Childhood adversity may lead to adult obesity

Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, appear to contribute to the development of obesity during adulthood, suggests an Iraq study presented at ESPGHAN 2025.

“Treatment of child abuse is recommended to decrease the occurrence of some behaviours that may lead to health problems in the future,” said lead author Dr Niga Hama Rashid, Dr Jamal Ahmad Rashid Pediatric Teaching Hospital, Sulaimanya, Iraq.

More than half (59.4 percent) of the 948 adolescent and adult participants (aged ≥18 years, 529 male) in this study reported at least one of the 10 categories of ACEs. More than one in 10 participants (15 percent) reported experiencing four or more types of ACEs, while more than half (59 percent) had one to three ACEs. [ESPGHAN 2025, abstract N-OP025]

These ACEs encompassed a range of stressful or traumatic events, including abuse (physical, emotional, and sexual), neglect (physical and emotional), and household dysfunction (mental illness, parental divorce, incarcerated relative, substance abuse, and violence towards the mother).

In this population, the most common ACEs reported were physical abuse (18.5 percent), emotional abuse (14.4 percent), psychological neglect (14.2 percent), physical neglect (13.9 percent), and domestic violence (9.7 percent).

A relatively robust association was observed between the number of ACEs and obesity (p=0.003). Of the participants, 12.4 percent had a BMI ≥30 kg/m². In addition, an increasing number of ACEs correlated with an increased risk of obesity, according to the authors.

“ACEs can lead to psychological issues such as depression and anxiety, which may result in unhealthy coping mechanisms, including overeating and sedentary behaviour,” Rashid said.

“Children with ACEs may develop maladaptive behaviours, such as poor nutrition and lack of physical activity, increasing their risk of obesity later in life,” she added.

These findings are similar to another study conducted between 2010 and 2013 in Albania, Latvia, Lithuania, Montenegro, Romania, the Russian Federation, the former Yugoslav Republic of Macedonia, and Turkey, according to Rashid.

In the said study, more than half of the 10,696 participants have been exposed to at least one form of abuse, and an “obvious correlation” was observed between the number of ACEs and “consequent health-risk acts.”

Interventions

Rashid and colleagues suggested the following strategies to address the effect of ACEs on obesity.

First, counselling and support (eg, therapy for families, child psychologists) can help manage psychological issues arising from ACEs. Second, school-based programs (eg, wellness program) may promote healthy behaviours and coping skills among children.

Third, community engagement (eg, local outreach programs, support groups) can help build supportive networks to reduce the impact of ACEs. Finally, physical activity initiatives (eg, sports leagues, fitness classes) will encourage exercise and healthy living in children.

In the current retrospective study, Rashid and her team randomly selected 948 participants and examined the associations between ACEs and the rate of obesity during adolescence and adulthood. Participants completed the ACEs questionnaire, originally produced by CDC and WHO.

Statistical analysis was performed using the SPSS software package, and comparing means analysis was carried out to explore the associations between variables. The authors obtained the height and weight and calculated the BMI of the participants.

“This study provides evidence that child abuse, neglect, and household dysfunction are common, and there is a clear association between them and obesity,” Rashid said.