The weight of abuse: the link between abuse and obesity

Obesity is complex. Incredibly complex. Yet, there’s this idea that continues to permeate our culture that suggests that being overweight or obese is due to a lack of will-power, control, or motivation; that it’s somehow a reflection of that person’s character, and ultimately their worth. But, there’s more to the story. 

A recently published scientific review examined the relationship between life adverse events, obesity, and binge eating disorder. For this particular study, ‘life adverse experiences’ refers to all kinds of traumatic experiences occurring in childhood, adolescence, and adulthood, which include emotional abuse, physical abuse, sexual abuse, sexual harassment, rape, bullying by peers, witnessing domestic violence, and serious accidents that threatened the lives of the subjects. Ultimately, the researchers wanted to weed out if there was a link between trauma, weight, and disordered eating.

The researchers behind this particular study looked at all available research data that examined the link between exposure to life adverse experiences and the risk of developing obesity and central weight gain in adulthood. There was also an exploration of the mediators in this relationship, including disordered eating, emotional eating, and mood and anxiety disorders. 

Primary findings: 

  • 87% of studies found that adverse life experiences are a risk factor for developing obesity and binge eating disorder
  • There was a positive association between traumatic experiences and obesity in 85% of studies
  • There was a positive association between PTSD and obesity in 86% of studies
  • 90% of studies that examined trauma and the development of binge eating disorder in adulthood strongly supported this association

The stats: 

  • Among women with childhood physical abuse compared with non-abused women, the odds of obesity were 35% higher
  • Sexually abused women were 2.85 times more likely to be obese during young adulthood compared to non-abused women
  • Obese patients with binge eating disorder reported 2-3 times higher rates of both emotional and physical neglect and emotional, physical, and sexual abuse
  • Physical abuse and sexual abuse increased the likelihood of binge eating disorder respectively by 1.7- and 1.6-fold

How does trauma impact weight and one’s relationship with food?

There isn’t yet a clear story on how traumatic experiences are linked to obesity, but scientists have a few ideas. 

Traumatic experiences can leave people with Post-Traumatic Stress Disorder (PTSD), and it could be the PTSD symptoms driving certain eating behaviours and physiological changes that contribute to obesity. When an individual experiences abuse, PTSD symptoms can be associated with an increase in the activation of the HPA Axis. 

The hypothalamic pituitary adrenal (HPA) axis is our central stress response system. When our stress system is activated, it creates a reaction of fight, flight, or freeze. This means that in general, we respond to stress by ‘fighting’, fleeing the situation, or simply becoming immobile – freezing. 

An increase in the activation of the HPA axis increases the amount of cortisol, one of the primary stress hormones, in our body. An increase in cortisol preps our body to respond to the perceived ‘threat’. High levels of cortisol have been linked to increased fat storage - especially in the abdominal area, stress-induced eating, night eating habits, and binge-eating behaviours. 

Another factor involved is the dissociative symptoms associated with trauma – this is the ‘freeze’ response. Scientists believe that when extreme negative emotional states are activated, the brain responds by shifting to lower levels of thinking and self-awareness, similar to dissociation (separation of normally related mental processes). Put simply, when people dissociate, they sort of ‘step outside of themselves’. 

This whole process tends to remove inhibitions, prompting the behaviours of binge eating or over-eating. So, without being consciously aware of it, it’s more likely that someone who’s experienced trauma will feel like they have less ‘will-power’ when it comes to food – even though it’s something they don’t have full control of. 

In addition to the increased sensitivity to stress via the HAPA axis and the influence of dissociative symptoms, depression and perceived stress may also play a role. In studies reviewed, depression was consistently associated with obesity and central obesity. Depressed people are more likely to follow emotional eating patterns, which can increase overall calorie intake and consumption of unhealthy foods, leading to weight gain and obesity. 

Studies also show that children who experience traumatic life events have a higher risk of developing maladaptive coping strategies, including stress-induced emotional eating. Emotional dysregulation related to trauma is also associated with increased appetite, cravings or foods that are high in sugar and fat, increased fat accumulation around the organs, and obesity. 

Here’s the good news: psychologists (Bessel van der Kolk and Bruce Perry are doing incredible work in the realm of trauma) and neuroscientists have found that there are therapies and practices that can help people who’ve experienced trauma to ‘rewire’ their brain and transform the way they interact with and respond to the world. By treating the underlying issue of trauma, people can change the way they cope with stress, and as a result, may find it easier to lose weight and improve their relationship with food. 

Holistic health practices aim to treat the whole person. We now know that nutrition heavily influences mental health, and mental health issues or illnesses impact dietary patterns, often resulting in inadequate nutrient intake. It’s a vicious cycle.

With the support of professionals who care, people who have experienced trauma canfind healing and live a happy, vibrant life.