Severe abuse suffered by girls during childhood may be linked to a subsequent food addiction, new research suggests.
Analysis of more than 57,000 women who participated in the Nurses' Health Study II (NHSII) showed that those who experienced physical or sexual abuse as children and/or adolescents were twice as likely to have a current food addiction as the women who did not suffer past abuse.
The risk for food addiction was even greater for the women who had experienced both physical and sexual abuse.
Although the investigators note that these results need to be replicated before a causal link can be definitively stated, they write that it is important for clinicians to work toward decreasing the risk for serious overeating in women with a history of abuse.
For example, those "who show a propensity toward uncontrolled eating could potentially be referred to prevention programs," whereas women who are obese might be screened for early trauma to address any psychological impediments to weight loss, said lead author Susan M. Mason, PhD, from the Connors Center for Women's Health and Gender Biology at Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, in a release.
"Of course, preventing childhood abuse in the first place would be the best strategy of all, but in the absence of a perfect child abuse prevention strategy, it is important that we try to head off its negative long-term health consequences," added Dr. Mason.
The study was published online May 2 in Obesity.
Beyond Comfort Food
According to the researchers, more than one third of all women in the United States experienced some form of abuse before their 18th birthday.
Although previous research has shown an association between childhood abuse and adulthood obesity, possibly because stress may lead to the overeating of so-called "comfort food," the current investigators sought to examine whether early abuse could increase the risk for a later food addiction.
They examined data on 57,321 female participants in the NHSII who were asked about past abuse and current food addiction. The latter was defined in the study as 3 or more "clinically significant symptoms on a modified version of the Yale Food Addiction Scale."
Results showed that 8.2% of all the women assessed met the clinical criteria for food addiction. In addition, 8.5% reported experiencing severe physical abuse as children or adolescents, and 5.3% reported repeated experiences of forced sexual activity.
Both types of abuse "were associated with roughly 90% increases in food addiction risk," report the investigators.
The risk ratio (RR) for those who experienced severe physical abuse was 1.92 (95% confidence interval [CI], 1.76 - 2.09) compared with those who had no physical abuse, and the RR for severe sexual abuse was 1.87 (95% CI, 1.69 - 2.05). The RR for those who suffered both was 2.40 (95% CI, 2.16 - 2.67).
The women who had a food addiction were also heavier, by a body mass index of 6 units, than those without the disorder.
Long-term Effects of Abuse
"Our large cohort allowed us to conduct in-depth examinations of the associations between the type and timing of child abuse and food addiction, a measure of uncontrolled eating reported by 8% of our sample," write the researchers.
However, the study had several limitations. These included that the timing of the onset of food addiction symptoms could not be ascertained, which would have clearly shown that the abuse happened first, and that the study participants were primarily white — so the results may not be generizable to the entire US population. The researchers also relied on the women's self-reports of child and adolescent abuse, which could not be validated.
Nevertheless, the findings add to "accumulating evidence of the importance of stress in the etiology of some obesity phenotypes, and may help to inform the development of weight-loss regimens for women with abuse histories," write the investigators.
"Our study also contributes to a growing body of literature documenting widespread and long-lasting mental and physical health repercussions of child abuse, which help to clarify the true societal costs of child maltreatment and lend urgency to abuse prevention efforts."
They add that future research should "further articulate the pathways from abuse to weight gain," to help identify critical points of vulnerability and to better assist with both prevention and treatment.
The study was funded by grants from the National Institutes of Health. The study authors have reported no relevant financial relationships.
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