Body weight and obesity in adults and self-reported abuse in childhood.
BACKGROUND
Little is known about childhood factors and adult obesity. A previous study found a strong association between childhood neglect and obesity in young adults.


OBJECTIVE
To estimate associations between self-reported abuse in childhood (sexual, verbal, fear of physical abuse and physical) adult body weight, and risk of obesity.


METHODS
Retrospective cohort study with surveys during 1995-1997.


METHODS
A total of 13,177 members of California health maintenance organization aged 19-92 y.


METHODS
Body weight measured during clinical examination, followed by mailed survey to recall experiences during first 18 y of life. Estimates adjusted for adult demographic factors and health practices, and characteristics of the childhood household.


RESULTS
Some 66% of participants reported one or more type of abuse. Physical abuse and verbal abuse were most strongly associated with body weight and obesity. Compared with no physical abuse (55%), being 'often hit and injured' (2.5%) had a 4.0 kg (95% confidence interval: 2.4-5.6 kg) higher weight and a 1.4 (1.2-1.6) relative risk (RR) of body mass index (BMI) > or = 30. Compared with no verbal abuse (53%), being 'often verbally abused' (9.5%) had an RR of 1.9 (1.3-2.7) for BMI > or = 40. The abuse associations were not mutually independent, however, because the abuse types strongly co-occurred. Obesity risk increased with number and severity of each type of abuse. The population attributable fraction for 'any mention' of abuse (67%) was 8% (3.4-12.3%) for BMI > or = 30 and 17.3% (-1.0-32.4%) for BMI > or = 40.


CONCLUSIONS
Abuse in childhood is associated with adult obesity. If causal, preventing child abuse may modestly decrease adult obesity. Treatment of obese adults abused as children may benefit from identification of mechanisms that lead to maintenance of adult obesity.
Division of Diabetes Translation, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia 30341-2717, USA. drw1@cdc.gov
D F
DF
Williamson
T J
TJ
Thompson
R F
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Anda
W H
WH
Dietz
V
V
Felitti
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D012649:Self Concept; D011795:Surveys and Questionnaires