Table 1.
Cross-sectional and case-control studies on the relationship between adverse childhood experiences and development of obesity in adulthood
| First author, year | Country/ Study design | Samples | Mean BMI (WC) | Obesity measures | Measures | ACE (n or %) | Variables predicted OB | Results |
| Aaron, 2007 | USA CS |
N = 416 ♀ OB = 90 Age = 37.8 |
27.8 | SR BMI OB = BMI ≥ 30 M-OB = BMI ≥ 35 |
CSA-Structured interview | CSA = 31% | OB/M-OB = CSA | BMI + in CSA |
| Alvarez, 2007 | USA CS |
N = 11116 OB = 2509 Age 18–65 |
SR BMI OB = BMI ≥ 30 |
TSS | ACE in OB = 29.9% | OB = Tot ACE, CSA & CPA |
||
| Anda, 2006 | USA CS |
N = 17337 (9367 ♀) Age = 57 |
SR BMI M-OB = BMI ≥ 35 |
Four questions from CTS ACEs Standardized Questionnaire |
CEA = 10.6% CPA = 28.3% CSA = 20.7% DV = 12.7% ≥4 ACE = 12.5% |
M-OB = ≥4 ACE | ||
| Bellis, 2014 | UK CS |
N = 1466 (882 ♀) OB = 268 M-OB = 40 Age = 18–70 |
SR BMI OB = BMI ≥ 30 M-OB = BMI ≥ 40 |
ACE questions | 1 ACE = 287 2–3 ACE = 234 ≥4 ACE = 185 |
OB = ≥4 ACE | ||
| Brewer-Smyth, 2014 | UK CS |
N = 81 ♀ OB = 35 |
LM BMI OB = BMI ≥ 30 |
Muenzenmaier’s scale | OB = CSA | |||
| Burke, 2011 | USA CS |
N = 701 (381 ♀) Age = 0–20.9 |
LM BMI OB = BMI ≥ 85th % |
Trauma screen on a chart review Social service report |
≥1 ACE = 67.2% ≥4 ACE = 12.0% |
OW/OB = ≥4 ACE | ≥4 ACE = 38 OB | |
| Buser, 2004 | USA CC |
N = 42 ♀ M-OB CSA = 21 Age CSA = 39.0 Age Non CSA = 36.1 |
CSA = 56.9 Non CSA = 51.1 |
LM BMI | Interview | CSA = 21 Non CSA = 21 |
BMI: CSA = Non CSA | |
| Chartier, 2008 | Canada CS |
N = 8116 (4074 ♀) OB = 829 Age 15–64 |
SR BMI OB = BMI ≥ 30 |
Mental Health Supplement of the Ontario Health Survey | CPA in OB = 15.0% CSA in OB = 18.2% |
OB = CSA | ||
| Clark, 2007 | USA CS |
N = 152 (111 ♀) Age = 51.3 |
SR BMI in 73 M-OB LM BMI in 79 M-OB OB = BMI ≥ 30 |
Semi-structured interview | CSA = 27% ASA = 9% CPA = 19% |
|||
| D’Argenio, 2009 | Italy CC |
N = 200 (130 ♀) OB = 65 (42 ♀) OB/PS = 85 (64 ♀) Age OB = 40.4 Age OB/PS = 39.1 |
OB = 41.3 OB/PS = 38.3 |
LM BMI OB = BMI ≥ 30 |
ETLE | ACE in OB = 38.5% ACE in OB/PS = 43.5% |
OB = Tot ACE | No ACE differences |
| Davis, 2014 | USA CS |
N = 210 (110 ♀) Age = 45.8 |
30.4 | LM BMI OB = BMI ≥ 30 OB = WHR > 2 |
ELSI AAI |
CEA = 23% CPA = 41% CSA = 30% DV = 29% |
BMI = ACE WHR = ACE |
|
| Felitti, 1993 | USA CS |
N = 200 (158 ♀) OB = 100 (79 ♀) NW = 100 (79 ♀) Age = 41 |
>65 pounds MIW |
LM of weight Weight = pounds |
Clinical interview Nurses information |
CSA in OB = 25% CSA in NW = 7% CEA/CN in OB = 29% CEA/CN in OB = 14% |
CSA + in OB CEA/CN + in OB |
|
| Fuller-Thomson, 2012 | Canada CS |
N = 12590 (6887 ♀) OB = 2787 (1254 ♀) Age = 18–80 |
N/R | SR BMI OB = BMI ≥ 30 |
CCHS | ♂ CPA = 4.9% ♀ CPA = 9.7% |
OB = CPA in ♀ | OB + in ♀ CPA |
| Goedecke, 2013 | South Africa CS |
N = 44 ♀ OB = 24 |
Black OB = 38.6 White OB = 37.8 |
LM BMI OB = BMI > 30 NW = BMI < 25 |
CTQ | Tot CTQ in black OB = 33.2 Tot CTQ in white OB = 45.9 Tot CTQ in black NW = 38.8 Tot CTQ in black NW = 43.1 |
CTQ: OB = OW | |
