear about how this often complex issue was dealt with to improve both mental and physical health.
Midei AJ, & Matthews KA (2011). Interpersonal violence in childhood as a risk factor for obesity: a systematic review of the literature and proposed pathways. Obesity reviews : an official journal of the International Association for the Study of Obesity PMID: 21401850