You may have heard the childhood chant, "Nobody loves me, Everybody hates me, I'm gonna go eat worms." While worms might not be the edible of choice for most, the ditty does point to a truth. Feeling bad leads many people straight to snacking. Now research shows that extreme trauma leads to eating a lot, which in turn leads to obesity.
In the late 1980's, Dr. Vincent Felitti, head of Preventive Medicine at Kaiser Permanente, conducted research on the link between obesity and sexual abuse. In reviewing records of 286 obese patients, he found that half had been molested as children. That's twice the rate in the population at large -- a startling correlation. More recent research supports those findings. In 2007, a study of 11,000 California women published in the American Journal of Preventive Medicine found that childhood abuse increased the risk of obesity in adulthood by 27 percent. A smaller study published in the journal Pediatrics that same year found that those who had been abused in childhood had more than twice the risk of obesity by age 24.
Then last year, a study of 15,000 male subjects found that those who had been abused as teens had a 66 percent greater chance of obesity in adulthood. Another 2009 study, this one out of the University of Medicine and Dentistry of New Jersey, found that physical abuse in childhood led to almost three times the risk of obesity in adulthood. Most recently, Kaiser Permanente's Adverse Childhood Experiences (ACE) study found strong links between negative childhood experiences and a wide array of conditions and diseases. That study included over 17,000 adult patients who indicated if in childhood they had been exposed to "negative conditions" such as neglect, emotional abuse, physical or sexual abuse, witnessing domestic violence, having a mentally ill, incarcerated or a drug-addicted parent, or living with just one parent instead of two or with someone other than a parent.
Not surprisingly, the correlations were clear. Those subjects who had experienced four or more of the negative conditions in childhood had twice the risk not only of obesity, but also of heart attack and stroke, and four times the risk of emphysema compared to those who had experienced none of these conditions.
Scientists say it isn't just eating in response to stress that causes weight gain and concomitant health problems, although that certainly plays a role. In fact, those who experienced early sexual abuse might unconsciously put on weight to make themselves unattractive so they don't get abused again, while those who experienced physical or emotional abuse might want extra "padding" for protection, again, an unconscious choice.
But according to the experts, there's also a psychological factor at play, because those who don't overeat but had many negative conditions in childhood still have high rates of obesity, heart disease, depression and diabetes. Apparently, the body responds to extraordinary stress by storing fat, no matter the diet. Dr. Jack Schonkoff of the Harvard Center of the Developing Child explains, "Early adverse experience can disrupt the body's metabolic systems. One of the cornerstones of biology is that our body's systems, when they are young, are reading the environment and establishing patterns to be maximally adaptive."
According to this theory, when we experience trauma, the body interprets the stress signals it receives to mean that famine is coming, and so it stores fat in preparation. And so, the solution to obesity requires more than going on Atkins or even the Mediterranean diet. It means minimizing stress. Dr. Shonkoff says, "It's not a secret that there is a growing epidemic of obesity and there's no question that the way we eat and the way we exercise, or do not exercise, is contributing to it. Yet it's a huge mistake to attribute it just to the need to close down fast-food restaurants and turn off the TV. There's important biology here early in life that needs attention."
But let's get real here. Obesity rates have tripled since 1980 in much of North America, the United Kingdom, China, Eastern Europe, the Pacific Islands and Australasia. Surely, there hasn't been a surge of abuse in the past 30 years in these places, a surge so severe as to triple the rate of trauma-related fat. Certainly, life wasn't just so much easier in the far skinnier Middle Ages, what with plague and war and all. Consider that in the past 10 years in the US, obesity has gone up 50 percent. Does it make sense that parents have grown markedly meaner and more perverted in just a decade, causing a huge spurt in weight problems?
Clearly something else is going on, and I'm fairly certain it boils down to the same old formula: calories burned have to exceed calories consumed or else weight gain results. And where too much weight is gained, health problems begin. We're eating more than ever, and eating more of the worst foods. As I've pointed out before, in 2003, the average person consumed 523 more calories on a daily basis than did the average person in 1970. The average fast-food burger today is five times larger than when McDonald's first started putting burgers to buns. Likewise, the average pizza slice has almost doubled in size in the past 20 years. The old eight-ounce bottle of Coke has given way to 12-ounce cans and 20-ounce bottles.
In fact, everything food-related has gotten bigger in the past 20 years -- from dinner plate sizes, which were typically 10 inches back then but now average 12 inches (yes, that's right, dinner plates have gotten bigger) -- to bagels, which have tripled in calories over the years from an average 120 calories 20 years ago to an average 350 calories today. (Oh, and don't forget the cream cheese and butter you smear on that bagel.) What does this mean? Studies show that we tend to eat what's put before us -- so bigger plates lead to bigger meals. A recent analysis showed that the average American now pours 20 percent more breakfast cereal and 30 percent more milk than back 20 years ago. And another, 2008 study, found that serving sizes have increased not only at restaurants and fast-food places, but also at home. In fact, burgers cooked at home have increased in size even more in the past 20 years than have restaurant burgers.
I'm not saying early stress, or stress at any time in life for that matter, doesn't play a role -- it certainly does. But again, we're eating more than we did in the past, plain and simple. If stress leads to eating and junk food is readily available and pushed by the media in commercial after commercial, those with a predisposition to overeating will almost certainly end up in trouble. Yes, it's essential to find ways to stop childhood stress and abuse, and if these things are contained, obesity rates might dip. But to reverse the obesity epidemic, the food options that are showcased in commercials and on the shelves at supermarkets and convenience stores need to change, the formulas used in making processed foods need to change, restaurant menus have to change, and consumer demand needs to change to reflect increased education about what healthy eating means.
Oh, and buy smaller plates.