Interpersonal Violence in Childhood as a Risk Factor for Obesities
Friday, 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.
AMS
Edmonton, Alberta
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
Friday, March 18, 2011
Fat kids are often treated like garbage by their peers, parents, and other adult authority figures? You don’t say.
My point is that the poor treatment could be more a result of how the kids look, rather than vice versa. You’ve got to be aware that fat kids are often bullied mercilessly by adults as well as peers (as well as by public health “education,” BMI on report cards, etc.).
Friday, March 18, 2011
Just because obesity can be an excuse for interpersonal violence doesn’t mean that interpersonal violence isn’t also a causative factor of obesity. Vicious cycles are often born this way.
As a girl in the primary grades in elementary school (in the 1970’s) I was a bit chubby. I was in the upper weight range to my peers, but certainly not in a way that my parents or teachers had particular concern about. However, as I was comparatively a bit heavier than kids in my class, the teasing began. In the years between grades three and four the bullying escalated critically and became very physically violent occasionally to the tune of nine (boys) on 1 (girl). Along with it, the social and emotional violence also ramped up, and along with that, my weight escalated as well – I went from being a child in the upper normal weight range to being classed as an obese child. By the time I graduated grade school I was near 200 pounds.
While I can not speak in any statistically significant way, I know in all certainty that the violence I faced in those formative years were causative factors for my lifelong struggle with obesity.
Friday, March 18, 2011
I was a grossly obese child and life was not pleasant. It turned me into a “sociopath” for the most part.
But that “sociopath personality” has lead to me discovering the missing information of my diet, and metabolism, and has been a major part of my recovery from a lifetime of struggle with weight issues and obesity. It is now my opinion that I should tell the information that nobody wants to hear.
You can study the problem as much as you like. That is where the money is at.
For some of us sugar, grains, excess omega 6 oils and manufactured eatable products lead directly to obesity. Avoid them and weight is no longer an issue. Eat real food. That is a solution. A solution that works, it is not easy, but it work, and is sustainable.
But what do I know
Friday, March 18, 2011
FW, I agree that it could potentially become a viscous cycle. Maybe that’s the key to getting the people involved in forming public health policy to see how important it is to avoid further stigmatizing fat children. “Don’t make things worse for them! It will just make them fatter!”
But you know what? We shouldn’t have to use that as a hook. It should be clear to everyone that it’s wrong to single children out for criticism based on their physical characteristics. What kind of sick world do we live in, where people can’t see that?
Friday, March 18, 2011
I am an example of this study (physical abuse & bullying during childhood) and trying to get back on track thanks to my surgery which broke the cycle.
Saturday, March 19, 2011
That’s an interesting thought. I’d have thought that growing up would have broken the cycle. As an adult, you get to choose which (if any) advice to listen to and your circle of potential friends widens. You can cut yourself off from media influence to a pretty large extent if you want to. You can ask doctors not to bring up your weight, and if they don’t listen, switch doctors. If someone assaults you, you can get them arrested.
Of course, that means psychological recovery, not necessarily weight loss. I’d argue that psychological recovery is what matters.
I could tell you two different stories about myself. In one of them, I’m not an example of that vicious cycle. In the other one I am. They’re both true. It’s all about how I frame my experiences as a kid.
Saturday, March 19, 2011
We all have psychological baggage, some based in violence, some in verbal abuse. As a matter of practicality, if one of your goals is weight-loss maintenance, I think it is best to deal with psychological issues apart from weight issues. I think, in our minds, they should be “surgically” separated, and the psychological issues then should be addressed as such, with the best that the mental health profession has to offer, and weight should be addressed only as a scientific puzzle (that we are still struggling to figure out).
Currently, The Biggest Loser’s Jillian Michaels loves to play pop psychologist and encourage her wards to get to the root of their psychological issues, otherwise they cannot expect to achieve their weight goals (as if those goals are stagnant and don’t require maintenance). I am NOT a Jillian Michaels fan.
Psychological issues are a conundrum. Weight issues are a conundrum. We drag our conundrums through our lives like anvils on chains. They are best dragged one at a time. (Divide and conquer.) If you tie two together, not only are they HARDER to drag, you make the one vulnerable to the other — when one anvil tips on its point and will not be budged, the anvil tied to it will be halted too.
Psychological issues nearly always resurface, because life is dynamic. If you have tied your weight issues to psychological issues, then when, for example, creepy uncle Ned (who molested you) shows up at a family gathering and ogles your niece, then you will likely respond by hitting the potluck buffet table with a vengeance. Not very productive. If you have separated the two anvils, you may continue with your scientific weight experiment, while also drawing on your coping mechanisms and counselor’s advice to do something productive about your family’s creepy uncle Ned problem.