| Grilo, 2005 | USA CS |
N = 340 M-OB (282 ♀) BED = 76 M-OB = 203 Age = 51.1 |
43.1 | LM BMI | CTQ | CEA in M-OB = 46.2% CPA in M-OB = 28.8% CSA in M-OB = 31.8% CEN in M-OB = 48.8% CPN in M-OB = 32.1% |
CN + in M-OB/BED | |
| Grilo, 2006 | USA CS |
N = 137 M-OB (122 ♀) Age = 42.3 |
51.8 | LM BMI | CTQ | CEA in M-OB = 46.0% CPA in M-OB = 29.2% CSA in M-OB = 32.1% CEN in M-OB = 49.6% CPN in M-OB = 27.7% |
No BMI differences | |
| Gunstad, 2006 | USA CS |
N = 696 (339 ♀) OB = 73 (37 ♀) Age = 36.59 |
OB = 34.8 | LM BMI OB = BMI ≥ 30 |
CAT | CEA in ♂ OB = 17% B in ♂ OB = 30% |
BMI = B BMI = CEA ♂ OB = ACE |
B + in ♂ OB B + in ♂ OW CEA + in ♂ OB |
| Hodge, 2014 | USA CS |
N = 459 (336 ♀) Median age = 42 |
31 | OB = BMI ≥ 30 M-OB = BMI ≥ 40 |
Questions about ACE | BMI = CEA | ||
| Hollingsworth, 2012 | Australia CS |
N = 239 ♀ OB = 63 |
26.24 | LM BMI OB = BMI ≥ 30 |
CTQ | CEA in OB = 41.3% CPA in OB = 41.9% CSA in OB = 31.9% CEN in OB = 21.4% CPN in OB = 26.3% |
OB = CEA, CPA | CEA + in OB CPA + in OB |
| Jia, 2004 | USA CS |
N = 237 ♀ OB = 53 Age = 38.9 |
OB = 40.1 | LM BMI OB = BMI ≥ 30 |
CPA-Structured interview CSA-Structured interview |
CPA in OB = 34 CSA in OB = 28 |
OB = CPA OW = CPA |
CSA + in OB/OW CPA + in OB/OW |
| Kestilä, 2009 | Finland CS |
N = 1369 (618 ♀) M-OB = 20 (12 ♀) OB = 101 (40 ♀) Age 18–29 |
SR BMI M-OB = BMI ≥ 35 OB = BMI ≥ 30 |
Health Examination Survey Structured interviews Self-administered questionnaires |
♀ B = 28% ♂ B = 21% |
♀ OB = B | ||
| Knutson, 2010 | USA CS |
N = 571 (282 ♀) OB = 93 OW = 85 Age = 6.3 |
LM BMI OB ≥ 95th % |
56 items about care neglect HEQ |
BMI = CN | |||
| Larsen, 2005 | the Netherlands CS |
N = 157 M-OB (144 ♀) Age = 40 |
CSA = 45.1 Non CSA = 45.7 |
LM BMI M-OB = BMI ≥ 40 |
Questions about CSA | CSA = 23% | BMI: CSA = Non CSA | |
| Maddi, 1997 | USA CS |
N = 1027 M-OB (855 ♀) Age = 37.31 |
46.13 | LM BMI M-OB = BMI ≥ 35 |
Interview | CPA in OB = 11.6% CEA in OB = 10.0% CSA in OB = 12.1% I in OB = 2.3% |
BMI = CEA, CPA, CSA | |
| Mahony, 2010 | USA CS |
N = 573 OB (419 ♀) Age = 40.14 |
PsyBari | CSA = 89 CPA = 133 |
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| Marcus, 2007 | USA CS |
N = 589 ♀ OB = 213 OW = 176 Age = 42–55 |
N/R | LM-BMI & WC OB = BMI ≥ 30 OB = WC ≥ 88 |
12-item questionnaire from National Comorbidity’s Study modification of the revised Diagnostic Interview Survey PTSD section | CPA/CSA = 15.6% | BMI = CPA/CSA | |
| McIntyre, 2012 | Canada CS |
N = 373 (230 ♀) MS = 83 (50 ♀) Age = 42.9 |
N/R | LM BMI & WC OB in ♀ = WC > 102 OB in ♂ = WC > 88 OB = BMI > 30 |
Klein Trauma & Abuse-Neglect self-report scale | CPA = 21.9% CSA = 24.9% DF = 39.0% Any ACE = 46.7% |
OB + in CSA | |
| Oppong, 2006 | USA CS |
N = 258 M-OB (208 ♀) Age = 40 |
Non CSA = 52 CSA = 51 |
LM BMI OB = BMI ≥ 30 M-OB = BMI ≥ 35 |
Questionnaire on ACE | ♀ CSA = 29.6% ♂ CSA = 12.2% |
BMI: CSA = Non CSA | |
| Pinhas-Hamiel, 2008 | Israel CS |
N = 145 ♀ OW OB = 42 Age = 10.4 |
29.9 | LM BMI OW = BMI > 95th % M-OB = BMI ≥ 35 |
