The correlation between adverse childhood experiences and the risk of obesity in adolescence is described in a study published in the journal Pediatric Research. The study identifies behavioral difficulties and self-concept as potential mediators of this association.
Study: Childhood Adversity and Risk of Obesity in Adolescence: A 9-Year Population-Based Prospective Cohort Study. Image source: Pixel-Shot / Shutterstock
The prevalence of obesity in adolescents is increasing significantly worldwide. In Western countries, the prevalence ranges from 20 to 30%. Various biological, social, and psychological factors limit the treatment and prevention of adolescent obesity. It is well-known that obesity in adolescents increases the risk of diabetes, high blood pressure, coronary heart disease, cancer, and premature mortality. The main cause of obesity is considered to be a complex interplay of environmental factors, genetic factors, and psychological behaviors. Existing evidence also suggests that the burden of negative childhood experiences may increase the risk of weight gain and obesity in adolescence.
Undesirable childhood experiences, including physical, emotional, and sexual abuse, mental illness in the caregiver, substance abuse, violent home environment, poverty, and loss of parents, can directly or indirectly affect children by compromising their sense of security. However, it is unclear how these experiences can increase the risk of obesity. The aim of the current study was to identify potential factors that could influence the association between negative childhood experiences and the risk of obesity in adolescents.
The researchers analyzed prospective data from the „Growing up in Ireland“ cohort study, which involved 8,568 9-year-old children born between 1997 and 1998 and their families. The children were followed-up at the ages of 13 and 18. A total of 6,216 families participated in the entire survey. The study considered children’s exposure to 14 negative experiences that occurred before the age of 9. The Body Mass Index (BMI), an established measure of obesity, was calculated in adolescents‘ households at the ages of 9, 13, and 18. Information on four types of mediators, including daily activity, dietary quality, self-concept, and behavioral difficulties, was collected when the children were 13 years old.
The final study analysis was conducted on 4,561 adolescents. Of them, 77.2% experienced adverse events in childhood, 50.5% were female, and 26.7% were overweight or obese at the age of 18. Adolescents who suffered from obesity at the age of 18 had a higher prevalence of childhood experiences such as the death of a family member, changing residences, or parental divorce compared to their non-obese peers. Children exposed to negative experiences had a higher BMI at the ages of 9 and 13 than non-exposed children. Throughout adolescence, those who had experienced negative experiences exhibited a lower self-concept and more behavioral difficulties. At the age of 13, significant differences in terms of behavior problems, BMI, and family income were observed between children exposed to adversities and those who were not. Children exposed to negative experiences mostly lived in low-income households during their entire adolescence. It was found that a higher parental BMI and lower household income were associated with a higher BMI at the age of 18. There was also a correlation between the frequency of intense physical activity and a lower BMI in adolescents at the age of 18, although no such association was found for dietary quality.
Analysis of the potential mediators indicated that a lower self-concept and greater behavioral difficulties indirectly mediate the association between negative childhood experiences and the risk of obesity in adolescence.
The study concludes that adverse experiences before the age of 9 exacerbate behavioral difficulties and diminish self-concept at the age of 13, leading to obesity at the age of 18. However, the study could not establish a direct link between negative childhood experiences and the risk of obesity in adolescents. As the researchers mentioned, a significant proportion of enrolled families did not participate in the entire survey, with predominantly high-income families remaining in the study. This lack of participation can lead to selection bias and limit the generalizability of the study results. To better determine the link between negative childhood experiences and the risk of obesity, future studies should consider the duration and frequency of exposure, as well as the age at the time of exposure in their study design.
- De Visser, Hannah S., et al. „Early Adversity and Obesity Risk in Adolescence: A 9-Year Population-Based Prospective Cohort Study.“ Pediatric Research, 2024, pp. 1–7, DOI: 10.1038/s41390-024-03040-7