Childhood Sexual Abuse and It's Link to Obesity
Getting to the Hart of the Problem of Obesity
I had the pleasure of hearing therapist Mary Jo Rapini from the TV show Big Medicine speak at the Atlanta OH conference this weekend. She mentioned briefly in her presentation the link between childhood sexual trauma and obesity. As a survivor of childhood abuse myself, this caused e to pause and research the subject. The data I found was interesting. I thought I would share it with you.
“Does Sexual Abuse Promote Obesity?
….I will continue to maintain that no obesity history is complete without explicitly exploring sexual, mental, and physical abuse and their relationship to ingestive behavior.”
~ Dr. Araya M. Sharma
The Crippling Shame of Incest / Sexual Abuse
To anyone running a bariatric clinic, stories of sexual abuse linked to obesity should come as no surprise. Previous reports have estimated that as many as 20-40% of patients seeking weight loss, particularly bariatric surgery, may have histories of sexual abuse.
"Incest (which I am defining here as it is defined by Survivors of Incest Anonymous, as sexual abuse by a family member, extended family member, or other person known to us whom we were led to trust) adds devastating betrayal issues and more crippling shame to the wounding."
"When trusted people violated our bodies they betrayed us heinously. They did further mutilate our relationships with our hearts and souls, with our bodies and sexuality - because we thought it was our fault. We thought it was our fault because we were kids relating to older people who were higher powers to us - and because too often the perpetrators told us it was our fault and threatened us if we told. A child who is abused by one parent and doesn't tell the other parent, or by a grandparent or uncle or family friend and doesn't tell parents - is a child who already knows that he/she will not be believed, a child who has already gotten the message that her/his needs and emotions are not important to the parent (s.) Any child who felt loved and protected by his/her parents would immediately tell them if someone was hurting her/him.
The incredible pain and shame generated by sexual abuse often causes a person to identify their body, and their sexuality, as the enemy. Incest and sexual abuse cause self hatred."
"Obesity is one of the effects of sexual abuse for some people. Food is not only a way of nurturing self and numbing the pain, but the extra weight is like armor put on for protection against the betrayal of our bodies and sexuality."
“The first study to link obesity with childhood sexual abuse (CSA) was reported by an observant clinician who noted that a high proportion of women enrolled in a weight loss program had a history of CSA (Felitti, 1991). Three (Felitti, 1993; Springs & Friedrich, 1992; Wadden et al., 2006) of four clinic-based studies (Felitti, 1993; Jia, Li, Leserman, Hu, & Drossman, 2004; Springs & Friedrich, 1992; Wadden et al., 2006) also noted an increased prevalence of CSA among obese relative to non-obese female patients. Several population-based, cross-sectional studies have evaluated this association (Aaron & Hughes, 2007; Alvarez, Pavao, Baumrind, & Kimerling, 2007; Brewerton, O'Neil, Dansky, & Kilpatrick, 1999; Cloutier, Martin, & Poole, 2002; Stein & Barrett Connor, 2000), and only one (Stein & Barrett Connor, 2000) of the five studies found no association. Perhaps the most compelling data linking CSA with adult obesity comes from the Adverse Childhood Experiences (ACE) study which addressed the health effects of a range of experiences in childhood in a large retrospective cohort of 13,177 California health maintenance organization members (Felitti et al., 1998). In subsequent analysis of these data which adjusted for psychosocial factors (Williamson, Thompson, Anda, Dietz, & Felitti, 2002), sexual assault in childhood that involved penetration was associated with a 30% increase in the incidence of obesity (95% confidence interval [CI] = 1.2-1.5). Two recent cohort studies provide additional prospective evidence that CSA may be a causal factor in obesity for young adults (Mamun et al., 2007; Noll, Zeller, Trickett, & Putnam, 2007).”
“In the current study, 48% of participants reported experiencing severe sexual violence. These abusive experiences were found to be significantly associated with obesity, the use of weight manipulation to avoid unwanted sexual experiences, and overeating, The cumulative effect of both severe sexual violence and childhood physical abuse resulted in a stronger association with overeating than severe sexual abuse alone.”
Abuse also is a form of control by adults over the child victims, and overeating may be a way for abused children to gain some control of their own, she said. Others have argued that being overweight is a way to make oneself unattractive and ward off undesired attention. “
~ "Obesity Risk for Female Victims of Childhood Sexual Abuse: A Prospective Study" is posted at <
So what does this mean? Has every obese person been abused? No. That's silly. What these studies show, is there is a proven link to childhood trauma and obesity. The studies I copied above focused on childhood sexual trauma. But, there is also a correlation between obesity and adult sexual trauma such as rape, domestic violence, childhood physical and emotional abuse, loss of a perent in childhood, and other post tramatic stress precursors.
If you have experienced some type of abuse or trauma in your past, you should seek help, and consider mentioning it to your wls or psych as you go through your wls journey.
We have to heal our insides as we heal our outsides. If food was used to mask the pain and shame of abuse in the past, it will not be accesible in large quantities post op. Otherwise, there may be a higher risk of transferred addiction or self sabatoge with non compliance in post op care.