Social worker and psychologist interview | CSA in OW = 3.5% CSA in OB = 9.5% |
OB + in CSA Δ BMI + in CSA |
|
| Rhode, 2008 | USA CS |
N = 4641 ♀ OB = 3251 Age = 52 |
SR BMI OB = BMI ≥ 30 |
Four questions from CTQ | CSA = 904 CPA = 709 |
OB = CSA/CPA | ||
| Salwen, 2014 | USA CS |
N = 187 (67 ♀) OB = 29 M-OB = 158 Age = 43.58 |
45.90 | LM BMI OB = BMI ≥ 30 M-OB = BMI ≥ 40 |
CTQ-short form | Severe CEA = 10.2% CPA = 8% CSA = 4.8% CEN = 8% CPN = 9.6% AIA = 30.5% Any ACE = 61.0% |
||
| Sansone, 2008 | USA CS |
N = 121 OB (104 ♀) Age = 44.6 |
47.2 | LM BMI OB = BMI ≥ 30 |
Questions about ACE | CEA = 43% CSA = 19% CPA = 17.4% CPN = 9.1% DV = 39% |
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| Schneiderman, 2012 | USA CC |
N = 454 (231 ♀) ACE = 303 (151 ♀) CG = 151 (60 ♀) Age = 10.93 |
N/R | LM BMI OB ≥ 95th % OW = 85–95th % |
Child Welfare Case Records | CEA = 156 (83 ♀) CPA = 156 (67 ♀) CSA = 64 (41 ♀) CN = 232 (111 ♀) |
BMI: ACE Group = CG CG > ACE Group in OB/OW | |
| Smith, 2010 | USA CS |
N = 867 ♀ OB = 310 Age = 47.6 |
N/R | LM BMI M-OB = BMI ≥ 40 S-OB = BMI ≥ 35 OB = BMI ≥ 30 |
Three questions about SA | OB = Any SA | ||
| Taylor, 2006 | USA CS |
N = 455 ♀ Age = 20.8 |
23.7 | LM BMI OW = BMI 25–32 |
CTQ Questions of negative comments about shape and weight |
NC = 114 OW NC = 40–50% 152 OW > 90th % on CEA, CEN & CPN |
MBS = NC, CEN | |
| van Reedt Dortland, 2012 | the Netherlands CS |
N = 2755 (1829 ♀) Age = 41.9 |
WC = 87.0 | LM WC | Childhood Trauma Interview used in the Netherlands Mental Survey and Incidence Study | CEA = 10.8% CPA = 2.8% CSA = 1.3% CEN = 20.4% |
WC = CPA, CSA & CEA | |
| Whitaker, 2007 | USA CS |
2412 children Age = 3 |
N/R | LM BMI OB = BMI > 95th % |
CTSPSC | CEA = 94% CPA = 84% CN = 11% |
OB = CN | |
| Wildes, 2008 | USA CS |
N = 230 M-OB (191 ♀) Age = 44.8 |
51.4 | LM BMI M-OB = BMI ≥ 40 OB = BMI ≥ 30 |
CTQ | Tot ACE = 151 CEA = 109 CSA = 71 CEN = 71 |
CEA + in ♀ OB CSA + in ♀ OB |
Index: AAI = Adult Attachment Interview; CAT = Child Abuse and Trauma Scale; CCHS = Canadian Community Health Survey; CTQ = Childhood Trauma Questionnaire; CTSPSC = Parent–Child Conflict Tactics Scales; CTS = Conflict Tactic Scale; ELSI = Evaluation of Lifetime Stressors Interview; ETLE = Early Traumatic Life Events; HEQ = The Home Environment Questionnaire; TSS = Traumatic Stress Schedule; AIA = Adult Interpersonal Abuse; ACE = Adverse Childhood Experiences; CSA = Childhood Sexual Abuse; CPA = Childhood Physical Abuse; CEN = Childhood Emotional Neglect; CPN = Childhood Physical Neglect; CEA = Childhood Emotional Abuse; ASA = Adult Sexual Abuse; DV = Domestic violence against mother; D/S = Divorce/Separation of parents; I = Incarcerated household members; B = Bullied/rejected; DF = Death of family members; NC = Negative comments in family; S-OB = Severe obese; M-OB = Morbid obese; OB = Obese; OB/PS = Obese with psychiatric disorders; NW = Normal weight; BMI = Body Mass Index (kg/m²); WC = Waist Circumference (cm); WHR = Waist–Hip Ratio; MBS = Maximum Body Size (kg).