Trauma, Abuse, and Obesity

Two recent publications draw our attention to the need for a more complete understanding of the mechanisms that link trauma, abuse, and obesity. In an analysis of 23 studies of 112,708 subjects, Erik Hemmingsson and colleagues found an increased risk of obesity in adulthood for people who experienced abuse in childhood. The overall increase was 34%, but when broken down by the type of abuse, the increased risk ranged from 28% to 45%.

The second publication provides a thorough review of what’s known about the link between posttraumatic stress disorder (PTSD) and obesity and the further knowledge we need. PTSD has been associated obesity and its complications, including high blood pressure, metabolic syndrome, and inflammatory activity.

Clues are abundant. What’s needed is empiric research. Does the hormonal pathway that connects the brain’s hypothalamus and pituitary gland (know as the HPA axis) get activated by trauma, abuse, and PTSD in a way the precipitates obesity? Is activation of the sympathetic nervous system part of the explanation? Does altered cognition lead to altered responses to food and its consumption?

With more definitive research, more personalized treatment strategies will be possible. A skilled obesity medicine physician can tell you that a person with obesity and a history of trauma or abuse will require very different care than someone with other types of obesity. But what’s lacking is the evidence base to inform treatment protocols for consistently better outcomes.

It’s well past time to invest in the research to understand and and solve the problem at hand. Shame and blame are not getting the job done.

“Research is what I’m doing when I don’t know what I’m doing.” — Wernher von Braun

Click here to read the review of what’s known about PTSD-associated obesity. Click here to read the study of childhood abuse and adult obesity.

My Ghost, photograph © vk-red / flock

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