Childhood Trauma Is a Cause of Obesity – Can We Talk?

In the popular imagination, obesity is simple. Many people presume that the root cause is obvious. But the presumptions vary. Some like to blame the food industry – for junk food, too much sugar, and predatory marketing. In the UK, where weight bias is common, the NHS is blunt. “Obesity is generally caused by eating too much and moving too little,“ says their website. But reality doesn’t match that facile explanation. The unpleasant truth is that childhood trauma sometimes lies at the root of obesity. Perhaps because it is unpleasant, this fact is often missing from our thinking about preventing obesity.

However, an excellent new systematic review makes it plain that we need to pay attention.

Adverse Childhood Experiences

The term of art is adverse childhood experiences (ACEs). Under this term, many different experiences share one common thread – traumatic events. Examples include the experience of violence, abuse, or neglect. It might be violence at home or in the community. It might stem from having a family member attempt or die by suicide.

Krista Schroeder and colleagues at Temple University screened 6,966 studies for their review. In the end, they included data from 24 studies in their analysis. Half of them were cross-sectional and half were longitudinal. In sum, they found a clear association between childhood trauma and obesity. The effect can take two to five years to show up. Girls may be more sensitive to it and sexual abuse seems to have a more potent effect than other ACEs. Further, there may be an additive effect from having multiple instances of such experiences.

Easier to Talk About Gluttony and Sloth?

In a certain sense, the omission of childhood trauma from discussions about obesity and its causes does not surprise us. This is a difficult subject. But it is common. About 61 percent of adults report having had an adverse childhood experience. Nearly one in six have had such experiences repeatedly – four times or more.

However, avoiding this subject skews our approaches to preventing obesity. If we presume it’s all about sugar, junk food, gluttony, and sloth, then we put our energies into fighting with the food industry. We vainly presume that nudging, teaching, or shaming people into eating less and moving more will solve the problem. So far, none of that has worked out very well.

Childhood trauma is preventable. It is a cause of childhood obesity. Perhaps it is time to think more broadly about preventing childhood obesity and consider the impact of childhood trauma.

Click here for the paper by Schroeder et al, and here for more on the evidence base for preventing adverse childhood experiences. For a very personal account of the interaction between trauma and obesity, we recommend this interview with Roxane Gay, as well as her renowned book, Hunger.

Rape of Proserpina, painting by Rembrandt / WikiArt

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February 8, 2021