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Wallace C, Krugman R. More Than What You Eat: A Review on the Association Between Childhood Maltreatment and Elevated Adult BMI. Curr Nutr Rep 2024; 13:377-381. [PMID: 38922364 PMCID: PMC11327177 DOI: 10.1007/s13668-024-00558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 06/27/2024]
Abstract
PURPOSE OF REVIEW Obesity is an overwhelmingly common medical entity seen in the adult population. A growing body of research demonstrates that there is a significant relationship between child maltreatment and adult obesity. RECENT FINDINGS Emerging research demonstrates a potential dose-response relationship between various types of child abuse and adulthood BMI. Recent work also explores the potential role of the hypothalamic-pituitary-adrenal (HPA) axis, and other hormonal mediators such as sex-hormone binding globulin and leptin. There are also studies that suggest factors such as depression and socioeconomic and environmental influences mediate this relationship. Comorbidities that have been reported include cardiovascular and metabolic disease, diabetes, and insulin resistance. Preliminary work also demonstrates potential gender and racial disparities in the effect of abuse on adulthood obesity. In this narrative review, we summarize the existing work describing the different child maltreatment types (physical, sexual, emotional, verbal, and child neglect) and their relation to adult obesity, what is known about a potential dose-response relationship, potential mediators and pathophysiology, comorbidities, and preliminary work on gender and racial/ethnic disparities. We review the limited data on interventions that have been studied, and close with a discussion of implications and suggestions for clinicians who treat adult obesity, as well as potential future research directions.
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Affiliation(s)
- Carmelle Wallace
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
- Section of Emergency Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
| | - Richard Krugman
- Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
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St-Arnaud V, Chicoine AX, Tardif JC, Busseuil D, D’Antono B. Childhood Maltreatment and Body Mass Index in Older Adults With Chronic Illness. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2024; 3:87-97. [PMID: 39070955 PMCID: PMC11282884 DOI: 10.1016/j.cjcpc.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/06/2024] [Indexed: 07/30/2024]
Abstract
Background Childhood trauma has been associated with greater psychological and physical morbidity, including a greater risk of developing coronary artery disease (CAD). Emotional dysregulation and increased body mass index (BMI) may be involved. This study evaluated whether (1) childhood maltreatment is associated with a higher BMI at study onset and with greater increases in BMI 5 years later among older adults with CAD or other chronic illnesses; (2) sex and/or CAD status moderate these results; and (3) baseline symptoms of anxiety, depression, and perceived stress (emotional dysregulation) mediate the association between childhood maltreatment and BMI at follow-up. Methods A total of 1232 men and women (aged 60.86 [6.95] years) completed validated questionnaires on childhood maltreatment and symptoms of psychological distress. The weight and height of the participant were measured, and the BMI was calculated using the weight (kg)/height (m2) ratio. Results Childhood maltreatment was not significantly associated with BMI at study onset nor at follow-up. This relation did not differ as a function of sex nor CAD status. Although childhood maltreatment was associated with significantly greater psychological distress at study onset (all P < 0.001), there latter was not found to mediate the relation between maltreatment and change in BMI at follow-up. Conclusions In contrast to previous literature, childhood maltreatment was not associated with BMI nor with the change in BMI over 5 years in men and women with chronic disease. However, as psychological distress increases risk for morbidity and mortality, it may represent an important target for prevention and intervention in survivors of childhood maltreatment.