I was blessed to find a wonderful counsellor who helped me through my healing process. Eventhough I have had therapy, it is something I still deal with every day.
I have shared my story on my blog. If you need a friend to talk to, please feel free to PM me your story.
Although I knew that child sexual abuse was a BIG part of my relationship with food, I had no idea that it played a role in so many other people seeking WLS. Up until maybe a year ago, when I told my husband about the abuse, I thought I was destined to be this way. Since then, though, it seems like such a great weight has been lifted. I don't WANT to be like this. I want to help myself, be healthy, love myself and be there for my family. I came to the conclusion after finally letting a few people in on my deep dark secret, that I will not let the person who did this to me win. One of the things on my "list" of things I want to be able to do after surgery is to have the confidence to tell him that I remember everything he did, I forgive him, but if I ever find out he touches his daughters, I'll go to the police with all of our stories. Right now, I feel like a child next to a giant everytime I think of it.
Whew...sorry for the novel. Thank you for posting this.
No one can make you feel inferior without your permission.
My WLS blog -- gamecaco4.wordpress.com/
Finding the courage to talk about my story and share it with the world is part of my healing process. By speaking out about it I am taking the power back that was stolen from me. When we keep it a secret, we allow our abuser to keep the power they held over us when we were intimidated into not telling.
I was 32 years old before I sought help, and that was only because holding it in got so bad I was on the verge of a breakdown. I still have good days and bad days, and I pray myself through a lot of down times.
Another point to consider is the men who were abused as children. Up until recent years that was unheard of in the media.
Abuse was something that happens in all social circles, all races, all economic classes...
There is no need to be ashamed anymore, This is not something you caused or deserved. You were helpless and likely did not even have knowledge of what was happening to you until you were older and found out what IT was. I am glad you found the courage to talk to your husband about it. I hope he is supportive and will love you through your healing.
This is very interesting:
"Many people who have a history of depression experience brief episodes of depressed mood and/or anxiety as you describe. While these mood appear suddenly, the individual doesn’t have the other symptoms associated with a Serotonin depression such as preoccupation with the past, sleep/appetite problems, fatigue, etc. The question is always…what’s going on?
When we’ve been depressed for several years or experienced several years of emotional trauma, we’ve recorded many memories during those difficult times. Due to the emotional distress at that time, those are “emotional memories” rather than regular memories such as our birthdate, type of first automobile, etc. Emotional Memory contains not only the details of an experience, but also the mood that was present at the time. In other words, if you start thinking about the death of a loved one, even when it happened several years ago, you slowly feel emotional grief again.
During our daily routine, many common activities and experiences trigger these old emotional memories and they are followed by, as you describe, the mood we experienced at that time. When this happens, our mood may become very depressed or anxious and we feel as though we’ve been suddenly hit in the face. Also as you describe, that mood tends to fade away after a few hours as long as we try to return our focus to our daily activities.
In answer to your question, Serotonin typically has a “level” that operates on a daily basis. Sustained low levels of Serotonin are associated with a variety of mental health issues (depression, OCD, eating disorders, etc.). Emotional memories can increase or decrease multiple neurotransmitters as the memory duplicates the mood in that memory. These changes in neurotransmitter levels are temporary, as when we are emotionally distressed following a traumatic experience such as an automobile accident, often requiring several hours to calm down from the experience as neurotransmitter levels return to the stable range."
The thing I don't understand about ME is I never considered myself an emotional eater. Nor did I think I had a food addiction??? Was I so far gone emotionally that I was not even concious of having an addiction? I don't mean I was walking aroung picking off imaginary bugs and talking to my dead relatives or anything, but was my subconcious so damaged so serverely for so long, that I wasn't even aware my emotions were causing the overeating? My abuse started when I was a toddler. My earliest memory was when I was about 3. I know for sure because I distinctly remember an abusive episode, and I remember my bedroom at the time. I know we moved out of that house when I was 4 after my sister was born. (PARENTS BE CAREFUL WHAT YOU DO TO AND AROUND YOUR CHILDREN, THEY REMEMBER THINGS FROM WHEN THEY ARE VERY LITTLE). I thought I was crazy because it didn't seem possible to remember back that far, but I described the wallpaper, furnishings, etc. to my mom and was accurate. There were no pictures from that house, so the only way I knew was my memories.
My abuse was also repetetive, at times it occured daily. I think this must be more traumatic than someone who suffers a single encounter. And likely caused more intense damage.
I agree it is very interesting you met so many other women with eating disorders that vere abused when you wer hospitalized. I hope there will be more studies on this issue and hopefully more people will share their stories.
I want to thank you so much for posting this.. I have nothing but the upmost respect for you.. I know it took a lot to post this.. It is an issue that affects a lot of people not only women.. I just want you to know that I have a lot of respect for you.. You will be in my thoughts and prayers..
