Teenagers who have suffered adverse childhood experiences (ACEs) - such as physical or emotional abuse, or having a parent who is incarcerated or addicted to drugs or alcohol - are at greater risk of being overweight or obese, according to a new study.
In fact, the study found that the more kinds of adverse experiences children endured, the more likely they would have excessive weight issues by middle school or high school.
"This study adds to our understanding of childhood overweight and obesity by showing that the relationship between ACEs and weight problems is evident even in adolescence," said study team leader Laurel Davis, a research associate at the University of Minnesota Medical School's department of pediatrics.
With more than 105,000 Minnesota eighth, ninth, and 11th graders reporting, Davis said, "this is the largest study of ACEs and obesity during childhood to date."
The research article appears in the Journal of Pediatrics' January issue.
The student participants were asked questions about six kinds of adverse experiences: if they had been subjected to physical abuse, sexual abuse, or psychological abuse, and if there was in their family substance misuse or addiction, domestic violence, or parental incarceration.
The youngsters with one type of adverse experience were 1.2 times more likely to be overweight than someone with no adverse experiences, 1.4 times more apt to be obese, and 1.5 times more likely to have severe obesity.
Unlike adults, for whom obesity is defined as a body mass index (BMI) over 30, teens' BMIs are compared with others of their age and sex. Overweight means a teen is in the 85th to under the 95th percentile of BMI; obesity means being at the 95th percentile or up to under 120 percent of the 95th percentile. Severe obesity is at or over 120 percent of the 95th percentile of BMI. For example, a 16-year-old girl who is 5-foot-4 and weighs 180 pounds would be considered obese. The same girl at 210 pounds would be considered severely obese. The federal Centers for Disease Control and Prevention has an online calculator to determine individual children's weight categories.
Adolescents who reported all six ACEs were 1.5 times more apt to be overweight, 2 times more likely to be obese, and more than 4 times at risk for severe obesity.
In the study, male teens who experienced poverty and other ACEs and lived outside of a metropolitan area were more likely to be overweight, although girls were more likely to have experienced more ACEs.
Obesity has reached epidemic proportions in the nation's children and adults. Youths with excess weight are more likely to develop a host of health problems including depression, high blood pressure, diabetes, fatty liver disease, and sleep or metabolic disorders.
In Pennsylvania and New Jersey, research suggests that more than 40 percent of youngsters endure one or more ACEs, according to a report by Child Trends, a nonprofit research organisation. Child Trends also considered experiences like the death of a parent or guardian and exposure to violence outside the home.
Early life traumas have been strongly linked to the development of health problems such as increased risk for suicide attempts, adult depressive disorders, and higher likelihood of substance-use disorders or being a victim of violence over the course of a person's life. ACEs exposure has also been tied to poor dental health, sleep disturbances, and long-term physical health problems including diabetes and heart disease.
These childhood traumas have also been known to cause toxic stress that damages the growth and structure of youngsters' developing brains.
Much of the research done, however, has focused on adult health problems and the possible relationship to trauma experienced in childhood. This new research suggests how early these experiences can have far-reaching health impacts.
Davis said the findings could be a call for standardised screening for ACEs by pediatric health providers, including for patients with weight issues, as well as training to inform health providers about how to screen for ACEs and how to respond to them.
"Preventing ACEs and identifying ACEs early to prevent obesity could help to ameliorate the public health toll of obesity," Davis said.
The Philadelphia Inquirer