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Affiliation(s)
- Vicki St-Arnaud
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Ann Xiuli Chicoine
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
| | - David Busseuil
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
| | - Bianca D’Antono
- Research Centre, Montreal Heart Institute, Montreal, Québec, Canada
- Psychology Department, Université de Montréal, Montreal, Québec, Canada
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Diallo A, Minier N, Bonnet JB, Bourrié C, Lacroix V, Robert A, Lefebvre P, Joumaa S, Avignon A, Renard E, Nocca D, Galtier F. Traumatic Life Events, Violence, and Obesity: A Cross-Sectional Study from 408 Patients Enrolled in a Bariatric Surgery Program. Obes Facts 2024; 17:237-242. [PMID: 38569475 PMCID: PMC11149977 DOI: 10.1159/000535067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/30/2023] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Obesity is a chronic disease that increases cardiovascular and metabolic morbidity and mortality, decreases quality of life, and increases health care costs. While the role of lifestyle behavioral factors in the development of obesity is well established, the role of traumatic life events, including violence, is unclear. The purpose of this study was to describe situations of traumatic life events reported by patients undergoing a bariatric surgery program, with a particular focus on sexual violence and its clinical correlates. METHODS In this cross-sectional study, patients with grade II or III obesity, admitted to our digestive surgery department for bariatric surgery from August 01, 2019, to December 31, 2020, underwent a structured interview by a trained psychologist to describe the history of traumatic life events self-reported by the patients. The primary endpoint was the presence of a history of sexual violence (SV). Multivariate logistic regressions were applied to identify independent risk factors for SV. RESULTS Of the 408 patients interviewed, 87.1% reported at least one traumatic life event and 33.1% reported having had an SV in the past. Female gender (aOR = 7.44, 95% confidence interval: 3.85-15.73; p < 0.001) and higher body mass index (1.05, 1.02-1.08; p = 0.002) were associated with an increased risk of SV. Male gender was associated with a higher risk of difficulties including sports cessation, depression, and work-related distress. CONCLUSION In the context of obesity, psychosocial trauma is characterized by a high frequency and several gender specificities that must be taken into account in the management of these patients.
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Affiliation(s)
- Alhassane Diallo
- Clinical Investigation Center (CIC) 1411, INSERM, CHU of Montpellier, University of Montpellier, Montpellier, France
| | - Nadine Minier
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Jean-Baptiste Bonnet
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
- UMR, Institute Desbrest of Epidemiology and Public Health, University Montpellier, INSERM, CHU, Montpellier, France
| | - Christine Bourrié
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Valérie Lacroix
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Alexandrine Robert
- Digestive Surgery Department Montpellier University Hospital, Montpellier, France
| | - Patrick Lefebvre
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Saadeddine Joumaa
- Digestive Surgery Department Montpellier University Hospital, Montpellier, France
| | - Antoine Avignon
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
| | - Eric Renard
- Clinical Investigation Center (CIC) 1411, INSERM, CHU of Montpellier, University of Montpellier, Montpellier, France
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - David Nocca
- Digestive Surgery Department Montpellier University Hospital, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Florence Galtier
- Clinical Investigation Center (CIC) 1411, INSERM, CHU of Montpellier, University of Montpellier, Montpellier, France
- Department of Endocrinology, Diabetes, Nutrition, Montpellier University Hospital, Montpellier, France
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Camp EA, Greeley CS, Donaruma M, Isaac R. Current Weight Status of Sexually Assaulted Pediatric Female Patients in an Emergency Department Setting. Child Obes 2023; 19:443-451. [PMID: 36206056 DOI: 10.1089/chi.2022.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: The relationship between childhood sexual abuse (CSA) and childhood obesity (CO) is unclear with studies reporting conflicting results in female populations. This study aims to assess the association between suspected CSA and current emergency department (ED) weight status when compared with trauma patients. Methods: This is a single-center retrospective case-control study that utilized pediatric ED data (2016-2018) from identified female patients (6-17 years old) with a chief complaint of sexual assault and trauma registry patients. Focus was on female patients for literary comparisons. Two weight measurements were calculated based on available height data: BMI-for-age and weight-for-age. Nonparametric testing and binary logistic regression were utilized. Results: There were 2044 study participants: 1454 (71.1%) cases and 590 (28.9%) controls. Cases were older, underrepresented minorities (URMs), and carried public insurance (all p-values <0.001). Using BMI-for-age, patients with a sexual assault complaint had a 67% increased odds for CO after adjusting for age, URM status, and insurance type [adjusted odds ratio (aOR) = 1.67 (95% confidence intervals [CIs] 1.07-2.62); p-value = 0.03], whereas the weight-for-age metric increased the aOR odds by 58% [aOR = 1.58 (95% CI 1.14-2.17); p-value = 0.01] when compared with pediatric trauma patients. Similar results were found in a sensitivity analysis using patients matched on age and URM. Conclusion: Our data demonstrated an association between suspected CSA and CO. More research is needed to identify the biopsychosocial implications for this relationship and the potential to augment clinical care.