Interview on www.weightlosssurgerychannel.com Please check it out.. http://www.weightlosssurgerychannel.com/programs/wls-journeys/wls-journeys-guest-ramon-lopez.html/
Video, about me, made by my best friend Yvonne.. http://www.youtube.com/watch?v=3gCxNTyRUo0
Granted that childhood abuse may be the cause behind some obesity cases or eating disorders, but keep in mind that many other factors, including genetics, play a big part in same .. Not all persons who were abused develop eating disorders or become obese, nor were all obese persons or those with eating disorders abused .. Look also at the high rate of obesity now in our nation -- were ALL those millions of persons "abused" as children? Is the rate of "abuse" increasing exponentially (if anything, with modern monitoring and reporting requirements, it should be on the decrease)?
As one member recently pointed out in a post, we've ALL been abused (I assume by that she means the public in general, not just OH members pr W:Sers) in one way or another as kids .. In that regard, how does one define "abuse"? It is such a vague and ambiguous term ..
If it were a matter of "abuse" as a kid, then therapy would solve the patient's obesity or eating disorder problem, right? No WLS needed .. But I don't think you'll find that it works that way, at least most of the time ..
(btw, Dr. Sharma's first name is "Arya" )
Frank talk about the DS / "All I ever wanted to be was thin, like that Rolling Stones dude ... "
HW/461 LW/251 GW190 CW/322 (yep, a DS failure - it happens :-( )
NO, all obese people wer not abused sexually or otherwise. And, all abuse survivors do not grow up to be obese. However, research is showing there is a higher liklihood of obesity if there was a history of abuse.
If you were abused, you should do some introspective thought to see if / how the abuse played a role in your weight problems.
I was abused and my 2 sisters wer not. We have the same genes, ate the same meals growing up, etc. I am fat, they never struggled with weight. Hmmm???
BTW this is a very sensitive subject for a person that who has ben traumatized. While I appreciate your perspective ..... BE NICE
It takes a lot to place your heart on the sidewalk and risk the world trampling it. As my OH brother, could you try to help me pick it up and put me back together again, and not hurt me more??
All these years that I have suffered and made my husband suffer becasue of my sick family life. It is no wonder that I have moved to another state and have no desire to even talk to any of them. Wow. I love breakthroughs!!!
Sorry - I have to cut this short because now I need to go deal with my new realization!!!!
I am sorry to hear about so many others having to deal with similar things. I know how hard it has been for me and how much it has ruined my life and caused me so much pain and suffering. I am here if anyone needs to talk.
I can eat as much as I want...I just don't want much.
I'm ashamed of what I did for a Klondike bar...
Currently I am writing a novel about Obesity & Gastric Bypass surgerry, based on my own & others experiences, with fiction thrown in. I have maintained my 100 & weight loss for 4 years and am very proud of it! I never would have been this successful without my OH friends
on 11/10/09 10:03 am
I too was a victim of CSA by my mother (Yes woman can be just as cruel and abusive as men) - but my stepfather was worse, and my mother failed to protect me and my sisters. I was very lucky to be placed in a fosterhome at 8.
I think most of us, who have studied the causes of obesity know that there is not one single factor causing obesity. Genetics, sociological, physical and psychological factors all play their part - and we sure know that there is no simple cure for obesity and that WLS is not an easy fix.
For me CSA made me struggle with recurrent depressions, severe Post Traumatic Stress Disorder and Bulimia for 21 years and Social phobias. I have no doubt that antidepressants and antianxiety medications have caused weight gain for me - because I became more sedantive.
During the years I have had more than 900 hours of therapy in order to survive and cope. I did recover from my eating disorder - but it took 21 years before I was able to stop binge-eating and puking afterwards. I have to live with the pain of CSA and it is hard.
I eat healthy food (but do not go out much ...) and even if I do not overeat to cope with unwanted or difficult to handle feelings - my weight increased until 3 years ago - even though I tried everything to loose the weight, I was never able to keep the weight off (sounds familiar?) . Increasing weight have made my social phobia worse.
So yes I am sure that some of the consequences of CSA have caused ME to become Obese. Would I have become obese if I had not been sexually abused as a child? Yes I think I would - but I might have been able to avoid WLS. I will however never know.
All I know is that I will treat myself really well and do what ever it takes to live and cope as good
as I can. I would not be getting WLS if I had given up on myself. Just like therapy I see it as getting a tool to help me improve my quality of life - it will not fix everything and I do not believe that loosing 100 pounds will make everything in my life perfect. It will give me other challenges and I am sure some feelings that are burried in excess bodyfat will need to be adressed. But bring it on! I will deal with that too.
IMO - all the therapy in the world to cope with the aftermath of CSA - will not prevent anyone from becoming obese. Obesity is a complex issue that has to be adressed and treated. And for severe obesity WLS is an option. Survivors of CSA will however still need to live with the pain and problems - WLS will not change that.
BTW - male survivors are not alone - a big online community and organisation exist offering support and healing retreats:
I am sure there are several other ressources availble for women too. Because I know that all survivors will need to adress certain issues in order to recover and LIVE.