The Role of Childhood Trauma Exposure and Postpartum Depression in Food Addiction in Postpartum Women

Background/Purpose: Health behaviors like high-risk eating (e.g. food addiction or excessive overeating of high-calorie food accompanied by loss of control and intense food cravings) are associated with long-term, negative health consequences such as obesity and diet-related disease. The early postpartum period is a sensitive time for maternal food addiction given women’s recent body and eating changes during pregnancy and postpartum body demand (e.g. breastfeeding, limited sleep) and changes (e.g. altered food tastes). The postpartum period is also a critical time to identify risk for women’s food addiction given potential intergenerational implications: during this time, women spend a lot of time with infants and are actively engaged in feeding and responding to their food cues, all which can shape infant eating behaviors. Yet, research is needed to identify the etiology of maternal food addiction during the postpartum period with the goal to interrupt the intergenerational transmission of eating-related concerns from mothers to infants and contribute to Social Work Grand Challenge to ensure healthy development of children.

The postpartum period is a high-stress time where mental health changes can also occur, including the activation of women’s childhood trauma and postpartum depression, two potentially important risk factors for food addiction. Given strong associations of both childhood trauma and adult depression symptoms with food addiction outside of the perinatal period, it may be that childhood trauma is contributing to food addiction through depression symptoms postpartum. Depression is a well-established sequelae of childhood trauma, which has also been specifically linked to postpartum depression. Therefore, the impact of childhood trauma and depression on food addiction may function via a spillover effect, with childhood trauma leading to postpartum depression, which then leads to postpartum food addiction. Examining this process in postpartum women may provide novel mechanistic information regarding the etiology of food addiction during this critical period for intergenerational transmission.

Methods: The present study sought to identify the role of childhood trauma exposure and postpartum depression symptoms in food addiction in postpartum women. Women (N = 277) in the early postpartum period reported on food addiction, childhood trauma exposure, and depression symptoms. Sequential mediation using a bootstrap resample approach with 1,000 resamples was used for inferring the indirect effects of mother’s childhood trauma exposure via the hypothesized mediational pathway of postpartum depression symptoms on food addiction.

Results: Women’s childhood trauma exposure (B = 0.19, se = 0.06, p = .001) and depression symptoms were significantly associated with food addiction (B = 0.27, se = 0.10, p = .005). Sequential mediation revealed a significant indirect effect of maternal childhood trauma exposure on food addiction during the postpartum period via postpartum depression symptoms B=0.06 (95% CI [0.003, 0.087]). These results suggest that postpartum depression is a mechanism by which women’s childhood trauma exposure may lead to postpartum food addiction.

Conclusions/Implications: Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.