A Systematic Review of the Relationship Between Childhood Maltreatment and Subsequent Obesity

The relationship between child maltreatment and subsequent obesity has been increasingly studied.  Prevalence of obesity varies by population, though it tends to be highest among disadvantaged, non-White populations of low socioeconomic status (SES) in developed countries such as the United States (Levine, 2011).  Child maltreatment is more frequently reported and substantiated in these populations, though it is likely that social and professional bias play a role in this disparity.  Physiological and social processes have been hypothesized to cause a relationship between childhood maltreatment and subsequent obesity.

The current review covers fourteen longitudinal studies of maltreated children and assesses the relationship between childhood maltreatment and subsequent obesity. Studies for this review were chosen for high internal validity, in part due to the reliable and diverse sources of maltreatment designation.  In order to reduce the likelihood of recall bias, included studies designated children as maltreated based on child welfare agency and court records, from parent and/or child statements during childhood, or combinations of these sources.

A majority of findings in this review indicated a null relationship between physical, sexual, and emotional abuse and subsequent obesity.  A slight majority of findings did indicate a positive relationship between neglect and subsequent obesity.  White study participants were most likely to exhibit a positive relationship between neglect and physical and emotional abuse with later obesity, whereas non-White participants were most likely to exhibit a null relationship. No race dynamic could be found in the relationship between childhood sexual abuse and subsequent obesity.  

Further studies of this topic should provide clear and detailed definitions of maltreatment and parameters for how participants are designated as maltreated.  Clear definitions of maltreatment can be hard to make, which is reflected in different laws and social service policy from state to state. Definitions should include subtypes, e.g. penetrative and non-penetrative sexual abuse; physical, medical, emotional, supervisory, and educational neglect.  Comorbidity of childhood maltreatment should be assessed to determine if particular combinations of maltreatment affect later obesity.  Further studies should focus on the relationship between childhood maltreatment and concurrent or later childhood obesity.  Finally, an important practice implication is that White victims of childhood maltreatment appeared to be more prone to later obesity than non-White victims.