The Link Between Abuse, Obesity, and Weight

Abuse in childhood can leave people with more than bad memories — verbal, emotional, physical, and sexual abuse are all linked to an increased risk of adult obesity.

Weight management experts say that obese adults who are struggling unsuccessfully with weight loss may want to take a look at their childhoods before continuing with intensive weight-loss programs. Until those issues are resolved, weight loss might be elusive.

Obesity and Abuse: Theories Behind the Link

As many as one in three obese women are survivors of childhood abuse. “You do see high rates of child and sexual abuse in individuals who are morbidly obese,” says psychologist Sherry Pagoto, PhD, assistant professor in the division of preventive and behavioral medicine at the University of Massachusetts in North Worcester. “Weight gain is often their way of protecting themselves from receiving any attention.”

There are many theories about why childhood abuse can lead to adult obesity, including:

• Childhood abuse reduces a person’s sense of control, which leads to an increased risk of making poor health choices.
• Women who gain weight to protect themselves are afraid of becoming thin and entering new relationships. “Patients will talk about that experience,” says Pagoto. “Romantic relationships can generate a lot of anxiety and bring the trauma back up.”
• Childhood abuse leads to depression in adulthood, which is linked to high rates of obesity.
• Childhood abuse results in feeling bad about your body, which makes it hard to make healthy choices.
• Childhood abuse results in disordered eating patterns — binge eating may be more common among survivors of childhood abuse.

Not everyone who was abused as a child struggles with obesity or has problems losing weight, but those who do may have other symptoms of ongoing trauma in their lives, says Pagoto. Difficulty dealing with stress, troubled relationships, and interrupted sleep patterns are other signs that abuse is still affecting you.

Obesity and Abuse: Getting the Right Treatment First

If you are working with a weight management team, it is probably focused on what you need to do to lose weight, not on your total emotional wellness. Data suggest that most patients don’t bring up past abuse with their doctors.

If your doctors know about it, they might deliver a “prescription” you don’t necessarily want to hear: Take a break from weight loss to work on your emotional and mental health.

This is hard to hear, says Pagoto, because many people who need to lose a lot of weight are motivated and focused — they believe if only they could lose 50 or 100 pounds, many of their personal problems would be solved. They may not even be thinking about getting into therapy to cope with past trauma. While many people do feel better about themselves with weight-loss success, they still have to face the impact of that trauma on their lives, says Pagoto.

Obesity and Abuse: Persistent Problems

Another barrier to success for people who were abused as children is that “the depression and trauma persist because they end up in these life situations that perpetuate the feelings,” says Pagoto. She has often observed that morbidly obese patients who struggle with weight loss tend to be surrounded by less than supportive family members, who make it hard to lose weight.

In an ideal world, says Pagoto, weight management strategies would treat the whole person, including the impact of past trauma and the way in which their current life is affected.

Obesity and Abuse: Breaking the Link

The bottom line is that therapy may be helpful if you are obese, were abused as a child, and have been frustrated in your weight-loss efforts, says Pagoto. While you are in therapy, you can still build healthy lifestyle choices into your day or week, as long as those choices help you feel more in control of your life and good about your body.

Whether or not you seek therapy, Pagoto recommends finding a way to be physically active that you enjoy. “So often we talk about exercise for weight loss, but really it is better for raising mood than for losing weight. If we talked about it as a form of psychotherapy, maybe more people would do it,” she says.