Impact of early life abuse on overall and central obesity in adulthood: Results from the Black Women's Health Study

Objective: To investigate the association between physical and sexual abuse in childhood and adolescence on risk of overall and central adiposity among Black women in the U.S.

Methods: Participants were 33,298 women enrolled in the Black Women's Health Study, an ongoing cohort study begun in 2005, who completed a retrospective questionnaire on early-life experiences of abuse in 2005. A cumulative indicator of severity of child/teen abuse was derived using factor analysis. Log-binomial regression models were used to derive risk ratios (RRs) and 95% confidence intervals (CI) for the relation between child/teen abuse and obesity in adulthood (BMI≥30, in 2005) and central adiposity (waist circumference>35 inches, in 2005).

Results: The RR for obesity was 1.19 (CI=1.13, 1.25) for women reporting severe physical and sexual abuse relative to no abuse, After control for postulated intermediates, including reproductive history, diet, physical activity, depressive symptoms, and demographics, the RR was 1.06 (CI=1.03, 1.10). The RR for waist circumference >35 inches for severe physical and sexual abuse relative to no abuse was 1.23 (CI 1.17-1.30) before adjustment for intermediates and 1.12 (CI=1.07,1.18) after adjustment. Similar results were observed among nonsmokers.

Conclusions: Sexual and physical child/teen abuse was associated with an increased risk of overall and central obesity. While the association between abuse and obesity was largely accounted for by health behaviors, reproductive history, and mental health, these factors did not fully account for the associations. Our data suggest that early life adversity is related to adult body size and weight distribution.