Obesity in adults and its possible link to experiences of childhood abuse

I was researching material on this topic of adult body weight and obesity and its link to adverse childhood experiences, in effort to support my my work with a couple of female clients who have come for therapy to work on their struggles with obesity. These clients are highly functioning individuals, and are relatively successful in life. They are baffled at how they aren’t able to take charge of their eating habits.

A usual practice I follow is to first send the clients for medical examination to exclude extra-ordinary physiological illnesses.

The study below shown as screenshot by Williamson et.al. is just one example of many linking adult obesity to experiences of childhood trauma.

CONCLUSIONS to the study: “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.”

Binge eating and other addictive behaviors around food have a protective function for the individual. Patients do this to brace themselves against emotional hardships. This behavior actually keeps them stable and functional. It is therefore fully understandable that the eating behavior is borne out of a real need. In adult survivors of childhood trauma, the impulse to eat uncontrollably stems from the need to regulate the nervous system which has been dysregulated by the experiencing of traumatic events.

A client reported that her trigger to binge eat happens the moment she gets home. When she enters the door of her apartment, she’d feel a frantic need to eat whatever is available in the refrigerator, and very quickly. Then she would not stop eating until her stomach starts to hurt. Following that, she’d feel a sense of calmness and guilt. This client has had a childhood history of feeling unsafe in the home. Her father was alcoholic, and her mother was verbally and physically abusive to my client and her siblings. As a child, the act of returning home from school filled her with need for comfort and a dread. This conflict of feelings, she says, returns to her body every time she returns home after a hard days work.

It is possible that one or more of the other clients who come to my office for weight management coaching may be survivors of childhood trauma. I would check with the clients first if they want to explore this. If they do, then the coaching sessions will have to be converted to trauma-focused psychotherapy. Whether or not change the focus of the session is entirely the choice of the client. The client will first have to provide us with informed consent.

Bibliography

Williamson, D. F., Thompson, T. J., Anda, R. F., Dietz, W. H., & Felitti, V. (2002). Body weight and obesity in adults and self-reported abuse in childhood. International journal of obesity26(8), 1075.