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Affiliation(s)
- Elizabeth A Camp
- Division of Emergency Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Christopher S Greeley
- Division of Public Health and Child Abuse Pediatrics, and Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Marcella Donaruma
- Division of Public Health Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Reena Isaac
- Division of Public Health Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
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Fipps DC, Sinha S, Diwan TS, Clark MM. Psychosocial considerations in the combined bariatric surgery and organ transplantation population: a review of the overlapping pathologies and outcomes. Curr Opin Organ Transplant 2022; 27:514-522. [PMID: 36103143 DOI: 10.1097/mot.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW This review highlights the salient data of the psychosocial concerns that influence outcomes of bariatric surgery and organ transplantation. RECENT FINDINGS Bariatric surgery has emerged as an important intervention with data supporting substantial and sustained weight loss, enhanced quality of life, remission of obesity-related medical comorbidities, and improved long-term patient and graft survival in transplant patients. Depression, suicide, anxiety, posttraumatic stress disorder, alcohol use, adherence, and psychopharmacology considerations can influence outcomes of both these surgeries. SUMMARY Obesity is increasingly prevalent among patients pursuing transplantation surgery, and it is often a factor in why a patient needs a transplant. However, obesity can be a barrier to receiving a transplant, with many centers implementing BMI criteria for surgery. Furthermore, obesity and obesity-related comorbidities after transplant can cause poor outcomes. In this context, many transplant centers have created programs that incorporate interventions (such as bariatric surgery) that target obesity in transplant candidates. A presurgery psychosocial assessment is an integral (and required) part of the process towards receiving a bariatric surgery and/or a transplantation surgery. When conducting a dual (bariatric and transplantation surgery) psychosocial assessment, it is prudent to understand the overlap and differentiation of specific psychosocial components that influence outcomes in these procedures.
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Affiliation(s)
| | - Shirshendu Sinha
- Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | - Matthew M Clark
- Department of Psychiatry and Psychology
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Association between Self-Reported Childhood Difficulties and Obesity and Health-Related Behaviors in Adulthood-A Cross-Sectional Study among 28,047 Adults from the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031395. [PMID: 35162418 PMCID: PMC8835689 DOI: 10.3390/ijerph19031395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 02/01/2023]
Abstract
The aim of the present study was to examine the associations between self-reported childhood difficulties, weight status, and lifestyle behaviors among a representative sample of Norwegian adults. This cross-sectional study included 28,047 adults (>18 years old) living in southern Norway. A self-report questionnaire was used to assess information about the overall quality of the respondents’ childhood retrospectively in addition to current weight status and current lifestyle behaviors. Multivariable logistic regression models adjusted for gender, age, and educational level showed that evaluating childhood as difficult was associated with increased odds of obesity (OR: 1.29; 95% CI; 1.16–1.44) in adulthood. Moreover, a difficult childhood was associated with increased odds of unhealthy lifestyle behaviors in adulthood, including low consumption of fruit and berries (1.21; 1.09–1.34) and fish (1.43; 1.30–1.57), high consumption of sugar-sweetened beverages (1.30; 1.14–1.48), low level of physical activity (1.10; 1.01–1.21), smoking cigarettes (1.78; 1.61–1.97), and using smokeless tobacco (1.20; 1.07–1.36). Overall, results from the present study suggest that experiencing childhood as difficult is associated with an increased risk of obesity and a range of unhealthy lifestyle behaviors in adulthood. Thus, our findings highlight the importance of identifying and providing support to children in difficult life circumstances in addition to customized and targeted public health efforts in adulthood.
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